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Anales de la Facultad de Ciencias Médicas (Asunción)

Print version ISSN 1816-8949


GIMENEZ, Edgar; RODRIGUEZ, José Carlos; OCAMPOS, Gladys  and  BARRIOS, Roberto. Catastrophic health expenditure and universal health coverage: Analysis in the National Health System of Paraguay. An. Fac. Cienc. Méd. (Asunción) [online]. 2018, vol.51, n.3, pp.41-52. ISSN 1816-8949.


Universal health coverage is a health goal of the UN Sustainable Development Goals by 2030. One component of health coverage is the financial protection to receive medical care for a disease. And, an indicator of financial protection is the incidence of Catastrophic Expenditures for health reasons.


This paper is to describe the evolution of the Catastrophic Health Expenditure of Paraguayan households between 2000 and 2015.

Materials and Methods:

The material used was the Permanent Household Survey of the DGEEC. Catastrophic Expenditure was defined as those out-of-pocket expenses ≥ 30% of the household’s payment capacity.


The results indicate that during this period, the proportion of households affected by catastrophic expenses ranged between 2.8% and 4.33%, with the median being 4.10%. Rural households and the poor were the most affected. The proportion of affected households showed a downward trend, especially for urban and non-poor households.


In conclusion, Paraguayan households are exposed to catastrophic expenses for health reasons. The occurrence is greater according to the referred socioeconomic characteristics. The current performance of the national health system will not be enough to achieve universal coverage with financial protection for all. Therefore, it is necessary to implement new policies for the most exposed population.

Keywords : health financing; health financial protection; out-of-pocket health expenditure; catastrophic health expenditure; universal health coverage..

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