Table 8 Financial Protection and Access to Health Care Services
Country | Increase/decrease of OOP as % THE since scheme introduction [15] | Incidence of catastrophic health expenditure as % of households (at 40% of households’ capacity to pay, or otherwise indicated) | Impoverishing health expenditure as a % of population | Changes in utilization rates of health care services after introduction of subsidization scheme |
|---|---|---|---|---|
Bolivia | - 6% (1996a-2014) | 3.75% (2002) [98] 3.3% (2006) [99] | n/a | n/a |
Chile | - 10% (2004b-2014) | 6.4% (2012) [99] At 25% threshold: 21% (2010) 15% of households in the 1st and 2nd income quintiles (2006) [7] | Poverty headcount $2.00: 1.2% (2006) Poverty headcount $1.25: 0.4% (2006) [7] | 3% increase in utilization of outpatient health services among the 1st and 2nd income quintiles from 2003 to 2011 [7] |
Colombia | - 23% (1995–2014) | Slight improvement (for data from 2005–2010) [100] 2.8% (2012) [99] At 25% threshold: 8% (2010) 13% of households in the 1st and 2nd income quintiles (2008) 10% of households in the 1st and 2nd income quintiles (2010) Catastrophic payments are concentrated among the poor [7] | Slight improvement (for data from 2005–2010) [100] Poverty headcount $2.00: 1.8% (2008); 1.5% (2010) Poverty headcount $1.25: 1.2% (2008); 0.7% (2010) [7] | 50% increase in the use of health services among the poorest and the rural population from 1995 to 2005 [24] |
Costa Rica | +4% (1995–2014) | 0.4% (2012) [99] At 25% threshold: 1% (2010) Below 1% of households in the 1st and 2nd income quintiles (2004) 1% of households in the 1st and 2nd income quintiles (2013) [7] | Poverty headcount $2.00: 0.3% (2004); 0.1% (2013) Poverty headcount $1.25: 0.1% (2004); below 0.1% (2013) [7] | n/a |
Dominican Republic | - 24% (2001–2014) | At 30% threshold: 9.8% (2012) [99] | n/a | n/a |
Mexico | - 9% (2004–2014) 2002: 58% of total OOP from the uninsured and Seguro Popular enrolees 2010: 36% of total OOP from the uninsured and Seguro Popular enrolees [36] | 2.4% (2012) [99] 2000: 3.1% catastrophic health expenditure 2010: 2% catastrophic health expenditure [36] At 25% threshold: 1% (2010) 2% of households in the 1st and 2nd income quintiles (2000) 1% of households in the 1st and 2nd income quintiles (2010) [7] | Poverty headcount $2.00: 0.9% (2000); 0.2% (2010) Poverty headcount $1.25: 0.3% (2000); 0.1% (2010) [7] | In 2010 (compared to 2000) utilization rates of public health care services had increased for those previously uninsured (e.g. proportion of births in Ministry of Health facilities increased from 32% to 48%) [36] Increased access to drugs and to the treatment for chronic diseases [37] 1% decrease in utilization of outpatient health services among the 1st and 2nd income quintiles from 2006 to 2012 [7] |
Peru | −7% (2001–2014) | 4.0% (2012)104 At 25% threshold: 5% (2010) 4% of households in the 1st and 2nd income quintiles (2008) 5% of households in the 1st and 2nd income quintiles (2011) [5] Slight improvement since 2009 | Poverty headcount $2.00: 1% (2004); 1.1% (2011) Poverty headcount $1.25: 0.6% (2004); 0.7% (2011) [5] | Increase of 13 percentage points between 2000 and 2004 [74] Proportion of institutional deliveries increased from 24% of births in rural areas and 58% of births in urban areas in 2000 to 58% in rural and 85% in urban areas in 2012 [30] |
Uruguay | +3% (2007–2012) | n/a | n/a | n/a |