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Tuesday, April 28, 2009
Refik Saydam (The Hilton Istanbul Hotel )
Background:
The increasing of health expenditures is one of the main questions in Heath Economics. This question is genuinely relevant in Brazilian health insurance market, that deals with about ¼ of the population of the country and that had developed the regulation since 1998, by means of Regulation Agency of Health (ANS).
Theoretically, two components due cost evolution: i) price variation (or inflation in health), that represents increasing of unitary costs and the cumulative technological incorporation; ii) quantity variation (rising of utilization), that could be explicated by the popularization of health methods and seniorization.
The aim of this study is to analyze Brazilian health insurance cost evolution, divided in this two theoretical components, considering some market segmentation.
The methodology applies the concept of index number, to estimates variations index of price, amount and value. Considering the actuarial definition, product cost (value) can be separated in frequency of use (amount) and event cost (price). The source is ANS’s database (2002 until 2006), that presents the market segmentation according to assistance (medical or dental plans) and to the category of the contract (collective or individual).
Price variation shows higher evolution than quantity component, principally in individual medical plans.
In the cost evolution at Brazilian private health, the component health inflation was more intense than rising of utilization. This differentiation is more severe in individual medical plans, and one of its determinants can be the fact that this segment presents more children and old-aged people in composition of demand, in comparison to the collectives ones.
Considering the importance to evaluate the determinants of increasing expenditures in health, this research should be developed, investigating other segments of health and countries.
The increasing of health expenditures is one of the main questions in Heath Economics. This question is genuinely relevant in Brazilian health insurance market, that deals with about ¼ of the population of the country and that had developed the regulation since 1998, by means of Regulation Agency of Health (ANS).
Theoretically, two components due cost evolution: i) price variation (or inflation in health), that represents increasing of unitary costs and the cumulative technological incorporation; ii) quantity variation (rising of utilization), that could be explicated by the popularization of health methods and seniorization.
The aim of this study is to analyze Brazilian health insurance cost evolution, divided in this two theoretical components, considering some market segmentation.
Methods:
The methodology applies the concept of index number, to estimates variations index of price, amount and value. Considering the actuarial definition, product cost (value) can be separated in frequency of use (amount) and event cost (price). The source is ANS’s database (2002 until 2006), that presents the market segmentation according to assistance (medical or dental plans) and to the category of the contract (collective or individual).
Results:
Price variation shows higher evolution than quantity component, principally in individual medical plans.
Conclusions:
In the cost evolution at Brazilian private health, the component health inflation was more intense than rising of utilization. This differentiation is more severe in individual medical plans, and one of its determinants can be the fact that this segment presents more children and old-aged people in composition of demand, in comparison to the collectives ones.
Considering the importance to evaluate the determinants of increasing expenditures in health, this research should be developed, investigating other segments of health and countries.
Learning Objectives: 1) Identify international literature of Health expenses components; 2) Articulate the Brazilian Health insurance case with other experiences; 3) Evaluate the determinants of the components of health costs in Brazil.
Sub-Theme: Strengthening Global Public Health Systems