Seguimiento de cobertura sanitaria universal con equidad en Chile entre 2000 y 2011 usando las Encuestas CASEN / Universal health coverage assessment based on national socioeconomic characterization surveys
Rev. méd. Chile
;
141(9): 1095-1106, set. 2013. ilus, tab
Article
in Spanish
| LILACS
| ID: lil-699676
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 andMethods:
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.
Full text:
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Index:
LILACS (Americas)
Main subject:
Health Care Reform
/
Universal Health Insurance
/
Health Services Accessibility
/
Health Services Needs and Demand
Type of study:
Prognostic study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Chile
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2013
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Universidad de Chile/CL
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