| title: | Influence of patient co-payment to the access of health care services |
|---|---|
| reg no: | ETF5792 |
| project type: | Estonian Science Foundation research grant |
| subject: |
3.4. Health Sciences |
| status: | accepted |
| institution: | TU Faculty of Medicine |
| head of project: | Raul-Allan Kiivet |
| duration: | 01.01.2004 - 31.12.2007 |
| description: | The development of medical sciences creates new possibilities for the diagnosis and treatment of diseases. New possibilities are usually more effective and safer, but also more expensive, as compared to the ones used so far. For example, the consumption of prescription medicines in volume terms (i.e. daily doses) has increased twofold during the last 5 years in Estonia, but the Estonian Health Insurance Fund has to pay four times more for the reimbursement of medicines. One of the ways to manage the increase of demand in the situation of limited resources is to increase patient co-payment for the health care services. In year 2003, two significant patient co-payments were introduced in Estonia - for prescription medicines and for out-patient specialist medical care. The aim was to control the increase of drug costs and to diminish poorly motivated use of specialist care. However, cost containment measures in the health care system, in a perfect world, should not have negative influence on the health of people. As well, if implemented in one sector, it should not increase costs elsewhere in health care, i.e limitations in drug reimbursement should not increase the use of emergency and hospital care. To study the outcome of patient co-payment increase, the following questions will be studied: - to what extent and among which medicines, the prescription patterns have changed and whether these are compatible with the evidence-based treatment guidelines; - what were the changes in the use of specialist medical care and whether this had influence on the use of services, provided by family physicians; - how does the discontinuation of drug treatment or specialist care influence the health of patients - for which patients and how did the use of other health care services change. The analysis will allow to evaluate, whether the savings in drug reimbursement and on out-patient specialist care have increased the possibilities to provide other effective health care services, or instead, it has caused an increase in utilization of other, so-called compensatory health care services. The importance of the project to the health care in Estonia is to develop methodologies to evaluate the outcomes of health care reforms and to identify vulnerable groups of patients, whose health condition can deteriorate or whose treatment can be considered inadequate. |
| project group | ||||
|---|---|---|---|---|
| no | name | institution | position | |
| 1. | Raul-Allan Kiivet | TU Faculty of Medicine | professor | |
| 2. | Ly Rootslane | University of Tartu | spetsialist | |
| 3. | Liis Rooväli | TÜ tervishoiu instituut | teadur | |