Income-, education- and gender-related inequalities in out-of-pocket health-care payments for 65+ patients - a systematic review

• Main Authors: Corrieri Sandro (Author), Heider Dirk (Author), Matschinger Herbert (Author), Lehnert Thomas (Author), Raum Elke (Author), König Hans-Helmut (Author)
• Format: Book
• Published: BMC, 2010-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

<p>Abstract</p> <p>Background</p> <p>In all OECD countries, there is a trend to increasing patients' copayments in order to balance rising overall health-care costs. This systematic review focuses on inequalities concerning the amount of out-of-pocket payments (OOPP) associated with income, education or gender in the Elderly aged 65+.</p> <p>Methods</p> <p>Based on an online search (PubMed), 29 studies providing information on OOPP of 65+ beneficiaries in relation to income, education and gender were reviewed.</p> <p>Results</p> <p>Low-income individuals pay the highest OOPP in relation to their earnings. Prescription drugs account for the biggest share. A lower educational level is associated with higher OOPP for prescription drugs and a higher probability of insufficient insurance protection. Generally, women face higher OOPP due to their lower income and lower labour participation rate, as well as less employer-sponsored health-care.</p> <p>Conclusions</p> <p>While most studies found educational and gender inequalities to be associated with income, there might also be effects induced solely by education; for example, an unhealthy lifestyle leading to higher payments for lower-educated people, or exclusively gender-induced effects, like sex-specific illnesses. Based on the considered studies, an explanation for inequalities in OOPP by these factors remains ambiguous.</p>

Item Description

10.1186/1475-9276-9-20
1475-9276