Increase in the poverty and inequity in the funding of the Ecuadorian health system

Abstract

The objective of this study is to measure the increase in poverty due to direct health expenditures and to analyze the equity of financing of the Ecuadorian health system, based on data from representative national surveys of the country. It was carried out with data from the 2013-2014 Living Conditions Survey and used poverty lines, with relative and absolute approaches to measure the increase in poverty and, through Analysis of Incidence in Financing, inequalities in the financing distribution. Poverty increased 2.2% due to families spending on health, especially on expenses for medications and medical consultations, which represented 36.7% and 14.6% of total expenditure on direct payments. Furthermore, the most important sources of financing turned out to be regressive, mainly affecting the middle class. When they were consolidated, the sources of financing analyzed turned out to be proportional that, although it is not the worst-case scenario, it is not the expected one for a health system that must guarantee financial protection to its users. Although there are financing goals that are difficult to achieve, at least the country's laws establish the pursuit of this goal. However, losses of financial resources make it difficult to achieve the objectives set.