László Gulácsi

Despite the growing interest in the sustainability of long-term care (LTC) systems, only a few studies have investigated the differences in the LTC financing across European countries. The objective of this paper is to describe the financing of LTC in Europe. For this purpose, we use indicators on LTC financing taken from international databases and reports. Desk research was carried out to identify relevant indicators. Hierarchical cluster analysis was used to identify typologies in LTC financing across the EU/EEA countries based on seven indicators selected. We found large differences in LTC financing across the EU/EEA countries in terms of total expenditure, the division of expenditure between the social and health care system, and in the role of in-kind and cash benefits. Four main financial models across the EU/EEA countries could be distinguished. Further, we identified some shortages in data reporting on the financing of LTC services. Some limitations and contradictions related to the indicators of LTC financing are highlighted. In particular, we stress the need for more comprehensive data to enable further cross-country comparisons and to provide valid input for policy.

The introduction of co-payments for using health care services is a relatively new issue for most of the Central-Eastern European (CEE) countries. Some CEE countries, like Slovakia, Hungary and Czech Republic have similar experiences with the introduction of such co-payments. These fees were met with a cold reception by the population and also political resistance, which led to the abolishment of these payments in Slovakia as well as in Hungary.
Our paper focuses on the experiences of Hungary, where co-payments for health care services were introduced in February, 2007 and abolished one year later as a result of a population referendum. Hungarian experiences can serve as a lesson for policy makers from other CEE countries to develop sustainable patient payment policies.