RESUMO
OBJECTIVE: Present information on the magnitude and composition of private health expenditure (PHE) in Mexico. MATERIAL AND METHODS: Total PHE by state was calculated using the System of National Health Accounts and National Performance Assessment Survey 2002-2003 by means of elasticities and growth relative contributions. RESULTS: 58% of the total PHE was private and 90% of this was out-of-pocket expenditure. Most of the latter is expenditure in ambulatory care and drugs. 60% of the PHE was concentrated in only six states. PHE was lower than public expenditure in six states. CONCLUSIONS: The magnitude of out-of-pocket expenditure in health is worrying, since it is the most unfair, inefficient and regressive way of financing health care. Health authorities should look for alternative ways to finance health care, like the Popular Health Insurance.
Assuntos
Financiamento Pessoal/estatística & dados numéricos , Gastos em Saúde , Assistência Ambulatorial/economia , Custos de Medicamentos , Financiamento Pessoal/economia , Previsões , Pesquisas sobre Atenção à Saúde , Gastos em Saúde/estatística & dados numéricos , Humanos , Seguro Saúde/tendências , México , Modelos TeóricosRESUMO
OBJECTIVE: To describe the magnitude, distribution, and determinants of catastrophic health expenditures in Mexico. MATERIAL AND METHODS: The information source was the National Performance Assessment Survey and the methodology, the one developed by the World Health Organization for assessing fair financing. Households with catastrophic expenditures were defined as those with health expenditures over 30% of their ability to pay. Multivariate analysis by logistic and linear regression were used to identify the determinants of catastrophic expenditures. RESULTS: A total of 3.8% of the households incurred in catastrophic health expenditures. There were huge differences by state. The uninsured, poor, and rural households showed a higher impoverishment risk. Sixty percent of the catastrophic expenditures were attributable to outpatient care and medication. A 10% increase of insured households could result in a 9.6% decrease in catastrophic expenditures. Disability, adults 60 years of age and older, and pregnancy increased the probability of catastrophic expenditures. CONCLUSIONS: The insurance of older adults, pregnant women, and persons with disabilities could reduce catastrophic health expenditures in Mexico.
Assuntos
Doença Catastrófica/economia , Financiamento Pessoal , Gastos em Saúde , Seguro Saúde , Adulto , Pessoas com Deficiência , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Modelos Lineares , Modelos Logísticos , Masculino , Pessoas sem Cobertura de Seguro de Saúde , México , Pessoa de Meia-Idade , Modelos Teóricos , Análise Multivariada , Pobreza , Gravidez , População Rural , Organização Mundial da SaúdeRESUMO
OBJECTIVE: To describe the differences in catastrophic health expenditures in five Mexican states. MATERIAL AND METHODS: This study included five states selected by convenience according to their social exclusion level. Household catastrophic health expenditures attributable to the three components of out of pocket health expenditures (ambulatory care, medication, and inpatient care) were calculated. RESULTS: The risk of impoverishment at the national level was greater in the most vulnerable households, namely, in the 20% poorest, rural, and uninsured households. Nevertheless, in states like Aguascalientes, Guerrero, Sinaloa, and Morelos the results were different. Over 70% of catastrophic health expenditures were attributable to medication and outpatient care expenditures in the poorest states. CONCLUSIONS: The differences found among states show that the implementation of local health policies to reduce catastrophic health expenditures should be based on evidence generated from analyses at the state level.
Assuntos
Doença Catastrófica/economia , Financiamento Pessoal , Gastos em Saúde , Seguro Saúde , Adulto , Assistência Ambulatorial/economia , Intervalos de Confiança , Custos e Análise de Custo , Custos de Medicamentos , Feminino , Política de Saúde , Hospitalização/economia , Humanos , Pacientes Internados , Masculino , Pessoas sem Cobertura de Seguro de Saúde , México , Pobreza , População Rural , População UrbanaRESUMO
®Se muestran los resultados del porcentaje de hogares con gastos catastróficos por motivos de salud por entidad federativa de acuerdo con la ENIGH de 1996. En esta encuesta, 8 de las 32 entidades gozaron de representatividad subnacional (estatal). El porcentaje de hogares con gastos catastróficos por motivos de salud en México en 1996 fue de 4.07 porciento, que es la cifra más baja en el periodo 1994 - 2000. El Estado de México fue la entidad con mayor proporción de hogares en riesgo de empobrecimiento (10.58 porciento), mientras que Coahuila mostró la menor proporción (2.95 porciento). La población más propensa a padecer gastos catastróficos se ubicó en los estratos socioeconómicos más bajos (quintiles I y II, hogares rurales y no asegurados). La inversión pública y los esquemas de aseguramiento funcionaron como factores protectores contra el riesgo de empobrecimiento por atender necesidades de salud¼ (AU). Contenido: 1) Introducción. 2) Material y métodos. 3) Resultados. 4) Conclusiones
Assuntos
Custos de Cuidados de Saúde , Gastos em SaúdeRESUMO
®El porcentaje de hogares que incurrió en gastos catastróficos por motivos de salud a nivel nacional en México en el último trimestre de 2002 fue 3.89; Chiapas, Zacatecas y Michoacán fueron las entidades que presentaron las cifras más altas, y Aguascalientes, Colima y Yucatán las más bajas. Es importante resaltar que los hogares pobres, no asegurados y rurales presentaron gastos catastróficos por motivos de salud con mayor frecuencia que sus contrapartes urbanos, asegurados y de mayores recursos. Las variables más estrechamente asociadas a gastos catastróficos son la presencia en el hogar de una persona con discapacidad, jefes del hogar mayores de 60 años, jefes del hogar de género femenino y la ocurrencia de un parto. Llama también la atención que 60 porciento de los gastos catastróficos son atribuidos a gastos en atención ambulatoria y medicamentos.¼ (AU). Contenido: 1) Introducción. 2) Material y métodos. 3) Resultados. 4) Conclusiones