Abstract

GIMENEZ, Edgar et al. Catastrophic health expenses in households of Paraguay. Mem. Inst. Investig. Cienc. Salud [online]. 2018, vol.16, n.2, pp.38-48. ISSN 1812-9528.  https://doi.org/10.18004/mem.iics/1812-9528/2018.016(02)38-048.

Every year, many families face excessive expenses in the presence of an illness, despite the fact that the health system has the equitable financial protection of the population as one of its objectives. The objective of this study was to describe the incidence of catastrophic health expenses in Paraguayan households. We analyzed the health module of the Permanent Household Survey (PHS) of the General Directorate of Statistics, Surveys and Census of Paraguay of 2014. We included consultations, medicines, diagnostic studies and hospitalizations of sick or injured people as direct out-of-pocket expenses. The ability to pay is defined as the sum of all incomes minus subsistence expenses, using a known structure of expenses. We calculated the catastrophic health expenses using different thresholds for the relationship between out-of-pocket cost and household payment capacity (OPC/HPC). In households with at least one patient who had out-of-pocket cost to receive care, the OPC/HPC ratio was 9.1% in average. Among all households, the estimated incidences of catastrophic expenses were 2%, 2.8%, 4.4% and 8.7% using 40%, 30%, 20% and 10% OPC/HPC thresholds respectively. The PHS is a useful instrument, but with limitations, to estimate catastrophic expenses in the Paraguayan health system. These results indicate that it is necessary to design and implement specific mechanisms to avoid this type of expenses.

Keywords : catastrophic health expenses; out-of-pocket health cost; financial protection; Paraguay.

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