Universidad Peruana Cayetano Heredia

A Gender-Based and Quasi-Experimental Study of the Catastrophic and Impoverishing Health-Care Expenditures in Mexican Households with Elderly Members, 2000-2020

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dc.contributor.author Serván-Mori, Edson
dc.contributor.author Orozco-Núñez, Emanuel
dc.contributor.author Guerrero-López, Carlos M.
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Jan, Stephen
dc.contributor.author Downey, Laura
dc.contributor.author Feeny, Emma
dc.contributor.author Heredia-Pi, Ileana
dc.contributor.author Flamand, Laura
dc.contributor.author Nigenda, Gustavo
dc.contributor.author Norton, Robyn
dc.contributor.author Lozano, Rafael
dc.date.accessioned 2023-04-16T04:38:11Z
dc.date.available 2023-04-16T04:38:11Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13348
dc.description.abstract Latin America has experienced a rise in noncommunicable diseases (NCDs) which is having repercussions on the structuring of healthcare delivery and social protection for vulnerable populations. We examined catastrophic (CHE) and excessive (EHE, impoverishing and/or catastrophic) health care expenditures in Mexican households with and without elderly members (≥65 years), by gender of head of the households, during 2000-2020. We analyzed pooled cross-sectional data for 380,509 households from eleven rounds of the National Household Income and Expenditure Survey. Male- and female-headed households (MHHs and FHHs) were matched using propensity scores to control for gender bias in systematic differences regarding care-seeking (demand for healthcare) preferences. Adjusted probabilities of positive health expenditures, CHE and EHE were estimated using probit and two-stage probit models, respectively. Quintiles of EHE by state among FHHs with elderly members were also mapped. CHE and EHE were greater among FHHs than among MHHs (4.7% vs 3.9% and 5.5% vs 4.6%), and greater in FHHs with elderly members (5.8% vs 4.9% and 6.9% vs 5.8%). EHE in FHHs with elderly members varied geographically from 3.9% to 9.1%, being greater in less developed eastern, north-central and southeastern states. Compared with MHHs, FHHs face greater risks of CHE and EHE. This vulnerability is exacerbated in FHHs with elderly members, because of gender intersectional vulnerability. The present context, marked by a growing burden of NCDs and inequities amplified by COVID-19, makes key interlinkages across multiple Sustainable Development Goals (SDGs) apparent, and calls for urgent measures that strengthen social protection in health. en_US
dc.language.iso eng
dc.publisher Taylor and Francis
dc.relation.ispartofseries Health Systems and Reform
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Aged en_US
dc.subject Female en_US
dc.subject Mexico en_US
dc.subject Cross-Sectional Studies en_US
dc.subject Family Characteristics en_US
dc.subject *COVID-19/epidemiology en_US
dc.subject *Noncommunicable Diseases/epidemiology en_US
dc.subject Financial protection en_US
dc.subject gender en_US
dc.subject Health Expenditures en_US
dc.subject NCDs en_US
dc.subject Sexism en_US
dc.subject UHC en_US
dc.title A Gender-Based and Quasi-Experimental Study of the Catastrophic and Impoverishing Health-Care Expenditures in Mexican Households with Elderly Members, 2000-2020 en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1080/23288604.2023.2183552
dc.relation.issn 2328-8620


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