The visit fees and its influence on overalL health expenditureS – the case of the Czech Republic

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dc.contributor.authorClark, J. Stephen
dc.contributor.authorDittrich, Ludwig O.
dc.contributor.authorStará, Dana
dc.contributor.authorBarták, Miroslav
dc.contributor.otherEkonomická fakultacs
dc.date.accessioned2017-06-26
dc.date.available2017-06-26
dc.date.issued2017-06-15
dc.description.abstractThe goal of the paper is to develop a simple demand model of health care services that can explain why the demand for health care services, and hence overall expenditures on health care, can rise with the introduction of visit fees based on real data available publicly in the Czech Republic. One of the most common problems with the costs of health care systems around the world is that they tend to increase expenditures at a rate that is greater than the rate of inflation. This has led to the introduction of visit fees by governments and/or public, private health care facilities and other health care providers. These fees are meant to rationalize the use of the health care system and slow the growth of health care expenditures. The Ministry of Health of the Czech Republic introduced from 1. January 2008 visit fees as a way to slow the growth of health care expenditures. On the contrary, total health care expenditures increased after the introduction of visit fees. A model of visits and visit intensity is developed, where visits and visit intensity are substitutes. The model shows that the demand for health care services will increase with an increase in the price of visits when the cross price elasticity of demand for visit intensity outweighs the own price elasticity of visits. The fees were abolished with the exception of fee for emergency room visit from 2015. The introduction of a visit fee is a counterproductive rationing device for health care services if it rations a component of overall health care services with a low own price elasticity of demand without rationing a substitute variable (visit intensity) with a higher cross elasticity of demand. Thus, the introduction of a visit fee may induce a sense of entitlement for further health care services per visit on the part of consumers, leading to an increase in overall health care expenditures.en
dc.formattext
dc.format.extent4-14 strancs
dc.identifier.doi10.15240/tul/001/2017-2-001
dc.identifier.eissn2336-5604
dc.identifier.issn1212-3609
dc.identifier.urihttps://dspace.tul.cz/handle/15240/20838
dc.language.isoen
dc.publisherTechnical university of Liberec, Czech Republicen
dc.publisherTechnická Univerzita v Libercics
dc.publisher.abbreviationTUL
dc.relation.isbasedonAaltonen, K. et al. (2013) Trends and income related differences in out-of-pocket costs for prescription and over-the-counter medicines in Finland from 1985 to 2006. Health Policy, 110(2-3),131-140. doi:10.1016/j.healthpol.2012.12.004.
dc.relation.isbasedonBaji, P. et al. (2012). Informal payments for healthcare services and short-term effects of the introduction of visit fee on these payments in Hungary. Int. J. Health Plann. Mgmt., 27(1), 63-79. doi:10.1002/hpm.1106.
dc.relation.isbasedonCZSO. (2013). Results of Health Accounts of the Czech Republic 2000–2012. Retrieved from https://www.czso.cz/csu/czso/vysledky-zdravotnickych-uctu-cr-2000-az-2012-efsq7vjwwi.
dc.relation.isbasedonCzech Republic. (1997). Law no 48/1997 Coll. Public Health Insurance. Retrieved from https://portal.gov.cz/app/zakony/zakon.jsp?page=0&nr=48~2F1997&rpp=15#seznam.
dc.relation.isbasedonCzech Republic. (2007). Law no 261/2007 Coll. Public budgets stabilization act. Retrieved from https://portal.gov.cz/app/zakony/zakon.jsp?page=0&nr=261~2F2007&rpp=15#seznam.
dc.relation.isbasedonChiappori, P.-A. et al. (1998). Moral hazard and the demand for physician services: first lessons from a French natural experiment. European Economic Review, 42(3-4), 499-511. doi:10.1016/S0014-2921(98)00015-4.
dc.relation.isbasedonDanyliv, A. et al. (2013). Willingness to pay for physician services at a primary contact in Ukraine: results of a contingent valuation study. BMC Health Services Research, 13(208). doi:10.1186/1472-6963-13-208.
dc.relation.isbasedonDittrich, L. O. & Stará, D. (2013). Regulation Fees and Health Care Spending. IntAdvEcon, 20(2), 237-238. doi:10.1007/s11294-013-9443-y.
