title: Willingness to pay for publicly financed health care services in Central and Eastern Europe: evidence from six countries based on a contingent valuation method.
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.
authors.affiliation: Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, Grzegorzecka 20, 31-531 Krakow Poland; Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: marzenawozniak8@wp.pl.
authors.forename: Marzena
authors.initials: M
authors.lastname: Tambor
authors.affiliation: Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Milena
authors.initials: M
authors.lastname: Pavlova
authors.affiliation: European Observatory on Health Systems and Policies, 15-17 Tavistock Place, London WC1H 9SH, UK; London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
authors.forename: Bernd
authors.initials: B
authors.lastname: Rechel
authors.affiliation: Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, Grzegorzecka 20, 31-531 Krakow Poland.
authors.forename: Stanisława
authors.initials: S
authors.lastname: Golinowska
authors.affiliation: Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, Grzegorzecka 20, 31-531 Krakow Poland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Sowada
authors.affiliation: Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Top Institute Evidence-Based Education Research (TIER), Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Groot
mesh_terms: D017047:Cost Sharing / Q000706:statistics & numerical data*; D005061:Europe, Eastern; D005382:Financing, Personal / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D013222:State Medicine / Q000706:statistics & numerical data*
keywords: Central and Eastern Europe; Contingent valuation method; Patient cost-sharing; Willingness to pay