Quantitative model to improve primary health care financing in Chile

Abstract

Objective. Propose and apply a methodology to estimate adjusted expected expenditure in each locality in the Chilean primary health care (PHC) system in 2016. Methods. First of all, expected per capita expenditure at the national level was calculated on the basis of a detailed health plan, and then a zero-sum adjustment was made to the expenditure in each locality, using the local age/sex profile and the local average socioeconomic level, years of life lost, and rurality, given their statistically significant impact on epidemiology and spending structures. Results. The model establishes a conceptual and empirical link between expected expenditure and adjustment variables; it is flexible in terms of successive improvements; and its zero-sum property facilitates discussion of the global budget. When real data for the year 2016 in Chile were used, it was found that the absolute distance between the amounts in the model and the amounts actually used that year was 7.6%, on average. Conclusions. There are simple empirical options for calculating expected expenditure across localities, for which it is very helpful to have a good estimate of expected expenditure at the national level.