Willingness to pay for publicly financed health care services in Central and Eastern Europe: evidence from six countries based on a contingent valuation method

Soc Sci Med. 2014 Sep:116:193-201. doi: 10.1016/j.socscimed.2014.07.009. Epub 2014 Jul 5.

Abstract

The increased interest in patient cost-sharing as a measure for sustainable health care financing calls for evidence to support the development of effective patient payment policies. In this paper, we present an application of a stated willingness-to-pay technique, i.e. contingent valuation method, to investigate the consumer's willingness and ability to pay for publicly financed health care services, specifically hospitalisations and consultations with specialists. Contingent valuation data were collected in nationally representative population-based surveys conducted in 2010 in six Central and Eastern European (CEE) countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine) using an identical survey methodology. The results indicate that the majority of health care consumers in the six CEE countries are willing to pay an official fee for publicly financed health care services that are of good quality and quick access. The consumers' willingness to pay is limited by the lack of financial ability to pay for services, and to a lesser extent by objection to pay. Significant differences across the six countries are observed, though. The results illustrate that the contingent valuation method can provide decision-makers with a broad range of information to facilitate cost-sharing policies. Nevertheless, the intrinsic limitations of the method (i.e. its hypothetical nature) and the context of CEE countries call for caution when applying its results.

Keywords: Central and Eastern Europe; Contingent valuation method; Patient cost-sharing; Willingness to pay.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost Sharing / statistics & numerical data*
  • Europe, Eastern
  • Financing, Personal / statistics & numerical data*
  • Health Expenditures / statistics & numerical data*
  • Health Services Accessibility
  • Humans
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Quality of Health Care
  • State Medicine / statistics & numerical data*