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Financing Healthcare in Central and Eastern European Countries: How Far Are We from Universal Health Coverage?

Author

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  • Marzena Tambor

    (Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland)

  • Jacek Klich

    (Department of Public Management, Cracow University of Economics, 31-510 Krakow, Poland)

  • Alicja Domagała

    (Department of Health Policy and Management, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland)

Abstract

After the fall of communism, the healthcare systems of Central and Eastern European countries underwent enormous transformation, resulting in departure from publicly financed healthcare. This had significant adverse effects on equity in healthcare, which are still evident. In this paper, we analyzed the role of government and households in financing healthcare in eight countries (EU-8): Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia, and Slovenia. A desk research method was applied to collect quantitative data on healthcare expenditures and qualitative data on gaps in universal health coverage. A linear regression analysis was used to analyze a trend in health expenditure over the years 2000–2018. Our results indicate that a high reliance on out-of-pocket payments persists in many EU-8 countries, and only a few countries have shown a significant downward trend over time. The gaps in universal coverage in the EU-8 countries are due to explicit rationing (a limited benefit package, patient cost sharing) and implicit mechanisms (wait times). There is need to increase the role of public financing in CEE countries through budget prioritization, reducing patient co-payments for medical products and medicines, and extending the benefit package for these goods, as well as improving the quality of care.

Suggested Citation

  • Marzena Tambor & Jacek Klich & Alicja Domagała, 2021. "Financing Healthcare in Central and Eastern European Countries: How Far Are We from Universal Health Coverage?," IJERPH, MDPI, vol. 18(4), pages 1-26, February.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:4:p:1382-:d:492173
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    References listed on IDEAS

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    1. Vladimer Papava, 2005. "On the theory of post-Communist economic transition to market," International Journal of Social Economics, Emerald Group Publishing, vol. 32(1/2), pages 77-97, January.
    2. Falilou Fall & Daniela Glocker, 2018. "Improving the Czech health care system," OECD Economics Department Working Papers 1522, OECD Publishing.
    3. Stanislawa Golinowska & Ewa Kocot & Agnieszka Sowa, 2008. "Scenarios For Health Expenditure in Poland," CASE Network Reports 0078, CASE-Center for Social and Economic Research.
    4. Mitenbergs, Uldis & Brigis, Girts & Quentin, Wilm, 2014. "Healthcare financing reform in Latvia: Switching from social health insurance to NHS and back?," Health Policy, Elsevier, vol. 118(2), pages 147-152.
    5. Domagała, Alicja & Klich, Jacek, 2018. "Planning of Polish physician workforce – Systemic inconsistencies, challenges and possible ways forward," Health Policy, Elsevier, vol. 122(2), pages 102-108.
    6. Tambor, Marzena & Pavlova, Milena & Golinowska, Stanisława & Sowada, Christoph & Groot, Wim, 2013. "The formal–informal patient payment mix in European countries. Governance, economics, culture or all of these?," Health Policy, Elsevier, vol. 113(3), pages 284-295.
    7. Stanislawa Golinowska & Ewa Kocot & Agnieszka Sowa, 2008. "Development of Scenarios for Health Expenditure in the New EU Member States: Bulgaria, Estonia, Hungary, Poland and Slovakia," CASE Network Reports 0077, CASE-Center for Social and Economic Research.
    8. Stanley Fischer & Alan Gelb, 1991. "The Process of Socialist Economic Transformation," Journal of Economic Perspectives, American Economic Association, vol. 5(4), pages 91-105, Fall.
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    Cited by:

    1. Purcel, Alexandra-Anca & Dragos, Cristian Mihai & Mare, Codruța & Dragos, Simona Laura, 2023. "Voluntary health insurance and out-of-pocket payments in European OECD countries," Economic Modelling, Elsevier, vol. 120(C).
    2. Petrovici, Norbert & Belbe, Stefana (Ștefana) & Mare, Codruta (Codruța) & Cotoi, Calin (Călin), 2023. "Hybrid health regimes: Access to primary care physicians and COVID-19 vaccine uptake across municipalities in Romania," Social Science & Medicine, Elsevier, vol. 337(C).
    3. Debora Di Gioacchino & Emanuela Ghignoni & Laura Sabani, 2024. "Health Disparities in Europe: Insights from a Cluster Analysis of Healthcare Systems," Working Papers in Public Economics 251, Department of Economics and Law, Sapienza University of Roma.
    4. Monika Karasiewicz & Ewelina Chawłowska & Agnieszka Lipiak & Barbara Więckowska, 2021. "A Step towards Understanding and Tackling Health Inequalities: The Use of Secondary Prevention Services and the Need for Health Promotion in a Rural Setting," IJERPH, MDPI, vol. 18(16), pages 1-18, August.
    5. Tomoyuki Takura & Hiroko Miura, 2022. "Socioeconomic Determinants of Universal Health Coverage in the Asian Region," IJERPH, MDPI, vol. 19(4), pages 1-15, February.
    6. Katarina Vojvodic & Zorica Terzic-Supic & Jovana Todorovic & Cristina Gagliardi & Milena Santric-Milicevic & Marina Popovic, 2022. "Financial Burden of Medical Care, Dental Care, and Medicines among Older-Aged Population in Slovenia, Serbia, and Croatia," IJERPH, MDPI, vol. 19(6), pages 1-23, March.

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