Cost-sharing and associated factors in the Peruvian private health care system

被引:0
作者
Bellido-Boza, Luciana [1 ,2 ]
Villarreal-Zegarra, David [1 ,3 ]
Pariona-Cardenas, Max [2 ]
Carrion, Roger [2 ]
Valdivia-Miranda, Paul [2 ]
Melendez-Torres, G. J. [4 ]
机构
[1] Univ Peruana Ciencias Aplicadas, Fac Ciencias Salud, Lima, Peru
[2] Superintendencia Nacl Salud, Lima, Peru
[3] Inst Peruano Orientac Psicol, Lima, Peru
[4] Univ Exeter, Fac Hlth & Life Sci, Exeter, England
关键词
ACCESS;
D O I
10.1371/journal.pone.0308277
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background The costs associated with healthcare are of critical importance to both decision-makers and users, given the limited resources allocated to the health sector. However, the available scientific evidence on healthcare costs in low- and middle-income countries, such as Peru, is scarce. In the Peruvian context, the health system is fragmented, and the private health insurance and its financing models have received less research attention. We aimed to analyse user cost-sharing and associated factors within the private healthcare system.Methods Our study was cross-sectional, using open data from the Electronic Transaction Model of Standardized Billing Data-TEDEF-SUSALUD, between 2021-2022. Our unit of analysis is the user's medical bills. We considered the total amount of cost-sharing, proportion of total payments as cost-sharing, and cost-sharing as a proportion of minimum salaries. We use a multiple regression model to perform the analyses.Results Our study included 5,286,556 health services provided to users of the private health insurance in Peru. We found a significant difference was observed in the cost-sharing for hospitalization-related services, with an average of 419.64 soles per day (95% CI: 413.44 to 425.85). Also, we identified that for hospitalization-related services per day is, on average, 0.41 (95% CI: 0.41 to 0.41) minimum salaries more expensive than outpatient care, although cost-sharing per day of hospitalization represent on average only 14% of the total amount submitted.Conclusions Our study provides a detailed overview of cost-sharing in the private healthcare system in Peru and the factors associated with them. Policymakers can use the study's finding that higher cost-sharing for inpatient hospitalization compared to outpatient care in private insurance can create inequities in access to healthcare to design policies aimed at reducing these costs and promoting a more equitable and accessible healthcare system in Peru.
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页数:12
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