Wpływ wydatków typu out-of-pocket na sprawiedliwość w finansowaniu ochrony zdrowia

Out-of-pocket expenditures versus equity in health care financingHealth care systems in OECD countries are financed by a mix of taxes, social or private insurance contributions and out-of-pocket payments. The various funding sources may have different impact on equity and redistributive effect in health care financing. The co-payments for certain medical services exist in all OECD countries, the most common are co-payments for the reimbursement drugs. This paper presents preliminary results of literature review of studies on equity in financing of health care, conducted in the framework of InterQuality Project. Recent studies on equity in the financing of reimbursement drugs in Poland and Hungary were identified, as well as earlier study, measuring horizontal inequity in utilization of prescription drugs in Denmark. The results show that inequity in financing and utilization of reimbursement drugs remained, and even increased in Hungary and Poland after implementation of health care reforms, which led to higher out-of-pocket expenditures on reimbursed drugs.