Latin America and the Caribbean regional project 598-0632 · 1986–1992 · health systems, policy and finance · International Resources Group (IRG)

The economic crisis of the last decade has forced most Latin American and Caribbean countries to reduce their public health expenditures, resulting in a serious deterioration in the quality of public health care. This paper examines health care financing in ten countries -- Belize, Bolivia, the Dominican Republic, Ecuador, El Salvador, Guatemala, Peru, St. Lucia, Honduras, and Jamaica -- during the period 1985 to 1989. The report first provides contextual information regarding economic conditions, organizational changes within health systems, and the health policies of the major donor agencies, A.I.D. and the World Bank. It then presents research findings on health care costs, demand, and financing alternatives. Major findings are as follows. (1) Cost containment is more complex at hospitals than at primary care facilities, but the magnitude of potential savings is far greater. Cost-containment measures should therefore focus initially on hospitals. (2) On the demand side, households and employers account for 20%-40% of total expenditures through direct payments for both public and private care, purchases of medicines, and payments for coverage under private, prepaid plans. (3) Soc

Source: DEC abstract, PN-ABJ-309 (1990). This is the source's own text, not a cited summary of the documents.