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1.
Rev Panam Salud Publica ; 43: e71, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31507636

RESUMO

Objective: Describe sociodemographic characteristics, health needs, effective referrals, and immediate evaluation of international migrants who participated in the Initial Care for Migrants program during its first year of implementation (May to December 2016) at the Ignacio Domeyko Family Health Center in Santiago, Chile. Methods: Descriptive study. An intervention was designed and implemented to welcome international migrants. It included an initial comprehensive evaluation, a situation assessment, identification of needs, referral to other health services, and transfer of information. Statistical analysis was performed, using measures of central tendency and absolute and relative frequencies to describe sociodemographic characteristics, migratory processes, health needs, and effective referrals after one year of monitoring, as well as the results of a user satisfaction survey. Results: 436 people were registered, of whom 270 (61.9%) participated; 80% were women, mostly from Peru and Venezuela. The largest number of referrals were to pregnancy services (32.6%), followed by family planning (30%) and social services (27.04%). After one year of monitoring, there was 100% compliance for referrals to cardiovascular testing, 97.7% for pregnancy, and 87.7% for social services. The lowest compliance was for referrals to mental health services (11.1%). Conclusions: This intervention, the first of its kind in Chile, welcomed international migrants and provided them with key information, while providing referrals based on health needs and promoting the inclusion of the immigrant population in the Chilean health system.

2.
PLoS One ; 14(9): e0221150, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31509544

RESUMO

INTRODUCTION: According to the International Labor Organization, Maternity Protection (MP) policies try to harmonize child care and women's paid work, without affecting family health and economic security. Chile Law 20.545 (2011) increased benefits for economically active women and reduced requirements for accessing these benefits. The goals of the reform included: 1) to increase MP coverage; and 2) to reduce inequities in access to the benefits. METHOD: This study uses two data sources. First, using individual data routinely collected from 2000 to 2015, yearly MP coverage access over time was calculated. Second, using national representative household surveys collected before and after the Law (2009 and 2013), coverage and a set of measures of inequality were estimated. To compare changes over time, we used non-experimental, before-after intervention design for independent samples. For each variable, we estimated comparative proportions at 95% confidence interval before and after the intervention. Additionally, we included multivariate and propensity score analysis. RESULTS: Between 2000 and 2015, MP coverage grew from 24.4% to 44.8%. Using comparable 2009 and 2013 survey data, we observed the same trend, with 31.6% of estimated MP coverage in 2009, escalating to 39.5% in 2013. We conclude that: 1) after the reform, there was an increase in MP coverage; and, 2) there was no significant reduction of inequities in the distribution of MP benefits. DISCUSSION/CONCLUSION: Few scientific evaluations of MP reforms have been conducted worldwide; even fewer including an equity analysis. This study provides an empirically-based evaluation of MP reform from both a population-level and an equity-focused perspective. We conclude that this reform needs to be complemented with other policies to ensure maternity protection in terms of access and equity in a country with deep socioeconomic stratification.

3.
Rev Panam Salud Publica ; 43, September 2019
Artigo em Espanhol | PAHO-IRIS | ID: phr-51516

RESUMO

[RESUMEN]. Objetivo. Describir las características sociodemográficas, necesidades de salud, derivaciones efectivas realizadas y evaluación inmediata de la población migrante internacional que participó en el Programa de Atención Inicial al Migrante durante el primer año de ejecución (entre mayo y diciembre del año 2016), implementado en el Centro de Salud Familiar Ignacio Domeyko, Santiago de Chile. Métodos. Estudio descriptivo. Se diseñó e implementó una intervención para dar bienvenida a migrantes internacionales, que contemplaba la evaluación integral inicial, el diagnóstico de situación y detección de necesidades y derivación a otras atenciones, y la entrega de información. Para el análisis se describen, por medio de medidas de tendencia central y frecuencias absolutas y relativas, las características sociodemográficas, el proceso migratorio, las necesidades de salud, el cumplimento de derivaciones a un año de seguimiento y los resultados de la encuesta de satisfacción usuaria. Resultados. Se inscribieron 436 personas, de las cuales asistieron 270 (61,9%). El 80% eran mujeres, provenientes en su mayoría de Perú y Venezuela. La principal derivación realizada fue a control de embarazo (32,6%), seguido de planificación familiar (30%) y servicios sociales (27,04%). A un año de seguimiento, las derivaciones para controles cardiovasculares alcanzaron 100% de cumplimiento, 97,7% para embarazo y 87,7% para servicios sociales. El menor cumplimiento en las derivaciones fue a salud mental (11,1%). Conclusiones. Esta intervención, pionera en Chile, permitió dar bienvenida y proporcionar información clave a la población migrante internacional, así como también realizar derivaciones basadas en necesidades de salud y promover la inserción de la población inmigrante al sistema de salud chileno.


