F Out-of-pocket health expenditure differences in Chile Insurance performance or selection 2017 – پروژه 20

Out-of-pocket health expenditure differences in Chile Insurance performance or selection 2017

Out-of-pocket health expenditure differences in Chile Insurance performance or selection 2017

tChile 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 publicinsurances. Selection  is a preeminent feature of the Chilean insurance system. In order to explain the roleof 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 inthe 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 decreaseswith income in households with private coverage, reflecting regressivity in health expenditure. On theother hand, health expenditure as share of expenditure increases with income for both groups.Per capita health expenditure in households with private coverage is four times the expenditure ofhouseholds with public insurance; this gap is mostly explained by differences in households’ expenditureand demographics. Roughly 80% of the difference in expenditure is explained by the model, showing therole of selection in understanding the expenditure gap between insurance schemes

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