Gasto catastrófico en salud en México y sus factores determinantes, 2002-2014

Gac Med Mex. 2017;153(7):757-764. doi: 10.24875/GMM.17002616.

Abstract

Objective: To assess the financial protection of public health insurance by analyzing the percentage of households with catastrophic health expenditure (HCHE) in Mexico and its relationship with poverty status, size of locality, federal entity, insurance status and items of health spending.

Method: Mexican National Survey of Income and Expenditures 2002-2014 was used to estimate the percentage of HCHE. Through a probit model, factors associated with the occurrence of catastrophic spending are identified. Analysis was performed using Stata-SE 12.

Results: In 2014 there were 2.08% of HCHE (1.82-2.34%; N = 657,474). The estimated probit model correctly classified 98.2% of HCHE (Pr (D) ≥ 0.5). Factors affecting the catastrophic expenditures were affiliation, presence of chronic disease, hospitalization expenditure, rural condition and that the household is below the food poverty line.

Conclusions: The percentage of HCHE decreased in recent years, improving financial protection in health. This decline seems to have stalled, keeping inequities in access to health services, especially in rural population without affiliation to any health institution, below the food poverty line and suffering from chronic diseases.

Keywords: Health expenditure; Out of pocket spending; Probabilistic models.

MeSH terms

  • Chronic Disease
  • Family Characteristics
  • Financing, Personal / economics
  • Financing, Personal / statistics & numerical data*
  • Health Expenditures / statistics & numerical data*
  • Healthcare Disparities / economics
  • Healthcare Disparities / statistics & numerical data
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data
  • Humans
  • Insurance, Major Medical / economics
  • Insurance, Major Medical / statistics & numerical data*
  • Mexico
  • Poverty / economics
  • Poverty / statistics & numerical data*
  • Rural Population / statistics & numerical data