[ABSTRACT]. Objective. Describe sociodemographic characteristics, health needs, effective referrals, and immediate evaluation of international migrants who participated in the Initial Care for Migrants program during its first year of implementation (May to December 2016) at the Ignacio Domeyko Family Health Center in Santiago, Chile. Methods. Descriptive study. An intervention was designed and implemented to welcome international migrants. It included an initial comprehensive evaluation, a situation assessment, identification of needs, referral to other health services, and transfer of information. Statistical analysis was performed, using measures of central tendency and absolute and relative frequencies to describe sociodemographic characteristics, migratory processes, health needs, and effective referrals after one year of monitoring, as well as the results of a user satisfaction survey. Results. 436 people were registered, of whom 270 (61.9%) participated; 80% were women, mostly from Peru and Venezuela. The largest number of referrals were to pregnancy services (32.6%), followed by family planning (30%) and social services (27.04%). After one year of monitoring, there was 100% compliance for referrals to cardiovascular testing, 97.7% for pregnancy, and 87.7% for social services. The lowest compliance was for referrals to mental health services (11.1%). Conclusions. This intervention, the first of its kind in Chile, welcomed international migrants and provided them with key information, while providing referrals based on health needs and promoting the inclusion of the immigrant population in the Chilean health system.


[RESUMO]. Objetivo. Descrever as características sociodemográficas, necessidades em saúde, encaminhamentos efetivados e avaliação imediata da população migrante internacional que participou do Programa de Atenção Inicial ao Migrante no primeiro ano da sua implementação (entre maio e dezembro de 2016) no Centro de Saúde Familiar Ignacio Domeyko, na cidade de Santiago, no Chile. Métodos. Estudo descritivo com base em uma intervenção que foi concebida e implementada para acolher populações migrantes internacionais. A intervenção consistiu de uma avaliação inicial completa, diagnóstico da situação, identificação das necessidades em saúde e encaminhamento a outros serviços de atendimento, além de um componente informativo. A análise se baseou em medidas de tendência central e frequências absolutas e relativas usadas para descrever características sociodemográficas, processo migratório, necessidades em saúde, efetivação dos encaminhamentos em um ano de acompanhamento e resultados da pesquisa de satisfação dos usuários. Resultados. Dos 436 inscritos, 270 participaram do programa (61,9%). Destes, 80% eram mulheres e a maioria era proveniente do Peru e da Venezuela. Os principais encaminhamentos efetivados foram ao atendimento pré-natal (32,6%), planejamento familiar (30%) e serviços sociais (27,04%). Após um ano de acompanhamento, os encaminhamentos para avaliação cardiovascular foram efetivados em 100%, para atenção pré-natal em 97,7% e para serviços sociais em 87,7%. O encaminhamento à atenção de saúde mental foi o menos efetivado (11,1%). Conclusões. Esta foi uma intervenção pioneira no Chile que possibilitou acolher e instruir as populações migrantes internacionais, além de realizar encaminhamentos a serviços conforme as necessidades em saúde e promover a inserção da população imigrante no sistema de saúde chileno.


