The impact of the COVID-19 pandemic on catastrophic health expenditure in Greece

Abstract

The measures implemented to combat the coronavirus disease 2019 (COVID-19) adversely affected both the Greek health system and the Greek population. This study aimed to investigate the influence of these measures on the catastrophic health expenditure (CHE) in Greece. The study used data from the household budget surveys (HBSs) of 2019, 2020 and 2021. Two-stage area sampling was applied in all three surveys, with stratification by geographic region and by degree of urbanization, and with samples of n2019 = 6180, n2020 = 6256 and n2021 = 6053. The analysis was based on the fit of two logistic regression models; the incidence of the CHE at the 10% and 25% thresholds was used as outcome variables. The increase in the incidence of the CHE at the 10% threshold during the pandemic was mainly due to the disruption of healthcare delivery, the increase in out-of-pocket (OOP) payments, income losses and the uneven distribution of healthcare resources across the country. Several occupational classes reported a higher CHE than manual workers. Moreover, the deterioration in health was found to contribute to the increase in the incidence of the CHE, while household size protected against the CHE. The latter was also true for the 25% threshold. The results indicated that the pandemic and the associated confinement measures negatively influenced the CHE in Greece.

Keywords

• covid-19
• greece
• catastrophic health expenditure
• out-of-pocket payments
• disruption of healthcare delivery
• income loss
• uneven distribution of healthcare resources
• deterioration in health