Unexpected impact of changes in out-of-pocket payments for health care on Czech household budgets

Krůtilová, Veronika; Yaya, Sanni

doi:10.1016/j.healthpol.2012.07.002

Cited by 21 publications

(18 citation statements)

References 14 publications

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“…Eighteen studies examined household residence as one of the potential determinants of CHE (15–32). Six studies found that this variable is not significant (15, 18, 19, 23, 30, 31), but most of the studies found that living in a rural area is a risk factor for incurring CHE (16, 17, 20–22, 24–29). Conversely, one study found that living in a rural area is a protective factor for incurring CHE (32).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 16 papers that studied this factor, six found that the presence of children aged under 5 years old is not a significant factor in determining CHE (19, 36, 41, 42, 44, 45), while three studies reported that it is a protective factor (16, 21, 23). The other seven studies found that the presence of children under 5 years old is a risk factor for CHE (22, 25, 26, 28, 32, 34, 39).…”

Section: Resultsmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Determinants of Household Catastrophic Health Expenditure: A Systematic Review

Azzani

Roslani

2019

MJMS

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“…However, to obtain a blood pressure monitor is a big challenge since more than half of our study population have an average household income less than 2,000 MYR which equivalent to (USD 605). The purchase of a reliable quality digital blood pressure monitor would cost about 10% of household income which is generally considered as catastrophic health care expenditure [ 39 ]. Our study proposed a solution to overcome the issue of unaffordability to obtain the blood pressure monitor.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of a life style modification and peer support home blood pressure monitoring in control of hypertension: protocol for a cluster randomized controlled trial

Majid

Nahar

et al. 2014

BMC Public Health

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Background: Death rates due to hypertension in low and middle income countries are higher compared to high income countries. The present study is designed to combine life style modification and home blood pressure monitoring for control of hypertension in the context of low and middle income countries. Methods: The study is a two armed, parallel group, un-blinded, cluster randomized controlled trial undertaken within lower income areas in Kuala Lumpur. Two housing complexes will be assigned to the intervention group and the other two housing complexes will be allocated in the control group. Based on power analysis, 320 participants will be recruited. The participants in the intervention group (n = 160) will undergo three main components in the intervention which are the peer support for home blood pressure monitoring, face to face health coaching on healthy diet and demonstration and training for indoor home based exercise activities while the control group will receive a pamphlet containing information on hypertension. The primary outcomes are systolic and diastolic blood pressure. Secondary outcome measures include practice of self-blood pressure monitoring, dietary intake, level of physical activity and physical fitness. Discussion: The present study will evaluate the effect of lifestyle modification and peer support home blood pressure monitoring on blood pressure control, during a 6 month intervention period. Moreover, the study aims to assess whether these effects can be sustainable more than six months after the intervention has ended.

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“…Evidence on the financial burden of payments for medicines, including its regressive character (i.e. higher share of total expenses for people on lower incomes) in some cases, is available for further high-income countries, such as Austria, Czech Republic, Estonia, Hungary and Latvia [60,[65][66][67][68][69].…”

Section: Discussionmentioning

confidence: 99%

Affordable and equitable access to subsidised outpatient medicines? Analysis of co-payments under the Additional Drug Package in Kyrgyzstan

Vogler

Schneider

Dedet

et al. 2019

Int J Equity Health

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Background: Out-of-pocket (OOP) payments can constitute a major barrier for affordable and equitable access to essential medicines. Household surveys in Kyrgyzstan pointed to a perceived growth in OOP payments for outpatient medicines, including those covered by the benefits package scheme (the Additional Drug Package, ADP). The study aimed to explore the extent of co-payments for ADP-listed medicines and to explain the reasons for developments. Methods: A descriptive statistical analysis was performed on prices and volumes of prescribed ADP-listed medicines dispensed in pharmacies during 2013-2015 (1,041,777 prescriptions claimed, data provided by the Mandatory Health Insurance Fund). Additionally, data on the value and volume of imported medicines in 2013-2015 (obtained from the National Medicines Regulatory Agency) were analysed. Results: In 2013-2015, co-payments for medicines dispensed under the ADP grew, on average, by 22.8%. Co-payments for ADP-listed medicines amounted to around 50% of a reimbursed baseline price, but as pharmacy retail prices were not regulated, co-payments tended to be higher in practice. The increase in co-payments coincided with a reduction in the number of prescriptions dispensed (by 14%) and an increase in average amounts reimbursed per prescription in nearly all therapeutic groups (by 22%) in the study period. While the decrease in prescriptions suggests possible underuse, as patients might forego filling prescriptions due to financial restraints, the growth in average amounts reimbursed could be an indication of inefficiencies in public funding. Variation between the regions suggests regional inequity. Devaluation of the national currency was observed, and the value of imported medicines increased by nearly 20%, whereas volumes of imports remained at around the same level in 2013-2015. Thus, patients and public procurers had to pay more for the same amount of medicines. Conclusions: The findings suggest an increase in pharmacy retail prices as the major driver for higher co-payments. The national currency devaluation contributed to the price increases, and the absence of medicine price regulation aggravated the effects of the depreciation. It is recommended that Kyrgyzstan should introduce medicine price regulation and exemptions for low-income people from co-payments to ensure a more affordable and equitable access to medicines.

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Unexpected impact of changes in out-of-pocket payments for health care on Czech household budgets

Cited by 21 publications

References 14 publications

Determinants of Household Catastrophic Health Expenditure: A Systematic Review

Determinants of Household Catastrophic Health Expenditure: A Systematic Review

The effectiveness of a life style modification and peer support home blood pressure monitoring in control of hypertension: protocol for a cluster randomized controlled trial

Affordable and equitable access to subsidised outpatient medicines? Analysis of co-payments under the Additional Drug Package in Kyrgyzstan

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