Assuntos
Migrantes , Sistemas de Saúde , Acesso aos Serviços de Saúde , Atenção Primária à Saúde , Chile , Migrantes , Sistemas de Saúde , Acesso aos Serviços de Saúde , Atenção Primária à Saúde , Sistemas de Saúde , Acesso aos Serviços de Saúde , Atenção Primária à Saúde
5.
Lancet ; 393(10188): 2297-2298, 2019 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-31122667
6.
Health Expect ; 22(2): 183-192, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30369026

RESUMO

BACKGROUND: In Chile, despite its steady decrease overall, adolescent pregnancy is concentrated in the most vulnerable population. Efforts in intersectoral collaboration between health and education to address the problem are being developed, but they have not been assessed. OBJECTIVE: To describe intersectoral strategies between health and education to address adolescent sexual and reproductive health, prevent adolescent pregnancy, and to explore adolescents' and health professionals' perceptions regarding those strategies. DESIGN: A qualitative ethnographic study was carried out in five municipalities in the Metropolitan Region of Chile. A sample of five key informants, 23 health professionals and 50 adolescents participated in a total of 38 semi-structured interviews and five discussion groups. RESULTS: Two intersectoral strategies to respond to adolescents' sexual and reproductive health needs were identified: (a) the "in-and-out" strategy, where health professionals provide health care mostly in health centres and carry out specific actions in schools and (b) the school-based strategy in which health professionals carry out continuous actions in schools as part of the curriculum. The second is perceived as responding better to adolescents' needs in sexual and reproductive health issues and in preventing adolescent pregnancy. DISCUSSION: The school-based strategy, with the constant presence of health professionals and lack of bureaucratic procedures, facilitates adolescents to access sexual and reproductive health care. This strategy enables sexual and reproductive health to be understood as an integral dimension of adolescents' lives, and it reinforces a holistic idea of health in which it is approached as a whole.

7.
Rev Peru Med Exp Salud Publica ; 36(4): 592-600, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31967250

RESUMO

OBJECTIVE: . To research the perception of different key actors regarding the role of intercultural facilitators in health care for Haitian migrants in the communes of Quilicura and Santiago de Chile. MATERIALS AND METHODS: . Qualitative study of exploratory and descriptive type, with case study design, in family health centers and hospitals of two communes of the Metropolitan Region of Chile. The technique of semi-structured interviews with key actors (health authorities, health workers, intercultural facilitators, and international migrants) was used with verbatim transcription and thematic analysis of contents (n=18). RESULTS: . The perception of the role of intercultural facilitators for the health care of international migrants is related to activities like translation, interpretation, health system education in Chile, intercultural mediation, and administrative tasks. In addition, it collaborates in educational activities for migrants who require support in addressing cultural differences. This vision is shared by several key actors considered for the study and according to the current health policy. CONCLUSIONS: . The intercultural facilitators make a contribution to the intercultural health encounter in Chile, and they are witnesses of how our institutions face different realities in linguistic and socio-cultural matters. Recognizing the importance of the intercultural facilitator in health care with intercultural relevance towards international migrant population is a social advance and one of the Chilean health system, which can be replicated in countries that face similar challenges and do not wish to ignore the growing social and cultural diversity in Latin America and the Caribbean, as a consequence of the dynamic transformations stemming from international migration processes.

8.
Salud Publica Mex ; 60(5): 566-578, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-30550118

RESUMO

OBJECTIVE: To explore the social determinants of health (SDH) of international migrant children, from the perceptions of caregivers, health workers and local authorities in eight municipalities in Chile. MATERIALS AND METHODS: A secondary analysis of data was conducted from a qualitative study that took place between 2014 and 2017. The original study involved semi-structured interviews and focus groups. The secondary thematic analysis of data included all emerging issues related to international migrant children and their living conditions, including use of health services. RESULTS: Findings were grouped according to the model of social determinants of health, which allow a reflection on living conditions of international migrant children and their health situation. CONCLUSIONS: This research shows the impact of SDH on international migrant children in Chile, highlighting relevant issues around this group.


