Gasto de bolsillo y gasto catastrófico en salud en los hogares de Cartagena, Colombia

Pocket expense and catastrophic expenditure in Health in the homes of Cartagena, Colombia

dc.creatorAlvis-Zakzuk, Jossie
dc.creatorMarrugo-Arnedo, Carlos
dc.creatorAlvis-Zakzuk, Nelson J.
dc.creatorGómez de la Rosa, Fernando
dc.creatorFlorez-Tanus, Álvaro
dc.creatorMoreno-Ruiz, Deicy
dc.creatorAlvis-Guzmán, Nelson
dc.date2019-05-24T14:30:44Z
dc.date2019-05-24T14:30:44Z
dc.date2018-04-20
dc.date.accessioned2023-10-03T19:01:50Z
dc.date.available2023-10-03T19:01:50Z
dc.identifier2539-3596
dc.identifier0124-0064
dc.identifierhttp://hdl.handle.net/11323/4697
dc.identifierCorporación Universidad de la Costa
dc.identifierREDICUC - Repositorio CUC
dc.identifierhttps://repositorio.cuc.edu.co/
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/9166910
dc.descriptionObjetivo Estimar el gasto de bolsillo y la probabilidad de gasto catastrófico de los hogares y sus determinantes socioeconómicos en Cartagena, Colombia. Materiales y Métodos Estudio transversal en una muestra poblacional estratificada aleatoria de hogares de Cartagena. Se estimaron dos modelos de regresión cuyas variables dependientes fueron gasto de bolsillo y probabilidad de gasto catastrófico en salud de los hogares. Resultados El gasto de bolsillo promedio anual en hogares pobres fue 1 566 036 COP (US$783) (IC95% 1 117 597–2 014 475); en hogares de estrato medio 2 492 928 COP (US$1246) (IC95% 1 695 845-3 290 011) y en hogares ricos 4 577 172 COP (US$2 288) (IC95% 1 838 222-7 316 122). Como proporción del ingreso, el gasto de bolsillo en salud fue de 14,6% en los hogares pobres, de 8,2% en los hogares de estrato medio y de 7,0% en los hogares ricos. La probabilidad de gasto catastrófico en salud de los hogares pobres fue 30,6% (IC95% 25,6-35,5%), de los de estrato medio del 10,2% (IC95% 4,5-15,9%) y de los hogares de estrato alto del 8,6% (IC95% 1,8- 23,0%). El estrato socioeconómico, la educación y la ocupación fueron los principales determinantes del gasto de bolsillo en salud y de la probabilidad de incurrir en gasto catastrófico en salud. Conclusiones En el sistema de salud persisten desigualdades en la protección financiera de los hogares contra el gasto de bolsillo y la probabilidad de gasto catastrófico. El presente estudio genera evidencia para revisar la política de protección social de los hogares socioeconómicamente más vulnerables.
dc.descriptionObjective To estimate the out-of-pocket expense and the probability of catastrophic expenditure of households and their socioeconomic determinants in Cartagena, Colombia. Materials and Methods Cross-sectional study in a random stratified population sample of households in Cartagena. Two regression models were estimated whose dependent variables were out-of-pocket expenses and the probability of catastrophic expenditure on household health. Results The annual average pocket expense in poor households was 1 566 036 COP (US $ 783) (IC95% 1 117 597-2 014 475); in middle-income households 2 492 928 COP (US $ 1246) (IC95% 1 695 845-3 290 011) and in wealthy households 4 577 172 COP (US $ 2 288) (IC95% 1 838 222-7 316 122). As a proportion of income, out-of-pocket health expenditure was 14.6% in poor households, 8.2% in middle-income households and 7.0% in wealthy households. The probability of catastrophic health expenditure in poor households was 30.6% (95% CI 25.6-35.5%), of middle-income 10.2% (95% CI 4.5-15.9%) ) and of households with a high level of 8.6% (IC95% 1.8-23.0%). The socio-economic stratum, education and occupation were the main determinants of out-of-pocket spending on health and the probability of incurring catastrophic health expenditure. Conclusions In the health system inequalities persist in the financial protection of households against out-of-pocket expenses and the probability of catastrophic expenditure. The present study generates evidence to review the social protection policy of the most socioeconomically vulnerable households.
dc.formatapplication/pdf
dc.languagespa
dc.publisherRevista de Salud Pública
dc.relationhttps://doi.org/10.15446/rsap.v20n5.61403
dc.relation1. Alvis-Estrada L, Alvis-Guzmán N, De la Hoz F. Gasto privado en salud de los hogares de Cartagena de Indias, 2004. Rev. Salud Pública (Bogota). 2007;9:11-25. 2. Muhammad Malik A, Azam Syed S. Socio-economic determinants of household out-of-pocket payments on healthcare in Pakistan. Int J Equity Health. 2012; 11(1):51. 3. The World Bank. World Development Indicators: Health systems. World Development Indicators. 2018. p. 1. 4. Chankova S, Sulzbach S, Diop F. Impact of mutual health organizations: evidence from West Africa. Health Policy Plan. 2008; 23(4):264-76. 5. Cid Pedraza C, Prieto Toledo L. El gasto de bolsillo en salud: el caso de Chile, 1997 y 2007. Rev Panam Salud Pública. 2012; 31(4):310-6. 6. Waters HR, Anderson GF, Mays J. Measuring financial protection in health in the United States. Health Policy (New York). 2004; 69(3):339-49. 7. Himmelstein DU, Warren E, Thorne D, Woolhandler S. Illness And Injury As Contributors To Bankruptcy. Health Aff. 2005; 24(1):w5-63. 