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Ability to pay and equity in access to Italian and British National Health Services

Domenighetti, Gianfranco ; Vineis, Paolo ; De Pietro, Carlo ; Tomada, Angelo

In: European Journal of Public Health, 2010, vol. 20, no. 5, p. 500-503

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    Titel
    • Ability to pay and equity in access to Italian and British National Health Services
    Autor
    • Domenighetti, Gianfranco. 1 Institute of Public Communication and Education, Institute of Microeconomics and Public Economics, University of Lugano Lugano, Switzerland
    • Vineis, Paolo. 2 Imperial College London, St Mary's; Campus, Norfolk Place, London, UK
    • De Pietro, Carlo. 3 Public Management and Policy Department, SDA Bocconi School of Management, Via Bocconi 8, Milano, Italy
    • Tomada, Angelo. 4 Institute of Public Communication and Education, University of Lugano, Via Buffi 13, Lugano, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • European Journal of Public Health, 2010, vol. 20, no. 5, p. 500-503. Oxford University Press
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:297121
    Summary
    Background: Equity in delivery and distribution of health care is an important determinant of health and a cornerstone in the long way to social justice. We performed a comparative analysis of the prevalence of Italian and British residents who have fully paid out-of-pocket for health services which they could have obtained free of charge or at a lower cost from their respective National Health Services. Methods: Cross-sectional study based on a standardized questionnaire survey carried out in autumn 2006 among two representative samples (n = 1000) of the general population aged 20-74 years in each of the two countries. Results: 78% (OR 19.9; 95% CI 15.5-25.6) of Italian residents have fully paid out-of-pocket for at least one access to health services in their lives, and 45% (OR 18.1; 95% CI 12.9-25.5) for more than five accesses. Considering only the last 2 years, 61% (OR 16.5; 95% CI 12.6-21.5) of Italians have fully paid out-of-pocket for at least one access. The corresponding pattern for British residents is 20 and 4% for lifelong prevalence, and 10% for the last 2 years. Conclusions: Opening the public health facilities to a privileged private access to all hospital physicians based on patient's ability to pay, as Italy does, could be a source of social inequality in access to care and could probably represent a major obstacle to decreasing waiting times for patients in the standard formal ‘free of charge' way of access