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Association between changes in out-ofpocket expenditures during 2020 with the Covid-19 pandemic in Mexico.

Objective. To disentangle the contribution of the Covid-19 pandemic and the abolition of the Seguro Popular (SP) health protection system to changes in out-of-pocket health expenditures (OPE) in Mexico during 2020. Materials and methods. We used national representative surveys between 2014 and 2020....

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Publicado en:Salud Pública de México Vol. 68; no. 3; pp. 197 - 205
Autores principales: Colchero, M. Arantxa, Morales-Ríos, Jesús E., Sánchez-Ortiz, Néstor A.
Formato: Artículo
Publicado: Instituto Nacional de Salud Publica may/jun2026
Materias:
Consumption (Economics)
COVID-19 pandemic
Health insurance
Social security
Mexico
Acceso en línea:Ver este registro en EBSCOhost
Sumario:Objective. To disentangle the contribution of the Covid-19 pandemic and the abolition of the Seguro Popular (SP) health protection system to changes in out-of-pocket health expenditures (OPE) in Mexico during 2020. Materials and methods. We used national representative surveys between 2014 and 2020. We described OPE in absolute and relative terms and per disposable income. Changes in OPE were estimated using adjusted two-part models. Results were reported nationally, by health insurance and income quintile. Results. OPE increased for all in 2020 with the largest increases for the high- and very high-income households and those with social security (30.4, 23.4 and 22.2 USD, respectively). Households with no health insurance and those with Seguro Popular/Instituto de Salud para el Bienestar had the lowest increase in OPE. However, for the lowest income households and those with no social security, OPE represented the highest proportion per disposable income as their income decreased during the Covid-19. Conclusions. Social safety nets, including access to health care services for the uninsured and lower income households, are crucial.
Objetivo. Aislar la contribución de la pandemia de Covid-19 y de la eliminación del Seguro Popular (SP) en cambios en gasto de bolsillo (GDB) en México en 2020. Material y métodos. Se utilizó información de encuestas nacionales (2014-2020). Se describió el GDB en términos absolutos y relativos, y por ingreso disponible. Se estimaron cambios en GDB con modelos en dos partes. Los resultados se presentan por tipo de afiliación y por quintil de ingresos. Resultados. El GDB se incrementó para todos en 2020 con aumentos mayores en hogares de ingresos altos, muy altos y en aquellos con afiliación (30.4, 23.4 y 22.2 USD). Los hogares sin afiliación y los de Seguro Popular/Instituto de Salud para el Bienestar presentaron los menores incrementos en GDB. Sin embargo, para los hogares de menores ingresos y aquellos sin seguridad social, el GDB representó la mayor proporción por ingreso disponible porque su ingreso se redujo durante la pandemia. Conclusiones. Es crucial contar con redes de protección social y acceso a servicios de salud, especialmente para hogares sin afiliación y aquellos de menores ingresos.