A Comparison of the Burden of Out‐of‐Pocket Health Payments in Denmark, Germany and Poland
| Author | Daniel Rabczenko,Urszula Ceglowska,Tomasz Rybnik,Katarzyna Kolasa,Jørgen T. Lauridsen,Anna Zawada,Christian Kronborg,Tomasz Hermanowski |
| Date | 01 March 2017 |
| DOI | http://doi.org/10.1111/1758-5899.12331 |
| Published date | 01 March 2017 |
A Comparison of the Burden of Out-of-Pocket
Health Payments in Denmark, Germany and
Poland
Anna Zawada
Medical University of Warsaw, Department of Pharmacoeconomics, Warsaw, Poland
Katarzyna Kolasa
Sopharm Sp. z o. o., Jablonna, Poland
Christian Kronborg
University of Southern Denmark, Department of Business and Economics, Odense,
Denmark
Daniel Rabczenko
Medical University of Warsaw, Department of Pharmacoeconomics, Warsaw, Poland, and
National Institute of Public Health –National Institute of Hygiene (NIPH –NIH),
Warsaw, Poland
Tomasz Rybnik
Sopharm Sp. z o. o., Jablonna, Poland
Jørgen T. Lauridsen
University of Southern Denmark, Department of Business and Economics, Odense,
Denmark
Urszula Ceglowska and Tomasz Hermanowski
Medical University of Warsaw, Department of Pharmacoeconomics, Warsaw, Poland
Abstract
It is important to monitor equity of access to health services in all countries. We assessed the levels of out-of-pocket (OOP)
health spending in three European countries: Denmark, Germany and Poland. Using data from national databases (i.e., Statis-
tics Denmark, German Socio-Economic Panel, and National Statistical Office of Poland) for the period 2000–2010, we applied
common methods to assess the rate of households with ‘catastrophic’OOP health spending and the concentration of health
spending in income-ordered groups of citizens. 20.3 per cent of Polish households experienced ‘catastrophic’expenditure
defined by OOP health spending/income ratio >10 per cent, compared to 1.0 per cent of households in Germany and 3.2 per
cent of households in Denmark. 8.8 per cent of Polish households experienced ‘catastrophic’expenditure defined by OOP
health spending/capacity to pay ratio >40 per cent, compared to 0.4 per cent of households in Germany and 0.8 per cent of
households in Denmark. Concentration indexes for OOP on drugs in 2010 were 0.01978 and –0.114 for Denmark and Poland,
respectively. The rate of households with ‘catastrophic’OOP expenditure in Poland is much higher than in both Denmark and
Germany; health spending in Poland is concentrated among the worst-off groups of citizens while in Denmark and Germany
they are distributed more equitably.
Global Policy (2017) 8:Suppl.2 doi: 10.1111/1758-5899.12331 ©2016 University of Durham and John Wiley & Sons, Ltd.
Global Policy Volume 8 . Supplement 2 . March 2017 123
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