European health systems are increasingly adopting cost-sharing
models, potentially increasing out-of-pocket expenditures for patients
who use health care services or buy medications. Government policies
that increase patient cost sharing are responding to incremental growth
in cost pressures from aging populations and the need to invest in new
health technologies, as well as to general constraints on public
expenditures resulting from the Great Recession (2007–09). We used data
from the Survey of Health, Ageing and Retirement in Europe to examine
changes from 2006–07 to 2013 in out-of-pocket expenditures among
people ages fifty and older in eleven European countries. Our results
identify increases both in the proportion of older European citizens who
incurred out-of-pocket expenditures and in mean out-of-pocket
expenditures over this period. We also identified a significant increase
over time in the percentage of people who incurred catastrophic health
expenditures (greater than 30 percent of the household income) in the
Czech Republic, Italy, and Spain. Poorer populations were less likely than
those in the highest income quintile to incur an out-of-pocket
expenditure and reported lower mean out-of-pocket expenditures, which
suggests that measures are in place to provide poorer groups with some
financial protection. These findings indicate the substantial weakening of
financial protection for people ages fifty and older in European health
systems after the Great Recession