Efeito dos sistemas de financiamento sobre os sistemas de saúde em países da América Latina e Caribe

Abstract

The main objective of this study is to investigate the impact of transitions between Health Financing Systems (SFS) from predominantly out-of-pocket (OOP) to predominantly government (GOV) or social health insurance (SHI) systems on health outcomes, both intermediate and health outcomes, in Latin American and Caribbean countries, in the period from 2000 to 2017. The effect of these transitions between SFS was estimated using a Differences in Differences model. The main results indicate that the transition to predominantly government financing or social health insurance systems is associated with a reduction in direct health expenditures. This reduction is most pronounced in transitions to predominantly social health insurance systems, with a decrease of 15.3%. In addition, the results suggest that transitions between different financing systems However, these transitions do not have a statistically significant effect on most health indicators. However, the reduction of direct expenditures to the population, without compromising health outcomes, suggests that financing systems based on government financing and social insurance are more efficient than those based on financing by direct disbursement. These results highlight the complexity of the relationships between health financing, governance, health outcomes, and the need for further empirical studies to assist policymakers in this area. The relevance of this study for the region lies in better understanding the unique challenges faced by countries in their health systems in improving the health status of the population. Therefore, empirical studies can provide solid evidence to guide the formulation of public policies related to health financing.