Grigorakis Nikolaos, Floros Christos, Tsangari Haritini, Tsoukatos Evangelos
School of Business, University of Nicosia, Nicosia, Cyprus.
School of Management and Economics, T.E.I of Crete, Heraklion, Greece.
Int J Health Econ Manag. 2017 Jan 3. doi: 10.1007/s10754-016-9203-7.
The high level of out of pocket (OOP) payments constitutes a major concern for Greece and several other European and OECD countries as a result of the significant down turning of their public health finances due to the 2008 financial crisis. The basic objective of this study is to provide empirical evidence on the effect of combining social health insurance (SHI) and private health insurance (PHI) on OOP payments. Further, this study examines the catastrophic impact of OOP payments on insured's welfare using the incidence and intensity methodological approach of measuring catastrophic health care expenditures. Conducting a cross-sectional survey in Greece in 2013, we find that the combination of SHI-PHI has a strong negative influence on insured OOP payments for inpatient health care in private hospitals. Furthermore, our results indicate that SHI coverage is not sufficient by itself to manage with this issue. Moreover, we find that poor people present a greater tendency to incur catastrophic OOP expenditures for hospital health care in private providers. Drawing evidence from Greece, a country with huge fiscal problems that has suffered the consequences of the economic crisis more than any other, could be a starting point for policymakers to consider the perspective of SHI-PHI co-operation against OOP payments more seriously.
由于2008年金融危机导致公共卫生财政大幅下滑，高额的自付费用（OOP）成为希腊以及其他几个欧洲和经合组织国家的主要担忧。本研究的基本目标是提供关于社会医疗保险（SHI）和私人医疗保险（PHI）相结合对自付费用影响的实证证据。此外，本研究使用衡量灾难性医疗支出的发生率和强度方法，考察自付费用对参保人福利的灾难性影响。通过在2013年对希腊进行横断面调查，我们发现社会医疗保险与私人医疗保险相结合对私立医院住院医疗的参保人自付费用有强烈的负面影响。此外，我们的结果表明，仅靠社会医疗保险覆盖不足以解决这个问题。而且，我们发现穷人在私立医疗机构接受医院医疗时更倾向于产生灾难性的自付支出。从希腊这个财政问题严重、比其他任何国家都更受经济危机影响的国家获取证据，可能是政策制定者更认真地考虑社会医疗保险与私人医疗保险合作以应对自付费用这一观点的一个起点。
