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中欧和东欧六个国家对医生服务的支付意愿和支付能力。

Willingness and ability to pay for physician services in six Central and Eastern European countries.

作者信息

Danyliv Andriy, Groot Wim, Gryga Irena, Pavlova Milena

机构信息

School of Public Health, National University of 'Kyiv-Mohyla Academy', Skovorody St. 2, Kiev 04655, Ukraine; Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Maastricht University, 6200 MD Maastricht, The Netherlands.

Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Maastricht University, 6200 MD Maastricht, The Netherlands; Top Institute Evidence Based Education Research (TIER), Maastricht University, 6200 MD Maastricht, The Netherlands.

出版信息

Health Policy. 2014 Jul;117(1):72-82. doi: 10.1016/j.healthpol.2014.02.012. Epub 2014 Feb 19.

Abstract

Patient charges for physician services are implemented in high-income countries and often are considered in the Central and Eastern Europe (CEE). However, there is no evidence on the potential consumption effects of service charges in these countries. This study provides evidence on the potential impact of patient charges on the consumption of specialized physician services in six CEE countries: Bulgaria, Hungary, Lithuania, Poland, Romania, and Ukraine. We apply a semi-parametric survival analysis to stated willingness and ability to pay (WATP) in order to identify potential demand pools and their price, income and age semi-elasticity. Data are collected through a survey held in 2010 among representative samples of about 1000 respondents in each country. Our results suggest that median WATP in the studied countries is comparable to the cost of the services. The obtained demand pools appear to be theoretically valid and externally consistent. They provide information on the shares of population that would be WATP certain fee levels, and their heterogeneity across socio-demographic groups gives an idea about the population groups that will need to be exempted.

摘要

在高收入国家实施了患者支付医生服务费用的政策,中东欧地区(CEE)也经常考虑这一政策。然而,尚无证据表明这些国家的服务收费对消费有潜在影响。本研究提供了关于患者收费对六个中东欧国家(保加利亚、匈牙利、立陶宛、波兰、罗马尼亚和乌克兰)专科医生服务消费潜在影响的证据。我们应用半参数生存分析来研究支付意愿和支付能力(WATP),以确定潜在需求群体及其价格、收入和年龄半弹性。数据通过2010年在每个国家对约1000名受访者的代表性样本进行的调查收集。我们的结果表明,所研究国家的WATP中位数与服务成本相当。所获得的需求群体在理论上似乎是有效的且外部一致。它们提供了愿意支付特定费用水平的人口比例信息,并且它们在社会人口群体中的异质性让我们了解到哪些人群需要被豁免。

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