Out-of-pocket expenditures

Targets and indicators for Health 2020 version 3:
http://www.euro.who.int/en/health-topics/health-policy/health-2020-the-european-policy-for-health-and-well-being/publications/2016/targets-and-indicators-for-health-2020.-version-3-2016

European Health Information Initiative:
http://www.euro.who.int/en/data-and-evidence/european-health-information-initiative-ehii

The European Health Statistics App:
http://www.euro.who.int/en/data-and-evidence/the-european-health-statistics-app

(16) 5.1.a. Private household out-ofpocket expenditure as a proportion of total health expenditure

This is a core indicator of health financing systems. It contributes to the understanding of the relative weight of direct payments by households in total health expenditure. High out-of-pocket payments are strongly associated with catastrophic and impoverishing spending, so this indicator represents a key support for equity and planning processes.

The level of out-of-pocket expenditure is expressed as a percentage of private expenditure on health.
Private households’ out-of-pocket payments on health are the direct outlays of households, including gratuities and payments in kind made to health practitioners and suppliers of pharmaceuticals, therapeutic appliances and other goods and services, whose primary intent is to contribute to the restoration or enhancement of the health status of individuals or population groups. They also include household payments to public services, non-profit institutions or
nongovernmental organizations, non-reimbursable cost sharing, deductibles, co-payments and fees for service. They exclude payments made by enterprises that deliver medical and paramedical benefits, mandated by law or not, to their employees and payments for overseas treatment.