Badaczka z University College London prelegentką Warsaw Economic Seminars – 4.12
Dr Chiara Berardi w swojej pracy naukowej koncentruje się na analizie ekonomicznej i politycznej finansowania oraz świadczenia usług w systemach ochrony zdrowia, a także na ich wpływie na funkcjonowanie tych systemów.
Podczas seminarium z cyklu Warsaw Economic Seminars, zaprezentuje zagadnienie pt. „Equity in health system financing and health disparities in OECD countries: a cross-country panel analysis”. Abstrakt wystąpienia prezentujemy poniżej. Z kolei najnowsze publikacje prelegentki znajdują się na stronie: https://profiles.ucl.ac.uk/106589-chiara-berardi.
Spotkanie rozpocznie się o godz. 17:00 w sali B104 na Wydziale Nauk Ekonomicznych UW.
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Health systems in high-income countries are undergoing two parallel long-term trends: an increasing reliance on a complex mix of mandatory government schemes and private health financing, and a widening of health disparities across socio-economic groups. Although existing evidence suggests that health system financing influences performance and population health outcomes, comparative research remains limited due to challenges in measuring financing structures. This study assesses the association between health system financing and disparities in health outcomes across 12 OECD countries between 1997 and 2022, drawing on both quantitative and qualitative data. Using OECD data, we built a composite indicator to capture the financing mix of mandatory and voluntary schemes, while health disparities are measured by the proportion of individuals reporting good self-perceived health, disaggregated by age, sex, and income. Fixed-effects regression models account for time-invariant differences across countries. Qualitative data from the Observatory on Health Systems and Policies complement this analysis through comparative case studies. Findings from the quantitative analysis show that both mandatory and voluntary financing are positively related to good health status. However, the interaction term is negative across all groups, with stronger diminishing marginal returns when voluntary financing expands alongside mandatory financing for the lowest (-0.014, p<0.05) compared to the highest income quintile (-0.012, p<0.01), for women (-0.019, p<0.05) compared to men (-0.012, p<0.1), and for older adults (-0.049, p<0.01) compared to those aged 15–64 (-0.011, p<0.1). While the econometric analysis demonstrates diminishing equity returns from mixed financing, the qualitative case studies reveal the underlying mechanisms. Regardless of the specific health system model, voluntary payments systematically enable differential access by granting shorter waiting times, enhanced provider choice, and higher service quality—all of which link access to timely and high-quality care to ability to pay rather than to need. Our mixed-methods approach indicates that expansion of mixed financing may inadvertently reinforce, rather than reduce, health inequities. These findings suggest that reform of public health financing should prioritise the reduction of long-term health disparities, particularly among vulnerable population groups.