Did socioeconomic inequality in self-reported health in Chile fall after the equity-based healthcare reform of 2005? a concentration index decomposition analysis

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dc.contributor.authorCabieses, Báltica
dc.contributor.authorCookson, Richard
dc.contributor.authorEspinoza, Manuel
dc.contributor.authorSantorelli, Gillian
dc.contributor.authorDelgado, Iris
dc.date.accessioned2017-05-08T11:30:13Z
dc.date.available2017-05-08T11:30:13Z
dc.date.issued2015
dc.description.abstractOBJECTIVE: Chile, a South American country recently defined as a high-income nation, carried out a major healthcare system reform from 2005 onwards that aimed at reducing socioeconomic inequality in health. This study aimed to estimate income-related inequality in self-reported health status (SRHS) in 2000 and 2013, before and after the reform, for the entire adult Chilean population. METHODS: Using data on equivalized household income and adult SRHS from the 2000 and 2013 CASEN surveys (independent samples of 101 046 and 172 330 adult participants, respectively) we estimated Erreygers concentration indices (CIs) for above average SRHS for both years. We also decomposed the contribution of both "legitimate" standardizing variables (age and sex) and "illegitimate" variables (income, education, occupation, ethnicity, urban/rural, marital status, number of people living in the household, and healthcare entitlement). RESULTS: There was a significant concentration of above average SRHS favoring richer people in Chile in both years, which was less pronounced in 2013 than 2000 (Erreygers corrected CI 0.165 [Standard Error, SE 0.007] in 2000 and 0.047 [SE 0.008] in 2013). To help interpret the magnitude of this decline, adults in the richest fifth of households were 33% more likely than those in the poorest fifth to report above-average health in 2000, falling to 11% in 2013. In 2013, the contribution of illegitimate factors to income-related inequality in SRHS remained higher than the contribution of legitimate factors. CONCLUSIONS: Income-related inequality in SRHS in Chile has fallen after the equity-based healthcare reform. Further research is needed to ascertain how far this fall in health inequality can be attributed to the 2005 healthcare reform as opposed to economic growth and other determinants of health that changed during the period.
dc.format.extent21
dc.identifier.citationPLoS One. 2015 Sep 29;10(9):e0138227
dc.identifier.urihttp://hdl.handle.net/11447/1207
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0138227
dc.language.isoen_US
dc.publisherPLoS
dc.subjectChile
dc.subjectHealth Care Reform
dc.subjectHealth Services Accessibility/statistics & numerical data
dc.subjectHealth Status Disparities
dc.subjectHealthcare Disparities/statistics & numerical data
dc.subjectSurveys and Questionnaires
dc.titleDid socioeconomic inequality in self-reported health in Chile fall after the equity-based healthcare reform of 2005? a concentration index decomposition analysis
dc.typeArtículo

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