Assuntos
Determinantes Sociais da Saúde , Migrantes , Criança , Chile , Humanos , Pesquisa Qualitativa , Fatores de Risco
9.
Value Health Reg Issues ; 17: 202-209, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30447541

RESUMO

OBJECTIVES: Out-of-pocket spent (OPS) of health services are considered inefficient and are a consequence of inequalities in financing and access. The main objective of this study was to compare OPS on health and medicine, including catastrophic expenditure, overall and by quintiles and deciles, for the great Santiago city in the periods 1997, 2007 and 2012. METHODS: Cross-sectional study based on household budget surveys 1997, 2007 and 2012. OPS on health and medicine for households of the great Santiago was estimated overall and for different quintiles and deciles. In addition, the probability of incurring in catastrophic due to health and drug expenditure were also estimated. RESULTS: OPS showed a progressive increase in the three periods. Drug spending showed a decrease concentrated in the lower deciles and an increase in top deciles of expenditure. Catastrophic drug expenditure decreased progressively. By observing the catastrophic drug spending by deciles were the three richest deciles which showed a large increase between 2007 and 2012. CONCLUSIONS: OPS on health remained high between 2007 and 2012, despite presenting slight decreases in some quintiles and deciles. However, drug coverage improved over time. This study demonstrates that improvements are needed in the financial protection mechanisms on health in Chile, especially for poorer quintiles and deciles.


Assuntos
Gastos em Saúde/tendências , Serviços de Saúde/economia , Medicamentos sob Prescrição/economia , Doença Catastrófica/economia , Chile , Estudos Transversais , Financiamento Pessoal/economia , Serviços de Saúde/tendências , Disparidades em Assistência à Saúde , Humanos
10.
Salud pública Méx ; 60(5): 566-578, sep.-oct. 2018. tab, graf
Artigo em Espanhol | LILACS-Express | ID: biblio-1004655

RESUMO

Resumen: Objetivo: Explorar los determinantes sociales de la salud (DSS) de niños migrantes, a partir de las percepciones de cuidadores y trabajadores/autoridades de salud en las zonas más densas de población migrante en Chile. Material y métodos: Se realizó un análisis de datos secundario de un estudio realizado entre los años 2014 y 2017 desde un paradigma cualitativo de investigación. El estudio original incluyó entrevistas semiestructuradas y grupos focales. El análisis temático secundario de datos contempló todos los temas emergentes referidos a niños migrantes y condiciones de vida, incluyendo utilización de servicios de salud. Resultados: Los DDS fueron agrupados de acuerdo con el Modelo de Determinantes Sociales de la Salud, el cual permite reflexionar en torno a las condiciones de vida de niños migrantes y su situación de salud. Conclusión: Esta investigación muestra el impacto de los DSS en salud de niños migrantes en Chile, resaltando temáticas relevantes en torno a este grupo.


Abstract: Objective: To explore the social determinants of health (SDH) of international migrant children, from the perceptions of caregivers, health workers and local authorities in eight municipalities in Chile. Materials and methods: A secondary analysis of data was conducted from a qualitative study that took place between 2014 and 2017. The original study involved semi-structured interviews and focus groups. The secondary thematic analysis of data included all emerging issues related to international migrant children and their living conditions, including use of health services. Results: Findings were grouped according to the model of social determinants of health, which allow a reflection on living conditions of international migrant children and their health situation. Conclusion: This research shows the impact of SDH on international migrant children in Chile, highlighting relevant issues around this group.

11.
Rev Peru Med Exp Salud Publica ; 35(2): 285-291, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-30183922

RESUMO

Evidence demonstrates the high levels of vulnerability that surround the current migration phenomenon. These conditions are crucial to health systems worldwide, as they are directly linked to worsening health status and quality of life. However, the study of the connection between the migration process and health remains insufficient, especially with regard to how international migration influences public health decision-making. In the Latin American and Caribbean region, there are initiatives to provide health services to international migrants, but they are still far from guaranteeing the fundamental health rights of those who migrate. This article aims to develop a critical discussion of the main social theories on migration, and its contribution to public health decision-making (push-pull theory, globalization theory, causal accumulation theory, and transnationalism). An academic narrative review was carried out until April 2017, the results of which indicate that institutional, state, and local public health action is essential to guarantee the health rights of the migrant population in the face of the precarious situation surrounding the migration phenomenon. It is hoped that this document will be a contribution to current knowledge in Latin America, both for teaching and for practice and research in public health.


