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Out-of-pocket health expenditure differences in Chile: Insurance performance or selection?

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  • Villalobos Dintrans, Pablo

Abstract

Chile has a mixed health system with public and private actors engaged in provision and insurance. This dual system generates important differences in health expenditure between private and public insurances. Selection is a preeminent feature of the Chilean insurance system. In order to explain the role of the insurance in out-of-pocket expenditures between households for different insurance schemes, decomposition methods are applied to disentangle the effect of household ‘composition and insurance’ degree of financial protection on health expenditures. Health expenditure patterns have not changed in the last 10 years with drugs, outpatient care, and dental health representing 60% of the health expenditure. Health expenditure/income is similar for different income groups in the public insurance, but decreases with income in households with private coverage, reflecting regressivity in health expenditure. On the other hand, health expenditure as share of expenditure increases with income for both groups.

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  • Villalobos Dintrans, Pablo, 2018. "Out-of-pocket health expenditure differences in Chile: Insurance performance or selection?," Health Policy, Elsevier, vol. 122(2), pages 184-191.
    • Handle: RePEc:eee:hepoli:v:122:y:2018:i:2:p:184-191
    DOI: 10.1016/j.healthpol.2017.11.007
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    References listed on IDEAS

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    1. Koch, Kira Johanna & Cid Pedraza, Camilo & Schmid, Andreas, 2017. "Out-of-pocket expenditure and financial protection in the Chilean health care system—A systematic review," Health Policy, Elsevier, vol. 121(5), pages 481-494.
    2. Fortin, Nicole & Lemieux, Thomas & Firpo, Sergio, 2011. "Decomposition Methods in Economics," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 4, chapter 1, pages 1-102, Elsevier.
    3. Oaxaca, Ronald, 1973. "Male-Female Wage Differentials in Urban Labor Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 14(3), pages 693-709, October.
    4. Alan S. Blinder, 1973. "Wage Discrimination: Reduced Form and Structural Estimates," Journal of Human Resources, University of Wisconsin Press, vol. 8(4), pages 436-455.
    5. Ben Jann, 2008. "A Stata implementation of the Blinder-Oaxaca decomposition," ETH Zurich Sociology Working Papers 5, ETH Zurich, Chair of Sociology, revised 14 May 2008.
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    1. Florencia Borrescio-Higa & Nieves Valdés, 2021. "Medical Cost of Cancer Care for Privately Insured Children in Chile," IJERPH, MDPI, vol. 18(13), pages 1-15, June.
    2. Carlos Piñones-Rivera & Nanette Liberona & Rodrigo Arancibia & Verónica Jiménez, 2022. "Indigenous Border Migrants and (Im)Mobility Policies in Chile in Times of COVID-19," IJERPH, MDPI, vol. 19(15), pages 1-18, August.
    3. Kim, Sujin & Kwon, Soonman, 2023. "Has South Korea achieved the goals of national health insurance? Trends in financial protection of households between 2011 and 2018," Social Science & Medicine, Elsevier, vol. 326(C).
    4. Gloria A Aguayo & Anna Schritz & Maria Ruiz-Castell & Luis Villarroel & Gonzalo Valdivia & Guy Fagherazzi & Daniel R Witte & Andrew Lawson, 2020. "Identifying hotspots of cardiometabolic outcomes based on a Bayesian approach: The example of Chile," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-16, June.
    5. Pablo Villalobos Dintrans, 2020. "Health Systems, Aging, and Inequity: An Example from Chile," IJERPH, MDPI, vol. 17(18), pages 1-9, September.

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