Cc. Ros et al., All rights reserved, or can we just copy? Cost sharing arrangements and characteristics of health care systems, HEALTH POLI, 52(1), 2000, pp. 1-13
Citations number
20
Categorie Soggetti
Public Health & Health Care Science","Health Care Sciences & Services
In most European countries cost sharing has been introduced in order to red
uce the demand for care. Different forms of cost sharing are available, but
because of historically grown system characteristics and prevailing values
countries differ in the application of specific forms. This review focuses
on eighteen European countries, and on the combinations of health system c
haracteristics and present forms of cost sharing. We found that some combin
ations are more present: different payment systems for primary care physici
ans go together with different forms of cost sharing, different services ha
ve different forms of cost sharing. In countries with a GP as gatekeeper no
charges are in use for the GP. No distinct relationship could be found bet
ween the financing system (tax-based or insurance-based) and the form of co
st sharing or the exclusion of vulnerable populations. It is concluded that
there are two ways of filtering 'unnecessary' demand. One is by introducin
g cost sharing for directly accessible services such as GPs. The second way
is by having GPs act as gatekeepers to more specialized, and more costly c
are. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.