Europe and central Asia's great post-communist social health insurance experiment: Aggregate impacts on health sector outcomes.
The post-Communist transition to social health insurance in many of the Central and Eastern European and Central Asian countries provides a unique opportunity to try to answer some of the unresolved issues in the debate over the relative merits of social health insurance and tax-financed health systems. This paper employs regression-based generalizations of the difference-in-differences method on panel data from 28 countries for the period 1990-2004. We find that, controlling for any concurrent provider payment reforms, adoption of social health insurance increased national health spending and hospital activity rates, but did not lead to better health outcomes.
Wagstaff
Adam
A
Development Research Group, The World Bank, 1818 H Street NW, Washington, DC 20433, USA. awagstaff@worldbank.org
Moreno-Serra
Rodrigo
R
D000465:Algorithms; D001209:Asia, Central; D003148:Communism; D005060:Europe; D018166:Health Care Reform; D019981:Health Care Sector; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D017059:Models, Econometric; D009313:National Health Programs / Q000191:economics* / Q000458:organization & administration; D017063:Outcome Assessment, Health Care / Q000639:trends*