OBJECTIVES: Several reforms have been implemented during the recent years to curtail public health spending in Greece. The aim of this study was to explore the impact of the recent reforms and economic crisis on out-of-pocket (OOP) payments

METHODS:

Data for 26.941 households were derived from the Household Budget Surveys for the period 2008-2014. Expenditure data were deflated (2008=100) with the price index and were also equivalised with respect to the economy scale of household consumption. Households were disaggregated into five consumption expenditure quantiles.

RESULTS: Both mean annual equivalised total consumption and OOP payments demonstrated a downward trend during 2008-2014, albeit for consumption the relative change was larger at the end of the period of observation, i.e. -32.3% (from 18402.00 € to 12459.73 €) vs. -21.7% (from 1016.00 € to 795.76 €), respectively; the share of OOP outlays to total consumption increased from 5.5% to 6.4% between 2008 and 2014. In the lowest expenditure quintile, although the share of OOP was reduced from 6.6% to 5.8%, an ascending trend is recorded following 2012. Spending for medical products and inpatient care increased by 25.8% (from 248.60 € to 312.85 €) and 48.45% (from 149.51 € to 222.08 €) respectively, while for outpatient care it decreased by -57.80% (from 617.89 € to 260.84 €). The poorest quintile devoted the chunk of their health spending to medical products across all years, and a 14% rise (from 51% to 66%) is recorded between 2008 and 2014

CONCLUSIONS:

The recent reforms have shifted part of the Greek health system’s financing to health consumers, for pharmaceutical and hospital care in particular. However, the increase in OOP inpatient spending is mainly driven by the higher socioeconomic strata. Promotion of the prescription and dispense of generic medicines may lessen the financial burden related to co-payments for poorer citizens.