Out-of-pocket expenditure on community healthcare services at end-of-life among decedents from cardiovascular disease in six European countries and Israel

Health Economics Review

Research

Aviad Tur-Sinai¹  Netta Bentur² 

[1] Department of Health Systems Management, The Max Stern Yezreel Valley College, 1930600, Yezreel Valley, Israel;School of Nursing, University of Rochester Medical Center, 14642-8404, Rochester, NY, USA;The Minerva Center on Intersectionality in Aging (MCIA), University of Haifa, 3498838, Haifa, Israel;The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel;

关键词: Cardiovascular disease;    Out-of-pocket;    Economic capacity;    Welfare regime;    SHARE;    I14;    I18;    I38;    J14;   

DOI  :  10.1186/s13561-023-00449-4

 received in 2022-06-16, accepted in 2023-06-02,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectivesMost people who develop chronic diseases, including cardiovascular disease (CVD), live in their homes in the community in their last year of life. Since cost-sharing is common in most countries, including those with universal health insurance, these people incur out of pocket expenditure (OOPE).The study aims to identify the prevalence and measure the size of OOPE among CVD decedents at end-of-life (EOL) explore differences among countries in OOPE, and examine whether the decedents’ characteristics or their countries’ health policy affects OOPE more.MethodsSHARE data among people aged 50 + from seven European countries (including Israel) who died from CVD are analyzed. Decedents’ family members are interviewed to learn about OOPE on their relatives’ account.ResultsWe identified 1,335 individuals who had died from CVD (average age 80.8 years, 54% men). More than half of CVD-decedent people spend OOPE on community services at EOL and their expenditure varies widely among countries. About one-third of people in France and Spain had OOPE, rising to around two-thirds in Israel and Italy and almost all in Greece. The average OOPE is 391.9 PPT, with wide variance across countries. Significant odds of OOPE exist in the country variable only, and significant differences exist in the amount of OOPE among countries and duration of illness preceding death.ConclusionsSince improving CVD care efficiency and effectiveness are key aims, healthcare policymakers should broaden the investigation into expanding public funding for community services in order to mitigate OOPE, alleviate the economic burden on households, mitigate forgoing of community services due to price, and reduce rehospitalization.

【 授权许可】

CC BY   
© The Author(s) 2023