The financial burden of out-of-pocket patient payments in the European Union and accession countries: Results of a systematic literature review

K. Moser, M. Pavlova, W. Groot

Research output: Contribution to journalArticleAcademic


A major issue for public health policy is to reduce the poverty and catastrophic effects of out-of-pocket payments. This paper reviews empirical
studies that analyze the financial burden of out-of-pocket payments and factors that are associated with this burden for households in the EU and accession
countries. The method of systematic literature review is applied. Poverty effects appear to be independent of geographical area. Catastrophic
healthcare expenditure ranges from a bit less than 0.05% to nearly 4%, and the impoverishment due to out-of-pocket payments is also up to 4%.
Analyses carried out in single countries reveal that living in a household with a pensioner contributes most to high payments for health care. The
results support calls for health policy to prevent the burden of out-of-pocket payments, especially for pharmaceutical expenditure. Special attention
should be paid to risk groups such as pensioners, female headed households and low income households.
Original languageEnglish
Pages (from-to)‎239‎-247‎
Number of pages9
JournalZeszyty Naukowe Ochrony Zdrowia. Zdrowie Publiczne i Zarządzanie
Issue number3
Publication statusPublished - 1 Jan 2014

Cite this