Assuntos
Emigração e Imigração , Política de Saúde , Saúde Pública , Teoria Social , Região do Caribe , Tomada de Decisões , Humanos , América Latina
12.
Rev. peru. med. exp. salud publica ; 35(2): 285-291, abr.-jun. 2018.
Artigo em Espanhol | LILACS-Express | ID: biblio-961884

RESUMO

RESUMEN La evidencia demuestra los altos niveles de vulnerabilidad que rodean al fenómeno migratorio en la actualidad. Dichas condiciones son de importancia para los sistemas de salud en todo el mundo, al vincularse directamente con el empeoramiento del estado de salud y calidad de vida de las personas. Sin embargo, el estudio del nexo entre el proceso migratorio y la salud se mantiene insuficiente, más aún respecto a cómo la migración internacional influye en la toma de decisión en salud pública. En la región Latinoamericana y del Caribe, existen iniciativas para prestar servicios de salud a migrantes internacionales, sin embargo, aún distan mucho de garantizar los derechos fundamentales en salud de quienes migran. Este artículo tiene como objetivo desarrollar una discusión crítica acerca de las principales teorías sociales sobre migración, y sobre su aporte a la toma de decisiones en salud pública (teoría de «tiraje y empuje¼, teoría de globalización, teoría de acumulación causal y el transnacionalismo). Se realizó una revisión narrativa académica hasta abril del 2017, cuyos resultados indican que es primordial la acción institucional, estatal y local de la salud pública para garantizar los derechos de salud de la población migrante frente al escenario de precariedad que rodea el fenómeno migratorio. Se espera que este documento sea un aporte al conocimiento actual en América Latina, tanto para la docencia como para la práctica e investigación en salud pública.


ABSTRACT Evidence demonstrates the high levels of vulnerability that surround the current migration phenomenon. These conditions are crucial to health systems worldwide, as they are directly linked to worsening health status and quality of life. However, the study of the connection between the migration process and health remains insufficient, especially with regard to how international migration influences public health decision-making. In the Latin American and Caribbean region, there are initiatives to provide health services to international migrants, but they are still far from guaranteeing the fundamental health rights of those who migrate. This article aims to develop a critical discussion of the main social theories on migration, and its contribution to public health decision-making (push-pull theory, globalization theory, causal accumulation theory, and transnationalism). An academic narrative review was carried out until April 2017, the results of which indicate that institutional, state, and local public health action is essential to guarantee the health rights of the migrant population in the face of the precarious situation surrounding the migration phenomenon. It is hoped that this document will be a contribution to current knowledge in Latin America, both for teaching and for practice and research in public health.

13.
Global Health ; 14(1): 52, 2018 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-29769091

RESUMO

BACKGROUND: Migrant children have specific health needs, and may face difficulties in accessing health care, but not enough is known about their health service use. This study aims to describe patterns of use of health services of international migrant children and differences to respective native populations. METHODS: Electronic databases PubMed and Web of Science, references of identified publications, and websites of relevant international agencies were searched. We included observational studies published between 2006 and 2016 that reported use of formal health services by migrant children (0-18 years), including first and second generation migrants. Data on study characteristics, study theme, main outcome and study quality were extracted. RESULTS: One hundred seven full texts were included in the review. Of the studies that reported comparable outcomes, half (50%) indicated less use of healthcare by migrants compared with non-migrants; 25% reported no difference, 18% reported greater use, and 7% did not report this outcome. There was variation by theme, so that the proportion of conclusions "less use" was most common in the categories "general access to care", "primary care" and "oral health", whereas in the use of emergency rooms or hospitalisations, the most common conclusion was "greater use". CONCLUSIONS: Migrant children appear to use different types of healthcare services less than native populations, with the exception of emergency and hospital services. SYSTEMATIC REVIEW REGISTRATION: PROSPERO systematic review registration number: CRD42016039876 .


