Out-of-pocket payments, vertical equity and unmet medical needs in France: A national multicenter prospective study on lymphedema

Grégoire Mercier (gregoire_mercier@hotmail.com), Jenica Pastor, Valérie Clément (valerie.clement@umontpellier.fr), Ulysse Rodts, Christine Moffat and Isabelle Quéré (i-quere@chu-montpellier.fr)
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Grégoire Mercier: CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier], CEPEL - Centre d'Etudes Politiques de l'Europe Latine - UM - Université de Montpellier - CNRS - Centre National de la Recherche Scientifique
Jenica Pastor: CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
Valérie Clément: MRE - Montpellier Recherche en Economie - UM - Université de Montpellier
Ulysse Rodts: CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
Christine Moffat: UON - University of Nottingham, UK
Isabelle Quéré: Hôpital Saint Eloi [CHU Montpellier] - CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier], CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier], EA 2992 - Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires - UM1 - Université Montpellier 1 - UM - Université de Montpellier

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Abstract: Out-of-pocket payments might threaten the vertical equity of financing and generate unmet medical needs. The main objective was to assess the vertical equity of outpatient out-of-pocket payments for lymphedema patients in France. Twenty-seven centres, among which 11 secondary care hospitals and 16 primary care practices participated in this prospective national multicenter study. We measured the lymphedema-specific outpatient out-of-pocket payments over 6 months. The vertical equity of out-of-pocket payments was examined using concentration curves, the Gini coefficient for income, the Kakwani index, and the Reynolds-Smolensky index. We included 231 lymphedema patients aged 7 years or more, living in metropolitan France, and being able to use Internet and email. After voluntary health insurance reimbursement, the mean out-of-pocket payment was equal to 101.4 Euros per month, mainly due to transport (32%) and medical devices (26%). Concentration curves indicated regressivity of out-of-pocket payments. Total out-of-pocket payments represented 10.1% of the income by consumption unit for the poorest quintile and 3.5% for the wealthiest (p

Date: 2019
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Published in PLoS ONE, 2019, 14 (5), pp.e0216386. ⟨10.1371/journal.pone.0216386⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-02862217

DOI: 10.1371/journal.pone.0216386

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