20 May 2019
Asthma , COPD, Allergy, Food Allergy, Other Diseases
- Healthcare

The World Health Organisation (WHO) has conducted the first systematically report to monitor healthcare related financial protection in Europe. It focuses on financial hardship and unmet needs for health services in Europe. The study assesses two indicators: Impoverishing and catastrophic health spending.

The study is of particular importance for allergy and airways diseases patients in Europe because not only they live with a chornic disease that can last a lifetime, but also disease severity and especially in the case of allergy reduce health service intervention, can make the threapies people need unaffordable.

A household is considered impoverished if its available income is below the poverty line after spending out of pocket healthcare. Catastrophic health spending occurs if a household is no longer able to pay for a basic need, like food or housing, because of necessary out-of-pocket payments for health services.

The report recognizes that a lack of financial protection may lead to or deepen poverty, undermine health and exacerbate health and socioeconomic inequalities. It further allows to draw the following conclusions:

  1. Out-of-pocket costs for healthcare are common but painful expenditures

All health systems in Europe involve at least some personal expenditure on health services. However, for some patients, out-of-pocket payments can create a financial barrier to access. This may result in unmet needs and lead to financial hardship.

  1. European countries experience huge variations regarding the impact of healthcare costs on household budgets

The study European countries present a huge variation on the impact of out-of-pocket expenditure on household budgets: The incidence of impoverishing health spending ranges from less than 0.1 % in the United Kingdom to 3.5% in the Republic of Moldova. For catastrophic health spending the range is even higher, from 1 % to 17% among the assessed countries.

Differences intra-country are also significant. According to the study, catastrophic health spending is consistently heavily concentrated among the poorest fifth of the population. Furthermore, out-of-pocket spending are mainly due to outpatient medicines, followed by inpatient care and dental care.

  1. Unmet health care needs are not inevitably correlated to out-of-pocket payments

The report shows that in countries where the incidence of catastrophic health spending is very low, unmet needs also tend to be low. However, in many countries unmet needs remain high although catastrophic health spending is also high. This indicates that in many countries health services are not at all affordable.

  1. Strengthening financial protection requires identification of gaps

A first step is to identify gaps within health-coverage of the population. Where gaps in coverage are significant, they lead to high levels of unmet needs and financial hardship. Excluded people will have to rely on emergency services and may experience an avoidable deterioration in health status.

Second, taking steps to benefit most disadvantaged people first is vital in contexts where public resources are severely limited. To be effective, changes to coverage policy should be supported by an adequate level of public spending on health. However, simply increasing public spending might not be enough.

The full WHO report on effects of out-of-pocket spending for healthcare on households can be found here.

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The EFA Team