<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1816-8949</journal-id>
<journal-title><![CDATA[Anales de la Facultad de Ciencias Médicas (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[An. Fac. Cienc. Méd. (Asunción)]]></abbrev-journal-title>
<issn>1816-8949</issn>
<publisher>
<publisher-name><![CDATA[EFACIM. Editorial de la Facultad de Ciencias Médicas - Universidad Nacional de Asunción]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1816-89492021000300051</article-id>
<article-id pub-id-type="doi">10.18004/anales/2021.054.03.51</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Magnitud, composición y efecto económico en los hogares del gasto de bolsillo de las personas ingresadas al hospital respiratorio integrado de Encarnación en un semestre durante la pandemia por COVID-19]]></article-title>
<article-title xml:lang="en"><![CDATA[Magnitude, composition, and economic effect on households of the out-of-pocket expenditure of people admitted to the Encarnacion integrated respiratory hospital in one semester during the COVID-19 pandemic]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Giménez]]></surname>
<given-names><![CDATA[Edgar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[Juan María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acosta]]></surname>
<given-names><![CDATA[José Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Itapúa Investigación para el Desarrollo ]]></institution>
<addr-line><![CDATA[Encarnación ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Previsión Social Hospital Integrado Respiratorio de Encarnación ]]></institution>
<addr-line><![CDATA[Encarnación ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>54</volume>
<numero>3</numero>
<fpage>51</fpage>
<lpage>60</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1816-89492021000300051&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1816-89492021000300051&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1816-89492021000300051&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  Ante el COVID-19 se reorganizaron hospitales en el sistema de salud de Paraguay donde el financiamiento predominante es el gasto de bolsillo.  Objetivos:  Analizar el gasto de bolsillo en el hospital respiratorio integrado de Encarnación.  Materiales y métodos:  Estudio cuantitativo, observacional, descriptivo entre agosto 2020 y febrero 2021. Incluyó una muestra no aleatoria de 95 casos. Se aplicó una encuesta telefónica a un informante clave. Las variables dependientes fueron: gasto de bolsillo, razón gasto/ingreso y razón gasto/días de internación. Las independientes fueron: sexo, adulto mayor, ingreso a UTI, seguro médico y diagnóstico de COVID-19. El gasto excesivo se definió como mayor a 0,1 del ingreso y el catastrófico como mayor a 0,25 del ingreso. La asociación significativa se determinó mediante pruebas de Chi2 y Mann-Whitney (p&lt;0,05).  Resultados:  El 97,8% tuvo gasto de bolsillo principalmente por medicamentos y descartables. El gasto total promedio fue 1,98 millones Gs, el gasto diario promedio 215,4 mil Gs y la razón gasto/ingreso 1,13. En cuidados intensivos el gasto total promedio fue 7,18 millones Gs (el máximo fue 18,41 millones Gs), el gasto diario promedio 666,8 mil Gs (el máximo fue 2,85 millones Gs diarios) y la razón gasto/ingreso 3,83. El gasto fue excesivo en el 87% de los casos y catastrófico en el 52% de los casos. El gasto se asoció significativamente con la edad mayor a 60 años, el haber ingresado a UTI y el diagnóstico de COVID-19, no así con el sexo ni con la tenencia de seguro.  Conclusión:  Los mecanismos de protección financiera fueron insuficientes para evitar gastos excesivos y catastróficos durante la hospitalización.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Faced with COVID-19, hospitals were reorganized in the Paraguayan health system where the predominant financing is out-of-pocket expenses.  Objectives:  To analyze the out-of-pocket expenditure in the Encarnacion integrated respiratory hospital.  Materials and methods:  Quantitative, observational, descriptive study between August 2020 and February 2021. It included a non-random sample of 95 cases. A telephone survey was applied to a key informant. The dependent variables were: out-of-pocket expense, expense / income ratio, and expense / hospital days ratio. The independent ones were: sex, elderly, admission to ICU, medical insurance and diagnosis of COVID-19. Excessive spending was defined as greater than 0.1 of income and catastrophic as greater than 0.25 of income. The significant association was determined by Chi2 and Mann-Whitney tests (p &lt;0.05).  Results:  97.8% had out-of-pocket expenses mainly for medications and disposables. The average total expense was Gs 1.98 million, the average daily expense was Gs 215.4 thousand and the expense / income ratio was 1.13. In intensive care, the average total expenditure was 7.18 million Gs (the maximum was 18.41 million Gs), the average daily expenditure was 666.8 thousand Gs (the maximum was 2.85 million Gs per day) and the expense / income ratio 3.83. The expense was excessive in 87% of the cases and catastrophic in 52% of the cases. The expense was significantly associated with age over 60 years, having been admitted to the ICU and the diagnosis of COVID-19, not with sex or with insurance.  Conclusion:  The financial protection mechanisms were insufficient to avoid excessive and catastrophic expenses during hospitalization.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[gasto de bolsillo]]></kwd>
<kwd lng="es"><![CDATA[gasto catastrófico]]></kwd>
<kwd lng="es"><![CDATA[protección financiera]]></kwd>
<kwd lng="es"><![CDATA[cobertura universal de salud]]></kwd>
<kwd lng="es"><![CDATA[COVID-19.]]></kwd>
<kwd lng="en"><![CDATA[out-of-pocket spending]]></kwd>
<kwd lng="en"><![CDATA[catastrophic spending]]></kwd>
<kwd lng="en"><![CDATA[financial protection]]></kwd>
<kwd lng="en"><![CDATA[universal health coverage]]></kwd>
<kwd lng="en"><![CDATA[COVID-19.]]></kwd>
</kwd-group>
</article-meta>
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