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Revista Facultad Nacional de Salud Pública

Print version ISSN 0120-386X

Abstract

MARRUGO-ARNEDO, Carlos Alberto et al. Concentration of Health Spending in a Subsidized-scheme Colombian Insurance Company, 2014. Rev. Fac. Nac. Salud Pública [online]. 2019, vol.37, n.1, pp.44-52. ISSN 0120-386X.  https://doi.org/10.17533/udea.rfnsp.v37n1a09.

Objective:

to estimate the concentration of health spending depending on pathology groups and types of services in a subsidized insurance company which enrolled low-income people (social economic strata 1 and 2) in the Colombian Healthcare System in 2014.

Methodology:

Health spending was analyzed in 1 666 477 members, set up by pathologies and types of services during 2014. To describe the concentration of health spending, researchers used the Gini coefficient and the Lorenz curve.

Results:

the health spending of the insurance company was US$418 million. Out of this, 81 % was used in service contained in the mandatory Health Plan (in Spanish, Plan Obligatorio de Salud -POS). The pathology groups that concentrated 43.4% of health spending were cardiovascular (14.3%), cancer (7.8%), respiratory diseases (7.3%), urinary diseases (7%) and trauma (6.9%). Diagnostic, healing and rehabilitation services represented 77.8% of health spending. Hospitalization was the service group with the highest impact on costs (47%), and consultations, the most used. The Lorenz curves showed that 70% of the health spending is concentrated in approximately 20% the Affiliated people, resulting in a 0.58 Gini coefficient.

Conclusion:

Diagnostic and treatment of chronic non-transmittable diseases concentrate a vast part of health spending, which produces a competition of resources for preventive services and healthcare promotion.

Keywords : health spending; insurance company; healthcare promoter; subsidized scheme; health system; economy in healthcare.

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