Evidence on Cost-sharing in Health Care : Applications to Hungary : Executive Summary

This study, done at the request of the Hungarian government, presents evidence on cost-sharing in the health sector, and its application in Hungary. It presents results on the impact of cost-sharing on revenues in health facilities and insurance, financial sustainability, informal payments, overall service use, and equity in access. Five keyfindings emerge: cost-sharing could lead to a reduction in unnecessary care provided to insured patients who do not have to pay the full price of care; cost-sharing could help reduce informal payments and keep patient payments in the system; cost-sharing with exemption policies are a prerequisite to provide equity in access to care; cost-sharing could support cost containment strategies; experience from OECD countries provides examples of successful cost-sharing policies. Based on these findings. the study recommends that Hungary continues to monitor and evaluate the impact of cost-sharing on access, to identify possible negative effects on equity in service use. In Hungary, financial incentives through the provider payment system could eventually support the effect of the government supply-side strategy. Such financial incentives could be set to providers through capitation payment to reward better quality of care, and Diagnosis Related Group (DRG) payments with expenditure ceilings with strict utilization review and quality assurance control to set an incentive for efficient provision of care.

Bibliographic Details

Main Author:	World Bank
Format:	Policy Note biblioteca
Language:	English en_US
Published:	Washington, DC 2008-02-15
Subjects:	ADMINISTRATIVE BURDEN, ADMINISTRATIVE COSTS, ADOLESCENTS, ADVERSE SELECTION, AFFORDABILITY, AMBULANCE, AMBULATORY CARE, AMBULATORY SURGERY, ANCILLARY SERVICES, BEDS, BREAST CANCER, BRIBES, CAPITATION, CAPITATION PAYMENT, CATASTROPHIC HEALTH EXPENDITURE, CATASTROPHIC HEALTH SPENDING, CHRONIC DISEASES, CLINICS, CONTRIBUTION TO COSTS, CORRUPTION, COST OF HEALTH CARE, COST SHARING, COST-SHARING, COST-SHARING ARRANGEMENTS, COST-SHARING POLICIES, DEDUCTIBLE, DEDUCTIBLES, DEMAND FOR HEALTH, DEMAND FOR SERVICES, DENTAL CARE, DETERMINATION OF ELIGIBILITY, DIAGNOSIS, DISABLED, DOCTORS, DRUG THERAPY, ELASTICITY OF DEMAND FOR HEALTH CARE, EMERGENCY CARE, ENTITLEMENT, EQUITY IN ACCESS, EXCHANGE RATE, EXCLUSIONS, FAMILIES, FEE-FOR-SERVICE, FINANCE OF HEALTH CARE, FINANCIAL BURDEN, FINANCIAL CONTRIBUTIONS, FINANCIAL INCENTIVES, FINANCIAL MANAGEMENT, FINANCIAL RISK, FINANCIAL SUPPORT, FINANCIAL SUSTAINABILITY, FLAT RATE, FREE CARE, GENERAL PRACTICE, HEALTH CARE, HEALTH CARE CENTERS, HEALTH CARE COSTS, HEALTH CARE FINANCING, HEALTH CARE REFORM, HEALTH CARE SECTOR, HEALTH CARE SYSTEM, HEALTH CARE SYSTEMS, HEALTH CARE UTILIZATION, HEALTH CENTRES, HEALTH ECONOMICS, HEALTH EXPENDITURE, HEALTH EXPENDITURES, HEALTH FACILITIES, HEALTH FINANCING, HEALTH FOR ALL, HEALTH INSURANCE, HEALTH INSURANCE FUND, HEALTH INSURANCE SYSTEM, HEALTH OUTCOMES, HEALTH PLANNING, HEALTH POLICY, HEALTH POLICY OBJECTIVES, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICES, HEALTH SERVICES RESEARCH, HEALTH SPENDING, HEALTH STATUS, HEALTH SYSTEM, HEALTH SYSTEMS, HEALTH WORKERS, HEALTH ­ RESULTS, HEALTH-CARE, HEALTH-CARE SYSTEM, HEALTHCARE, HEALTHCARE PROVIDERS, HEALTHCARE SERVICES, HEALTHCARE SYSTEM, HOMELESS PEOPLE, HOSPITAL ADMISSIONS, HOSPITAL BEDS, HOSPITAL CARE, HOSPITAL COSTS, HOSPITAL EMERGENCY SERVICES, HOSPITAL INPATIENT, HOSPITAL SERVICES, HOSPITALIZATION, HOSPITALS, HR, HYGIENE, IMPACT OF COST, INCOME, INCOME CATEGORIES, INCOME GROUPS, INCOME HOUSEHOLDS, INDUCED DEMAND, INEQUALITIES, INEQUALITIES IN HEALTH CARE, INEQUALITY, INEQUITY IN HEALTH, INFANT CARE, INFORMAL PAYMENTS, INPATIENT ADMISSION, INPATIENT CARE, INPATIENT TREATMENT, INSURANCE, INSURANCE AGENCIES, INSURANCE AGENCY, INSURANCE COMPANIES, INSURANCE COVERAGE, INSURANCE PACKAGE, INSURANCE POLICY, INSURANCE RATES, INSURANCE SYSTEM, INSURERS, INTERNATIONAL COMPARISONS, LAWS, LOW INCOME, LOW-INCOME COUNTRIES, MEDICAID, MEDICAL CARE, MEDICAL SERVICES, MEDICATION, MEDICINES, MORAL HAZARD, MORBIDITY, MORTALITY, NATIONAL HEALTH, NURSING, OPERATIONAL COSTS, OUTPATIENT CARE, OUTPATIENT SERVICES, PATIENT, PATIENT COST, PATIENTS, PAYMENTS FOR HEALTH CARE, PHARMACEUTICAL COMPANIES, PHYSICIAN, PHYSICIANS, PHYSIOTHERAPY, POCKET PAYMENTS, POLICY RESEARCH, PREGNANCY, PREGNANT WOMEN, PRESCRIPTION DRUGS, PRESCRIPTIONS, PREVENTIVE CARE, PRICE ELASTICITIES, PRIMARY CARE, PRIVATE HEALTH INSURANCE, PRIVATE HOSPITALS, PRIVATE INSURANCE, PRIVATE SECTOR, PRIVATE SPENDING, PROVIDER PAYMENT, PROVISION OF CARE, PSYCHIATRIC CARE, PUBLIC ATTITUDES, PUBLIC EXPENDITURE, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC HEALTH SERVICES, PUBLIC HOSPITAL, PUBLIC HOSPITAL SERVICES, PUBLIC HOSPITALS, PUBLIC INSURANCE, QUALITY OF CARE, REFORM OF HEALTH CARE, SAVINGS, SLIDING SCALE, SOCIAL HEALTH INSURANCE, SOCIAL INSURANCE, SURGERY, TREATMENTS, USER FEE, USER FEES, VICTIMS, VISITS, VULNERABLE GROUPS, WELFARE BENEFITS, WORKERS, WORKING CONDITIONS,
Online Access:	http://documents.worldbank.org/curated/en/2008/02/16414657/hungary-evidence-cost-sharing-health-care-applications-hungary-executive-summary http://hdl.handle.net/10986/12854
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