medigraphic.com
SPANISH

Salud Pública de México

Instituto Nacional de Salud Pública
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2019, Number 4

<< Back Next >>

salud publica mex 2019; 61 (4)

Out of pocket expenditure on health during the last year of life of Mexican elderly: analysis of the Enasem

Salinas-Escudero G, Carrillo-Vega MF, Pérez-Zepeda MU, García-Peña C
Full text How to cite this article

Language: Spanish
References: 38
Page: 504-513
PDF size: 397.65 Kb.


Key words:

out-of-pocket expenditures, elderly population, end of life care, social security, Mexico.

ABSTRACT

Objective. To estimate the out-of-pocket expenses (OOPE) during the last year of life in Mexican older adults (OA). Materials and methods. Estimation of the OOPE corresponding to the last year of life of OA, adjusting by type of management, affiliation and cause of death. Data from the National Health and Aging Study in Mexico (2012) were used. To calculate the total OOPE, the expenses in the last year were used in: medications, medical consultations and hospitalization. The OOPE was adjusted for inflation and is reported in US dollars 2018. Results. The mean OOPE was $6 255.3±18 500. In the ambulatory care group, the OOPE was $4 134.9±13 631.3. The OOPE in hospitalization was $7 050.6±19 971.0. Conclusions. The probability of incurre in OOPE is lower when hospitalization is not required. With hospitalization, affiliation to social security and attending to public hospitals plays a protective role.


REFERENCES

  1. United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing. New York: United Nations, 2017.

  2. United Nations, Department of Economic and Social Affairs, Population Division. World Population Prospects: The 2015 Revision, key findings and advance tables. Working Paper No. ESA/P/WP.241. 2015. New York: United Nations, 2015.

  3. Consejo Nacional de Población. Proyecciones de la Población 2010- 2050. Población a mitad de año por sexo y edad. México: CONAPO [acceso 15 de noviembre 2016]. Disponible en: http://www.conapo.gob. mx/es/CONAPO/Proyecciones_Datos

  4. Stanton MW, Rutherford MK. The high concentration of US health care expenditures. Rockville MD: Agency for Healthcare Research and Quality (AHRQ), 2015.

  5. Organización para la Cooperación y el Desarrollo Económicos. OECD Health Statistics 2016. Expenditure by disease, age and gender under the System of Health Accounts (SHA). Framework: Current health spending by age. París: OECD, 2016.

  6. Dieleman JL, Baral R, Birger M, Bui AL, Bulchis A, Chapin A, et al. US spending on personal health care and public health, 1996-2013. Jama. 2016;316:2627-46. https://doi.org/10.1001/jama.2016.16885

  7. Secretaría de Salud, Dirección General de Información en Salud. Sistema de Cuentas en Salud a Nivel Federal y Estatal (SICUENTAS). México: Secretaría de Salud, 2016.

  8. Hoover DR, Crystal S, Kumar R, Sambamoorthi U, Cantor JC. Medical expenditures during the last year of life: findings from the 1992-1996 Medicare current beneficiary survey. Health Serv Res. 2002;37:1625-42. https://doi.org/10.1111/1475-6773.01113

  9. Wong R, Michaels-Obregon A, Palloni A, Gutiérrez-Robledo LM, González-González C, López-Ortega M, et al. Progression of aging in Mexico: the Mexican Health and Aging Study (MHAS) 2012. Salud Publica Mex. 2015;57Suppl 1:S79-89. https://doi.org/10.21149/spm.v57s1.7593

  10. Penders YW, Rietjens J, Albers G, Croezen S, Van den Block L. Differences in out-of-pocket costs of healthcare in the last year of life of older people in 13 European countries. Palliat Med. 2017;31:42-52. https://doi. org/10.1177/0269216316647206

  11. Gottret P, Schieber G. Estudio del financiamiento de la salud: una guía para especialistas. Colombia: Banco Mundial/Mayol Ediciones, 2007.

  12. Xu K, Ravndal F, Evans DB, Carrin G. Assessing the reliability of household expenditure data: results of the World Health Survey. Health Policy. 2009;91:297-05. https://doi.org/10.1016/j.healthpol.2009.01.002

  13. Organización para la Cooperación y el Desarrollo Económicos. Realinear el financiamiento para cubrir mejor las necesidades de la atención de la salud individual. Estudios de la OCDE sobre los Sistemas de Salud. Paris: OECD Publishing, 2016.

  14. Bagchee S. Private health sector in India: single level health care is the only solution. BMJ. 2005;331:1339.

  15. Xu K, Saksena P, Jowett M, Indikadahena C, Kutzin J, Evans DB. Exploring the thresholds of health expenditure for protection against financial risk. World Health Report (2010) Background Paper, No 19. Geneva: WHO, 2010.

