Factors Associated with Out-of-Pocket Health Expenditure in Polish Regions.

Błażej Łyszczarz,Zhaleh Abdi

doi:10.3390/healthcare9121750

Abstract

Out-of-pocket (OOP) payments are perceived as the most regressive means of health financing. Using the panel-data approach and region-aggregated data from Statistics Poland, this research investigated associations between socio-economic factors and OOP health spending in 16 Polish regions for the period 1999–2019. The dependent variable was real (inflation-adjusted) monthly OOP health expenditure per person in Polish households. Potential independent variables included economic, labour, demographic, educational, health, environmental, and lifestyle measures based on previous research. A set of panel-data estimators was used in regression models. The factors that were positively associated with OOP health spending were disposable income, the proportions of children (aged 0–9) and elderly (70+ years) in the population, healthcare supply (proxied by physicians’ density), air pollution, and tobacco and alcohol expenditure. On the other hand, the increased unemployment rate, life expectancy at age 65, mortality rate, and higher sports participation were all related to lower OOP health spending. The results may guide national strategies to improve health-care allocations and offer additional financial protection for vulnerable groups, such as households with children and elderly members.

Highlights

Sustainable financing of health services is a subject of major concern throughout the world [1]
The coefficient of variation (CoV) for the Hexp variable in the period investigated varied from 11.4% in 2002 to 17.8% in 2010–2011, and this variation was notably higher than the respective coefficient for disposable income
The annual average growth rate (AAGR) of OOP health expenditure was noticeably heterogeneous across regions; it reached 2.8% in opolskie region but was only 0.3% in małopolskie (Table 2)

Summary

Introduction

Sustainable financing of health services is a subject of major concern throughout the world [1]. Healthcare spending has typically outpaced economic growth in recent decades in most Organization for Economic Co-operation Development (OECD) countries [2] While such growth has improved health outcomes, there are concerns regarding the fiscal sustainability of this rising trend, as healthcare systems are predominantly funded from public resources in most OECD countries [3]. Several factors such as demography, rising income, technological progress, and associated healthcare legislation have all been identified as underlying causes behind the persistent growth in health expenditure [4,5]. Protecting people against financial hardship associated with using healthcare is crucial for achieving universal health coverage [11]

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Discussion

Conclusion