PMID- 33158223
OWN - NLM
STAT- MEDLINE
DCOM- 20210114
LR  - 20240330
IS  - 1660-4601 (Electronic)
IS  - 1661-7827 (Print)
IS  - 1660-4601 (Linking)
VI  - 17
IP  - 21
DP  - 2020 Nov 4
TI  - The Determinants of Out-of-Pocket Expenditure in IBD Italian Patients. Results 
      from the AMICI Survey.
LID - 10.3390/ijerph17218156 [doi]
LID - 8156
AB  - Decision makers are used to consider Out-of-Pocket Expenditure (OOPE) within a 
      health technology assessment framework in order to account for an indicator 
      relying on the level of fairness and on the quality of care of a health system. 
      In this paper, we provide estimates on the determinants of OOPE in Italy by using 
      data coming from an observational cross-sectional study that enrolled a sample of 
      2526 patients suffering from inflammatory bowel diseases. We explore the 
      association between OOPE and: (1) geographical location; (2) income effects; (3) 
      performances in delivering healthcare. A regression model was used. Individuals' 
      age were in the range of 18-88 (mean 44 +/- 14.55). Forty-six percent were females, 
      54% were married and 19% held a bachelor degree. Ninety-six percent of 
      respondents declared an OOPE >0 whose mean value was euro960 +/- euro950. Individuals 
      belonging to low-income and low-performance regions were more likely to declare 
      an OOPE >0 (99%). Regression findings suggest that increases in OOPE could be 
      considered as a response from patients aiming to compensate for lacks and 
      inefficiencies in the public healthcare offers. Policymakers should consider 
      increases in OOPE in patients with Inflammatory Bowel Diseases (IBDs) as an 
      indicator of poor quality of care and poor fairness.
FAU - Ruggeri, Matteo
AU  - Ruggeri M
AD  - National Center for HTA, Istituto Superiore di Sanita, 00161 Rome, Italy.
AD  - School of Medicine, St. Camillus International University of Health Sciences, 
      00131 Rome, Italy.
FAU - Drago, Carlo
AU  - Drago C
AD  - Faculty of Economics, Universita Niccolo Cusano, 00166 Rome, Italy.
FAU - Cadeddu, Chiara
AU  - Cadeddu C
AUID- ORCID: 0000-0003-0149-1078
AD  - School of Medicine, Universita Cattolica del Sacro Cuore, 00168 Rome, Italy.
FAU - Armuzzi, Alessandro
AU  - Armuzzi A
AUID- ORCID: 0000-0003-1572-0118
AD  - School of Medicine, Universita Cattolica del Sacro Cuore, 00168 Rome, Italy.
AD  - Fondazione Policlinico Universitario "A. Gemelli" IRCCS, 00168 Rome, Italy.
FAU - Leone, Salvo
AU  - Leone S
AUID- ORCID: 0000-0003-1690-8147
AD  - Amici Italia Onlus, 20125 Milan, Italy.
FAU - Marchetti, Marco
AU  - Marchetti M
AUID- ORCID: 0000-0002-8367-8268
AD  - National Center for HTA, Istituto Superiore di Sanita, 00161 Rome, Italy.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20201104
PL  - Switzerland
TA  - Int J Environ Res Public Health
JT  - International journal of environmental research and public health
JID - 101238455
SB  - IM
MH  - Cross-Sectional Studies
MH  - Female
MH  - *Health Expenditures
MH  - Humans
MH  - Inflammatory Bowel Diseases/economics/*epidemiology
MH  - Italy/epidemiology
MH  - Male
MH  - State Medicine
MH  - Surveys and Questionnaires
PMC - PMC7663576
OTO - NOTNLM
OT  - IBD
OT  - equity and quality of care
OT  - out of pocket expenditure
COIS- The authors declare no conflict of interest.
EDAT- 2020/11/08 06:00
MHDA- 2021/01/15 06:00
PMCR- 2020/11/01
CRDT- 2020/11/07 01:03
PHST- 2020/09/25 00:00 [received]
PHST- 2020/10/27 00:00 [revised]
PHST- 2020/10/29 00:00 [accepted]
PHST- 2020/11/07 01:03 [entrez]
PHST- 2020/11/08 06:00 [pubmed]
PHST- 2021/01/15 06:00 [medline]
PHST- 2020/11/01 00:00 [pmc-release]
AID - ijerph17218156 [pii]
AID - ijerph-17-08156 [pii]
AID - 10.3390/ijerph17218156 [doi]
PST - epublish
SO  - Int J Environ Res Public Health. 2020 Nov 4;17(21):8156. doi: 
      10.3390/ijerph17218156.