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دسته بندی:
مدیریت بحران - Crisis Management
سال انتشار:
2018
عنوان انگلیسی مقاله:
Financial protection of households against health shocks in Greece during the economic crisis
ترجمه فارسی عنوان مقاله:
حمایت مالی از خانوارها در برابر بحران اقتصادی در یونان در طول بحران اقتصادی
منبع:
Sciencedirect - Elsevier - Social Science & Medicine, 211 (2018) 338-351. doi:10.1016/j.socscimed.2018.06.024
نویسنده:
Athanasios E. Chantzaras∗, John N. Yfantopoulos
چکیده انگلیسی:
Background: Harsh funding cutbacks along with measures shifting cost to patients have been implemented in the
Greek health system in recent years. Our objective was to investigate the evolution of financial protection of
Greek households against out-of-pocket payments (OOPP) during the economic crisis.
Methods: National representative data of 33,091 households were derived from the Household Budget Surveys
for the period 2008–2015. Financial protection was assessed by applying the approaches of catastrophic (CHE)
and impoverishing OOPP. The determinants of CHE and impoverishment were examined using binary logistic
regressions.
Results: OOPP dropped by 23.5% in real values between 2008 and 2015, though their share in households
budget rose from 6.9% to 7.8%, with an increasing trend since 2012. These outcomes were driven by significant
increases in medical products (20.2%) and inpatient (63%) OOPP, while outpatient expenses decreased con
siderably (−62%). Both incidence and overshoot of CHE were significantly exacerbated. The additional burden
was distributed progressively, hence, financial risk inequalities decreased. Food poverty increased, but its in
cidence still remains at very low levels. Both incidence and intensity of relative poverty increased considerably
in real terms. The poverty impact of OOPP is aggravating following 2012, and 1.9% of individuals were im
poverished due to OOPP in 2015. Households of higher size, lower expenditure quintile, in urban areas, without
disabled, elderly or young children members, and with younger or retired, better-educated breadwinners were
significantly less vulnerable to CHE. Households in the lower-middle expenditure quintile, in rural regions, and
with elderly members were facing higher risk, while wealthier families exhibited a considerable lower likelihood
of impoverishment.
Conclusions: The expansion of reliance of healthcare funding on OOPP has increased the financial risk and
hardship of Greek households, which may disrupt their living conditions and create barriers to healthcare access.
Cost-sharing policies should recognise the different social protection needs of households.
Keywords: Financial fairness ، Equity ، Healthcare financing ، Catastrophic health expenditure ، Poverty ، Impoverishment ، Out-of-pocket payment ، Greece
قیمت: رایگان
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