Is there any data on the proportion of the population incurring in out-of-pocket expenditure when purchasing long-term care services? | Mexico Is there any data on the proportion of the population incurring in out-of-pocket expenditure when purchasing long-term care services? | Mexico

12 Jul 2022

No data is available at national level regarding the purchase of long-term care services or the number of people incurring in catastrophic levels of out-of-pocket LTC expenditures within the private market (profit or non-profit). However, some information on unpaid care work and its value is available.

As part of Mexico’s National Accounts, the National Statistics Institute, INEGI generates different Satellite Accounts[1] in order to cover activities that are not part of the core economy but they are linked to it in a highly relevant way. To date, many countries have a parallel system of Satellite Accounts, being environmental accounts, tourism, unpaid household (domestic) work satellite accounts, and satellite accounts on non-profit institutions and voluntary work are some of the most widely estimated.

Mexico currently estimates satellite accounts for unpaid household work, for unpaid health and personal care, a tourism satellite account, among others (INEGI, 2018b). Unpaid health and personal care is estimated on a yearly basis and published as the National Satellite Health Accounts of the Health Sector (Cuenta Satelite del Sector Salud en Mexico, CSSSM), with data from the National Time Use Survey. Data for 2017 (base year 2013) reports that GDP of the health sector is 5.6% of the national GDP. Of this 5.6%, 1.4% represents unpaid health and personal care (performed within the household). Within the health sector GDP, 72.3% corresponds to the economic activities of the sector and 27.7% to unpaid health and personal care work.

In order to take into account the dimension of the role of unpaid personal and health unpaid work performed within the household, it is important to note that the monetary value of household’s contribution to personal health care of other household members (27.7%) represents more than half of what is generated by public sector establishments (39.5%). This is also larger than the contribution of primary care (ambulatory) medical services (17.0%) and is similar to the one generated by all hospital services (20.7%) (INEGI, 2018b).

Figures of unpaid work in health refer to care for people of all ages. However, changes in the population structure due to the aging process are visible. Since among the population reporting motor, cognitive or sensory limitations in the country, 26% of them refers to old age as being the cause of their limitations, it can be expected that a significant percentage of unpaid care is dedicated to care for the elderly.

Results from the 10/66 research group’s INDEP study (The Economic and Social Effects of Care Dependence in Later Life) show that significant health care costs for households with care additionally presented higher likelihood of catastrophic healthcare spending (Guerchet et al., 2018).

[1]According to the European Union, satellite accounts provide a framework linked to the central accounts and which enables attention to be focussed on a certain field or aspect of economic and social life in the context of national accounts; common examples are satellite accounts for the environment, or tourism, or unpaid household work (European system of national and regional accounts (ESA 2010).


Guerchet, M. M., Guerra, M., Huang, Y., Lloyd-Sherlock, P., Sosa, A. L., Uwakwe, R., Acosta, I., Ezeah, P., Gallardo, S., Liu, Z., Mayston, R., de Oca, V. M., Wang, H., & Prince, M. J. (2018). A cohort study of the effects of older adult care dependence upon household economic functioning, in Peru, Mexico and China. PLoS ONE, 13(4). https://doi.org/10.1371/journal.pone.0195567

INEGI. (2018b). INEGI. Datos. https://www.inegi.org.mx/datos/