Abstract

GIMENEZ-CABALLERO, Edgar et al. Association between out-of-pocket health expenses and poverty using data from the Permanent Household Survey in Paraguay in 2014. Mem. Inst. Investig. Cienc. Salud [online]. 2021, vol.19, n.1, pp.18-30. ISSN 1812-9528.  https://doi.org/10.18004/mem.iics/1812-9528/2021.019.01.18.

Universal health coverage and access requires financial protection, which can be assessed through out-of-pocket costs for illness. The objective of the study was to analyze the association between out-of-pocket health spending and poverty in Paraguay. The 2014 Permanent Household Survey was used to determine the ratio between out-of-pocket expenses for illness and household income, state transfers for the poor, and the basic consumption and food basket. Five thousand one hundred sixty five households were included, of which 21.49% were poor. There was out-of-pocket spending in 45.19% of the households, significantly associated with poverty (OR: 1.8; 95%CI: 1.57 to 2.06), 1.99% of households had out-of-pocket expenses greater than 25% of their income and 5.98% greater than 10% of their income, both indicators were significantly associated with poverty (OR: 3.70; 95%CI: 2.50 to 5.50 and OR: 3.04; 95%CI: 2.40 to 2.06, respectively). There was impoverishment in 1.44% of households, and the poverty gap went from 34.58% to 37.67%. Among poor households, out-of-pocket spending was equivalent to 4.9 days of consumption, 11.5 days of food, and 42% of the value of state transfers. These findings reflect insufficient financial protection for the health system in Paraguay.

Keywords : Out-of-pocket health expenditure; universal health coverage; poverty.

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