Abstract

OBJECTIVE: To determine whether there is a relationship between access to health systems and out-of-pocket spending with socio demographic characteristics in Ecuador.

METHODS: Retrospective analysis of national level data on household medical expenditure from the National Survey of Household Income and Expenditure in Urban and Rural Houses conducted by the Ecuadorian National Institute of Statistics and Census Databases as well as other scientific, institutional, technical-administrative datasets.

RESULTS: Families in the lowest percentile of poverty spend proportionally more out-of-pocket on pharmaceutical drugs than wealthier families. Furthermore, the lowest income deciles have no access to private health coverage. Populations from the bigger cities have more access to health care services than smaller rural cities. In Ecuador, 71% of pharmaceutical products are imported and 8% of the total of drugs are generic.

CONCLUSIONS: Despite efforts by the current government, health access remains uneven, as indicated by drug access and out-of-pocket expenses per family. Poorer families have higher relative health expenditures for drugs than families with higher incomes, although poorer families have no access to private insurances.

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