Php20 the Effect of the Introduction of Hospital Daily Fee on the Number of Admissions to Acute Care Hospitalwards in Hungary

Nagy, J.; Kövi, Rita; Sebestyén, A.; Kiss, Zsuzsanna Soósné; Molnar, Adrian; Kőrösi, László; Kriszbacher, I; Betlehem, József; Boncz, I

doi:10.1016/s1098-3015(10)66262-6

Cited by 5 publications

(12 citation statements)

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“…Also, we do not find any short‐term change in the probability of paying informally in general. This supports previous empirical evidence that the introduction of visit fees is more effective as a policy tool to reduce service use and saving public resources than in decreasing informal payments (Boncz et al , ; Mihályi, ; Nagy et al , ; Kőrösi et al , ). Despite of this, one of the policy goals of the introduction of the visit fee in Hungary in 2007 was to deal with informal payments, which questions the adequacy of this goal.…”

Section: Resultssupporting

confidence: 88%

“…It is probable that more time is needed to observe any change in the behaviour of consumers and providers. Although, the decrease in healthcare utilisation was noticeable right after the implementation of the visit fee (Boncz et al, 2008;Nagy et al, 2008;Kőrösi et al, 2009), we do not observe such reduction in informal payments on a short-run. Moreover, we do not account for the effect of exemptions from patient payments because we do not have data on whether the respondent was eligible for exemptions.…”

Section: Resultscontrasting

confidence: 75%

“…The number of visits and hospitalisations decreased by 15%–20% after the introduction of the visit fee (Boncz et al , ; Nagy et al , ; Kőrösi et al , ), which led to 92.6 million Euros cost saving for NHIFA. In addition, an amount of 81.5 million Euros was collected in 2007 from the visit fee (36.7 million Euros for GP services, 23.3 million Euros for out‐patient care and 11.1 million Euros for hospital care), (Mihályi, ).…”

Section: Reform Arrangements and Introduction Of The Visit Fee In Hunmentioning

confidence: 99%

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Informal payments for healthcare services and short‐term effects of the introduction of visit fee on these payments in Hungary

Baji

Pavlova

Gulàcsi

et al. 2011

Health Planning & Management

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The objective of this paper is to study the short-term effects of the introduction of the visit fee in Hungary in 2007 on informal patient payments. We present the pattern of informal payments in primary, out-patient specialist and in in-patient care in the period before and shortly after the visit fee was introduced. We also analyse whether in the short run, the introduction of visit fee decreased the probability of paying informally. For the analysis, we use a dataset for a representative sample of 2500 respondents collected in 2007 shortly after the introduction of the visit fee, which contains data on informal payments for healthcare services. According to our results, 9% of the patients paid informally during their last visit to GP (2 Euros on average), 14% paid informally for specialist care (35 Euros on average) and 50% paid informally for hospitalisation (58 Euros on average). We find a significant reduction in the probability of paying informally only for elderly patients in case of in-patient care. Our results suggest that informal payments are widely spread in Hungary, especially in in-patient care. The short run potential of the introduction of the visit fee to reduce informal payments seems to be minor.

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Section: Resultssupporting

confidence: 88%

Section: Resultscontrasting

confidence: 75%

Section: Reform Arrangements and Introduction Of The Visit Fee In Hunmentioning

confidence: 99%

See 1 more Smart Citation

Informal payments for healthcare services and short‐term effects of the introduction of visit fee on these payments in Hungary

Baji

Pavlova

Gulàcsi

et al. 2011

Health Planning & Management

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show abstract

“…Evidence shows that during the period of visit fee, health care utilization decreased by 15-20% in GP and outpatient services as well as days spent in hospital [13][14][15]. However, we have to highlight that other elements of the complex reforms could have also contributed to the decrease in the number of visits and days spent in hospital.…”

Section: Background: the Case Of User Fees In Hungarymentioning

confidence: 87%

User fees for public health care services in Hungary: Expectations, experience, and acceptability from the perspectives of different stakeholders

et al. 2011

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“…First, we have to highlight that the National Household Budget Survey does not contain data on the utilization of services. However, according to previous literature, the reform arrangements have resulted in major changes in the utilization of health care [ 43 - 45 ]. Due to the lack of utilization data in the dataset, we cannot quantify the effect of the increase in co-payments on the access to health care across households with different income.…”

Section: Discussion Of the Limitationsmentioning

confidence: 99%

Changes in Equity in Out-of-pocket Payments during the Period of Health Care Reforms: Evidence from Hungary

Baji

Pavlova

Gulàcsi

et al. 2012

International Journal for Equity in Health

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BackgroundAt the beginning of 2007, health care reforms were implemented in Hungary in order to decrease public expenditure on health care. Reforms involved the increase of co-payments for pharmaceuticals and the introduction of co-payments for health care services.ObjectiveThe objective of this paper is to examine the progressivity of household expenditure on health care during the reform period, separately for expenditures on pharmaceuticals and medical devices, as well as for formal and informal patient payments for health care services.MethodsWe use data on household expenditure from the Household Budget Survey carried out by the Central Statistical Office of Hungary. We present household expenditure as a percentage of household income across different income quintiles and calculate Kakwani indexes as a measure of progressivity for a four years period (2005–2008): before, during and after the implementation of the health care reforms.ResultsWe find that out-of-pocket payments on health care are highly regressive in Hungary with a Kakwani index of −0.22. In particular, households from the lowest income quintile spend an about three times larger share of their income on out-of-pocket payments (6–7 %) compared to households in the highest income quintile (2 %). Expenditures on pharmaceuticals and medical devices are the most regressive types of expenditure (Kakwani index −0.23/-0.24), and at the same time they represent a major part of the total household expenditure on health care (78–85 %). Informal payments are also regressive while expenditures on formal payments for services are the most proportional to income. We find that expenditures on formal payments became regressive after the introduction of user fees (Kakwani index −0.1). At the same time, we observe that expenditures on informal payments became less regressive during the reform period (Kakwani index increases from −0.20/-0.18 to −0.12.)ConclusionsMore attention should be paid on the protection of low-income social groups when increasing or introducing co-payments especially for pharmaceuticals but also for services. Also, it is important to eliminate the practice of informal payments in order to improve equity in health care financing.

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Php20 the Effect of the Introduction of Hospital Daily Fee on the Number of Admissions to Acute Care Hospitalwards in Hungary

Cited by 5 publications

References 0 publications

Informal payments for healthcare services and short‐term effects of the introduction of visit fee on these payments in Hungary

Informal payments for healthcare services and short‐term effects of the introduction of visit fee on these payments in Hungary

User fees for public health care services in Hungary: Expectations, experience, and acceptability from the perspectives of different stakeholders

Changes in Equity in Out-of-pocket Payments during the Period of Health Care Reforms: Evidence from Hungary

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