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Public satisfaction with health system coverage, empirical evidence from SHARE data

Abstract

People’s satisfaction with the health system, including the coverage provided, has been a concern for some years now but research into the main explanatory factors is in progress. This work focuses on European countries plus Israel, using the SHARE database to find what determines people’s satisfaction with the basic coverage provided by the health system of each country. On top of the usual individual socioeconomic characteristics, other explanatory factors were also considered. These include, at individual level, trust in others, political positioning, and risk aversion; at country level, they include access to specialist care and the type of health system financing. Estimation of an ordered logistic model found that the main predictors for satisfaction with a health system’s basic coverage include trust in others, unmet health needs, self-assessed health, free access to specialists, health system financed through social insurance, and out-of-pocket payments. These results provide the basis for possible policies designed to improve people’s satisfaction.

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Acknowledgements

We thank an anonymous reviewer whose suggestions and helpful comments contributed to the improvement of the earlier draft of this manuscript. This paper uses data from SHARE Waves 1, 2, 3 (SHARELIFE), 4, 5 and 6 (DOIs: https://doi.org/10.6103/share.w1.611, https://doi.org/10.6103/share.w2.611, https://doi.org/10.6103/share.w3.611, https://doi.org/10.6103/share.w4.611, https://doi.org/10.6103/share.w5.611, https://doi.org/10.6103/share.w6.611), see Börsch-Supan et al. (2013) for methodological details.

Funding

The SHARE data collection has been primarily funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812) and FP7 (SHARE-PREP: N°211909, SHARE-LEAP: N°227822, SHARE M4: N°261982). Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C) and from various national funding sources is gratefully acknowledged (see www.share-project.org).

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Correspondence to Aida Isabel Tavares.

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Appendix

Appendix

See Tables 4, 5, 6 and 7.

Table 4 Country characteristics
Table 5 Results ordered logistic regression
Table 6 Tests of the parallel regression assumption
Table 7 Results generalized ordered logistic model

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Tavares, A.I., Ferreira, P.L. Public satisfaction with health system coverage, empirical evidence from SHARE data. Int J Health Econ Manag. (2020). https://doi.org/10.1007/s10754-020-09279-x

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Keywords

  • Satisfaction
  • Determinants
  • Health system coverage
  • SHARE
  • Ordered logistic regression

JEL Classification

  • I10
  • I18
  • I13