What are the equity, efficiency, cost containment and choice implications of private health-care funding in western Europe?

This is a Health Evidence Network (HEN) synthesis report on private health-care funding in western Europe. Over the last 20 years the level of private spending on health care has risen in many western European countries, leading to concern about its impact. Evidence shows that private sources of health care funding are often regressive and present financial barriers to access. They contribute little to efforts to contain costs and may actually encourage cost inflation. Cost sharing is widely used in western European health systems to moderate demand and/or raise revenue. However, the theoretical case for cost sharing is weak, particularly when applied to health care arising from referral or prescription. HEN, initiated and coordinated by the WHO Regional Office for Europe, is an information service for public health and health care decision-makers in the WHO European Region. Other interested parties might also benefit from HEN.