SciELO - Scientific Electronic Library Online

vol.47 número6Prevalencia de infección por virus de papiloma humano (VPH) de alto riesgo y factores asociados en embarazadas derechohabientes del IMSS en el estado de MorelosDimensiones culturales en el proceso de atención primaria infantil: perspectivas de las madres índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados




Links relacionados

  • No hay artículos similaresSimilares en SciELO


Salud Pública de México

versión impresa ISSN 0036-3634


KNAUL, Felicia Marie; ARREOLA-ORNELAS, Héctor  y  MENDEZ, Oscar. Financial protection in health: Mexico, 1992 to 2004. Salud pública Méx [online]. 2005, vol.47, n.6, pp.430-439. ISSN 0036-3634.

OBJECTIVE: To document trends in financial protection in the health care system in Mexico between 1992 and 2004, applying a series of indicators that measure catastrophic and impoverishing health spending and the Index of Fairness in Financial Contributions. MATERIAL AND METHODS: This study uses the biannual time series of the Survey of Household Income and Expenditures (ENIGH) spanning the period 1992 to 2004. The methodologies seek to measure the level and distribution of the burden of health care finance on households, and the financial protection offered to them by the health care system. Four indicators are presented: 1) the Index of Fairness in Financial Contributions, 2) the proportion of households with catastrophic health expenditure, 3) the proportion of households with impoverishment due to health spending and 4) the sum of the proportion of households with catastrophic or impoverishing health spending, which is referred to as excessive health spending. The analysis presented in this document is descriptive, leaving for later studies a deeper analysis of causal aspects. RESULTS: The number of families that suffer impoverishment due to health spending increased from 5.2% in 1992, reached a high of 9.9% in 1996, and then gradually declined to 1.8% by 2004. The proportion of households with catastrophic expenses began at 2.8% in 1992, increased to 4.2% in 1998 and then fell to a level of 2.6% in 2004. The improvements from 2000 on are concentrated among the uninsured population, families affiliated to Popular Health Insurance, and households in the poorest two quintiles of the income distribution. CONCLUSIONS: The patterns over time in excessive health spending reflect a worsening during periods of economic crisis, post-crisis recovery, and a sustained improvement beginning in the year 2000. The data suggest that part of the reduction in the number of households with excessive health spending is due to the extension of financial protection for Mexican families through the Popular Health Insurance, while another part is associated with a decline in poverty. In addition, this paper documents an important relationship between economic trends and catastrophic and impoverishing health spending, suggesting the importance of financially protecting families through health insurance. Financial protection assists in guaranteeing that when economic crisis of a country -or of a family- coincides with illness, health care payments do not become the cause of a long or permanent period of impoverishment for households.

Palabras llave : financial protection; Popular Health Insurance; System for Social Protection in Health; out-of-pocket health spending; catastrophic health spending; index of fairness in financial contributions; impoverishment; economic crisis; Mexican health system; Mexico.

        · resumen en Español     · texto en Español     · Español ( pdf )


Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons