@article{Crookes:2020:10.1136/bmjopen-2020-038158,
author = {Crookes, C and Palladino, R and Seferidi, P and Hirve, R and Siskou, O and Filippidis, F},
doi = {10.1136/bmjopen-2020-038158},
journal = {BMJ Open},
pages = {1--11},
title = {The impact of the economic crisis on household health expenditure in Greece: an interrupted time series analysis},
url = {http://dx.doi.org/10.1136/bmjopen-2020-038158},
volume = {10},
year = {2020}
}

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TY  - JOUR
AB  - Objectives and setting The 2008 financial crisis had a particularly severe impact onGreece. To contain spending, the government capped public health expenditure andintroduced increased cost-sharing. The Greek case is important for studying theimpact of recessions on health systems. This study analysed changes in householdhealth expenditure in Greece over the economic crisis and explored whether theimpact differed across socioeconomic groups.Participants We used data from the Greek Household Budget Survey for the years2004 and 2008-2017. The dataset comprised 51,654 households, with a total of128,111 members.Design We compared pre- and post-crisis trends in Greek household out-of-pocketpayments for healthcare from 2004-2017 using an interrupted time series analysis.This study explored spending in Euros and as a share of total household purchases.Results Our results indicated that the population level trend in household healthspending was reversed after the crisis began (pre-crisis trend:€0.040 decrease perquarter (95% CI: -0.785 to -0.022), post-crisis trend:€0.315 increase per quarter(95% CI: -0.004 to 0.635)). We also found that spending on inpatient services andpharmaceuticals has been increasing since the start of the crisis, whereas outpatientservices expenditure has been decreasing. Across all households, out-of-pocketpayments incurred a greater financial burden after the crisis relative to pre-existingtrends, but the poorest households incurred a disproportionately higher burden.Conclusions This was the first study to use an interrupted time series analysis toassess the impact of the economic crisis on household health expenditure in Greece.Our findings suggest that there was an erosion of financial protection for Greekhouseholds as a consequence of the economic crisis. This effect was particularlypronounced amongst poorer households, which is indicative of a regressivefinancing system.
AU  - Crookes,C
AU  - Palladino,R
AU  - Seferidi,P
AU  - Hirve,R
AU  - Siskou,O
AU  - Filippidis,F
DO  - 10.1136/bmjopen-2020-038158
EP  - 11
PY  - 2020///
SN  - 2044-6055
SP  - 1
TI  - The impact of the economic crisis on household health expenditure in Greece: an interrupted time series analysis
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2020-038158
UR  - https://bmjopen.bmj.com/content/10/8/e038158
UR  - http://hdl.handle.net/10044/1/81153
VL  - 10
ER  - 

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