Gasto de bolsillo en adultos mayores afiliados a un seguro público de salud en México

Pavón-León, Patricia; Reyes-Morales, Hortensia; Martínez, Armando J.; Méndez-Maín, Silvia María; Gogeascoechea-Trejo, María del Carmen; Blázquez-Morales, María Sobeida Leticia

doi:10.1016/j.gaceta.2016.12.015

Cited by 20 publications

(18 citation statements)

References 5 publications

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“…The uncovered medical expenses were a considerable element of total hospitalization expenses. According to the research of Pavón-León et al, uncovered medical expenses rise from 12.8% to 27.5% as total medical costs increase [29]. The high-cost group usually needs additional medical consumable materials and drugs that are not included in the reimbursement list.…”

Section: Discussionmentioning

confidence: 99%

Impact of Critical Illness Insurance on the Burden of High-Cost Rural Residents in Central China: An Interrupted Time Series Study

Jiang

et al. 2019

IJERPH

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Critical illness insurance (CII) in China was introduced to protect high-cost groups from health expenditure shocks for the purpose of mutual aid. This study aimed to evaluate the impact of CII on the burden of high-cost groups in central rural China. Data were extracted from the basic medical insurance (BMI) hospitalization database of Xiantao City from January 2010 to December 2016. A total of 77,757 hospitalization records were included in our analysis. The out-of-pocket (OOP) expenses and reimbursement ratio (RR) were the two main outcome variables. Interrupted time series analysis with a segmented regression approach was adopted. Level and slope changes were reported to reflect short- and long-term effects, respectively. Results indicated that the number of high-cost inpatient visits, the average monthly hospitalization expenses, and OOP expenses per high-cost inpatient visit were increased after CII introduction. By contrast, the RR from BMI and non-reimbursable expenses ratio were decreased. The OOP expenses and RR covered by CII were higher than those uncovered. We estimated a significant level decrease in OOP expenses (p < 0.01) and rise in RR (p < 0.01), whereas the slope decreases of OOP expenses (p = 0.19) and rise of RR (p = 0.11) after the CII were non-significant. We concluded that the short-term effect of the CII policy is significant and contributes to decreasing OOP expenses and raising RR for high-cost groups, whereas the long-term effect is non-significant. These findings can be explained by increasing hospitalization expenses, many non-reimbursable expenses, low coverage for high-cost groups, and the unsustainability of the financing methods.

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Section: Discussionmentioning

confidence: 99%

Impact of Critical Illness Insurance on the Burden of High-Cost Rural Residents in Central China: An Interrupted Time Series Study

Jiang

et al. 2019

IJERPH

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“…La necesidad de contar con seguridad social en salud no se cubre solo con la afiliación, pues aunque el nivel de cobertura es amplio, las deficiencias en la calidad de la atención, la falta de accesibilidad a las instituciones y a los especialistas, la ausencia de personal sanitario y la suspensión de la medicación para patologías preexistentes (como hipertensión, diabetes, cáncer y enfermedades cardiovasculares) llevan a la búsqueda de otras instituciones públicas o privadas, lo que podría generar mayor exposición al SARS-CoV-2, aumentar el riesgo de contagio y generar gasto de bolsillo, que ante la situación actual podría ser catastrófico para los AM. [22][23][24][25] Dada la complejidad en las condiciones individuales de los AM como la cronicidad de multipatologías, la polifarmacia, la fragilidad física, la dependencia y la vulnerabilidad socioeconómica, es necesaria la atención multidisciplinario en caso de padecer COVID-19.…”

Section: Discussionunclassified

Estado de salud y valoración gerontológica en adultos mayores mexicanos ante la pandemia por COVID-19

Guzmán-Olea¹,

Agis-Juárez²,

Bermúdez-Morales³

et al. 2020

GMM

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“…Como consecuencia los pacientes no suelen utilizar este servicio, incentivando a pagar por servicios privados (29) . Otros estudios coinciden en que algunos seguros no protegen adecuadamente a la población asegurada (8,30) . Otro estudio coincide que en Perú el uso de servicios de salud es diferente según la tenencia y el tipo de seguro (29) .…”

