Financial risk protection and unmet healthcare need in Russia

Background: Achieving universal health coverage (UHC) includes financial risk protection. To date, catastrophic healthcare expenditure (CHE), the impoverishing effect of out-of-pocket (OOP) healthcare payments, and unmet healthcare need are the most widely used indicators for assessing the financial risk protection of a healthcare system. This study aimed to estimate the Russian healthcare system’s financial risk protection by focusing on CHE, OOP and unmet healthcare need. Methods: The study used eight waves of the Russia Longitudinal Monitoring Survey (RLMS) (2010-2017) to analyze the financial risk protection of the Russian healthcare system. Commonly used indicators – CHE, both incidence and intensity, the impoverishing effect of CHE and unmet need – were used. Results: We found low incidence and intensity of CHE in the Russian Federation. Our results are robust to various definitions of CHE (eg, as a share of total household expenditure or total household income). Furthermore, the impoverishing effect of OOP healthcare payments remains limited, despite the most recent economic slowdown (2014– 2016). This could be explained by a noticeable reduction in CHE during the crisis years, as postponing healthcare was adopted as a coping mechanism, particularly among households heavily affected by the crisis. Conclusion: As stressed by the UHC framework, our findings suggest that CHE only partly captures inefficiencies and inequities in coverage, because one tenth of households forwent medical care for medicines and certain services. As spending on medicines and dental care are the main drivers of CHE, policy interventions should focus on extending coverage for pharmaceutical and dental care and target financial barriers to seeking care, particularly for the poor and vulnerable

Kuwait: health system review

In 2017 the London School of Economics and Political Science (LSE Health) was engaged by the Kuwait Foundation for the Advancement of Sciences (KFAS) to undertake two interconnected tasks: first, a review of the Kuwait healthcare system and, second, to develop a public health strategy for the country. This report represents findings from the first task by outlining and assessing governance, financing, workforce, IT, service provision and public health arrangements within Kuwait’s healthcare system

Controlling expenditure within the Spanish pharmaceutical market: macro- and micro-level policy approaches

This policy brief provides an overview of the Spanish pharmaceutical sector. It examines trends and drivers of pharmaceutical expenditure and evaluates the feasibility of a recently implemented budget cap policy. A number of findings and recommendations are presented

Efficiency review of Austria’s social insurance and healthcare system: volume 1 – international comparisons and policy options

In 2016, the London School of Economics and Political Science (LSE Health) was engaged by the Austrian Ministry of Labour, Social Affairs and Consumer Protection to undertake an efficiency review of the country’s social insurance system (see Appendix A for the original Concept Note). The review was specifically targeted at health competencies within the social insurance system; for this reason, consideration of accident and pension insurance, as well as other forms of care covered by Federal and Länder governments, were only examined where directly applicable