World Bank2013-03-222013-03-222008-02-15https://hdl.handle.net/10986/12854This study, done at the request of the Hungarian government, presents evidence on cost-sharing in the health sector, and its application in Hungary. It presents results on the impact of cost-sharing on revenues in health facilities and insurance, financial sustainability, informal payments, overall service use, and equity in access. Five keyfindings emerge: cost-sharing could lead to a reduction in unnecessary care provided to insured patients who do not have to pay the full price of care; cost-sharing could help reduce informal payments and keep patient payments in the system; cost-sharing with exemption policies are a prerequisite to provide equity in access to care; cost-sharing could support cost containment strategies; experience from OECD countries provides examples of successful cost-sharing policies. Based on these findings. the study recommends that Hungary continues to monitor and evaluate the impact of cost-sharing on access, to identify possible negative effects on equity in service use. In Hungary, financial incentives through the provider payment system could eventually support the effect of the government supply-side strategy. Such financial incentives could be set to providers through capitation payment to reward better quality of care, and Diagnosis Related Group (DRG) payments with expenditure ceilings with strict utilization review and quality assurance control to set an incentive for efficient provision of care.en-USCC BY 3.0 IGOADMINISTRATIVE BURDENADMINISTRATIVE COSTSADOLESCENTSADVERSE SELECTIONAFFORDABILITYAMBULANCEAMBULATORY CAREAMBULATORY SURGERYANCILLARY SERVICESBEDSBREAST CANCERBRIBESCAPITATIONCAPITATION PAYMENTCATASTROPHIC HEALTH EXPENDITURECATASTROPHIC HEALTH SPENDINGCHRONIC DISEASESCLINICSCONTRIBUTION TO COSTSCORRUPTIONCOST OF HEALTH CARECOST SHARINGCOST-SHARINGCOST-SHARING ARRANGEMENTSCOST-SHARING POLICIESDEDUCTIBLEDEDUCTIBLESDEMAND FOR HEALTHDEMAND FOR SERVICESDENTAL CAREDETERMINATION OF ELIGIBILITYDIAGNOSISDISABLEDDOCTORSDRUG THERAPYELASTICITY OF DEMAND FOR HEALTH CAREEMERGENCY CAREENTITLEMENTEQUITY IN ACCESSEXCHANGE RATEEXCLUSIONSFAMILIESFEE-FOR-SERVICEFINANCE OF HEALTH CAREFINANCIAL BURDENFINANCIAL CONTRIBUTIONSFINANCIAL INCENTIVESFINANCIAL MANAGEMENTFINANCIAL RISKFINANCIAL SUPPORTFINANCIAL SUSTAINABILITYFLAT RATEFREE CAREGENERAL PRACTICEHEALTH CAREHEALTH CARE CENTERSHEALTH CARE COSTSHEALTH CARE FINANCINGHEALTH CARE REFORMHEALTH CARE SECTORHEALTH CARE SYSTEMHEALTH CARE SYSTEMSHEALTH CARE UTILIZATIONHEALTH CENTRESHEALTH ECONOMICSHEALTH EXPENDITUREHEALTH EXPENDITURESHEALTH FACILITIESHEALTH FINANCINGHEALTH FOR ALLHEALTH INSURANCEHEALTH INSURANCE FUNDHEALTH INSURANCE SYSTEMHEALTH OUTCOMESHEALTH PLANNINGHEALTH POLICYHEALTH POLICY OBJECTIVESHEALTH SECTORHEALTH SERVICEHEALTH SERVICESHEALTH SERVICES RESEARCHHEALTH SPENDINGHEALTH STATUSHEALTH SYSTEMHEALTH SYSTEMSHEALTH WORKERSHEALTH ­ RESULTSHEALTH-CAREHEALTH-CARE SYSTEMHEALTHCAREHEALTHCARE PROVIDERSHEALTHCARE SERVICESHEALTHCARE SYSTEMHOMELESS PEOPLEHOSPITAL ADMISSIONSHOSPITAL BEDSHOSPITAL CAREHOSPITAL COSTSHOSPITAL EMERGENCY SERVICESHOSPITAL INPATIENTHOSPITAL SERVICESHOSPITALIZATIONHOSPITALSHRHYGIENEIMPACT OF COSTINCOMEINCOME CATEGORIESINCOME GROUPSINCOME HOUSEHOLDSINDUCED DEMANDINEQUALITIESINEQUALITIES IN HEALTH CAREINEQUALITYINEQUITY IN HEALTHINFANT CAREINFORMAL PAYMENTSINPATIENT ADMISSIONINPATIENT CAREINPATIENT TREATMENTINSURANCEINSURANCE AGENCIESINSURANCE AGENCYINSURANCE COMPANIESINSURANCE COVERAGEINSURANCE PACKAGEINSURANCE POLICYINSURANCE RATESINSURANCE SYSTEMINSURERSINTERNATIONAL COMPARISONSLAWSLOW INCOMELOW-INCOME COUNTRIESMEDICAIDMEDICAL CAREMEDICAL SERVICESMEDICATIONMEDICINESMORAL HAZARDMORBIDITYMORTALITYNATIONAL HEALTHNURSINGOPERATIONAL COSTSOUTPATIENT CAREOUTPATIENT SERVICESPATIENTPATIENT COSTPATIENTSPAYMENTS FOR HEALTH CAREPHARMACEUTICAL COMPANIESPHYSICIANPHYSICIANSPHYSIOTHERAPYPOCKET PAYMENTSPOLICY RESEARCHPREGNANCYPREGNANT WOMENPRESCRIPTION DRUGSPRESCRIPTIONSPREVENTIVE CAREPRICE ELASTICITIESPRIMARY CAREPRIVATE HEALTH INSURANCEPRIVATE HOSPITALSPRIVATE INSURANCEPRIVATE SECTORPRIVATE SPENDINGPROVIDER PAYMENTPROVISION OF CAREPSYCHIATRIC CAREPUBLIC ATTITUDESPUBLIC EXPENDITUREPUBLIC HEALTHPUBLIC HEALTH CAREPUBLIC HEALTH SERVICESPUBLIC HOSPITALPUBLIC HOSPITAL SERVICESPUBLIC HOSPITALSPUBLIC INSURANCEQUALITY OF CAREREFORM OF HEALTH CARESAVINGSSLIDING SCALESOCIAL HEALTH INSURANCESOCIAL INSURANCESURGERYTREATMENTSUSER FEEUSER FEESVICTIMSVISITSVULNERABLE GROUPSWELFARE BENEFITSWORKERSWORKING CONDITIONSWorld Bank10.1596/12854