Out-Of-Pocket Health Care Spending by the Chronically Ill in Chile

Out-of-pocket spending is the most unequal and inefficient way to fund health care. Nevertheless, it is widely spread across Latin-American countries, accounting in Chile for more than 40% of total health spending in the 2000s. Focusing on chronic conditions associated with lifestyle, we estimated the marginal impact of epidemiological characteristics of households on out-of-pocket health spending. To do so, we use two nationally-urban representative surveys and multivariate analysis. The number of chronic conditions, health care use, household income and insurance type were associated with out-of-pocket spending. Likewise, lower-middle income individuals with chronic diseases and their families are particularly exposed to these payments.