Abstract

ALVIS-ESTRADA, Luís; ALVIS-GUZMAN, Nelson  and  DE LA HOZ, Fernando. Household spending on private health care in Cartagena de Indias, 2004. Rev. salud pública [online]. 2007, vol.9, n.1, pp.11-25. ISSN 0124-0064.

Objective Determining household out-of-pocket payments for access to health care services in Cartagena, Colombia, and its correlation with head of household characteristics (socioeconomic level, schooling, general social health security system (GSHSS) affiliation and type of work). Methods A cross-sectional study was carried out on a sample of 384 homes selected by using proportional stratified random sampling. Data was collected using a standardised form. SPSS (version 10.0) was used for statistical and econometric analysis. Results The lowest socioeconomic strata (1 and 2) were incurring higher out-of-pocket expenditure than higher strata (3-6). Other factors predicting greater expenditure on health compared to income were household heads' low level of schooling, being unemployed or working independently and the fact of not being affiliated to the GSHSS. Conclusions Market mechanism expansion into the Colombian health system has resulted in greater inequality in terms of out-of-pocket payment for the lowest social strata. Our findings suggest that the need for such financing represents an important barrier for gaining access to health care.

Keywords : Health system; financing; equity; out-of-pocket expenditure.

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