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Out-of-pocket expenditure and financial protection in the Chilean health care system : a systematic review

Title data

Koch, Kira Johanna ; Pedraza, Camilo Cid ; Schmid, Andreas:
Out-of-pocket expenditure and financial protection in the Chilean health care system : a systematic review.
In: Health Policy. Vol. 121 (2017) Issue 5 . - 481 - 494.
ISSN 0168-8510
DOI: https://doi.org/10.1016/j.healthpol.2017.02.013

Official URL: Volltext

Abstract in another language

Background: Protection against financial risk due to medical spending is an explicit health guarantee within Chile’s {AUGE} health reform. This paper seeks to analyze the degree to which out-of-pocket expenditure still expose Chilean households to financial catastrophe and impoverishment, and to explore inequalities in financial protection. Methods: A systematic literature review was conducted to identify empirical studies analyzing financial protection in Chile. The search included databases as well as grey literature, i.e. governmental and institutional webpages. The indicators are based on the conceptual framework of financial protection, as portrayed in the World Health Report 2013. Results: We identify n = 16 studies that fulfill the inclusion criteria. Empirical studies indicate that 4 of Chilean households faced catastrophic health expenditure defined as out-of-pocket expenditure exceeding 30 of household’s capacity to pay, while less than 1 were pushed into poverty in 2012. In contrast to prior studies, recent data report that even publicly insured who should be fully protected from co-payments were affected by catastrophic health expenditure. Also in the private insurance system financial catastrophe is a common risk. Conclusion: Despite health reform efforts, financial protection is insufficient and varies to the disadvantage of the poor and vulnerable groups. More research is required to understand why current mechanisms are not as effective as expected and to enable according reforms of the insurance system.

Further data

Item Type: Article in a journal
Refereed: Yes
Keywords: Out-of-pocket expenditure; Financial protection; Catastrophic health expenditure; Impoverishment; Chile; AUGE reform
Institutions of the University: Faculties > Faculty of Law, Business and Economics > Department of Business Administration > Juniorprofessur Gesundheitsmanagement > Juniorprofessur Gesundheitsmanagement - Juniorprof. Dr. Andreas Schmid
Faculties
Faculties > Faculty of Law, Business and Economics
Faculties > Faculty of Law, Business and Economics > Department of Business Administration
Faculties > Faculty of Law, Business and Economics > Department of Business Administration > Juniorprofessur Gesundheitsmanagement
Result of work at the UBT: Yes
DDC Subjects: 300 Social sciences > 330 Economics
Date Deposited: 03 May 2017 05:53
Last Modified: 03 May 2017 05:53
URI: https://eref.uni-bayreuth.de/id/eprint/36938