Can mothers rely on the Brazilian health system for their deliveries? An assessment of use of the public system and out-of-pocket expenditure in the 2004 Pelotas Birth Cohort Study, Brazil
Open Access
- 18 March 2008
- journal article
- Published by Springer Nature in BMC Health Services Research
- Vol. 8 (1) , 1-7
- https://doi.org/10.1186/1472-6963-8-57
Abstract
In a country where comprehensive free health care is provided via a public health system (SUS), an unexpected high frequency of catastrophic out-of-pocket expenditure has been described. We studied how deliveries were financed among mothers of a birth cohort and whether they were an important source of household out-of-pocket expenditure. All deliveries occurring in the city of Pelotas, Brazil, during 2004, were recruited for a birth cohort study. All mothers were interviewed just after birth and three months later. Comprehensive data on the pregnancy, delivery, birth conditions and newborn health were collected, along with detailed information on expenses related to the delivery. The majority of the deliveries (81%) were financed by the public health system, a proportion that increased to more than 95% among the 40% poorest mothers. Less than 1% of these mothers reported some out-of-pocket expenditure. Even among those mothers covered by a private health plan, nearly 50% of births were financed by the SUS. Among the 20% richest, a third of the deliveries were paid by the SUS, 50% by private health plans and 17% by direct payment. The public health system offered services in quantity and quality enough to attract even beneficiaries of private health plans and spared mothers from the poorest strata of the population of practically any expense.Keywords
This publication has 12 references indexed in Scilit:
- An Analysis Of Equity In Brazilian Health System FinancingHealth Affairs, 2007
- Desenvolvimento do SUS, rumos estratégicos e estratégias para visualização dos rumosCiencia & Saude Coletiva, 2007
- Perfil sociodemográfico e padrão de utilização de serviços de saúde para usuários e não-usuários do SUS - PNAD 2003Ciencia & Saude Coletiva, 2006
- O mercado de planos e seguros de saúde no Brasil: uma abordagem exploratória sobre a estratificação das demandas segundo a PNAD 2003Ciencia & Saude Coletiva, 2006
- Coorte de nascimentos de Pelotas, 2004: metodologia e descriçãoRevista de Saúde Pública, 2006
- Coverage of the Brazilian population 18 years and older by private health plans: an analysis of data from the World Health SurveyCadernos de Saude Publica, 2005
- Household catastrophic health expenditure: a multicountry analysisThe Lancet, 2003
- Segmentação da demanda dos planos e seguros privados de saúde: uma análise das informações da PNAD/98Ciencia & Saude Coletiva, 2002
- Os gastos das famílias com saúdeCiencia & Saude Coletiva, 2002
- The Hidden Cost of 'Free' Maternity Care in Dhaka, BangladeshHealth Policy and Planning, 1998