Equity in out-of-pocket payment in Chile

Abstract

OBJECTIVE To assess the distribution of financial burden in Chile, with a focus on the burden and progressivity of out-of-pocket payment.METHODS Based on the principle of ability to pay, we explore factors that contribute to inequities in the health system finance and issues about the burden of out-of-pocket payment, as well as the progressivity and redistributive effect of out-of-pocket payment in Chile. Our analysis is based on data from the 2006 National Survey on Satisfaction and Out-of-Pocket Payments.RESULTS Results from this study indicate evidence of inequity, in spite of the progressivity of the healthcare system. Our analysis also identifies relevant policy variables such as education, insurance system, and method of payment that should be taken into consideration in the ongoing debates and research in improving the Chilean system.CONCLUSIONS In order to reduce the detected disparities among income groups, healthcare priorities should target low-income groups. Furthermore, policies should explore changes in the access to education and its impact on equity.

Redistributive effects of health care out-of-pocket payments in Cameroon

“…Like in Ataguba and McIntyre's [5] study on South Africa, Mills et al [17] in Ghana, South Africa, and Tanzania, Mondaca and Chi [19] in Chile, the progressive financing system of health care through out-of-pocket payments in Cameroon is pro-rich in terms of health care benefits. The rich consume more health care in Cameroon than the poor and thus incur more out-of-pocket costs.…”

“…Despite the rising burden of out-of-pocket payments, household participation in the financing of the health care system can generate additional resources for the public health sector and could potentially increase the utilization and the quality of health services (Litvack and Bordart [13]; Ntembe [22]). However, low-income households disproportionately face the brunt of the rising cost of health care through out-of-pocket payments with escalating impoverishing effects [10,16,19]. The burden of payments can be alleviated through the implementation of prepayment schemes such as social insurance that can provide funding support to health care [16].…”

“…The study also shows that, income inequality would be lesser within the six geopolitical zones in Nigeria without out-ofpocket payments. Thus, regardless of whether the health care financing system is progressive or not, out-of-pocket payments will lead to inequity in health care payments within the same income groups [19].…”

“…The extent to which income redistribution occurs has important implications for the distribution of goods and services other than health care (Wagstaff [35]; Wagstaff and Doorslaer [27]). Although health care payments in some African countries have been largely progressive and propoor with more benefits accruing to the poor, the burden of illness has been greater for lower-income groups who face disproportionately limited access to health care services [2,17,19]. The impediments to expanding access to health care for the poor must be dismantled to allow universal coverage [2].…”

Evaluación Económica Del Costo De Estadía Hospitalaria en Una Unidad De Paciente Crítico

“…Dentro de los métodos de evaluación económica se encuentra el análisis de costos (16) , minimización de costos, la evaluación de costo efectividad y la evaluación de costo utilidad, entre otras (17,18) . Debido a las diversas demandas de salud de las poblaciones y a los altos gastos incurridos en la cobertura de dichas necesidades (19)(20)(21) , es necesario evaluar económicamente procedimientos de salud y procesos hospitalarios, con el n de aportar con evidencia para la optimización en la administración de los recursos. Según lo expuesto, el objetivo de este estudio fue analizar económicamente la estadía hospitalaria de usuarios en la UPC de un hospital de alta complejidad, de la red pública de salud.…”