Determinants of Out-of-Pocket Health Spending in Households in Peru in the Times of the Pandemic (COVID-19)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Research Approach and Type
2.2. Research Design
2.3. Econometric Model
2.4. Data Collection Techniques and Instruments
2.5. Population
2.6. Type of Sample and Sample Obtained
3. Results
Variables | Out-of-Pocket Expenses | Type of Insurance | Suffering from a Disease | COVID-19 Test Results | Health Spending | Permanent Limitations | Potable Water Service | Presence of an Older Adult in the Household | Education Level | Marital Status of Head of Household | Residence Area |
---|---|---|---|---|---|---|---|---|---|---|---|
Out-of-pocket expenses | 1.0000 | ||||||||||
Type of insurance | 0.3048 | 1.0000 | |||||||||
Suffering from a disease | 0.1141 | −0.0408 | 1.0000 | ||||||||
COVID-19 test results | 0.0352 | 0.0361 | 0.0155 | 1.0000 | |||||||
Health spending | 0.2199 | −0.1860 | 0.0911 | −0.0315 | 1.0000 | ||||||
Permanent limitations | 0.1280 | 0.0359 | 0.1763 | −0.0157 | −0.0084 | 1.0000 | |||||
Potable water service | −0.1068 | −0.2320 | 0.0449 | −0.0525 | 0.1433 | −0.0275 | 1.0000 | ||||
Presence of an older adult in the household | 0.1551 | −0.0436 | 0.1807 | −0.0034 | 0.0741 | 0.1622 | 0.0616 | 1.0000 | |||
Education level | −0.1613 | −0.3609 | 0.0481 | −0.0229 | 0.1828 | −0.0871 | 0.1874 | −0.1387 | 1.0000 | ||
Marital status of head of household | 0.0259 | −0.0306 | 0.0781 | 0.0164 | −0.0211 | 0.0089 | 0.1402 | 0.0218 | 0.0766 | 1.0000 | |
Residence area | −0.1786 | −0.2659 | 0.0499 | −0.0428 | 0.1334 | −0.0327 | 0.4555 | 0.0170 | 0.2517 | 0.1584 | 1.0000 |
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Variable Type | Categorization |
---|---|---|
Out-of-pocket expenses | Qualitative | 1: Incurred out-of-pocket expenses 0: Did not incur out-of-pocket expenses |
Type of insurance | Qualitative | 1: Insured through SIS 0: Insured through ESSALUD |
Suffering from a disease | Qualitative | 1: Yes, suffered 0: Did not suffer |
COVID-19 test results | Qualitative | 1: Negative result 2: Positive result 3: Did not receive the results |
Health spending | Quantitative | Numeric |
Permanent limitations | Qualitative | 1: Had at least one permanent limitation 0: Had no permanent limitations |
Potable water service | Qualitative | 1: Had potable water in the household 0: Did not have potable water in the household |
Presence of older adult in the household | Qualitative | 1: Had an elderly person in the household 0: Did not have an elderly person in the household |
Education level | Qualitative | 1: No educational level 2: Primary or secondary educational level 3: Higher or university educational level 4: Postgraduate level of studies |
Marital status of head of household | Qualitative | 1: Cohabitant 2: Married 3: Widow(er) 4: Divorced 5: Separated (a) 6: Single |
Residence area | Qualitative | 1: Rural area 2: Urban area |
Variable | Mean | Standard Deviation | Minimum Value | Maximum Value | Asymmetry | Kurtosis |
---|---|---|---|---|---|---|
Out-of-pocket expenses | 0.4354 | 0.4959 | 0 | 1 | 0.2604 | 1.0678 |
Type of insurance | 0.5136 | 0.4999 | 0 | 1 | −0.0544 | 1.0030 |
Suffering from a disease | 0.5176 | 0.4998 | 0 | 1 | −0.0705 | 1.0050 |
COVID-19 test results | 1.0275 | 0.2329 | 1 | 3 | 8.3537 | 70.7848 |