dc.relation.isbasedonEvans, R. G. (1974). Supplier-Induced Demand. In M. Perlman (Ed.), The Economics of Health and Medical Care (pp. 162-173). London: Macmillan.
dc.relation.isbasedonGavurova, B., & Soltes, M. (2016). System of Day Surgery in Slovakia: Analysis of pediatric Day Surgery Discrepancies in the Regions and their Importance in Strategy of its Development. E&M Ekonomie a Management, 19(1), pp. 74-92. doi:10.15240/tul/001/2016-1-006.
dc.relation.isbasedonGavurova, B., & Vagasova, T. (2016). Regional differences of standardised mortality rates for ischemic heart diseases in the Slovak Republic for the period 1996-2013 in the context of income inequality. Health Economics Review, 6(21). doi:10.1186/s13561-016-0099-1.
dc.relation.isbasedonGlied, S., & Smith, P. C. (Eds.). (2013). The Oxford Handbook of Health Economics. Oxford: Oxford University Press.
dc.relation.isbasedonGrossmann, M. (1972). On the Concept of Health Capital and the Demand for Health. Journal of Political Economy, 80(2), 223-255.
dc.relation.isbasedonIvlev, I., Kneppo, P., & Barták, M. (2014). Multicriteria decision analysis: a multifaceted approach to medical equipment management. Technological and Economic Development of Economy, 20(3), 576-589. doi:10.3846/20294913.2014.943333.
dc.relation.isbasedonJung, K. (1998). Influence of the introduction of a per-visit copayment on health care use and expenditures: The Korean experience. The Journal of Risk and Insurance, 65(1), 33-56. doi:10.2307/253490.
dc.relation.isbasedonJust, D. R., & Wansink, B. (2011). The flat rate pricing paradox: Conflicting effects of “All-You-Can-Eat” buffet pricing. Review of Economics and Statistics, 93(1), 193-200. doi:10.1162/REST_a_00057.
dc.relation.isbasedonKossarova, L., & Madarova, H. (2008). Czech Republic: First steps on the path to health care reform. EuroHealth, 14(4), 10-12.
dc.relation.isbasedonKim, J. et al. (2005). The effects of patient cost sharing on ambulatory utilization in South Korea. Health Policy, 72(3), 293-300. doi:10.1016/j.healthpol.2004.09.002.
dc.relation.isbasedonKinkorová, J., & Topolčan, O. (2012). Overview of healthcare system in the Czech Republic. EPMA Journal, 3(4). doi:10.1007/s13167-012-0139-9.
dc.relation.isbasedonKrutilová, V. (2010). Impact of user fees in health care system on health care consumption. Národohospodářský obzor – Review of Economic Perspectives, 10(4), 113-132. doi:10.2478/v10135-011-0001-3
dc.relation.isbasedonKrůtilová, V., & Yaya, S. (2012). Unexpected impact of changes in out-of-pocket payments for health care on Czech household budgets. Health Policy, 107(2-3). 276-288. doi:10.1016/j.healthpol.2012.07.002.
dc.relation.isbasedonLaba, T. L. et al. (2015). Co-payments for health care: what is their real cost? Aust. Health Review 39(1), 33-36. doi:10.1071/AH14087.
dc.relation.isbasedonMa, Y., & Nolan, A. (2016). Public Healthcare Entitlements and Healthcare Utilization among the Older Population in Ireland. Health Econ. doi:10.1002/hec.3429.
dc.relation.isbasedonMinistry of Health Czech Republic. (2009). Press Release: Regulatory fee brings the total saving of 10 billion CZK, that was invested into previously limited and costly care for severe ill. Retrieved from http://www.mzcr.cz/dokumenty/tiskova-zprava-regulacni-poplatky-prinesly-celkovou-usporu-miliard-korun-ktera-se-investovala-do-drive-omezene-dostupne-a-nakladne-lecby-vazne-nemocnych_1259_868_1.html.
dc.relation.isbasedonOECD. (2015). Focus on health spending OECD Health statistics. Retrieved from http://www.oecd.org/health/health-systems/Focus-Health-Spending-2015.pdf.
