The Determinants of Out-of-Pocket Expenditure in IBD Italian Patients. Results from the AMICI Survey

Matteo Ruggeri, Carlo Drago, Chiara Cadeddu, Alessandro Armuzzi, Salvo Leone and Marco Marchetti
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Matteo Ruggeri: National Center for HTA, Istituto Superiore di Sanità, 00161 Rome, Italy
Chiara Cadeddu: School of Medicine, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Alessandro Armuzzi: School of Medicine, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
Salvo Leone: Amici Italia Onlus, 20125 Milan, Italy
Marco Marchetti: National Center for HTA, Istituto Superiore di Sanità, 00161 Rome, Italy

IJERPH, 2020, vol. 17, issue 21, 1-14

Abstract: Decision makers are used to consider Out-of-Pocket Expenditure (OOPE) within a health technology assessment framework in order to account for an indicator relying on the level of fairness and on the quality of care of a health system. In this paper, we provide estimates on the determinants of OOPE in Italy by using data coming from an observational cross-sectional study that enrolled a sample of 2526 patients suffering from inflammatory bowel diseases. We explore the association between OOPE and: (1) geographical location; (2) income effects; (3) performances in delivering healthcare. A regression model was used. Individuals’ age were in the range of 18–88 (mean 44 ± 14.55). Forty-six percent were females, 54% were married and 19% held a bachelor degree. Ninety-six percent of respondents declared an OOPE >0 whose mean value was €960 ± €950. Individuals belonging to low-income and low-performance regions were more likely to declare an OOPE >0 (99%). Regression findings suggest that increases in OOPE could be considered as a response from patients aiming to compensate for lacks and inefficiencies in the public healthcare offers. Policymakers should consider increases in OOPE in patients with Inflammatory Bowel Diseases (IBDs) as an indicator of poor quality of care and poor fairness.

Keywords: out of pocket expenditure; equity and quality of care; IBD (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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