How does the introduction of patient co-payments for selected health services affect formal and informal out-of-pocket payments and utilization? Evidence from Armenia (2017)

This report presents the findings of an evaluation of the introduction in Armenia of patient co-payments for specific services provided through the publicly financed basic benefits package (BBP) at the inpatient level. A baseline survey was conducted in July/August 2011 and a follow-up survey in December 2011 with data disaggregated in a number of ways to facilitate equity analysis. Overall, out-of-pocket payments fell as a result of the policy, with approximately 6% fewer patients nationally accessing care without making any form of out-of-pocket payment. Furthermore, nationally the number of patients making an unofficial payment fell significantly. However, this picture hides the impact of the policy on different population groups, for different services, and in different parts of the country. One significant finding is that although the number of people making an unofficial payment decreased, the average amount of each payment increased considerably.