Seguimiento de cobertura sanitaria universal con equidad en Chile entre 2000 y 2011 usando las Encuestas CASEN
Date
2013
Type:
Artículo
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12
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Journal Title
Journal ISSN
Volume Title
Publisher
Sociedad Médica de Santiago
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Abstract
Background: The Chilean health reform aimed to expand universal health
coverage (UHC) with equity. Aim: To analyze progress in health system affiliation,
attended health needs (health visit for a recent problem) and direct payment for services,
between 2000 and 2011. Material and Methods: We evaluated these outcomes
for adults aged 20 years or older, analyzing databases of five National Socioeconomic
Characterization Surveys. Using logistic regression models for no affiliation and
unattended needs, we estimated odds ratios (OR) and prevalences, adjusted for
socio-demographic characteristics. Results: The unaffiliated population decreased
from 11.0% (95% confidence interval (CI) 10.6-11.4) in 2000 to 3.0% (95% CI 2.8-
3.2) in 2011. According to the model, self-employed workers had a higher adjusted
prevalence of no affiliation: 27.4% (95% CI 24.1-30.6) in 2000 and 7.8% (95% CI:
5.9-9.7) in 2011. The level of unmet needs decreased from 33.5% (95% CI 31.8-35.1)
to 9.1% (95% CI 8.1-10.1) in this period. Not being affiliated to the health system
was associated with higher unmet needs in the adjusted model. Indigent affiliates,
entitled to free care in the public system, reported payments for general and specialist
visits in a much lower proportion than other groups. However, direct payments
for visits increased for this group during the decade. Conclusions: Concurrent with
the introduction of new health and social policies, we observed significant progress
in health system enrolment and attended health needs. However, the percentage of
impoverished people who made direct payments for services increased.
Description
Centro de Epidemiología y Políticas de Salud
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Citation
Revista Médica de Chile, 2013, 141:1095-1106
Keywords
Universal, coverage, Health systems, plans, Healthcare disparities, Chile, Health care reform