Gasto de bolsillo y gasto catastrófico en salud en los hogares de Cartagena, Colombia

Alvis-Zakzuk, J.; Marrugo-Arnedo, Carlos Alberto; Alvis-Zakzuk, Nelson J.; Rosa, Fernando Gómez de la; Flórez-Tanus, Álvaro; Moreno-Ruiz, Deicy; Alvis-Guzmán, Nelson

doi:10.15446/rsap.v20n5.61403

Cited by 6 publications

(12 citation statements)

References 27 publications

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“…In Colombia, since the creation of the "Cuenta de Alto Costo" (that is, high-cost account) to pool funds, thereby redistributing financial risk for catastrophic conditions across the entire population 143 , the prevalence of treated kidney failure has increased but the incidence has decreased, suggesting the success of integrated prevention strategies and the utility of a CKD registry to monitor outcomes 144 . However, this system has been criticized for lack of transparency, emphasis on KRT rather than prevention, and persistent inequalities regarding the financial protection of households 145,146 .…”

Section: Sustainability and Innovationmentioning

confidence: 99%

Sustainable Development Goals relevant to kidney health: an update on progress

et al. 2020

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Section: Sustainability and Innovationmentioning

confidence: 99%

Sustainable Development Goals relevant to kidney health: an update on progress

et al. 2020

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“…Los resultados señalaron que los pobres tuvieron más posibilidad de obtener medicamentos gratuitos (OR 1,7) pero que este mecanismo (43) fue insuficiente para evitar una mayor posibilidad de GBS excesivos y catastróficos para ellos (OR 3,04 y 3,07, respectivamente). Esta distribución desigual del GBS y GCS entre los pobres fue consistente con los hallazgos en otros países como Colombia, México y Perú, donde el GBS se ha asociado a la vulnerabilidad social y a la falta de cobertura de la seguridad social (20,22,24) .…”

Section: Discussionunclassified

“…En Colombia, Pérez y Silva reportaron que el GCS afectó al 4,1% de los hogares distribuidos según ciertos determinantes y regiones del país (19) . Otro estudio específico sobre hogares de Cartagena, Colombia, de Alvis-Zakzuk y colaboradores, encontró diferencias entre la incidencia del GBS sobre los ingresos y la distribución de GCS entre hogares pobres y no pobres: el GBS fue el 30% de los ingresos de hogares pobres y el 7% de los hogares ricos, mientras que el riesgo de GCS fue 30,6% en los hogares pobres y de 8,6% en los hogares de mayor ingreso (20) . En México, Knaul y colaboradores encontraron asociación significativa ente la afiliación al seguro popular de salud y la reducción de GES (21) .…”

Section: Introductionunclassified

Asociación entre gastos de bolsillo de salud y pobreza utilizando datos de la Encuesta Permanente de Hogares en Paraguay en el 2014

Giménez-Caballero

Flores

Rodríguez

et al. 2021

Mem. Inst. Investig. Cienc. Salud

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La cobertura y acceso universal de salud requiere de protección financiera, lo que puede evaluarse a través del gasto de bolsillo ante una enfermedad. El objetivo del trabajo fue analizar la asociación entre el gasto de bolsillo de salud y la pobreza en Paraguay. Se utilizó la Encuesta Permanente de Hogares del 2014 para determinar la razón entre gasto de bolsillo ante una enfermedad con los ingresos del hogar, con las transferencias estatales para pobres, con la canasta básica de consumo y de alimentos. Fueron incluidos 5.165 hogares de los cuales 21,49% eran pobres. Hubo gasto de bolsillo en el 45,19% de los hogares asociándose significativamente con la pobreza (OR: 1,8; IC95%: 1,57 a 2,06). El 1,99% de los hogares tuvo gasto de bolsillo mayor a 25% de sus ingresos y el 5,98% mayor a 10% de sus ingresos, ambos indicadores se asociaron significativamente con la pobreza (OR: 3,70; IC95%: 2,50 a 5,50 y OR: 3,04; IC95%: 2,40 a 2,06, respectivamente). Hubo empobrecimiento en el 1,44% de los hogares, y la brecha de la pobreza pasó de 34,58% a 37,67%. Entre los hogares pobres el gasto de bolsillo fue equivalente a 4,9 días de consumo, a 11,5 días de alimentación y a 42% del valor de transferencias estatales. Estos hallazgos reflejan una insuficiente protección financiera del sistema de salud en Paraguay.

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“…According to the study, the incidence of CHE was higher in the Pacific and Atlantic regions of Colombia, with rates of 16.9% and 11.3% respectively [19]. Studies conducted in Colombia that have analysed OOP payments patterns and differences based on geographical, socioeconomic, and demographic characteristics have confirmed that a household's area of residence is a factor in the incidence of CHE [19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 97%

What are the factors associated with catastrophic health expenditure in Colombia? A multi-level analysis

Ramirez-Agudelo,

Pinilla-Roncancio

2023

PLoS ONE

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Introduction Target 3.8 of the Sustainable Development Goals calls for the guaranteeing of universal health service coverage without generating financial risks for households and individuals. In Colombia, there is no up-to-date information on the proportion of households that suffer catastrophic health expenditure (CHE), nor about how these expenses are associated with the place of residence. To contribute to an understanding of these issues, this study analyses the differences in the levels of CHE among Colombian households, and their association with the province and area (urban or rural) of residence. Methods This is a descriptive and analytical cross-sectional study using the 2016–2017 National Household Budget Survey, the household and population Census 2018, and the Register of Health Providers 2017. We used the definition of CHE proposed by the World Health Organization, with a threshold of 20%. We estimated the percentage of households facing CHE, and its intensity, and estimated a multi-level logistic regression model, using as the dependent variable the question of whether a household experienced CHE, and the province as a second level, where explanatory variables related to the province were included. Results We found differences in CHE levels according to the province of residence. At the national level, 1.77% of households experienced CHE, and households in the provinces of Boyacá (5.04%), Nariño (4.04%), Cauca (3.82%), and Chocó (3.78%) faced the highest CHE. For most households with CHE in these provinces, spending on medicines and medical consultations represented close to 50% of their out-of-pocket spending. The multi-level logistic regression model indicated that there are significant variations in CHE attributed to the provinces under study, where the contextual variables of hospital-bed density (AOR = 0.91; 95% CI 0.86–0.96) and incidence of multi-dimensional poverty (AOR = 1.13; 95% CI 1.01–1.30) were factors associated with CHE. For an urban household, 6.58% of the CHE variation is attributed to the province in question, while for a rural household the corresponding variation is 1.56%. Conclusions The geographical location of the household is a key factor when studying CHE in Colombia, where rural households present higher levels of CHE, mainly in the delivery of medicines and medical consultations. The findings reveal the need to analyse financial protection at the local level and establish policies to protect households, especially poor households, from CHE.

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Gasto de bolsillo y gasto catastrófico en salud en los hogares de Cartagena, Colombia

Cited by 6 publications

References 27 publications

Sustainable Development Goals relevant to kidney health: an update on progress

Sustainable Development Goals relevant to kidney health: an update on progress

Asociación entre gastos de bolsillo de salud y pobreza utilizando datos de la Encuesta Permanente de Hogares en Paraguay en el 2014

What are the factors associated with catastrophic health expenditure in Colombia? A multi-level analysis

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