Study on the concentration, distribution, and persistence of health spending for the contributory scheme in Colombia

Espinosa, Oscar, Friebel, Rocco ORCID: 0000-0003-1256-9096, Bejarano, Valeria, Arias, Martha Liliana, Husereau, Don and Smith, Adrian (2024) Study on the concentration, distribution, and persistence of health spending for the contributory scheme in Colombia. BMC Health Services Research, 24 (1). ISSN 1472-6963

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Abstract

Colombia is among the countries with the most robust financial protection against personal health spending in the world, with out-of-pocket spending ranking lowest across OECD countries. We investigate the evolution, distribution, and persistence of health spending by age group, sex, health care setting, health condition and geographic region for over 19 million users of Colombia’s health system between 2013 and 2021 (contributory scheme). We use average patient-level expenditure data from the Health-Promoting Entities of the Ministry of Health and Social Protection. We applied multivariate statistical techniques such as multiple correspondence analysis, factor maps and correlations. For both sexes, average health expenditure increases gradually with age until 60 years, accelerating thereafter abruptly. Health conditions with the highest percentage of expenditure were those related to neoplasms, blood diseases, circulatory system, pregnancy, puerperium and perinatal period. We found that home-based care in Amazonía-Orinoquía is almost non-existent, and that outpatient care represents a high proportion in all age groups (over 65%) compared to the other regions. There is a strong persistence of expenditure from one year to the next (i.e. they can provide relevant information for prediction), especially in areas with a larger supply of health services such as Bogotá-Cundinamarca. To the authors’ knowledge, this is the most comprehensive and detailed micro-analysis of health spending that has been developed for a Latin American country to date.

Item Type:	Article
Additional Information:	© 2024 The Author(s).
Divisions:	Health Policy
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
JEL classification:	H - Public Economics > H5 - National Government Expenditures and Related Policies > H51 - Government Expenditures and Health I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy; Regulation; Public Health C - Mathematical and Quantitative Methods > C5 - Econometric Modeling > C59 - Other
Date Deposited:	25 Oct 2024 11:21
Last Modified:	01 Nov 2024 18:27
URI:	http://eprints.lse.ac.uk/id/eprint/125891

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