Confidence in receiving medical care when seriously ill: a seven-country comparison of the impact of cost barriers

Wendt, Claus ; Mischke, Monika ; Pfeifer, Michaela ; Reibling, Nadine

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Document Type: Article
Year of publication: 2012
The title of a journal, publication series: Health Expectations
Volume: 15
Issue number: 2
Page range: 212-224
Place of publication: Oxford [u.a.]
Publishing house: Wiley-Blackwell
ISSN: 1369-6513 , 1369-7625
Publication language: English
Institution: Außerfakultäre Einrichtungen > Graduate School of Economic and Social Sciences- CDSS (Social Sciences)
Außerfakultäre Einrichtungen > Mannheim Centre for European Social Research - Research Department A
Subject: 300 Social sciences, sociology, anthropology
Abstract: This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods: The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results: Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions: The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems.

Dieser Eintrag ist Teil der Universitätsbibliographie.

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