Out of pocket payments and social health insurance for private hospital care: Evidence from Greece

Grigorakis, Nikolaos; Floros, Christos; Tsangari, Haritini; Tsoukatos, Evangelos

doi:10.1016/j.healthpol.2016.06.011

Cited by 50 publications

(34 citation statements)

References 78 publications

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“…The out of pocket costs for mental health services in Greece remain high notwithstanding the financial crisis [ 66 ]. This is due to the ineffectiveness of the public health services, the long waiting lists, and the limited access to specialized care for the unemployed [ 66 , 67 ].…”

Section: Discussionmentioning

confidence: 99%

Psychiatrists role in primary health care in Greece: findings from a quantitative study

Souliotis

Agapidaki

Tzavara

et al. 2017

Int J Ment Health Syst

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BackgroundAlthough the need for integration of mental health services into primary care is well established little has been done. The outbreak of the recession found the Greek mental health system in transition. As a response to the crisis, governments implemented horizontal budget cuts instead of health reforms. This resulted in an unfavorable situation for mental health which was set once again on the sidelines of the health policy agenda. Previous studies suggest that the most prevalent disorders in the years of financial crisis in Greece are depression and anxiety while a general increase of the psychiatric morbidity is observed does not follow the population’ needs.MethodsThe present descriptive study was carried out between March and June of 2015. A convenience sample of 174 psychiatrists and psychiatry residents who met the inclusion criteria were finally selected to participate. Data were collected by using a 40-items questionnaire consisted of three sections: (a) nine questions about demographics, (b) nine questions pertaining to general aspects of administrative regulations related to primary care, (c) 22 questions about psychiatrists attitudes and perceptions towards their role in primary care. Quantitative variables are expressed as mean values, while qualitative variables as absolute and relative frequencies.ResultsThe vast majority of participants perceives the public primary care services and mental health services in their community as inadequate and considers psychiatrists’ participation in primary care as important in order to improve the detection and management rates of people demonstrating mental health symptoms. They also believe that: (a) primary care practitioners’ usually fail to detect the mental health conditions of patients; (b) their participation in primary care will decrease the social stigmatization for mental health conditions; (c) patients receiving pharmaceutical treatment for mental health problems by GPs and other primary care professionals usually fail to comply.ConclusionsRespondents in the present study are receptive to participate in primary care. They believe that their inclusion to primary care will result to decreased social stigmatization for mental health problems, increased patient’ access and improved detection and management rates for common mental health conditions.

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Section: Discussionmentioning

confidence: 99%

Psychiatrists role in primary health care in Greece: findings from a quantitative study

Souliotis

Agapidaki

Tzavara

et al. 2017

Int J Ment Health Syst

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“…Grigorakis et al 12 highlight increased out-ofpocket costs for the Greek public as a result of the difficulties in accessing public health services. This phenomenon was aggravated by reduced household incomes, a consequence of unemployment, reduced salaries, reduced income transfers to social welfare, and shrinking reimbursement of medical expenses by health insurers.…”

Section: Impacts On Society and Health Servicesmentioning

confidence: 99%

“…The role of social protection policies is particularly highlighted in the scientific literature as a mitigating factor of the effects of unemployment and/or reduced income from work. Countries or provinces that maintained or reinforced their array of social welfare policies, including cash transfers to populations in poverty and extreme poverty, presented lower levels of mental illness and suicide 9,12,16,17 . In Italy, from 2000 to 2010, De Vogli 18 observed that social protection policies function as protective measures against increases in unemployment-related suicide.…”

Section: Impacts On Society and Health Servicesmentioning

confidence: 99%

Fiscal austerity and the health sector: the cost of adjustments

Paes-Sousa

Schramm

Mendes

2019

Ciênc. saúde coletiva

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Fiscal austerity policies have been used as responses to economic crises and fiscal deficits in both developed and developing countries. While they vary in regard to their content, intensity and implementation, such models recommend reducing public expenses and social investments, retracting the public service and substituting the private sector in lieu of the State to provide certain services tied to social policies. The present article discusses the main effects of the recent economic crisis on public health based on an updated review with consideration for three dimensions: health risks, epidemiological profiles of different populations, and health policies. In Brazil, the combination of economic crisis and fiscal austerity policies is capable of producing a direr situation than those experienced in developed countries. The country is characterized by historically high levels of social inequality, an under-financed health sector, highly prevalent chronic degenerative diseases and persisting preventable infectious diseases. It is imperative to develop alternatives to mitigate the effects of the economic crisis taking into consideration not only the sustainability of public finance but also public well-being.