  16. Orlovic M, Marti J, Mossialos E. Analysis of end-of-life care, outof- pocket spending, and place of death in 16 European countries and Israel. Health Aff (Millwood). 2017;36:1201-10. 2017/07/07. https://doi. org/10.1377/hlthaff.2017.0166

  17. Rogowski J, Lillard LA, Kington R. The financial burden of prescription drug use among elderly persons. Gerontologist. 1997;37:475-82. https:// doi.org/10.1093/geront/37.4.475

  18. Sambamoorthi U, Shea D, Crystal S. Total and out-of-pocket expenditures for prescription drugs among older persons. Gerontologist. 2003;43:345-359. https://doi.org/10.1093/geront/43.3.345

  19. Gregersen FA. The impact of ageing on health care expenditures: a study of steepening. Eur J Health Econ. 2014;15:979-89. https://doi. org/10.1007/s10198-013-0541-9

  20. Dobkin C, Finkelstein A, Kluender R, Notowidigdo MJ. The Economic Consequences of Hospital Admissions. Am Econ Rev. 2018;108:308-52. https://doi.org/10.1257/aer.20161038

  21. Polder JJ, Barendregt JJ, van Oers H. Health care costs in the last year of life--the Dutch experience. Soc Sci Med. 2006;63:1720-31. https://doi. org/10.1016/j.socscimed.2006.04.018

  22. Kelley AS, McGarry K, Fahle S, Marshall SM, Du Q, Skinner JS. Out-of-pocket spending in the last five years of life. J Gen Intern Med. 2013;28:304-9. https://doi.org/10.1007/s11606-012-2199-x

  23. Langa KM, Fendrick AM, Chernew ME, Kabeto MU, Paisley KL, Hayman JA. Out-of-pocket health-care expenditures among older Americans with cancer. Value Health. 2004;7:186-94. https://doi.org/10.1111/j.1524- 4733.2004.72334.x

  24. Narang AK, Nicholas LH. Out-of-pocket spending and financial burden among medicare beneficiaries with cancer. JAMA Oncol. 2017;3:757-65. https://doi.org/10.1001/jamaoncol.2016.4865

  25. Jing Z, Chu J, Imam Syeda Z, Zhang X, Xu Q, Sun L, et al. Catastrophic health expenditure among type 2 diabetes mellitus patients: A provincewide study in Shandong, China. J Diabetes Investig. 2018. https://doi. org/10.1111/jdi.12901

  26. Zhang A, Nikoloski Z, Mossialos E. Does health insurance reduce out-of-pocket expenditure? Heterogeneity among China’s middle-aged and elderly. Soc Sci Med. 2017;190:11-9. https://doi.org/10.1016/j.socscimed. 2017.08.005

  27. King G, Gakidou E, Ravishankar N, Moore RT, Lakin J, Vargas M, et al. A politically robust experimental design for public policy evaluation, with application to the Mexican universal health insurance program. J Policy Anal Manage. 2007;26(3):479-506. https://doi.org/10.1002/pam.20279

  28. Brinda EM, Kowal P, Attermann J, Enemark U. Health service use, out-of-pocket payments and catastrophic health expenditure among older people in India: the WHO Study on global AGEing and adult health (SAGE). J Epidemiol Community Health. 2015;69:489-494. https://doi. org/10.1136/jech-2014-204960

  29. Balarajan Y, Selvaraj S, Subramanian SV. Health care and equity in India. Lancet 2011;377:505-15. https://doi.org/10.1016/S0140-6736(10)61894-6.36

  30. Jeyashree K. Profile of and expenditure on morbidity and hospitalizations among elderly—Analysis of a nationally representative sample survey in India. Arch Gerontol Geriatr. 2018;74:55-61. https://doi. org/10.1016/j.archger.2017.09.007

  31. Albanese E, Liu Z, Acosta D, Guerra M, Huang Y, Jacob KS, et al. Equity in the delivery of community healthcare to older people: findings from 10/66 Dementia Research Group cross-sectional surveys in Latin America, China, India and Nigeria. BMC Health Serv Res. 2011;11:153. https://doi. org/10.1186/1472-6963-11-153

  32. Makinen M, Waters H, Rauch M, Almagambetova N, Bitran R, Gilson L, et al. Inequalities in health care use and expenditures: empirical data from eight developingcountries and countries in transition. Bull World Health Organ. 2000;78(1):55-65.

  33. Gotsadze G, Gaál P. Coverage decisions: benefit entitlements and patient cost sharing. En: Kutzin J, Cashin C, Jakab M. Implementing health financing reform: lessons from countries in transition. Copenhagen: World Health Organization, 2010. 187-217.

  34. Instituto Nacional de Salud Pública. Encuesta Nacional de Salud y Nutrición 2012. Resultados por entidad federativa, Distrito Federal. Cuernavaca, México: Instituto Nacional de Salud Pública, 2013.

  35. Consejo Nacional de Evaluación de la Política de Desarrollo Social. Indicadores de acceso y uso efectivo de los servicios de salud de afiliados al Seguro Popular. México, DF: Coneval, 2014.

  36. Perez-Zepeda MU, Cesari M, Carrillo-Vega MF, Salinas-Escudero G, Tella-Vega P, García-Peña C. A frailty index from next-of-kin data: a crosssectional analysis from the Mexican health and aging study. BioMed Res Int. 2017;2017:6069374. https://doi.org/10.1155/2017/6069374

  37. Halanych JH, Shuaib F, Parmar G, Tanikella R, Howard VJ, Roth DL, et al. Agreement on cause of death between proxies, death certificates, and clinician adjudicators in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Am J Epidemiol. 2011;173:1319-26. 2011/05/05. https://doi.org/10.1093/aje/kwr033

  38. Instituto Nacional de Estadística y Geografía (INEGI). Encuesta Intercensal 2015. México: INEGI, 2015. Disponible en: https://www.inegi.org. mx/programas/intercensal/2015/




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

salud publica mex. 2019;61