Trends in out-of-pocket payments for health care in Kyrgyzstan, 2001-2007

Abstract

Within the countries of the former Soviet Union, the Kyrgyz Republic has been a pioneer in reforming the system of health care finance. Since the introduction of its compulsory health insurance fund in 1997, the country has gradually moved from subsidizing the supply of services to subsidizing the purchase of services through the ‘single payer’ of the health insurance fund. In 2002 the government introduced a new co-payment for inpatients along with a basic benefit package. A key objective of the reforms has been to replace the burgeoning system of unofficial informal payments for health care with a transparent official co-payment, thereby reducing the financial burden of health care spending for the poor. This article investigates trends in out-of-pocket payments for health care using the results of a series of nationally representative household surveys conducted over the period 2001–2007, when the reforms were being rolled out. The analysis shows that there has been a significant improvement in financial access to health care amongst the population. The proportion paying state providers for consultations fell between 2004 and 2007. As a result of the introduction of co-payments for hospital care, fewer inpatients report making payments to medical personnel, but when they are made, payments are high, especially to surgeons and anaesthetists. However, although financial access for outpatient care has improved, the burden of health care payments amongst the poor remains significant.

Bibliometric analysis of medicine-related publications on poverty (2005–2015)

“…A fourth dimension in retrieved articles was health policies to face poverty as global or national public health burden (McGarry and Schoeni 2005; Mahmud Khan et al 2006; Meessen et al 2006; Woolf et al 2006; Ferguson et al 2007; Limwattananon et al 2007; Khun and Manderson 2008; Kruk et al 2008; Zimmer 2008; Garg and Karan 2009; Schneider et al 2009; Falkingham et al 2010; Leatherman and Dunford 2010; Shahrawat and Rao 2012; Bhutta et al 2014). Such articles focused on raising calls for implementation of economic plans for better distribution of national wealth to help poor people to get access to medicines and healthcare.…”

Health Care Reform in the Former Soviet Union: Beyond the Transition

“…While informal payments to health workers slightly increased over the period, this was more than offset by reductions in informal payments for drugs and medical supplies . While large sums are still being paid for specialist care, the frequency of payment has declined for routine consultations and treatment and there appears to have been sustained decrease in outof-pocket and informal payments (Falkingham, Akkazieva, and Baschieri 2010;Ministry of Health 2011). There is also some evidence from Russia, where regions now have the ability to impose different payment schemes, that formal and informal payments may substitute for one another (Aarva et al 2009).…”

Rethinking informal payments by patients in Europe: An institutional approach

“…This has been identified in studies conducted in large geographical areas, such as in 35 European countries [26], Central Asia [30] as well as in 33 African countries [31], or in smaller studies comprising only one nation as, for example, Bulgaria [1,6,13,32,33], Poland [34,35], Hungary [2,[36][37][38][39][40], Greece [4,41], Lithuania [34,42], Russia [43,44]; Ukraine [34,45], Moldova [46], Serbia [47], Kazakhstan [48], Albania [5,49,50], Kosovo [8], Tajikistan [51,52], Kyrgyzstan [53], Taiwan [54], Cameroon [55], Tanzania [3,56] and Turkey [57]. Nevertheless, informal patient payments phenomenon is poorly examined at a cross-country level.…”