Your browser doesn't support javascript.
loading
A Gender-Based and Quasi-Experimental Study of the Catastrophic and Impoverishing Health-Care Expenditures in Mexican Households with Elderly Members, 2000-2020.
Serván-Mori, Edson; Orozco-Núñez, Emanuel; Guerrero-López, Carlos M; Miranda, J Jaime; Jan, Stephen; Downey, Laura; Feeny, Emma; Heredia-Pi, Ileana; Flamand, Laura; Nigenda, Gustavo; Norton, Robyn; Lozano, Rafael.
Afiliação
  • Serván-Mori E; Center for Health Systems Research, The National Institute of Public Health, Cuernavaca, Mexico.
  • Orozco-Núñez E; Center for Health Systems Research, The National Institute of Public Health, Cuernavaca, Mexico.
  • Guerrero-López CM; Center for Health Systems Research, The National Institute of Public Health, Cuernavaca, Mexico.
  • Miranda JJ; The George Institute for Global Health, School of Public Health, Imperial College London, London, UK.
  • Jan S; CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Downey L; School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
  • Feeny E; The George Institute for Global Health, School of Public Health, Imperial College London, London, UK.
  • Heredia-Pi I; School of Public Health, The George Institute for Global Health, Imperial College London, London, UK.
  • Flamand L; Center for Health Economics and Policy Innovation, Business School, Imperial College London, London, UK.
  • Nigenda G; The George Institute for Global Health, School of Public Health, Imperial College London, London, UK.
  • Norton R; School of Public Health, The George Institute for Global Health, Imperial College London, London, UK.
  • Lozano R; School of Public Health, The George Institute for Global Health, Imperial College London, London, UK.
Health Syst Reform ; 9(1): 2183552, 2023 12 31.
Article em En | MEDLINE | ID: mdl-37014089
Latin America has experienced a rise in noncommunicable diseases (NCDs) which is having repercussions on the structuring of healthcare delivery and social protection for vulnerable populations. We examined catastrophic (CHE) and excessive (EHE, impoverishing and/or catastrophic) health care expenditures in Mexican households with and without elderly members (≥65 years), by gender of head of the households, during 2000-2020. We analyzed pooled cross-sectional data for 380,509 households from eleven rounds of the National Household Income and Expenditure Survey. Male- and female-headed households (MHHs and FHHs) were matched using propensity scores to control for gender bias in systematic differences regarding care-seeking (demand for healthcare) preferences. Adjusted probabilities of positive health expenditures, CHE and EHE were estimated using probit and two-stage probit models, respectively. Quintiles of EHE by state among FHHs with elderly members were also mapped. CHE and EHE were greater among FHHs than among MHHs (4.7% vs 3.9% and 5.5% vs 4.6%), and greater in FHHs with elderly members (5.8% vs 4.9% and 6.9% vs 5.8%). EHE in FHHs with elderly members varied geographically from 3.9% to 9.1%, being greater in less developed eastern, north-central and southeastern states. Compared with MHHs, FHHs face greater risks of CHE and EHE. This vulnerability is exacerbated in FHHs with elderly members, because of gender intersectional vulnerability. The present context, marked by a growing burden of NCDs and inequities amplified by COVID-19, makes key interlinkages across multiple Sustainable Development Goals (SDGs) apparent, and calls for urgent measures that strengthen social protection in health.
Assuntos
Palavras-chave
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças não Transmissíveis / COVID-19 Tipo de estudo: Health_economic_evaluation / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Aged / Female / Humans / Male País/Região como assunto: Mexico Idioma: En Revista: Health Syst Reform Ano de publicação: 2023 Tipo de documento: Article País de afiliação: México País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças não Transmissíveis / COVID-19 Tipo de estudo: Health_economic_evaluation / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Aged / Female / Humans / Male País/Região como assunto: Mexico Idioma: En Revista: Health Syst Reform Ano de publicação: 2023 Tipo de documento: Article País de afiliação: México País de publicação: Estados Unidos