Atención médica en Santiago, 1993 / Medical care in Santiago, 1993

RESUMO

Results of morbidity and medical care surveys performed in Santiago in 1993-94 are presented in this paper. The study has been done in an aleatory population sample of 4.700 people coming from 1.000 dwellings. Main results are as following: The Health National Fund (FONASA) is the most important financing medical care's agency in Santiago (49 percent out of total population). A majority of medical services are given in private officers or clinics. Medical care systems show significant differences among the studied city districts. A significant direct correlation between people's income and private practice is noticed. One half of acute diseases had medical care ant the other half used self care practices; the proportion of medical care is 29 percent in the case of chronic disease patients. National Health Service eligible people show a significant higher morbidity rate and medical consultation rate than other gruops. Lack of medical care mainly depends on low severity of illness episodes or lack of symptoms in chronic disease conditions. In 12 percent out of total cases, lack of medical care was due to problems in the medical care systems. The quality of care was judged good or excellent by 82 percent of the people, fair by 9 percent and bad or deficient by the remaining 8 percent. Personal expenditures due to health care are high, one third depending on medical care and two thirds on dental care. In the case of medical care the reasons for expenditures are linked to chronic diseases (60 percent), acute diseases (28 percent), injuries and health examinations (15 percent). Main activities causing personal disbursements are the purchase of drugs (44 percent), medical visits (30 percent), laboratory tests (13 percent) and hospital charges (7 percent). Comparing the results of this study with other performed in the past, it is possible to conclude that Santiago's people increases its illness perception: 5,0 episodes of diseases per person each year in 1969 and 1977 compared to 7,7 in 1993. During the last years, frequency of medical visits remain stable: 3,6 in 1983 and 3,7 visits per person in 1993