Page 150 - Effective healthcare cost containment policies Using the Netherlands as a case study - Niek W. Stadhouders

Chapter 7
Included articles examine eleven different indicators of accessibility (Table 7.5). The majority of the included studies do raise concerns about accessibility to private hospitals; most of them flag this issue by analysing the complexity of the cases and various patients’ characteristics. In many countries, private providers do target higher socioeconomic classes, often through parallel private insurance. High income patients hold better access to private hospitals, and that waiting times in the private sector are lower.
7.3.2 Accessibility
Number Outcome/indicator Type (private) Countries Impact
Table 7.5: Accessibility indicators overview
Concept
of
Affordable
status, residents from deprived versus affluent region)
maternity, psychiatric) ,
Kingdom, Greece,
Public hospitals perform better
health insurance and pay out-of-
Physical
(number of non-resident patients
Physical
Affordable
Private hospitals perform better
Physical
Timely
studies
8 SES of patients (e.g. employment Private (i.a. Italy, United
ISTCs Spain 2 Method of payment (i.e. private Private Greece
pocket)
1 Payment per discharge FP
3 Case-mix differences (e.g. cream FP, ISTCs
Greece Italy, UK
skimming)
1 Access to specialty care (i.e. Private France
adjusted rates of revascularization)
1 Admission pattern Private Italy
psychiatric
1 Access to pre-emptive registration FP France
1 Regional physical mobility Private Italy
in the region admitted)
1 Mean expenditure and usage of FP France
No difference
drugs
1 Access to specialty care (i.e. Private France
ambulatory care services)
1 Method of payment (i.e. informal Private Greece
payment)
1 Chance op follow-up treatment Private Italy
psychiatric
1 Waiting times ISTCs UK
In the UK, patients of private ISTCs are less likely to coming from deprived residential areas(Mason et al., 2010; Street et al., 2010). One other study concludes that patients in private hospitals diagnosed with prostate cancer come from the more affluent regions (Barbiere et al., 2012). In Greece, monthly family income is positively related to private hospital admissions (Pappa and Niakas, 2006; Siskou et al., 2008; Tountas et al., 2011). In
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Affordable access