Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil.
Cad Saude Publica. 2011;27 Suppl 2:S254-62. doi: 10.1590/s0102-311x2011001400012.
The objective of this study was to estimate catastrophic healthcare expenditure in Brazil, using different definitions, and to identify vulnerability indicators. Data from the 2002-2003 Brazilian Household Budget Survey were used to derive total household consumption, health expenditure and household income. Socioeconomic position was defined by quintiles of the National Economic Indicator using reference cut-off points for the country. Analysis was restricted to urban households. Catastrophic health expenditure was defined as expenditure in excess of 10% and 20% of total household consumption, and in excess of 40% of household capacity to pay. Catastrophic health expenditure varied from 2% to 16%, depending on the definition. For most definitions, it was highest among the poorer. The highest proportions of catastrophic health expenditure were found to be in the Central region of Brazil, while the South and the Southeast had the lowest. Presence of an elderly person, health insurance and socioeconomic position were associated with the outcome, and coverage by health insurance did not protect from catastrophic health expenditure.
本研究旨在使用不同的定义来估计巴西的灾难性医疗支出，并确定易受伤害的指标。研究数据来自 2002-2003 年巴西家庭预算调查，用于推导出家庭总消费、医疗支出和家庭收入。社会经济地位是通过使用国家参考临界点的国家经济指标五分位数来定义的。分析仅限于城市家庭。灾难性医疗支出的定义为超过家庭总消费的 10%和 20%的支出，以及超过家庭支付能力的 40%的支出。根据定义，灾难性医疗支出从 2%到 16%不等。对于大多数定义，最贫穷的人群中灾难性医疗支出的比例最高。巴西中部地区的灾难性医疗支出比例最高，而南部和东南部地区的比例最低。有老年人、医疗保险和社会经济地位与结果有关，医疗保险的覆盖范围并不能防止灾难性医疗支出。
