Getting a Pulse on Health Quality
109
Country
Income quintile 1
2
3
4
5
All
Argentina Belize Bolivia Brazil Chile Colombia Costa Rica Dominican Republic Ecuador El Salvador Guatemala Guyana Honduras Mexico Nicaragua Panama Paraguay Peru Uruguay Venezuela
59.7 37.5 59.8 43.9 50.3 54.0 78.6 50.7 42.2 60.7 53.0 55.0 61.9 56.9 49.7 60.8 43.3 46.3 84.4 75.2
65.5 58.8 55.6 47.1 46.8 60.3 80.9 63.3 58.5 62.1 47.0 72.5 55.9 58.1 56.1 57.0 46.1 35.2 78.9 69.3
61.4 52.9 54.9 48.3 43.0 56.7 73.5 55.6 54.7 62.8 51.0 68.3 50.8 58.9 57.2 63.5 48.8 43.0 74.8 79.7
57.9 35.3 57.1 44.8 45.6 54.3 77.1 51.3 50.8 55.2 58.0 62.5 57.6 52.7 61.1 61.4 45.5 50.3 73.2 71.9
54.5 52.9 60.2 46.6 37.8 58.9 74.2 56.3 50.8 62.1 57.0 63.4 54.2 59.5 55.6 63.5 51.5 45.5 79.7 68.2
59.8 47.6 57.5 46.1 44.7 56.8 76.9 55.5 51.4 60.6 53.2 64.4 56.1 57.2 56.0 61.2 47.0 44.1 78.2 72.8
Average
56.2
57.7
57.4
56.3
56.9
56.9
Source: Authors’ calculations from Gallup (2007).
they are satisfied with health care services in their city or area, in contrast to less than half of those in Belize, Brazil, Chile, Paraguay, and Peru. Men and women do not have significantly different perceptions when it comes to their confidence in the health care system or their satisfaction with the health care services available in their community. The only significant difference in perceptions across demographic groups is by age. Based on the same Gallup poll, after other factors are controlled for, Latin Americans in their fifties and sixties express greater satisfaction with health care services than those in their twenties (see Table 5.6). Perceptions of health care services are also largely unrelated to income, despite evidence that poorer individuals have less access to health care services when they are sick and that the services they receive tend to be of poorer quality. This suggests that poorer people are more tolerant of poor-quality health care services than those who are wealthier, perhaps because their health care service aspirations are lower, consistent with the “aspirations paradox” discussed in Chapter 2. Because poorer people in the Latin American region who receive health care services are often beneficiaries of public programs, it may be that they are less demanding and more grateful for access to care that higher income groups might consider inferior in quality. In fact, people who report that they would use public health care services—a group that is disproportionately from lower income groups—express confidence in the health care system as much as those who are covered by social security or private insurance. Only people who expect to pay out of pocket for major health expenditures express significantly lower
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Table 5.5 Percentage of Respondents Who Are Satisfied with the Availability of Quality Health Care in the City or Area Where They Live, by Income Quintile