Health spending | 2400.7620 | 3861.7210 | 0 | 42,509.76 | 4.0197 | 26.9875 |
Permanent limitations | 0.0498 | 0.2176 | 0 | 1 | 4.1385 | 18.1271 |
Potable water service | 0.7206 | 0.4488 | 0 | 1 | −0.9832 | 1.9667 |
Presence of an older adult in the household | 0.2628 | 0.4402 | 0 | 1 | 1.0777 | 2.1615 |
Education level | 2.3424 | 0.5829 | 1 | 4 | 0.7448 | 3.3844 |
Marital status of head of household | 2.5070 | 1.6014 | 1 | 6 | 0.9512 | 2.5339 |
Residence area | 0.8090 | 0.3931 | 0 | 1 | −1.5725 | 3.4729 |
Variable | Type of Insurance | Total | ||
---|---|---|---|---|
Category | Insured through ESSALUD | Insured through SIS | ||
Out-of-pocket expenses | Did not incur out-of-pocket expenses | 1223 | 749 | 1972 |
% | 62.02 | 37.98 | 100 | |
Incurred out-of-pocket expenses | 476 | 1045 | 1521 | |
% | 31.3 | 68.7 | 100 | |
Total | 1699 | 1794 | 3493 | |
48.64 | 51.36 | 100 |
Variable | Suffering from a Disease | Total | ||
---|---|---|---|---|
Category | No | Yes | ||
Out-of-pocket expenses | Did not incur out-of-pocket expenses | 1050 | 922 | 1972 |
% | 53.25 | 46.75 | 100 | |
Incurred out-of-pocket expenses | 635 | 886 | 1521 | |
% | 41.75 | 58.25 | 100 | |
Total | 1685 | 1808 | 3493 | |
48.24 | 51.76 | 100 |
Variable | COVID-19 Test Results | Total | ||
---|---|---|---|---|
Category | Negative | Did Not Have the Results | ||
Out-of-pocket expenses | Did not incur out-of-pocket expenses | 1952 | 20 | 1972 |
% | 98.99 | 1.01 | 100 | |
Incurred out-of-pocket expenses | 1493 | 28 | 1521 | |
% | 98.16 | 1.84 | 100 | |
Total | 3445 | 48 | 3493 | |
98.63 | 1.37 | 100 |
Variable | Permanent Limitations | Total | ||
---|---|---|---|---|
Category | No Limitations | At Least One Permanent Limitation | ||
Out-of-pocket expenses | Did not incur out-of-pocket expenses | 1922 | 50 | 1972 |
% | 97.46 | 2.54 | 100 | |
Incurred out-of-pocket expenses | 1397 | 124 | 1521 | |
% | 91.85 | 8.15 | 100 | |
Total | 3319 | 174 | 3493 | |
95.02 | 4.98 | 100 |
Variable | Potable Water Service | Total | ||
---|---|---|---|---|
Category | Did Not Have Potable Water Service | Did Have Potable Water Service | ||
Out-of-pocket expenses | Did not incur out-of-pocket expenses | 468 | 1504 | 1972 |
% | 23.73 | 76.27 | 100 | |
Incurred out-of-pocket expenses | 508 | 1013 | 1521 | |
% | 33.40 | 66.60 | 100 | |
Total | 976 | 2517 | 3493 | |
27.94 | 72.06 | 100 |
Variable | Presence of an Older Adult in the Household | Total | ||
---|---|---|---|---|
Category | No | Yes | ||
Out-of-pocket expenses | Did not incur out-of-pocket expenses | 1572 | 400 | 1972 |
% | 79.72 | 20.28 | 100 | |
Incurred out-of-pocket expenses | 1003 | 518 | 1521 | |
% | 65.94 | 34.06 | 100 | |
Total | 2575 | 918 | 3493 | |
73.72 | 26.28 | 100 |
Variable | Out-of-Pocket Expenses | Total | ||
---|---|---|---|---|
Category | Did Not Incur Out-of-Pocket Expenses | Incurred Out-of-Pocket Expenses | ||
Education level | No educational level | 24 | 63 | 87 |
% | 27.59 | 72.41 | 100 | |
Primary or secondary education | 1169 | 1067 | 2236 | |
% | 52.28 | 47.72 | 100 | |
Higher or university education | 696 | 361 | 1057 | |
% | 65.85 | 34.15 | 100 | |
Postgraduate studies | 83 | 30 | 113 | |
% | 73.45 | 26.55 | 100 | |
Total | 1972 | 1521 | 3493 | |
56.46 | 43.54 | 100 |
Variable | Out-of-Pocket Expenses | Total | ||
---|---|---|---|---|
