SynthesisThe European journal of health economics : HEPAC : health economics in prevention and care2014
How does copayment for health care services affect demand, health and redistribution? A systematic review of the empirical evidence from 1990 to 2011.
Synthesis in The European journal of health economics : HEPAC : health economics in prevention and care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
60 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A systematic review of strategies used for controlling consumer moral hazard in health systems.BMC health services research · 2022Pooled it
- A systematic umbrella review of the association of prescription drug insurance and cost-sharing with drug use, health services use, and health.BMC health services research · 2022Pooled it
- [Patient steering from a health economics perspective: conditions for effective cost-sharing in a European comparison].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Article
- Exploring the challenges of a pilot dental services payment initiative: a qualitative policy analysis at an Iranian dental school.BMC oral health · 2026Article
- Racial and Ethnic Inequities in Managing Prescription Drug Costs Among Older Adults in Medicare.Journal of racial and ethnic health disparities · 2026Article
- Impacts of cost-sharing rate increment on the expenditure of outpatient care among older adults: quasi-experimental study of cost-sharing reform in Japan.BMC health services research · 2026Article
- Poverty and access to health care: the political economy of redesigning user charges in the context of fiscal pressure.European journal of public health · 2026Review
- Dynamic effects of outpatient pooling scheme on socioeconomic inequality in healthcare utilization in China from 2011 to 2020.Scientific reports · 2025Article
- The unseen impact of affordability: copayment sensitivity for long-acting PrEP among MSM in six European Countries, October 2023-April 2024.Scientific reports · 2025Article
- Utilization of second medical opinions as a function of the payment method.BMC health services research · 2025Article
- "I Can't Afford the Copays, So Guess I'll Die?" Using Discounting Methodology to Quantify How Cost Affects Health-Care Utilization.Behavior and social issues · 2024Article
- Health, Access to Care, and Financial Barriers to Care Among People Incarcerated in US Prisons.JAMA internal medicine · 2024Article
- Inequality in benefit distribution of reducing the outpatient cost-sharing: evidence from the outpatient pooling scheme in China.Frontiers in public health · 2024Article
- Economic and cost considerations of delivering and using mobile X-ray services in residential aged care facilities: A qualitative study.Australasian journal on ageing · 2023Article
- Understanding patient cost-sharing thresholds for diabetes treatment attributes via a discrete choice experiment.Journal of managed care & specialty pharmacy · 2023Review
- Evaluation of the National Health Insurance Program of Nepal: are political promises translated into actions?Health research policy and systems · 2023Review
- Real price of health-experiences of out-of-pocket costs in Australia: protocol for a systematic review.BMJ open · 2022Article
- The impact of cost-sharing on prescription drug demand: evidence from a double-difference regression kink design.The European journal of health economics : HEPAC : health economics in prevention and care · 2022Article
- Socioeconomic inequalities in insulin initiation among individuals with type 2 diabetes - A quasi-experimental nationwide register study.SSM - population health · 2022Article
- The effects of patient cost-sharing on health expenditure and health among older people: Heterogeneity across income groups.The European journal of health economics : HEPAC : health economics in prevention and care · 2022Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This article reviews the quantitative evidence on the behavioural effects of copayment within the health area across a wide range of countries. The review distinguishes itself from previous similar reviews by having a high degree of transparency for the search strategy used to identify the studies included in the review as well as the criteria for inclusion and by including the most recent literature. Empirical studies were identified by performing searches in EconLit. The literature search identified a total of 47 studies of the behavioural effects of copayment. Considering the demand effects, the majority of the reviewed studies found that copayment reduces the use of prescription medicine, consultations with general practitioners and specialists, and ambulatory care, respectively. The literature found no significant effects of copayment on the prevalence of hospitalisations. The empirical evidence on whether copayment for some services, but not for others, causes substitution from the services that are subject to copayment to the 'free' services rather than lower total use is sparse and mixed. Likewise, the health effects of copayment have only been analysed empirically in a limited number of studies, of which half did not find any significant effects in the short term. Finally, the empirical evidence on the distributional consequences of copayment indicates that individuals with low income and in particular need of care generally reduce their use relatively more than the remaining population in consequence of copayment. Hence, it is clear that copayment involves some important economic and political trade-offs.
Indexed as
Identifiers
23989938What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.