Household catastrophic health expenditures: A comparative analysis of twelve latin American and Caribbean countries

Felicia Marie Knaul, Rebeca Wong, Héctor Arreola-Ornelas, M. Health Econ, Oscar Méndez, Ricardo Bitran, Antonio Carlos Campino, Carmen Elisa Flórez Nieto, Roberto Iunes Fontes, Ursula Giedion, Daniel Maceira, Magdalena Rathe, Martin Valdivia, Juan Rafael Vargas, Juan José Díaz, María Dolores Montoya Díaz, Werner Valdes, Ricardo Valladares Carmona, Maria Paola Zuniga, Liv LafontaineRodrigo Muñoz, Renata Pardo, Ana María Reynoso, María Isabel Santana, Rosa Vidarte

Research output: Contribution to journalArticlepeer-review

69 Scopus citations


Objective: Compare patterns of catastrophic health expenditures in 12 countries in Latin America and the Caribbean. Material and Methods: Prevalence of catastrophic expenses was estimated uniformly at the household level using household surveys. Two types of prevalence indicators were used based on out-of-pocket health expense: a) relative to an international poverty line, and b) relative to the household's ability to pay net of their food basket. Ratios of catastrophic expenditures were estimated across subgroups defined by economic and social variables. Results: The percent of households with catastrophic health expenditures ranged from 1 to 25% in the twelve countries. In general, rural residence, lowest quintile of income, presence of older adults, and lack of health insurance in the household are associated with higher propensity of catastrophic health expenditures. However, there is vast heterogeneity by country. Conclusions: Cross national studies may serve to examine how health systems contribute to the social protection of Latin American households.

Original languageEnglish (US)
Pages (from-to)S85-S95
JournalSalud publica de Mexico
Issue numberSUPPL. 2
StatePublished - 2011


  • Health
  • Health expenditures
  • Latin America
  • Social policy

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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