Category | Did Not Incur Out-of-Pocket Expenses | Incurred Out-of-Pocket Expenses | ||
Marital status of the head of the household | Cohabitant | 628 | 470 | 1098 |
% | 57.19 | 42.81 | 100 | |
Married | 771 | 525 | 1296 | |
% | 59.49 | 40.51 | 100 | |
Widow(er) | 128 | 166 | 294 | |
% | 43.54 | 56.46 | 100 | |
Divorced | 25 | 23 | 48 | |
% | 52.08 | 47.92 | 100 | |
Separated | 302 | 247 | 549 | |
% | 55.01 | 44.99 | 100 | |
Single | 118 | 90 | 208 | |
% | 56.73 | 43.27 | 100 | |
Total | 1972 | 1521 | 3493 | |
56.46 | 43.54 | 100 |
Variable | Residence Area | Total | ||
---|---|---|---|---|
Category | Rural | Urban | ||
Out-of-pocket expenses | Did not incur out-of-pocket expenses | 255 | 1717 | 1972 |
% | 12.93 | 87.07 | 100 | |
Incurred out-of-pocket expenses | 412 | 1109 | 1521 | |
% | 27.09 | 72.91 | 100 | |
Total | 667 | 2826 | 3493 | |
19.10 | 80.90 | 100 |
Out-of-Pocket Expenses | Coefficients | Z-Value | Probability | Marginal Effects |
---|---|---|---|---|
Type of insurance | 1.5809 | 19.33 | 0.00 | 0.368523 |
Suffering from a disease | 0.3475 | 4.29 | 0.00 | 0.084898 |
COVID-19 test results | 0.2653 | 1.63 | 0.10 | 0.065031 |
Health spending | 0.0003 | 15.76 | 0.00 | 0.000065 |
Permanent limitations | 0.9736 | 5.31 | 0.00 | 0.237341 |
Potable water service | −0.1954 | −1.98 | 0.05 | −0.048129 |
Presence of an older adult in the household | 0.6805 | 7.35 | 0.00 | 0.167921 |
Education level | −0.2755 | −3.52 | 0.00 | −0.067520 |
Marital status of head of household | 0.0997 | 4.01 | 0.00 | 0.024432 |
Residence area | −0.7806 | −7.11 | 0.00 | −0.192640 |
Constant | −1.2403 | −4.46 | 0.00 | |
Number of observations | 3493 | Pseudo R2 | 0.1977 | |
LR chi2(10) | 945.86 | Log likelihood | −1919.0381 | |
Prob > chi2 | 0.00000 | Marginal effects after logit | 0.4299 | |
Estat class (correctly classified) | 70.77% | Fitstat (count R2) | 0.708 |
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Quispe Mamani, J.C.; Cutipa Quilca, B.E.; Cáceres Quenta, R.; Quispe Maquera, N.B.; Quispe Quispe, B.; Mamani Flores, A.; Incacutipa Limachi, D.J.; Esteves Villanueva, A.R.; Málaga Apaza, V.; Tintaya Choquehuanca, O. Determinants of Out-of-Pocket Health Spending in Households in Peru in the Times of the Pandemic (COVID-19). Int. J. Environ. Res. Public Health 2023, 20, 6759. https://doi.org/10.3390/ijerph20186759
Quispe Mamani JC, Cutipa Quilca BE, Cáceres Quenta R, Quispe Maquera NB, Quispe Quispe B, Mamani Flores A, Incacutipa Limachi DJ, Esteves Villanueva AR, Málaga Apaza V, Tintaya Choquehuanca O. Determinants of Out-of-Pocket Health Spending in Households in Peru in the Times of the Pandemic (COVID-19). International Journal of Environmental Research and Public Health. 2023; 20(18):6759. https://doi.org/10.3390/ijerph20186759
Chicago/Turabian StyleQuispe Mamani, Julio Cesar, Balbina Esperanza Cutipa Quilca, Rolando Cáceres Quenta, Nelly Beatriz Quispe Maquera, Betsy Quispe Quispe, Adderly Mamani Flores, Duverly Joao Incacutipa Limachi, Angela Rosario Esteves Villanueva, Vicente Málaga Apaza, and Olimpia Tintaya Choquehuanca. 2023. "Determinants of Out-of-Pocket Health Spending in Households in Peru in the Times of the Pandemic (COVID-19)" International Journal of Environmental Research and Public Health 20, no. 18: 6759. https://doi.org/10.3390/ijerph20186759