Marcela Oyarte1, Manuel Espinoza2, Carlos Balmaceda3, Rodrigo Villegas4, Báltica Cabieses5, Janepsy Díaz4. 1. Instituto de Salud Pública de Chile, Santiago, Chile; Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile. 2. Departamento de Salud Pública Facultad de Medicina Pontificia, Universidad Católica de Chile, Santiago, Chile; Centre for Health Economics University of York, York, UK. Electronic address: maespinoza@med.puc.cl. 3. Instituto de Salud Pública de Chile, Santiago, Chile; Departamento de Salud Pública Facultad de Medicina Pontificia, Universidad Católica de Chile, Santiago, Chile. 4. Instituto de Salud Pública de Chile, Santiago, Chile. 5. Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Department of Health Sciences University of York, York, UK.
Abstract
OBJECTIVES: Out-of-pocket spent (OPS) of health services are considered inefficient and are a consequence of inequalities in financing and access. The main objective of this study was to compare OPS on health and medicine, including catastrophic expenditure, overall and by quintiles and deciles, for the great Santiago city in the periods 1997, 2007 and 2012. METHODS: Cross-sectional study based on household budget surveys 1997, 2007 and 2012. OPS on health and medicine for households of the great Santiago was estimated overall and for different quintiles and deciles. In addition, the probability of incurring in catastrophic due to health and drug expenditure were also estimated. RESULTS: OPS showed a progressive increase in the three periods. Drug spending showed a decrease concentrated in the lower deciles and an increase in top deciles of expenditure. Catastrophic drug expenditure decreased progressively. By observing the catastrophic drug spending by deciles were the three richest deciles which showed a large increase between 2007 and 2012. CONCLUSIONS: OPS on health remained high between 2007 and 2012, despite presenting slight decreases in some quintiles and deciles. However, drug coverage improved over time. This study demonstrates that improvements are needed in the financial protection mechanisms on health in Chile, especially for poorer quintiles and deciles.
OBJECTIVES: Out-of-pocket spent (OPS) of health services are considered inefficient and are a consequence of inequalities in financing and access. The main objective of this study was to compare OPS on health and medicine, including catastrophic expenditure, overall and by quintiles and deciles, for the great Santiago city in the periods 1997, 2007 and 2012. METHODS: Cross-sectional study based on household budget surveys 1997, 2007 and 2012. OPS on health and medicine for households of the great Santiago was estimated overall and for different quintiles and deciles. In addition, the probability of incurring in catastrophic due to health and drug expenditure were also estimated. RESULTS: OPS showed a progressive increase in the three periods. Drug spending showed a decrease concentrated in the lower deciles and an increase in top deciles of expenditure. Catastrophic drug expenditure decreased progressively. By observing the catastrophic drug spending by deciles were the three richest deciles which showed a large increase between 2007 and 2012. CONCLUSIONS: OPS on health remained high between 2007 and 2012, despite presenting slight decreases in some quintiles and deciles. However, drug coverage improved over time. This study demonstrates that improvements are needed in the financial protection mechanisms on health in Chile, especially for poorer quintiles and deciles.
Authors: Carlos Piñones-Rivera; Nanette Liberona; Rodrigo Arancibia; Verónica Jiménez Journal: Int J Environ Res Public Health Date: 2022-08-07 Impact factor: 4.614