Section: Discussionunclassified

Gasto de bolsillo en salud en adultos mayores peruanos: análisis de la Encuesta Nacional de Hogares sobre Condiciones de Vida y Pobreza 2017

Hernández-Vasquéz

Rojas‐Roque²,

Santero

et al. 2018

Rev Peru Med Exp Salud Publica

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RESUMENObjetivos. Estimar el gasto de bolsillo en salud (GBS) e identificar sus factores asociados en adultos mayores peruanos. Materiales y métodos. Estudio transversal analítico de la Encuesta Nacional de Hogares sobre Condiciones de Vida y Pobreza (ENAHO) 2017. Se consideró como adulto mayor a todo individuo de 60 y más años y el GBS como variable principal de estudio. Se estimaron razones de prevalencia (RP) y razones de prevalencia ajustada (RPa) para cada uno de los factores asociados a GBS. Las medias del GBS fueron estimadas mediante un modelo lineal generalizado con distribución gamma y función de enlace log. Todos los intervalos de confianza (95 %) de los estimadores fueron calculados mediante bootstrapping con el método basado en la normal. Resultados. Se incluyeron 18 386 adultos mayores, de los cuales en el 56,5 % se reportó GBS. La media y mediana del GBS es de 140,8 (USD 43,2) y 34,5 (USD 10,6) soles, respectivamente. Factores como procedencia urbana, mayor nivel de educación, padecer enfermedades crónicas y mayores gastos per cápita aumentan hasta 1,6 veces la probabilidad de GBS. En los afiliados al Seguro Integral de Salud (SIS) se reduce el GBS en 63,0 soles (USD 19,3) comparado con aquellos sin ningún seguro de salud. Conclusiones. Seis de cada diez adultos mayores peruanos reportó GBS para atender su salud. Esto genera inequidad en el acceso a los servicios de salud, principalmente para los grupos socialmente vulnerables. Se sugiere investigar el impacto económico de los seguros sanitarios y el abordaje preventivo-promocional de las enfermedades crónicas, en aras de reducir el GBS y mejorar la eficiencia del sistema de salud peruano. ABSTRACT Objectives.To estimate out-of-pocket spending on health (GBS) and identify its associated factors in Peruvian older adults. Materials and Methods. Analytical cross-sectional study of the National Household Survey on Living Conditions and Poverty (ENAHO) 2017. Older adults were considered to be all individuals aged 60 and over and the GBS was considered the main study variable. Prevalence ratios (PR) and adjusted prevalence ratios (PRa) were estimated for each of the factors associated with GBS. GBS means were estimated using a generalized linear model with gamma distribution and log binding function. All confidence intervals (95%) of the estimators were calculated by bootstrapping with the normal-based method. Results. Eighteen 386 older adults were included, of which 56.5% reported GBS. The mean and median GBS is S/. 140.8 (USD 43.2) and S/. 34.5 (USD 10.6), respectively. Factors such as urban origin, a higher level of education, chronic diseases and higher per capita expenses increase the probability of GBS by up to 1.6 times. In those affiliated to the Integral Health Insurance (SIS), the GBS is reduced by 63.0 soles (USD 19.3) compared to those without any health insurance. Conclusions. Six out of ten older Peruvian adults reported GBS to attend to their health needs. This generates an access inequity in terms of health services, mainly for socially-...

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Gasto de bolsillo en adultos mayores afiliados a un seguro público de salud en México

Abstract: People over age 60 enrolled in SP pay out of their pocket to meet their health needs, despite having public health insurance. This represents an inequity in access, especially for the most vulnerable such as the rural population.

Cited by 20 publications

References 5 publications

Impact of Critical Illness Insurance on the Burden of High-Cost Rural Residents in Central China: An Interrupted Time Series Study

Impact of Critical Illness Insurance on the Burden of High-Cost Rural Residents in Central China: An Interrupted Time Series Study

Estado de salud y valoración gerontológica en adultos mayores mexicanos ante la pandemia por COVID-19

Gasto de bolsillo en salud en adultos mayores peruanos: análisis de la Encuesta Nacional de Hogares sobre Condiciones de Vida y Pobreza 2017

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