期刊
HEALTH POLICY
卷 112, 期 1-2, 页码 35-44出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.healthpol.2013.05.020
关键词
Cost sharing; Out-of-pocket; Deductibles; Co-insurance; Co-payment; Vulnerable groups
Many high income countries increased their level of patient cost sharing between 2000 and 2010 as one component of their policy agenda to reduce the level of health care spending. We use data from the OECD, European Observatory, and country-specific resources to analyze trends in the UK, Germany, Japan, France, and the United States. Some forms of cost sharing-deductibles, co-insurance, or co-payments increased in all these countries, with the highest rates of increase occurring in the pharmaceutical sector. In spite of higher levels of cost-sharing, out-of-pocket spending as a percentage of total spending remained unchanged in most of these countries because they instituted programs to protect certain categories of individuals by creating out-of-pocket limits, exempting people with certain chronic diseases, or eliminating cost sharing for certain demographic groups and low-income people. (C) 2013 The Authors. Published by Elsevier Ireland Ltd. All rights reserved.
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