The Ariadne's thread in co-payment, primary health care usage and financial crisis: findings from Cyprus public health care sector

Abstract

ObjectivesCyprus entered a prolonged financial recession in 2011 and by early 2013 it applied for an international bail-out agreement. This presupposed massive reforms in public governance. Health sector was considerably reformed and one of the measures was the introduction of co-payment for outpatient visits to public health care sector. The scope of this study is to assess the impact of financial crisis and co-payment to public outpatient visits in Nicosia urban and greater Nicosia region. Study designAn Interrupted time-series analysis. MethodsAll outpatient visits to public health care family doctor/general practitioners in Nicosia urban and greater Nicosia region from January 2011 until May of 2014 were registered and analysed. ResultsFinancial crisis did not alter outpatient visits. Introduction of co-payment led to a statistically significant decrease from the second month after its introduction (p = 0.048) (R2 = 0.329, Q = 23.75, p = 0.137). This decrease was consistent until the end of the observational period and it did not level off. ConclusionsFinancial crisis did not affect outpatient visits while co-payment can be considered as a potent cost containment measure during financial recession, by normalising utilisation of healthcare resources.