Attitudes toward Health Systems Financing in Chile

Area of Science:

• Health Policy and Economics
• Public Health
• Social Sciences

Background:

• Understanding public attitudes towards health system financing is essential for policy development.
• Previous research has not fully captured the multidimensional nature of these attitudes.

Purpose of the Study:

• To develop and validate an exploratory model classifying public attitudes toward health system financing and organization.
• To identify distinct groups based on these attitudes within a Chilean adult population.

Main Methods:

• Exploratory Structural Equation Modeling (ESEM) was used to select 17 indicators across 5 factors: pay-as-you-use, solidarity, willingness to contribute, mixed financing, and public provision.
• Cluster analysis was applied to the ESEM model results to identify distinct attitudinal groups.

Main Results:

• Two primary clusters emerged: "Taxes-public" (47%) and "Insurance-choice" (53%).
• The "Insurance-choice" group demonstrated harsher evaluations of healthcare providers and insurers, lower willingness to contribute, and less solidarity.
• This group also showed greater agreement with mixed financing and a preference for provider choice, contrasting with a service-purchase model based on health needs.

Conclusions:

• Public attitudes towards health system financing are heterogeneous and can be meaningfully categorized.
• The identified clusters, "Taxes-public" and "Insurance-choice," offer insights into differing public preferences for healthcare organization and funding.
• These findings underscore the importance of incorporating public opinion into policy debates regarding health system financing and structure.