Statistics from several Organization for Economic Cooperation and Development countries on consumption and cost of health care services, physician workload, and physician earnings are presented. Data are analyzed according to type of physician payment used: fee for service, per case, capitation, or salary. Incentives theoretically embodied in each payment method are often offset by other factor...

Background Private health insurance is one of the sources of funds for financing health care apart from direct taxes, public insurance and out of pocket payments. Regardless of the choice between a social and private insurance, health insurance ownership has been linked with lower OOP. Thus, health insurance as a type of health care financing, no doubt, will be one of the financing mechanisms i...

A large number of health plans and employers have adopted three-tier prescription drug formularies in an effort to control rising prescription drug costs. We assessed the behavioral response to three-tier adoption by estimating econometric models of the probability of selecting drugs assigned to the third tier with the highest co-payment requirement and changes in expected out-ofpocket (OOP) sp...

Many studies find that consumers reduce spending in response to higher health insurance cost-sharing, but there is mixed evidence as to whether these spending reductions reflect a rational trade-off between health benefits and costs. This paper provides new evidence on the rationality of consumer responses to cost-sharing using novel variation in two common types of cost-sharing incentives: ded...

BACKGROUND Most low- and middle-income countries (LMIC) rely significantly on private health expenditure in the form of out-of-pocket payments (OOP) and voluntary health insurance (VHI). This paper assesses VHI expenditure trends in LMIC and explores possible explanations. This illuminates challenges deriving from changes in VHI expenditure as countries aim to progress equitably towards univers...

OBJECTIVES The goal of this study is: (1) to estimate the current direct out-of-pocket (OOP) and indirect non-communicable diseases (NCD) burden on Indonesian households and (2) to project NCD prevalence and burden in 2020 focusing specifically on hypertension, diabetes, heart problems and stroke. METHODS This study relies on econometric analyses based on four waves of the Indonesian Family L...

Abstract Background As low- and middle-income countries progress toward Universal Health Coverage, there is an increasing focus on measuring out-of-pocket (OOP) expenditure health services utilization within countries. While have been several reforms to improve coverage financial protection in Pakistan, limited empirical research comparing OOP between public private facilities exploring their d...

BACKGROUND To promote skilled attendance at births and reduce maternal deaths, the government of Ghana introduced the free maternal care policy under the National Health Insurance Scheme (NHIS) in 2008. The objective is to eliminate financial barriers associated with the use of services. But studies elsewhere showed that out of pocket (OOP) payments still exist in the midst of fee exemptions. T...

BACKGROUND Generic-only pharmacy benefits may present more of a burden to patients with chronic disease conditions such as chronic obstructive pulmonary disease (COPD), where generic drug therapy choices are more limited. OBJECTIVE To evaluate the strategies that elderly patients with COPD use to manage their out-of-pocket (OOP) prescription expenses in a generic-only pharmacy benefit compare...