Out-of-Pocket Expenditures in Health and Medications in Chile: Comparative Analysis Between 1997, 2007, and 2012

Measuring Out-of-pocket Payment, Catastrophic Health Expenditure and the Related Socioeconomic Inequality in Peru: A Comparison Between 2008 and 2017

“…The reduction of CHE in Peru was similar to national estimates of a retrospective study worldwide [ 6 ], although it differs from the growing trend of CHE in countries in other parts of the world, such as Cambodia [ 32 ], Iran [ 33 ], India [ 34 ], or countries in the region, such as Brazil [ 35 ] and Chile [ 4 ]. Differences in population characteristics, poverty rates, national income level, economic structure, and payment mechanisms for access to health services may explain the difference in CHE proportions.…”

“…One study found that 12.9% of Peruvians reported that they did not receive medical care because they did not have money, and 43.1% of people in moderate or extreme poverty claimed that money was a barrier for access to healthcare [31]. The reduction of CHE in Peru was similar to national estimates of a retrospective study worldwide [6], although it differs from the growing trend of CHE in countries in other parts of the world, such as Cambodia [32], Iran [33], India [34], or countries in the region, such as Brazil [35] and Chile [4]. Differences in population characteristics, poverty rates, national income level, economic structure, and payment mechanisms for access to health services may explain the difference in CHE proportions.…”

“…The reduction of OOP, especially in households with social disadvantage in Peru, goes against the evidence of a growing trend of OOP in Latin America [ 24 ] and other countries such as Chile [ 4 ]. This reduction may be explained because a larger proportion of poor people, or people without health insurance, increased their access to health through the Comprehensive Health Insurance (CHI), which rose from 17.0% of affiliates in 2007 to 46.3% in 2016 [ 30 ].…”

“…OOP is more frequent in countries that depend on user fees to contain the costs of the system and rationalize the use of health services [ 3 ]. However, OOP may be inefficient and can generate inequalities in health access and financing because of the lower capacity of low-income households to pay for health services [ 4 ]. These households may incur catastrophic health expenditure (CHE) when high OOP levels exceed a certain proportion of their payment capacity [ 5 ].…”

Indigenous Border Migrants and (Im)Mobility Policies in Chile in Times of COVID-19

“…Neoliberal reforms to the healthcare system are linked to a worsening of collective health [ 1 , 2 ]. The commodification of all vital arrangements that is typical of neoliberalism in Chile has not only turned it into one of the countries with the highest out-of-pocket spending among the member nations of the Organization for Economic Co-operation and Development (OECD) [ 3 , 4 ] but also to have one of the highest costs for medications in Latin America [ 5 ]. The latter is due to the structure of a strongly monopolized pharmaceutical market focused on sectorial decisions rather than on people’s rights and needs [ 6 ].…”