8. Ruiz F, Amaya L, Venegas S. Progressive segmented health insurance: Colombian health reform and access to health services. Health Econ. 2007;16(1):3–18. 9. Amaya Lara JL, Ruiz Gómez F. Determining factors of catastrophic health spending in Bogota, Colombia. Int J Health Care Finance Econ. 2011; 11(2):83–100. 10. Xu K, Evans DB, Kawabata K, Zeramdini R, Klavus J, Murray CJ. Household catastrophic health expenditure: a multicountry analysis. Lancet. 2003; 362(9378):111–7. 11. World Health Organization. Distribución del gasto en salud y gastos catastróficos: metodología. Discuss Pap. 2005; 2(1):12. 12. Mankiw G. Principios de economía. 6a ed. Cengage Learning, editor. México: Paraninfo; 2014. 888 p. 13. World Health Organization. Informe sobre la salud en el mundo 2000 - Mejorar el desempeño de los sistemas de salud. Vol. 1, WHO. Ginebra: World Health Organization; 2000. 14. Molina R, Pinto M, Henderson P, Vieira C. Gasto y financiamiento en salud: situación y tendencias. Rev Panam Salud Pública. 2000; 8(1- 2):71-83. 15. Amaya-Lara JL. Catastrophic expenditure due to out-of-pocket health payments and its determinants in Colombian households. Int J Equity Health. 2016; 15(1):182. 16. Grossman M. On the Concept of Health Capital and the Demand for Health. J Polit Econ. 1972;80(2):223–55. 17. Lopera MM, Einarson TR, Iván Bula J. Out-of-pocket expenditures and coping strategies for people living with HIV: Bogotá, Colombia, 2009. AIDS Care. 2011; 23(12):1602–8. 18. Kien VD, Van Minh H, Giang KB, Dao A, Tuan LT, Ng N. Socioeconomic inequalities in catastrophic health expenditure and impoverishment associated with non-communicable diseases in urban Hanoi, Vietnam. Int J Equity Health. 2016; 15(1):169. 19. Piroozi B, Moradi G, Nouri B, Mohamadi Bolbanabad A, Safari H. Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran. Int J Heal policy Manag. 2016; 5(7):417–23. 20. Kronenberg C, Barros PP. Catastrophic healthcare expenditure – Drivers and protection: The Portuguese case. Health Policy (New York). 2014; 115(1):44–51. 21. Rahman MM, Gilmour S, Saito E, Sultana P, Shibuya K. Health-Related Financial Catastrophe, Inequality and Chronic Illness in Bangladesh. van Baal PHM, editor. PLoS One. 2013; 8(2):e56873. 22. Okunade AA, Suraratdecha C, Benson DA. Determinants of Thailand household healthcare expenditure: the relevance of permanent resources and other correlates. Health Econ. 2010; 19(3):365–76. 23. Pal R. Measuring incidence of catastrophic out-of-pocket health expenditure: with application to India. Int J Health Care Finance Econ. 2012;12(1):63–85. 24. Hajizadeh M, Nghiem HS. Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments? Int J Health Care Finance Econ. 2011; 11(4):267–85. 25. Habibov N. Hospitalization in Tajikistan: determinants of admission, length of stay, and out-of-pocket expenditures. Results of a national survey. Int J Health Plann Manage. 2010; 25(3):251–69. 26. Hotchkiss DR, Hutchinson PL, Malaj A, Berruti AA. Out-of-pocket payments and utilization of health care services in Albania: Evidence from three districts. Health Policy (New York). 2005; 75(1):18–39. 27. Bock J-O, Matschinger H, Brenner H, Wild B, Haefeli WE, Quinzler R, et al. Inequalities in out-of-pocket payments for health care services among elderly Germans – results of a population-based cross-sectional study. Int J Equity Health. 2014; 13(1):3. 28. Özgen Narcı H, Şahin İ, Yıldırım HH. Financial catastrophe and poverty impacts of out-of-pocket health payments in Turkey. Eur J Heal Econ. 2015; 16(3):255–70. 29. Rocha-García A, Hernández-Peña P, Ruiz-Velazco S, Avila-Burgos L, Marín-Palomares T, Lazcano-Ponce E. Gasto de hogares durante la hospitalización de menores derechohabientes, con diagnóstico de leucemia, en dos hospitales en México. Salud Publica Mex. 2003; 45(4):285–92. 30. Rous JJ, Hotchkiss DR. Estimation of the determinants of household health care expenditures in Nepal with controls for endogenous illness and provider choice. Health Econ. 2003; 12(6):431-51. 31. Brinda EM, Andrés RA, Enemark U, Enemark U. Correlates of out-ofpocket and catastrophic health expenditures in Tanzania: results from a national household survey. BMC Int Health Hum Rights. 2014; 14(1):5.
dc.rightshttp://creativecommons.org/licenses/by-nc-sa/4.0/
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightshttp://purl.org/coar/access_right/c_abf2
dc.subjectGastos en salud
dc.subjectEquidad en salud
dc.subjectHealth expenditures
dc.subjectHealth equity
dc.titleGasto de bolsillo y gasto catastrófico en salud en los hogares de Cartagena, Colombia
dc.titlePocket expense and catastrophic expenditure in Health in the homes of Cartagena, Colombia
dc.typeArtículo de revista
dc.typehttp://purl.org/coar/resource_type/c_6501
dc.typeText
dc.typeinfo:eu-repo/semantics/article
dc.typeinfo:eu-repo/semantics/publishedVersion
dc.typehttp://purl.org/redcol/resource_type/ART
dc.typeinfo:eu-repo/semantics/acceptedVersion
dc.typehttp://purl.org/coar/version/c_ab4af688f83e57aa


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