Impacto de la reforma del sistema de seguridad social sobre la equidad en los servicios de salud en Colombia / The impact of social security system reform on health services equity in Colombia
Cad. saúde pública
;
18(4): 1003-1024, jul.-ago. 2002.
Article
in Spanish
| LILACS
| ID: lil-330959
RESUMO
To evaluate the impact on access to, and use of, health services in Colombia's new national health insurance system, the authors compared two cross sections of the population before (1993) and after (1997), with the approval of Act 100, creating the General System for Social Security in Health (SGSSS). Two equity indicators were assessed concentration curves (CC) and concentration indices (CI), summarizing the distribution of access to health care and utilization of health care services provided by the SGSSS according to income deciles. Between 1993 and 1997, the CI for access to insurance halved from 0.34 to 0.17; simultaneously, coverage increased from 23 to 57, especially among the poorest segments of the population, where it increased from 3.7 to 43.7 as a result of subsidies provided by local governments. The CI for utilization of health care services did not vary significantly. Increased disease prevalence and utilization of services among the insured, due to biased selection of risks and moral hazards, were also documented. These findings suggest a positive impact by the Reform on inequalities in access to health care insurance; however, a similar effect on inequities in utilization of health services is not clear.
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Index:
LILACS (Americas)
Main subject:
Social Justice
/
Social Security
/
Health Care Reform
/
Health Services
/
Health Services Accessibility
/
National Health Programs
Type of study:
Etiology study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
South America
/
Colombia
Language:
Spanish
Journal:
Cad. saúde pública
Journal subject:
Public Health
/
Toxicology
Year:
2002
Type:
Article
Affiliation country:
Colombia
/
United kingdom
Institution/Affiliation country:
Consultores Internacionales en Seguridad Social y Salud/CO
/
Escuela Superior de Administración Pública/CO
/
London School of Hygiene and Tropical Medicine/GB
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