Forgone health care due to cost among older adults in European countries and in Israel

Litwin, Howard; Sapir, E.

doi:10.1007/s10433-009-0126-8

Cited by 33 publications

(37 citation statements)

References 40 publications

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“…We follow a similar approach. Their analysis showed that this variable was a main factor of reduced health care due to cost, revealing that financial uncertainty may lead to underutilisation of health services [29].…”

Section: Datamentioning

confidence: 99%

Use of formal and informal care services among older people in Ireland and France

Gannon

Davin

2010

Eur J Health Econ

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This paper focuses on current use of elderly care services in Ireland and France. In light of health care resource allocation problems, it is important to know the level of current use of home care on which future projections may be based. With the availability of SHARE (Survey of Health Ageing and Retirement in Europe) data, it is now possible to analyse this process and estimate the relationship between formal and informal care, and our econometric model tests for endogeneity of informal care. Previous research has not included Ireland into the analysis. Given that Ireland has a younger population base, lessons could be learned from countries with older populations, such as France. Results suggest informal care is endogenous and negatively linked with formal care in the pooled (France and Ireland) model. There is a higher unmet need for care in Ireland. These results have important policy implications for Ireland as the demographic makeup will change from 11 per cent to 15 per cent of older people over the next 10 years.

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Section: Datamentioning

confidence: 99%

Use of formal and informal care services among older people in Ireland and France

Gannon

Davin

2010

Eur J Health Econ

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“…The resulting pattern of what constitutes the most vulnerable groups remains remarkably robust. SUN is a more serious issue for the children of the poor (the reader is referred to a systematic review of the literature on children until 2006 [22] and some later studies [23][24][25][26][27][28][29]), for the homeless [30][31][32][33], for chronically ill patients [19,20,[34][35][36], for the disabled [21,37,38], for the sick and poor elderly [39][40][41][42] and for immigrants [43]. Extending insurance coverage for these groups or strengthening social protection measures (lowering OOP payments or increasing their income) should be an obvious target for any policy aiming at improving equity of access.…”

Section: Subjective Unmet Need and Out-of-pocket Paymentsmentioning

confidence: 99%

Out-of-Pocket Payments and Subjective Unmet Need of Healthcare

Schokkaert

Steel

Voorde

2017

Appl Health Econ Health Policy

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We present a critical review of the literature that discusses the link between the level of out-of-pocket payments in developed countries and the share of people in these countries reporting that they postpone or forgo healthcare for financial reasons. We discuss the pros and cons of measuring access problems with this subjective variable. Whereas the quantitative findings in terms of numbers of people postponing care must be interpreted with utmost caution, the picture for the vulnerable groups in society is reasonably robust and unsurprising: people with low incomes and high morbidity and incomplete (or non-existent) insurance coverage are most likely to postpone or forgo healthcare for financial reasons. It is more surprising that people with high incomes and generous insurance coverage also report that they postpone care. We focus on some policy-relevant issues that call for further research: the subtle interactions between financial and non-financial factors, the possibility of differentiation of out-of-pocket payments between patients and between healthcare services, and the normative debate around accessibility and affordability.

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“…It operationalizes the decision to seek care as conditional upon predisposing factors underlying the propensity to use services (sociodemographic characteristics); enabling factors reflecting the ability to secure services (e.g., income, employment status, social support); and need indicating the illness level (e.g., symptom perception, self-perceived health, disease severity, chronic disease) (Andersen 1995). While this model has been used extensively in health services research, it has been largely neglected in cross-country settings, and when used, has often omitted important predisposing and enabling constructs (Evashwich et al 1984; Bird et al 2002; Fernandez-Mayoralas et al 2000; Litwin and Sapir 2009). …”

Section: Introductionmentioning

confidence: 99%

Decomposing differences in utilization of health services between depressed and non-depressed elders in Europe

Ladin

2012

Eur J Ageing

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Utilization rates of non-psychiatric health services are often higher in depressed compared to non-depressed adults. We examine whether these differences can be explained by the increased prevalence or the increased impact of demographic, socioeconomic, geographic, and health-related factors. The sample was taken from The Survey of Health, Ageing and Retirement in Europe (Wave 1 Release 2), a prospective observational study of 31,115 randomly selected people ages 50+ living in Austria, Germany, Sweden, the Netherlands, Spain, Italy, France, Denmark, Greece, Switzerland, Belgium, and Israel. Blinder–Oaxaca decomposition methods for multivariate linear regression models were used to estimate the influence of prevalence and impact of covariates on utilization among depressed and non-depressed participants. We find robust evidence that the gap in utilization between depressed and non-depressed can be accounted for by both prevalence (explained) and impact (unexplained) differences. The prevalence effect accounted for 57.7% whereas differences in the impact of covariates between depressed and non-depressed persons explained 42.3% of differences in utilization rates. Despite cross-national differences in quality and coverage of health services, in all countries, the prevalence effect was explained entirely by health measures, including: chronic diseases, functional mobility, painful symptoms, and self-reported health. The impact effect varied cross-nationally, but was largely explained by socioeconomic status and urbanicity. Hospitalization among depressed adults was twice that of non-depressed adults. Policies aimed at improving adherence and improving disease management among depressed adults should be explored.

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Forgone health care due to cost among older adults in European countries and in Israel

Cited by 33 publications

References 40 publications

Use of formal and informal care services among older people in Ireland and France

Use of formal and informal care services among older people in Ireland and France

Out-of-Pocket Payments and Subjective Unmet Need of Healthcare

Decomposing differences in utilization of health services between depressed and non-depressed elders in Europe

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