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“…DRGs pricing used in Mongolia does not include costs for labour and infrastructure costs (the wages for workers, heating, electricity and etc. ), as in Australia, Germany, and the USA (Grigorakis et al, 2016). The reimbursement rate for DRGs is the product of the variable cost (multiplicand) and the relative cost (multiplier).…”

Section: Payments For Providersmentioning

confidence: 99%

“…Studies in Thailand and Greece, where universal social health insurance exists, also found catastrophic out-of-pocket payments due to high private inpatient care costs (Limwattananon et al, 2007, Grigorakis et al, 2016.…”

Section: Expenditures On Private Admissionmentioning

confidence: 99%

Regulating for-profit private health care providers in the context of universal health coverage: a case study from Mongolia

Tsevelvaanchig¹

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This thesis investigates, for the first time, contemporary regulation practices for the nascent private health care sector in Mongolia for the achievement of Universal Health Coverage (UHC). The number of private health care providers has been increasing dramatically in Mongolia during the last two decades. Identifying conducive ways of harnessing and regulating private health care providers is a pressing policy issue for the Mongolian mixed health system in moving towards UHC. However, this issue is yet to be extensively examined. No evidence currently exists on the role of private providers and the appropriateness of current regulatory policy for the achievement of UHC. The "what, how, and why' of the constraining and enabling factors of effective regulation remain largely unknown. This lack of evidence on the contribution of private providers affects not only Mongolia, but developing countries generally. Hence, this comprehensive and rigorous case study of regulation of the private health care sector in Mongolia makes a significant contribution to the advancement of regulatory policy and practices in that country, and informs similar developing countries, in particular, Post-Soviet states. This thesis uses a case-study approach employing both qualitative and quantitative methods. First, in order to define the current role of private providers in the provision of accessible, affordable, and equitable health services, nationally representative hospital admission records for 2013 (n=664,952), have been analysed. This quantitative analysis was supplemented with a qualitative analysis of in-depth interviews and document reviews to clarify findings. Second, to identify the gaps in regulatory policy design and implementation, stepped qualitative analysis by Sheikh et al. (2015) has been employed. Document review and analysis were complemented by participant observation and semi-structured in-depth interviews with 45 purposively-selected key informants. Third, to understand how and why regulation of private health care fails or succeeds in Mongolia, regulatory policy analysis has been conducted. The main sources of data used are the analytical synthesis of research findings, in-depth interviews, document reviews, and long-term participant observation of evolution of the system in Mongolia. This thesis has found that until this point, the contribution of the private sector to improving the system performance has been limited. Private-for-profit hospitals are concentrated in urban areas (60% of private hospital admissions were located in Ulaanbaatar, while 95% of private admissions outside Ulaanbaatar were in provincial capitals), deepening the existing rural/urban mal-distribution already established by public providers. Subsequent duplication of public and private services, both iii in terms of their geographical location and the range of services delivered has led to unnecessary admissions and unnecessary health care costs, having negative financial implications for both patients and overall health expenditure. This ...

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Out of pocket payments and social health insurance for private hospital care: Evidence from Greece

Cited by 50 publications

References 78 publications

Psychiatrists role in primary health care in Greece: findings from a quantitative study

Psychiatrists role in primary health care in Greece: findings from a quantitative study

Fiscal austerity and the health sector: the cost of adjustments

Regulating for-profit private health care providers in the context of universal health coverage: a case study from Mongolia

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