Abstract

CABALLERO, Edgar Giménez; RODRIGUEZ, José Carlos; OCAMPOS, Gladys  and  FLORES, Laura. Composition of out-of-pocket health spending in the health system of Paraguay. Mem. Inst. Investig. Cienc. Salud [online]. 2017, vol.15, n.3, pp.64-72. ISSN 1812-9528.  https://doi.org/10.18004/mem.iics/1812-9528/2017.015(03)64-072.

Financial protection with equity for the population is an objective of the health system. However, many sick people incur pocket expenses to obtain care, a situation that is inequitable. The objective of this article is to analyze the composition of pocket expenses, its magnitude and distribution in the general and poor population. As a methodology, the health module of the Permanent Household Survey for 2014 was analyzed. The population that incurred in pocket expenses was 75.1% of the sick population, 75.8% of the non-poor, 73.3% of the non-extreme poor, and 73.0% of the extreme poor. The average pocket expenses was 54.5 USD, 63.3 USD for non-poor, 26.2 USD for non-extreme poor and 30.4 USD for extreme poor. Fifty three percent of the pocket expenses were for payments of medicines, 22.6% due to diagnostic studies, 18.7% for hospitalizations and 5.7% for consultations. The proportion of pocket expenses per drug purchase was higher among the poor: 72.3% for the extreme poor and 68.6% for the non-extreme poor. While pocket expenses accounted for 87.0% of the non-poor incomes, the ratio of average prices to average income was higher among the poor: 95.8% for extreme poor, 40.7% for non-extreme poor, and 21, 4% for non-poor, but hospitalization expenses may exceed total income. These data indicate inequity in the financing of the Paraguayan health system.

Keywords : out-of-pocket health spending; Paraguay; poverty condition.

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