Out-of-pocket expenditures on child health during an economic recession in Brazil
DOI:
https://doi.org/10.11606/s15188787.2025059006388Keywords:
Health Expenditures, Children, Economic Recession, Health EconomicsAbstract
OBJECTIVE: To investigate the association between the 2014–2016 economic recession in Brazil and households’ direct expenditures on child health across the distribution of such expenditures. METHODS: Using longitudinal datasets that followed children born in Pelotas, in the state of Rio Grande do Sul, in 2004 and 2015, estimates were obtained using a Double–Hurdle model, which provides one outcome for the probability of incurring any expenditure and another for the expected value of those expenses when they occur. RESULTS: The findings showed that the economic recession during this period reduced the likelihood of incurring any health-related expenditure, excluding health insurance, by 34% among 12-month-old children and by 29% among 24-month-old children. Regarding health insurance expenditures, the recession reduced the likelihood of occurrence by 37% among 12-month-olds and by a substantial 68% among 24-month-olds. As for the amount spent, given that some expenditure occurred, the economic recession was associated with an expected 15% higher total spending excluding health insurance, and a 9% lower expected spending on health insurance for 12-month-old children. CONCLUSIONS: Thus, total health expenditures, excluding health insurance, were less likely to occur during the economic recession; however, when such expenditures occurred, their expected value was higher. In contrast, spending on health insurance was lower in both analyses, reinforcing its preventive nature.
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Copyright (c) 2025 Marcelo Torres da Silva, Cesar Augusto Oviedo Tejada, Anderson Moreira Aristides, Alicia Matijasevich, Iná S. Santos, Andréa Dâmaso Bertoldi
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Funding data
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Associação Brasileira de Saúde Coletiva
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Wellcome Trust
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Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul
Grant numbers PqG 21/2551-0002004-0 -
Conselho Nacional de Desenvolvimento Científico e Tecnológico
Grant numbers 407813/2021-7;406582/2021-1
