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Applied Health Economics and Health Policy

, Volume 15, Issue 5, pp 545–555 | Cite as

Out-of-Pocket Payments and Subjective Unmet Need of Healthcare

  • Erik SchokkaertEmail author
  • Jonas Steel
  • Carine Van de Voorde
Current Opinion

Abstract

We present a critical review of the literature that discusses the link between the level of out-of-pocket payments in developed countries and the share of people in these countries reporting that they postpone or forgo healthcare for financial reasons. We discuss the pros and cons of measuring access problems with this subjective variable. Whereas the quantitative findings in terms of numbers of people postponing care must be interpreted with utmost caution, the picture for the vulnerable groups in society is reasonably robust and unsurprising: people with low incomes and high morbidity and incomplete (or non-existent) insurance coverage are most likely to postpone or forgo healthcare for financial reasons. It is more surprising that people with high incomes and generous insurance coverage also report that they postpone care. We focus on some policy-relevant issues that call for further research: the subtle interactions between financial and non-financial factors, the possibility of differentiation of out-of-pocket payments between patients and between healthcare services, and the normative debate around accessibility and affordability.

Keywords

Dental Care Price Elasticity Utilization Data Financial Reason European Social Survey 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Author Contributions

The authors contributed equally to the content of the paper. The final version was written by ES.

Compliance with Ethical Standards

Conflict of interest

Erik Schokkaert, Jonas Steel and Carine Van de Voorde have no conflicts of interest.

Funding

No external funding was received for the work reported in this study.

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of EconomicsKU Leuven and CORE, Université catholique de LouvainLouvain-la-NeuveBelgium
  2. 2.Department of EconomicsKU LeuvenLouvainBelgium

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