IDEAS home Printed from https://ideas.repec.org/p/imf/imfwpa/2006-285.html
   My bibliography  Save this paper

How Does the Introduction of Health Insurance Change the Equity of Health Care Provision in Bulgaria?

Author

Listed:
  • Ms. Nora K Markova

Abstract

The study examines the effect of health care reform in Bulgaria in 1999 on the equity of health care financing. It explores the distribution of different types of health care financing by income. Furthermore, it separates the financial and social reasons for these differences, dividing them into economic and social inequalities. It suggests a method of distinguishing between financially based and "exclusion based" reasons for having progressive/regressive health care financing. Moreover, it looks at the social factors that shape health expenditure patterns and identifies those social characteristics that lead to exclusion from the health care system.

Suggested Citation

  • Ms. Nora K Markova, 2006. "How Does the Introduction of Health Insurance Change the Equity of Health Care Provision in Bulgaria?," IMF Working Papers 2006/285, International Monetary Fund.
    • Handle: RePEc:imf:imfwpa:2006/285
    as

    Download full text from publisher

    File URL: http://www.imf.org/external/pubs/cat/longres.aspx?sk=20043
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Schokkaert, Erik & Van de Voorde, Carine, 2004. "Risk selection and the specification of the conventional risk adjustment formula," Journal of Health Economics, Elsevier, vol. 23(6), pages 1237-1259, November.
    2. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income‐related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628, July.
    3. Kakwani, Nanak C, 1977. "Applications of Lorenz Curves in Economic Analysis," Econometrica, Econometric Society, vol. 45(3), pages 719-727, April.
    4. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    5. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1989. "Equity in the Finance and Delivery of Health Care: Some Tentative Cross-country Comparisons," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 5(1), pages 89-112, Spring.
    6. Michael Marmot, 2001. "Income inequality, social environment, and inequalities in health," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 20(1), pages 156-159.
    7. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
    8. Uitenbroek, Daan G. & Kerekovska, Albena & Festchieva, Nevijana, 1996. "Health lifestyle behaviour and socio-demographic characteristics. A study of Varna, Glasgow and Edinburgh," Social Science & Medicine, Elsevier, vol. 43(3), pages 367-377, August.
    9. Pavlova, Milena & Groot, Wim & van Merode, Godefridus, 2002. "Public attitudes towards patient payments in Bulgarian public health care sector: results of a household survey," Health Policy, Elsevier, vol. 59(1), pages 1-24, January.
    10. Eddy van Doorslaer & Andrew M. Jones, 2004. "Income‐related inequality in health and health care in the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 605-608, July.
    11. van Doorslaer, Eddy & Wagstaff, Adam, 1992. "Equity in the delivery of health care: some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 389-411, December.
    12. Doorslaer, Eddy van & Jones, Andrew M., 2003. "Inequalities in self-reported health: validation of a new approach to measurement," Journal of Health Economics, Elsevier, vol. 22(1), pages 61-87, January.
    13. Wagstaff, Adam & van Doorslaer, Eddy, 1992. "Equity in the finance of health care: Some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 361-387, December.
    14. Delcheva, Evgenia & Balabanova, Dina & McKee, Martin, 1997. "Under-the-counter payments for health care: Evidence from Bulgaria," Health Policy, Elsevier, vol. 42(2), pages 89-100, November.
    15. Minev, Duchomir & Dermendjieva, Bogdana & Mileva, Natasha, 1990. "The Bulgarian country profile: The dynamics of some inequalities in health," Social Science & Medicine, Elsevier, vol. 31(8), pages 837-846, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Rama Joglekar, 2008. "Can Insurance Reduce Catastrophic Out-of-Pocket Health Expenditure?," Labor Economics Working Papers 22367, East Asian Bureau of Economic Research.
