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Study on the concentration, distribution, and persistence of health spending for the contributory scheme in Colombia.
Espinosa, Oscar; Friebel, Rocco; Bejarano, Valeria; Arias, Martha-Liliana; Husereau, Don; Smith, Adrian.
Afiliação
  • Espinosa O; Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C., Colombia. oaespinosaa@unal.edu.co.
  • Friebel R; Department of Health Policy, London School of Economics and Political Science, London, UK.
  • Bejarano V; Economic Models and Quantitative Methods Research Group, Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
  • Arias ML; Department of Accounting Sciences, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia.
  • Husereau D; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
  • Smith A; Department of Population Health, University of Oxford, Oxford, UK.
BMC Health Serv Res ; 24(1): 1225, 2024 Oct 12.
Article em En | MEDLINE | ID: mdl-39395982
ABSTRACT
Colombia is among the countries with the most robust financial protection against personal health spending in the world, with out-of-pocket spending ranking lowest across OECD countries. We investigate the evolution, distribution, and persistence of health spending by age group, sex, health care setting, health condition and geographic region for over 19 million users of Colombia's health system between 2013 and 2021 (contributory scheme). We use average patient-level expenditure data from the Health-Promoting Entities of the Ministry of Health and Social Protection. We applied multivariate statistical techniques such as multiple correspondence analysis, factor maps and correlations. For both sexes, average health expenditure increases gradually with age until 60 years, accelerating thereafter abruptly. Health conditions with the highest percentage of expenditure were those related to neoplasms, blood diseases, circulatory system, pregnancy, puerperium and perinatal period. We found that home-based care in Amazonía-Orinoquía is almost non-existent, and that outpatient care represents a high proportion in all age groups (over 65%) compared to the other regions. There is a strong persistence of expenditure from one year to the next (i.e. they can provide relevant information for prediction), especially in areas with a larger supply of health services such as Bogotá-Cundinamarca. To the authors' knowledge, this is the most comprehensive and detailed micro-analysis of health spending that has been developed for a Latin American country to date.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Gastos em Saúde Limite: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Região como assunto: America do sul / Colombia Idioma: En Revista: BMC Health Serv Res Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido
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: Gastos em Saúde Limite: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Região como assunto: America do sul / Colombia Idioma: En Revista: BMC Health Serv Res Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Colômbia País de publicação: Reino Unido