Comparing cost-sharing practices for pharmaceuticals and health care services among four central European countries

Petra Baji, Imre Boncz (), György Jenei and László Gulácsi
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György Jenei: Center for Public Affairs Studies Foundation Budapest Hungary

Society and Economy, 2012, vol. 34, issue 2, 221-240

Abstract: The paper reviews the existing cost-sharing practices in four Central European countries namely the Czech Republic, Hungary, Poland and Slovakia focusing on patient co-payments for pharmaceuticals and services covered by the social health insurance. The aim is to examine the role of cost-sharing arrangements and to evaluate them in terms of efficiency, equity and public acceptance to support policy making on patient payments in Central Europe. Our results suggest that the share of out-of-pocket payments in total health care expenditure is relatively high (24–27%) in the countries examined. The main driver of these payments is the expenditure on pharmaceuticals and medical devices, which share exceeds 70% of the household expenditure on health care. The four countries use similar cost-sharing techniques for pharmaceuticals, however there are differences concerning the measure of exemption mechanisms for vulnerable social groups. Patient payment policies for health care services covered by the social health insurance are also converging. All the four countries apply co-payments for dental care, some hotel services or in the case of free choice of physician. Also the countries (except for Poland) tried to extend co-payments for physician services and hospital care. However, their introduction met strong political opposition and unpopularity among public.

Keywords: cost-sharing; visit fee; co-payments; out-of-pocket payments; Central Europe (search for similar items in EconPapers)
JEL-codes: I11 I18 (search for similar items in EconPapers)
Date: 2012
Note: The study is financed by the European Commission under the 7th Framework Program, Theme 8 Socio-economic Sciences and Humanities, Project ASSPRO CEE 2007 (Grant Agreement no. 217431). The content of the publication is the sole responsibility of the authors and it in no way represents the views of the Commission or its services.
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