Assessing the impact of the crisis on access to the healthcare across Europe

Rodrigues, Ricardo; Zolyomi, Eszter

doi:10.1093/eurpub/cku164.057

Cited by 7 publications

(9 citation statements)

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“…Table 2 gives country-specific information. Two well-known patterns [ 27 , 28 , 30 , 31 ] can be noted – the huge between-country differences, and the ubiquitous social inequalities. In 2012/2013, for example, foregone medical care in the Disadvantaged subsamples varied from 0.1 % in Slovenia to 35.4 % in Romania.…”

Section: Resultsmentioning

confidence: 99%

“…First, an account is given of self-perceived difficulties in access to medical care in Europe during The Great Recession. Previous reports on this topic indicate that an overall deterioration has occurred [ 26 , 27 ], but changes do not seem dramatic, and country differences are large [ 22 , 25 , 28 – 30 ]. The present analysis covers developments in 30 European countries up to 2013.…”

Section: Introductionmentioning

confidence: 99%

“…The present analysis covers developments in 30 European countries up to 2013. Although practically all European countries have health insurance with wide coverage [ 31 , 32 ], it is well documented that low-income categories report unmet need for medical care more often than other parts of the population [ 27 , 28 , 30 ]. The present study expands on previous analyses by drawing attention to the experiences of those who are especially vulnerable since they combine two unfavourable characteristics: limited economic resources and considerable need for medical care.…”

Section: Introductionmentioning

confidence: 99%

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Income inequality and foregone medical care in Europe during The Great Recession: multilevel analyses of EU-SILC surveys 2008–2013

Elstad

2016

Int J Equity Health

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BackgroundThe association between income inequality and societal performance has been intensely debated in recent decades. This paper reports how unmet need for medical care has changed in Europe during The Great Recession, and investigates whether countries with smaller income differences have been more successful than inegalitarian countries in protecting access to medical care during an economic crisis.MethodsSix waves of EU-SILC surveys (2008—2013) from 30 European countries were analyzed. Foregone medical care, defined as self-reported unmet need for medical care due to costs, waiting lists, or travel difficulties, was examined among respondents aged 30–59 years (N = 1.24 million). Countries’ macro-economic situation was measured by Real Gross Domestic Product (GDP) per capita. The S80/S20 ratio indicated the country’s level of income inequality. Equity issues were highlighted by separate analyses of disadvantaged respondents with limited economic resources and relatively poor health. Cross-tabulations and multilevel linear probability regression models were utilized.ResultsForegone medical care increased 2008—2013 in the majority of the 30 countries, especially among the disadvantaged parts of the population. For the disadvantaged, unmet need for medical care tended to be higher in countries with larger income inequalities, regardless of the average economic standard in terms of GDP per capita. Both for disadvantaged and for other parts of the samples, a decline in GDP had more severe effects on access in inegalitarian countries than in countries with less income inequality.ConclusionsDuring The Great Recession, unmet need for medical care increased in Europe, and social inequalities in foregone medical care widened. Overall, countries with a more egalitarian income distribution have been more able to protect their populations, and especially disadvantaged groups, against deteriorated access to medical care when the country is confronted with an economic crisis.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Income inequality and foregone medical care in Europe during The Great Recession: multilevel analyses of EU-SILC surveys 2008–2013

Elstad

2016

Int J Equity Health

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“…Reconsideration and upgrading of the health insurance benefits package is crucial to reach a satisfactory level of financial risk protection. In Portugal for instance, although there is an exemption policy for children, the elderly and unemployed, that exemption does not cover the cost of pharmaceutical products and as such causes high OOP expenditure and financial burden ( 57 ). Likewise, in Uganda, the policy of charging users fees for health care was eliminated in 2001 in order to increase healthcare utilisation among the poor.…”

Section: Discussionmentioning

confidence: 99%

Determinants of Household Catastrophic Health Expenditure: A Systematic Review

Azzani

Roslani

2019

MJMS

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The World Health Organization estimates that annually 150 million people experience severe (catastrophic) financial difficulties as a result of healthcare payments. Therefore, a systematic review was carried out to identify the determinants of household catastrophic health expenditure (CHE) in low-to high-income countries around the world. Both electronic and manual searches were conducted. The main outcome of interest was the determinants of CHE due to healthcare payments. Thirty eight studies met the inclusion criteria for review. The analysis revealed that household economic status, incidence of hospitalisation, presence of an elderly or disabled household member in the family, and presence of a family member with a chronic illness were the common significant factors associated with household CHE. The crucial finding of the current study is that socioeconomic inequality plays an important role in the incidence of CHE all over the world, where low-income households are at high risk of financial hardship from healthcare payments. This suggests that healthcare financing policies should be revised in order to narrow the gap in socioeconomic inequality and social safety nets should be implemented and strengthened for people who have a high need for health care.

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“…The continued decline in overall survival among the most deprived might have been compounded by the economic recession in 2008 when the Irish health care system was deeply impacted [31, 32]. However, the impact of a recession on health generally displays a significant time lag, so the whole picture will only be visible over the long term [33]. …”

Section: Discussionmentioning

confidence: 99%

Oral cancer incidence and survival rates in the Republic of Ireland, 1994-2009

et al. 2016

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BackgroundOral cancer is a significant public health problem world-wide and exerts high economic, social, psychological, and physical burdens on patients, their families, and on their primary care providers. We set out to describe the changing trends in incidence and survival rates of oral cancer in Ireland between 1994 and 2009.MethodsNational data on incident oral cancers [ICD 10 codes C01-C06] were obtained from the National Cancer Registry Ireland from 1994 to 2009. We estimated annual percentage change (APC) in oral cancer incidence during 1994–2009 using joinpoint regression software (version 4.2.0.2). The lifetime risk of oral cancer to age 79 was estimated using Irish incidence and population data from 2007 to 2009. Survival rates were also examined using Kaplan-Meier curves and Cox proportional hazard models to explore the influence of several demographic/lifestyle covariates with follow-up to end 2012.ResultsData were obtained on 2,147 oral cancer incident cases. Men accounted for two-thirds of oral cancer cases (n = 1,430). Annual rates in men decreased significantly during 1994–2001 (APC = -4.8 %, 95 % CI: −8.7 to −0.7) and then increased moderately (APC = 2.3 %, 95 % CI: −0.9 to 5.6). In contrast, annual incidence increased significantly in women throughout the study period (APC = 3.2 %, 95 % CI: 1.9 to 4.6). There was an elevated risk of death among oral cancer patients who were: older than 60 years of age; smokers; unemployed or retired; those living in the most deprived areas; and those whose tumour was sited in the base of the tongue. Being married and diagnosed in more recent years were associated with reduced risk of death.ConclusionOral cancer increased significantly in both sexes between 1999 and 2009 in Ireland. Our analyses demonstrate the influence of measured factors such as smoking, time of diagnosis and age on observed trends. Unmeasured factors such as alcohol use, HPV and dietary factors may also be contributing to increased trends. Several of these are modifiable risk factors which are crucial for informing public health policies, and thus more research is needed.

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Assessing the impact of the crisis on access to the healthcare across Europe

Cited by 7 publications

References 0 publications

Income inequality and foregone medical care in Europe during The Great Recession: multilevel analyses of EU-SILC surveys 2008–2013

Income inequality and foregone medical care in Europe during The Great Recession: multilevel analyses of EU-SILC surveys 2008–2013

Determinants of Household Catastrophic Health Expenditure: A Systematic Review

Oral cancer incidence and survival rates in the Republic of Ireland, 1994-2009

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