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Out-of-Pocket Payments and Subjective Unmet Need of Healthcare

Author

Listed:
  • Erik Schokkaert

    (KU Leuven and CORE, Université catholique de Louvain)

  • Jonas Steel

    (KU Leuven)

  • Carine Van de Voorde

    (KU Leuven)

Abstract

We present a critical review of the literature that discusses the link between the level of out-of-pocket payments in developed countries and the share of people in these countries reporting that they postpone or forgo healthcare for financial reasons. We discuss the pros and cons of measuring access problems with this subjective variable. Whereas the quantitative findings in terms of numbers of people postponing care must be interpreted with utmost caution, the picture for the vulnerable groups in society is reasonably robust and unsurprising: people with low incomes and high morbidity and incomplete (or non-existent) insurance coverage are most likely to postpone or forgo healthcare for financial reasons. It is more surprising that people with high incomes and generous insurance coverage also report that they postpone care. We focus on some policy-relevant issues that call for further research: the subtle interactions between financial and non-financial factors, the possibility of differentiation of out-of-pocket payments between patients and between healthcare services, and the normative debate around accessibility and affordability.

Suggested Citation

  • Erik Schokkaert & Jonas Steel & Carine Van de Voorde, 2017. "Out-of-Pocket Payments and Subjective Unmet Need of Healthcare," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 545-555, October.
    • Handle: RePEc:spr:aphecp:v:15:y:2017:i:5:d:10.1007_s40258-017-0331-0
    DOI: 10.1007/s40258-017-0331-0
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    Cited by:

    1. H. Xavier Jara & Erik Schokkaert, 2017. "Putting measures of individual well-being to use for ex-ante policy evaluation," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 15(4), pages 421-440, December.
    2. Veronika Kočiš Krůtilová & Lewe Bahnsen, 2021. "Cost-Induced Unmet Need for Health Care among Europe's Older Adults - The Role of Specific Diseases," European Journal of Business Science and Technology, Mendel University in Brno, Faculty of Business and Economics, vol. 7(2), pages 210-222.
    3. Markus Fels, 2020. "Incentivizing efficient utilization without reducing access: The case against cost‐sharing in insurance," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 827-840, July.
    4. Ramos, Luís Moura & Quintal, Carlota & Lourenço, Óscar & Antunes, Micaela, 2019. "Unmet needs across Europe: Disclosing knowledge beyond the ordinary measure," Health Policy, Elsevier, vol. 123(12), pages 1155-1162.
    5. Quintal, Carlota & Lourenço, Óscar & Ramos, Luís Moura & Antunes, Micaela, 2019. "No unmet needs without needs! Assessing the role of social capital using data from European social survey 2014," Health Policy, Elsevier, vol. 123(8), pages 747-755.
    6. Aaltonen, Katri & Vaalavuo, Maria, 2024. "Financial burden of medicines in five Northern European countries: A decommodification perspective," Social Science & Medicine, Elsevier, vol. 347(C).

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