TY - JOUR
T1 - Health care-seeking behaviour and out-of-pocket payments in Tbilisi, Georgia
AU - Gotsadze, George
AU - Bennett, Sara
AU - Ranson, Kent
AU - Gzirishvili, David
PY - 2005/7
Y1 - 2005/7
N2 - Based on a household survey conducted in Tbilisi, Georgia, in 2000, this paper examines current patterns of health care-seeking behaviour and the extent of out-of-pocket payments. Results show that health care services are a financial burden and that private (out-of-pocket) payment creates financial barriers to accessing health services. Members of the poorest households are less likely to seek care than people from more affluent households, and devote a higher share of household monthly expenditure to health care. Households have adopted various strategies to overcome these financial barriers, but the strategies are likely to contribute to both declining economic status and worsening health outcomes. The paper provides an evidence base to help direct future policy reform in Georgia. Government needs to: (1) prioritize public financing of services for the poor, in particular through amending the Basic Benefit Package so that it better reflects the needs of the poor; (2) promote the quality and utilization of primary care services; (3) address the issue of rational drug use; and (4) consider mobilizing out-of-pocket payments on a pre-paid basis through formal or community-based risk pooling schemes.
AB - Based on a household survey conducted in Tbilisi, Georgia, in 2000, this paper examines current patterns of health care-seeking behaviour and the extent of out-of-pocket payments. Results show that health care services are a financial burden and that private (out-of-pocket) payment creates financial barriers to accessing health services. Members of the poorest households are less likely to seek care than people from more affluent households, and devote a higher share of household monthly expenditure to health care. Households have adopted various strategies to overcome these financial barriers, but the strategies are likely to contribute to both declining economic status and worsening health outcomes. The paper provides an evidence base to help direct future policy reform in Georgia. Government needs to: (1) prioritize public financing of services for the poor, in particular through amending the Basic Benefit Package so that it better reflects the needs of the poor; (2) promote the quality and utilization of primary care services; (3) address the issue of rational drug use; and (4) consider mobilizing out-of-pocket payments on a pre-paid basis through formal or community-based risk pooling schemes.
KW - Care-seeking behaviour
KW - Health financing
KW - Transition economies
UR - http://www.scopus.com/inward/record.url?scp=21744457416&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=21744457416&partnerID=8YFLogxK
U2 - 10.1093/heapol/czi029
DO - 10.1093/heapol/czi029
M3 - Review article
C2 - 15965035
AN - SCOPUS:21744457416
SN - 0268-1080
VL - 20
SP - 232
EP - 242
JO - Health policy and planning
JF - Health policy and planning
IS - 4
ER -