Public Health Financing and Out-of-Pocket Health Expenditure: A Comparative Analysis of Eight Latin American Countries (2000–2023)
DOI:
https://doi.org/10.57188/Keywords:
Health Expenditures; Health Financing; Public Expenditure; Health Systems; Latin America.Abstract
Objectives: To analyze the relationship between public health financing and out-of-pocket health expenditure in eight Latin American countries during the period 2000–2023. Materials and Methods: An observational, descriptive, comparative, ecological study was conducted using aggregated secondary data from Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Peru, and Uruguay. Average values for 2000–2023 were analyzed. Out-of-pocket expenditure was measured as a percentage of current health expenditure and as per capita expenditure adjusted by purchasing power parity (PPP). Public financing was assessed using general government health expenditure as a percentage of GDP, public health expenditure per capita (PPP), and its share of total general government expenditure. Results: Considerable variability in out-of-pocket expenditure was observed across countries. Higher levels of public health financing, both relative and per capita, were generally associated with lower household out-of-pocket expenditure; however, this relationship was not strictly linear. Conclusions: Increasing public health financing is a necessary, but not sufficient, condition for reducing out-of-pocket expenditure. Financial protection also depends on institutional arrangements and the organization of health systems.
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Copyright (c) 2026 Ronald Jonathan Cañarte Siguencia, María Fernanda Benavides Figueroa, Rafael Antonio Vera Villamar, Carlos Luis García Arguello
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