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

Pablo Villalobos Dintrans

Health Policy, 2018, vol. 122, issue 2, 184-191

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.

Keywords: Out-of-pocket health expenditure; Health insurance; Mixed public-private systems; Mean decomposition (search for similar items in EconPapers)
Date: 2018
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