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Evolution of health social security expenditure in Chile: A review of financial aggregates from 2000 to 2018

Evolución del gasto de la seguridad social de salud en Chile: revisión de agregados financieros entre 2000 y 2018


Introduction In Chile, there is controversy regarding the magnitude of financing for the health system. Some experts state that more resources are needed, while others refer to the problems that may arise in managing a growing pool of resources.

Aim This article aims to offer evidence to encourage critical discussion through a time series analysis of the leading financial aggregates in constant 2018 Chilean pesos of the Chilean social security in the period from 2000 to 2018.

Methods We did an observational, descriptive, longitudinal, and time series trend analysis study. Financial aggregates are organized according to social security definitions and by financial administrators—the public National Health Fund and the private health insurers.

Results Social security health spending has increased almost four-fold in the study period. After enacting the Explicit Guarantees in Health, the National Health Fund expanded more than the private health insurance system due to government allocations to the National Health Fund. In contrast, individual contributions decreased steadily every year during the study period. Per capita expenditure was higher in the private health insurance system. However, the per capita expenditure of the private insurance system over the public health fund has gradually decreased over time.

Conclusion Firstly, Chile increased its health spending at a rate higher than observed in other Organization for Economic Co-operation and Development countries. Secondly, it transitioned from financing health mainly through workers’ contributions to growing prominence of the government’s overall contribution. In the wake of the announced health reform, the discussion of health funding will include employers’ role in health financing.

This article does not have an English translation available.