Rising cost in health care has become a challenge in many developed countries. Some countries are focusing on patient cost-sharing to reduce this rising cost, but how effective can this strategy really be?
A brief from Goodell and Swartz (2010)*, based on the RAND health insurance study and some others, states that:
- Patients reduce the amount of care when they face increased cost-sharing, and this reduction is larger in low-income groups and unhealthy populations.
- However, the initial reduction in the amount of care among the vulnerable group may cancel out due to shift in services used (e.g. later hospitalisation).
- When people reduce the amount of care, they seem to be unable to differentiate between appropriate and inappropriate care.
- The effect of reduced amount of health care differed between sub-groups. There was no adverse effect on health of average adults, but it was associated with increased adverse effects among vulnerable groups.
Considering the fact that most of medical cost is spent by small fraction of unhealthy population, this strategy does not necessarilly seem to be an effective strategy to reduce health care spending. Moreover, it is not targeted at low-valued services and may be harmful for the vulnerable group.
*Sarah Cost-sharing: Effects on spending and outcomes
By Sarah Goodell and Katherine Swartz (2010)
http://www.pnhp.org/sites/default/files/docs/2011/121710.policysynthesis.costsharing.brief_.pdf