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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | NĂ¼bler, Laura Busse, Reinhard Siegel, Martin |
| Abstract | Background Analyses of out-of-pocket healthcare spending often suffer from an inability to distinguish necessary from optional spending in the data without making further assumptions. We propose a two-dimensional rating of the spending categories often available in household budget survey data where we consider the requirement to pay for necessary healthcare as one dimension and the incentive to pay extra for additional services, higher quality options or more convenience as a second dimension to assess the distortionary potential of higher spending for additional healthcare or higher quality options. Methods We use three waves of a large German Household Budget Survey and decompose the Kakwani-index of total out-of-pocket healthcare spending into contributions of the eleven spending categories available in our data, across which user charge regulations vary considerably. We compute and decompose Kakwani-indexes for the different spending categories to compare the degrees of regressiveness across them. Results The results suggest that categories with higher incentives for additional spending exhibit smaller contributions to the overall regressive effect of total out-of-pocket spending than categories where spending is presumably mostly on necessary and effective care. Conclusions Assessing the consumer choice potential of different spending categories is important because extra spending among the better-off may outweigh necessary spending in aggregate expenditure data, and may also hint at potential inequalities in the quality of provided healthcare. |
| Related Links | https://equityhealthj.biomedcentral.com/counter/pdf/10.1186/s12939-023-01838-1.pdf |
| Ending Page | 10 |
| Page Count | 10 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14759276 |
| DOI | 10.1186/s12939-023-01838-1 |
| Journal | International Journal for Equity in Health |
| Issue Number | 1 |
| Volume Number | 22 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-01-31 |
| Access Restriction | Open |
| Subject Keyword | Public Health Health Promotion and Disease Prevention Health Services Research Health Policy Social Justice Equality and Human Rights Social Policy Out-of-pocket spending on health Kakwani index Consumer choice Policy analysis Decomposition analysis Health insurance Germany |
| Content Type | Text |
| Resource Type | Article |
| Subject | Health Policy Public Health, Environmental and Occupational Health |
| Journal Impact Factor | 4.5/2023 |
| 5-Year Journal Impact Factor | 4.7/2023 |
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