    2. Atanasova, Elka & Pavlova, Milena & Velickovski, Robert & Nikov, Bogomil & Moutafova, Emanuela & Groot, Wim, 2011. "What have 10 years of health insurance reforms brought about in Bulgaria? Re-appraising the Health Insurance Act of 1998," Health Policy, Elsevier, vol. 102(2), pages 263-269.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    2. Hai Zhong, 2010. "On decomposing the inequality and inequity change in health care utilization: change in means, or change in the distributions?," International Journal of Health Economics and Management, Springer, vol. 10(4), pages 369-386, December.
    3. Jones, Andrew M. & Rice, Nigel & Robone, Silvana & Dias, Pedro Rosa, 2011. "Inequality and polarisation in health systems' responsiveness: A cross-country analysis," Journal of Health Economics, Elsevier, vol. 30(4), pages 616-625, July.
    4. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    5. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income‐related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647, July.
    6. Eddy van Doorslaer & Andrew M. Jones, 2004. "Income‐related inequality in health and health care in the European Union," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 605-608, July.
    7. Pilar García Gómez & Ángel López Nicolás, 2005. "Socio-economic inequalities in health in Catalonia," Hacienda Pública Española / Review of Public Economics, IEF, vol. 175(4), pages 103-121, december.
    8. Hai Zhong, 2010. "The impact of missing data in the estimation of concentration index: a potential source of bias," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 255-266, June.
    9. Ana I. Balsa & Máximo Rossi & Patricia Triunfo, 2011. "Horizontal Inequity in Access to Health Care in Four South American Cities," Revista de Economía del Rosario, Universidad del Rosario, June.
    10. Hernández-Quevedo, Cristina & Jones, Andrew M. & López-Nicolás, Angel & Rice, Nigel, 2006. "Socioeconomic inequalities in health: A comparative longitudinal analysis using the European Community Household Panel," Social Science & Medicine, Elsevier, vol. 63(5), pages 1246-1261, September.
    11. Nübler, Laura & Busse, Reinhard & Siegel, Martin, 2022. "The role of consumer choice in out-of-pocket spending on health: A mixed-methods approach," EconStor Preprints 260395, ZBW - Leibniz Information Centre for Economics.
    12. Kim, Tae Jun & Vonneilich, Nico & Lüdecke, Daniel & von dem Knesebeck, Olaf, 2017. "Income, financial barriers to health care and public health expenditure: A multilevel analysis of 28 countries," Social Science & Medicine, Elsevier, vol. 176(C), pages 158-165.
    13. Magnus Lindelow, 2006. "Sometimes more equal than others: how health inequalities depend on the choice of welfare indicator," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 263-279, March.
    14. Magnus Lindelow, 2002. "Sometimes More Equal than Others How the choice of welfare indicator can affect the measurement of health inequalities and the incidence of public spending," Economics Series Working Papers WPS/2002-15, University of Oxford, Department of Economics.
    15. Andrew Jones & Ángel López Nicolás, 2006. "Allowing for heterogeneity in the decomposition of measures of inequality in health," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 4(3), pages 347-365, December.
    16. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2011. "Equity in health and health care," LIDAM Discussion Papers CORE 2011026, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    17. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & Citoni, Guido & Di Biase, Rita & Gerdtham, Ulf-G. & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "The redistributive effect of health care finance in twelve OECD countries," Journal of Health Economics, Elsevier, vol. 18(3), pages 291-313, June.
    18. Chen, Zhuo & Roy, Kakoli, 2009. "Calculating concentration index with repetitive values of indicators of economic welfare," Journal of Health Economics, Elsevier, vol. 28(1), pages 169-175, January.
    19. Owen O’Donnell & Eddy van Doorslaer & Adam Wagstaff, 2012. "Decomposition of Inequalities in Health and Health Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 17, Edward Elgar Publishing.
    20. Buhong Zheng, 2011. "A new approach to measure socioeconomic inequality in health," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 9(4), pages 555-577, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:imf:imfwpa:2006/285. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Akshay Modi (email available below). General contact details of provider: https://edirc.repec.org/data/imfffus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.