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[墨西哥的灾难性医疗支出:规模、分布及决定因素]

[Catastrophic health expenditures in Mexico: magnitude, distribution and determinants].

作者信息

Sesma-Vázquez Sergio, Pérez-Rico Raymundo, Sosa-Manzano Carlos Lino, Gómez-Dantés Octavio

机构信息

Dirección General de Evaluación del Desempeño, Secretaría de Salud, México, DF, Mexico.

出版信息

Salud Publica Mex. 2005;47 Suppl 1:S37-46.

Abstract

OBJECTIVE

To describe the magnitude, distribution, and determinants of catastrophic health expenditures in Mexico.

MATERIAL AND METHODS

The information source was the National Performance Assessment Survey and the methodology, the one developed by the World Health Organization for assessing fair financing. Households with catastrophic expenditures were defined as those with health expenditures over 30% of their ability to pay. Multivariate analysis by logistic and linear regression were used to identify the determinants of catastrophic expenditures.

RESULTS

A total of 3.8% of the households incurred in catastrophic health expenditures. There were huge differences by state. The uninsured, poor, and rural households showed a higher impoverishment risk. Sixty percent of the catastrophic expenditures were attributable to outpatient care and medication. A 10% increase of insured households could result in a 9.6% decrease in catastrophic expenditures. Disability, adults 60 years of age and older, and pregnancy increased the probability of catastrophic expenditures.

CONCLUSIONS

The insurance of older adults, pregnant women, and persons with disabilities could reduce catastrophic health expenditures in Mexico.

摘要

目的

描述墨西哥灾难性卫生支出的规模、分布及决定因素。

材料与方法

信息来源为国家绩效评估调查,方法是世界卫生组织制定的用于评估公平筹资的方法。发生灾难性支出的家庭定义为卫生支出超过其支付能力30%的家庭。采用逻辑回归和线性回归进行多变量分析以确定灾难性支出的决定因素。

结果

共有3.8%的家庭发生了灾难性卫生支出。各州之间存在巨大差异。未参保家庭、贫困家庭和农村家庭显示出更高的贫困风险。60%的灾难性支出归因于门诊护理和药品。参保家庭增加10%可能导致灾难性支出减少9.6%。残疾、60岁及以上成年人和怀孕增加了发生灾难性支出的可能性。

结论

为老年人、孕妇和残疾人提供保险可以减少墨西哥的灾难性卫生支出。

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