Healthcare can be paid for by means of a variety of financing arrangements. There are several factors why this study, analysing video recordings of routine GP consultations in the Netherlands, is particularly relevant: Dutch GPs play a gatekeeper function OOP expenses have increased relatively swiftly and patients have both the right to decide on their treatment, and to choose a provider. Policy makers, GPs and insurers should think about how GPs and patients can be facilitated when considering the OOP expenses of treatment. This result complies with existing literature. While GPs may often be in the position to provide patients with information about treatment alternatives, few patients discuss the financial effects of their referral or prescription with their GP. In some consultations, the GP brought up the subject, while in others, the patient initiated the discussion. The reimbursement of the cost of medication was discussed most often and patients’ current insurance and co-payments least often. In 9.5% of all the consultations, issues concerning patients’ health insurance and OOP expenses were discussed. In total, 475 consultations were analysed. We achieved an almost perfect inter-rater agreement (Kappa = .82). The consultations were coded by three observers using an observation protocol. In 2016, another eight GPs and 102 patients participated, spread throughout the Netherlands. In 2015, 20 GPs and 392 patients from the eastern part of the Netherlands participated. Video recordings were collected from patient-GP consultations in 2015–2016. In the current study, we observed the degree to which matters around patients’ insurance and OOP expenses are discussed in the Netherlands, using video recordings of consultations between patients and GPs. This also applies to the Netherlands, where OOP expenses increased rapidly over the years. Patients are often reliant on their GP and may, therefore, expect their GP to provide them with information about the costs of treatment options, taking into consideration their individual insurance plan. Patients indicate that, in practice, there are often some OOP expenses, incurred when they receive medical care, which are unexpected for them and should have been taken into account when deciding on a course of action.
Generally, a significant portion of healthcare spending consists of out-of-pocket (OOP) expenses.
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