The DOI matches its Crossref record; 31 of the 34 references it cites were found in a registry or an index.
Out-of-pocket expenditure and financial protection in the Chilean health care system—A systematic review
Open accessAbstract
Background Protection against financial risk due to medical spending is an explicit health guarantee within Chile's AUGE health reform. This paper seeks to analyze the degree to which out-of-pocket expenditure still expose Chilean households to financial catastrophe and impoverishment, and to explore inequalities in financial protection. Methods A systematic literature review was conducted to identify empirical studies analyzing financial protection in Chile. The search included databases as well as grey literature, i.e. governmental and institutional webpages. The indicators are based on the conceptual framework of financial protection, as portrayed in the World Health Report 2013. Results We identify n=16 studies that fulfill the inclusion criteria. Empirical studies indicate that 4% of Chilean households faced catastrophic health expenditure defined as out-of-pocket expenditure exceeding 30% of household's capacity to pay, while less than 1% were pushed into poverty in 2012. In contrast to prior studies, recent data report that even publicly insured who should be fully protected from co-payments were affected by catastrophic health expenditure. Also in the private insurance system financial catastrophe is a common risk. Conclusion Despite health reform efforts, financial protection is insufficient and varies to the disadvantage of the poor and vulnerable groups. More research is required to understand why current mechanisms are not as effective as expected and to enable according reforms of the insurance system.
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“The incidence of catastrophic health expenditure we found in sub-Saharan Africa was lower than in China in the last decade,139 but higher than in Europe,140–142 Asia,134,143,144 and South America,145,146 irrespective of the definition used.”
From Catastrophic health expenditure in sub-Saharan Africa: systematic review and meta-analysis (2022) · cites this paper as [145]
In the citing paper
“Our findings are consistent with findings in comparable regions such as Southeast Asia [105, 106] and South America [107, 108].”
From Factors associated with catastrophic health expenditure in sub-Saharan Africa: A systematic review (2022) · cites this paper as [107]
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Cited by
The effects of neoliberal policies on access to healthcare for people with disabilities
Sakellariou, D., & Rotarou, E. S. (2017) · International Journal for Equity in Health · doi:10.1186/s12939-017-0699-3 · Cited by 195
Catastrophic health expenditure in sub-Saharan Africa: systematic review and meta-analysis
Eze, P., Osaheni Lawani, L., Justina Agu, U., & Acharya, Y. (2022) · Bulletin of the World Health Organization · doi:10.2471/blt.21.287673 · Cited by 133
Out-of-Pocket Health Expenditure and Poverty: Evidence from a Dynamic Panel Threshold Analysis
Sirag, A., & Nor, N. M. (2021) · Healthcare · doi:10.3390/healthcare9050536 · Cited by 133
Factors associated with catastrophic health expenditure in sub-Saharan Africa: A systematic review
Eze, P., Lawani, L. O., Agu, U. J., Amara, L. U., Okorie, C. A., & Acharya, Y. (2022) · PLOS ONE · doi:10.1371/journal.pone.0276266 · Cited by 60
Huang, A., Qiu, L., & Li, Z. (2020) · Journal of Computational and Applied Mathematics · doi:10.1016/j.cam.2020.113065 · Cited by 49
Metadata
- Authors
- Koch, K. J., Cid Pedraza, C., & Schmid, A.
- Affiliations
- University of Bayreuth (DE)
- Corresponding author
- Koch, Kira Johanna
- Venue
- Health Policy
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 121
- Issue
- 5
- Pages
- 481-494
- ISSN
- 0168-8510 (ISSN-L)
- OpenAlex
- W2594895769
- Cited by
- 51
- References
- 34
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 7 · 2021: 8 · 2020: 16 · 2019: 3 · 2018: 2 · 2017: 2
- FWCI
- 1.29
- Type
- journal article
- Language
- en
- Open access
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- Locations
- Health Policy (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- ERef Bayreuth (University of Bayreuth) (submittedVersion, cc-by-nc-nd)
- Funders
- Ludwig-Maximilians-Universität München
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Reforms
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- out-of-pocket costs, financial protection, catastrophic health expenditure, impoverishment, health insurance, Chilean health system, health disparities, copayments
- MeSH terms
- Catastrophic Illness, Chile, Health Expenditures, Financing, Personal, Humans, Insurance, Health, Poverty, Socioeconomic Factors, Health Care Reform
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- Koch, K. J., Cid Pedraza, C., & Schmid, A. (2017). Out-of-pocket expenditure and financial protection in the Chilean health care system—A systematic review. Health Policy. https://doi.org/10.1016/j.healthpol.2017.02.013
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
