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|a Sanwald, Alice
|e verfasserin
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|a Out-of-pocket payments in the Austrian healthcare system
|b a distributional analysis
|c Alice Sanwald; Engelbert Theurl
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|a Innsbruck
|b Univ. of Innsbruck, Inst. für Finanzwiss.
|c 2015
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|a Online-Ressource (22 S.)
|b graph. Darst.
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|a Working papers in economics and statistics
|v 2015-05
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| 520 |
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|a Introduction: Out-of-pocket spending is an important source of healthcare financing even in countries with established prepaid financing of healthcare. However, out-of-pocket payments (OOPP) may have undesirable effects from an equity perspective. In this study, we analyse the distributive effects of OOPP in Austria based on cross-sectional information from the Austrian Household Budget Survey 2009/10. Methods: We combine evidence from disaggregated measures (concentration curve and Lorenz curve) and summary indices (Gini coefficient, Kakwani index, and Reynolds-Smolensky index) to demonstrate the distributive effects of total OOPP and their subcomponents. Thereby, we use different specifications of household ability to pay. We follow the Aronson-Johnson-Lampert approach and split the distributive effect into its three components: progressivity, horizontal equity, and reranking. Results: OOPP in Austria have regressive effects on income distribution. These regressive effects are especially pronounced for the OOPP category prescription fees and over-the-counter pharmaceuticals. Disaggregated evidence shows that the effects differ between income groups. The decomposition analysis reveals a high degree of reranking and horizontal inequity for total OOPP, and particularly, for therapeutic aids and physician services. Conclusions: The results - especially those for prescription fees and therapeutic aids - are of high relevance for the recent and on-going discussion on the reform of benefit catalogues and cost-sharing schemes in the public health insurance system in Austria.
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|a Systemvoraussetzungen: Acrobat Reader.
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|a Working papers in economics and statistics
|v 2015-05
|9 2015,5
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|u http://econpapers.repec.org/RePEc:inn:wpaper:2015-05
|x Verlag
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|u http://hdl.handle.net/10419/122220
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|a reranking
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