Out-of-pocket funding of medical services among older adults

Abstract

Abstract Background The current composition of Israeli private funding is inconsistent with the principles of the State Health Insurance Law. According with the aging process, this study identifies and investigates the predictors of out-of-pocket (hereinafter- OOP) funding of medical care and healthcare among the 50+ population. Its three objectives are to profile the healthcare services for which older adults pay out of pocket, profile the older adults who pay OOP for medical services and detect changes over the years, and identify predictors of private healthcare service funding by older adults. Methods The study is based on the SHARE-Israel database. Relating to longitudinal information yielded by the SHARE-Israel, it sheds light on the characteristics of those who reported having paid OOP for medical services. Results A large majority of the 50+ population in Israel that consumes healthcare services is asked to pay for them out of pocket. Their average age is sixty-seven. Possession of supplemental health insurance coverage, state of health and changes in it, and economic resources are found to have the strongest effect on the probability of OOP funding. The motive of financial and/or social support that older adults receive from and/or give to their immediate surroundings makes it more likely that they will pay OOP for healthcare services. The decision on whether to pay out of pocket in advanced age is positively dependent on age but negatively dependent on level of education. The probability of OOP funding varies between Jews and Arabs and between non-immigrant Jews and recent-immigrant Jews from the former Soviet Union. Conclusions The share of OOP funding of healthcare in older adult households' total annual income is trending upward. The funding of older adult healthcare services in Israel is marked by inequality. Furthermore, economic motives are central in determining whether older adults' out-of-pocket expenditure on healthcare services will stabilize over time. Key messages The funding of older adult healthcare services in Israel is marked by inequality. Economic motives are central in determining whether older adults’ out-of-pocket expenditure on healthcare services will stabilize over time.