dc.relation.isbasedonPaul, A., & Nilsson, A. (2014). The Effect of Copayments on Children's and Adolescents' Demand for Medical Care. Beiträge zur Jahrestagung des Vereins für Socialpolitik Evidenzbasierte Wirtschaftspolitik – Session: Health III, No. C10-V2. Retrieved from http://hdl.handle.net/10419/100403.
dc.relation.isbasedonParis, V., Devaux, M., & Wei, L. (2010). Health Systems Institutional Characteristics: A Survey of 29 OECD Countries [OECD Health Working Papers, No. 50]. Paris: OECD Publishing. doi:10.1787/5kmfxfq9qbnr-en.
dc.relation.isbasedonParis, V. et al. (2016). Health care coverage in OECD countries in 2012 [OECD Health Working Papers, No. 88]. Paris: OECD Publishing. doi:10.1787/5jlz3kbf7pzv-en.
dc.relation.isbasedonPražmová, V., & Dušek, K. (2011). Outcome of regulatory fees in healthcare. Journal of Nursing, Social Studies and Public Health. 2(1-2), 60-72.
dc.relation.isbasedonPražmová, V. (2014). The impact of regulatory fees on the number of patient visits at the doctor’s. Journal of Nursing, Social Studies, Public Health and Rehabilitation. 3-4, 133-142.
dc.relation.isbasedonPražmová, V., Talpová, E. (2014). Health financing and regulatory fees in the Czech Republic. Kontakt, 16(3), e187-e194. Doi:10.1016/j.kontakt.2014.08.003.
dc.relation.isbasedonRingel, J. S., Hosek, S.D., Vollaard, B.A., & Mahnovski, S. (2002). The elasticity of demand for health care; A review of the literature and its application to the military health system. National Defense Research Institute, RAND Health. Retrieved from http://www.rand.org/content/dam/rand/pubs/monograph_reports/2005/MR1355.pdf.
dc.relation.isbasedonSchreyögg, J., & Grabka, M. M. (2010). Copayments for ambulatory care in Germany: a natural experiment using a difference-in-difference approach. European Journal of Health Economics, 11(3), 331-341. doi:10.1007/s10198-009-0179-9.
dc.relation.isbasedonTučková, Z., Fialová, Š., & Popesko, B. (2011). Regulatory Fees – Suitable Way for Czech Health Care Management? In Lazard, M. et al. (Eds.), Recent Advances in Applied & Biomedical Informatics and Computational Engineering in Systems Applications (pp. 311-316). Florence.
dc.relation.isbasedonZápal, J. (2010). Doctor-Visit Co-Payment Exemption for Children: First Look at the Data. Finance a úvěr-Czech Journal of Economics and Finance, 60(1), 58-72.
dc.relation.isbasedonZare, H., & Anderson, G. (2013). Trends in cost sharing among selected high income countries—2000–2010. Health Policy, 112(1), 35-44. doi:10.1016/j.healthpol.2013.05.020.
dc.relation.isbasedonZhou, Z., Su, Y., Gao, J., Xu, L., & Zhang, Y. (2011). New estimates of elasticity of demand for healthcare in rural Chine. Health Policy, 103(2-3), 255-265. doi:10.1016/j.healthpol.2011.09.005.
dc.relation.isbasedonŽilová, P., & Votápková, J. (2012). The effect of the abolition of user charges on the demand for ambulatory doctor visits [IES Working Paper, 30/2012]. Prague: IES FSV, Charles University. Retrieved from http://ies.fsv.cuni.cz/sci/publication/show/id/4783.
dc.relation.ispartofEkonomie a Managementcs
dc.relation.ispartofEconomics and Managementen
dc.relation.isrefereedtrue
dc.rightsCC BY-NC
dc.subjecthealth careen
dc.subjectdemand price elasticityen
dc.subjectvisit feesen
dc.subjectservice intensityen
dc.subjectrationing deviceen
dc.subject.classificationI18
dc.titleThe visit fees and its influence on overalL health expenditureS – the case of the Czech Republicen
dc.typeArticleen
local.accessopen
local.citation.epage14
local.citation.spage4
local.facultyFaculty of Economics
local.fulltextyes
local.relation.abbreviationE+Mcs
local.relation.abbreviationE&Men
local.relation.issue2
local.relation.volume20
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