Consumer payment patterns for primary health care services in low-income communities of Rio de Janeiro: implications for designing service financing schemes.

Abstract

Primary health care (PHC) services are now recognized as a mainstay of development in low-income regions of the world. Yet, in many of these areas, economic conditions that include a burgeoning international debt, precipitous drops in the prices of raw materials, expanding population bases, and faltering currency rates, make the effective financing of PHC services an issue requiring the most immediate attention. A potentially valuable source of assistance in such endeavors is data on consumers' payment patterns for PHC services, and on socioeconomic conditions within their communities. The Centro de Pesquisas de Assistência Integrada à Mulher e à Criança (CPAIMC), the principal private source of PHC in Rio de Janeiro, has collected these type of data for nine low-income communities (LICs) within the Greater Rio de Janeiro Metropolitan Region. The current paper interfaces these data with previously developed solutions to address the problem of financing PHC services within the nine LICs. The solutions were recommended by a methodology developed and implemented by two of the authors. Results indicate that the consumer payment pattern and socioeconomic data support the methodology's recommendations and, more importantly, may be used to improve the effectiveness of those recommendations. Examples are provided and implications discussed.