Assuntos
Internacionalidade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Migrantes , Criança , Humanos
14.
Rev Saude Publica ; 52: 36, 2018 Apr 09.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29641660

RESUMO

OBJECTIVE: To compare cancer hospital morbidity among the local population and the immigrant population in Chile. METHODS: This is a prevalence study based on the analysis of hospital discharges of all the health centers of Chile. Cancer hospital discharges were characterized in 2012 according to the migratory status. The crude and specific rates of hospital morbidity for this cause were estimated for the analysis of their association with migratory status using zero-inflated negative binomial regression, adjusted for sociodemographic variables. RESULTS: The neoplasms were the third cause of hospital discharges for immigrants and the seventh one for Chileans. The adjusted rate of cancer hospital discharges was higher for Chileans than immigrants, and the latter had fewer days of hospitalization and greater proportion of surgical interventions. In the group of immigrants, cancer hospital discharges mainly corresponded to patients belonging to the private system (46%), and in the group of Chileans they mainly corresponded to patients in the public system (71.1%). We observed a large difference in the proportion of cancer hospital discharges for patients with no health insurance between the two populations (22.6%: immigrants, 1.0%: Chileans). In both populations, the three most frequent types of cancer were: (i) lymphoid tissue, hematopoietic organs, and related tissues, (ii) digestive organs, and (iii) breast cancer. CONCLUSIONS: Models of differentiated care should be considered for immigrants, with the creation of specific programs of information, coverage, and protection against cancer. More information on this problem must be generated at the local and international level.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Neoplasias/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Chile/epidemiologia , Estudos Transversais , Feminino , Disparidades nos Níveis de Saúde , Humanos , Lactente , América Latina/epidemiologia , Masculino , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Neoplasias/classificação , Fatores Socioeconômicos , Adulto Jovem
15.
Rev. saúde pública (Online) ; 52: 36, 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-903460

RESUMO

ABSTRACT OBJECTIVE To compare cancer hospital morbidity among the local population and the immigrant population in Chile. METHODS This is a prevalence study based on the analysis of hospital discharges of all the health centers of Chile. Cancer hospital discharges were characterized in 2012 according to the migratory status. The crude and specific rates of hospital morbidity for this cause were estimated for the analysis of their association with migratory status using zero-inflated negative binomial regression, adjusted for sociodemographic variables. RESULTS The neoplasms were the third cause of hospital discharges for immigrants and the seventh one for Chileans. The adjusted rate of cancer hospital discharges was higher for Chileans than immigrants, and the latter had fewer days of hospitalization and greater proportion of surgical interventions. In the group of immigrants, cancer hospital discharges mainly corresponded to patients belonging to the private system (46%), and in the group of Chileans they mainly corresponded to patients in the public system (71.1%). We observed a large difference in the proportion of cancer hospital discharges for patients with no health insurance between the two populations (22.6%: immigrants, 1.0%: Chileans). In both populations, the three most frequent types of cancer were: (i) lymphoid tissue, hematopoietic organs, and related tissues, (ii) digestive organs, and (iii) breast cancer. CONCLUSIONS Models of differentiated care should be considered for immigrants, with the creation of specific programs of information, coverage, and protection against cancer. More information on this problem must be generated at the local and international level.


RESUMEN OBJETIVO Comparar la morbilidad hospitalaria por cáncer entre población local e inmigrante en Chile. MÉTODOS Estudio de prevalencia basado en el análisis de egresos hospitalarios de todos los centros de Chile. Se caracterizaron los egresos hospitalarios por cáncer en 2012 según condición migratoria. Se estimaran las tasas brutas y específicas de morbilidad hospitalaria por esta causa, para finalmente analizar su asociación con el estatus migratorio mediante una regresión binomial negativa inflada por ceros ajustada por variables sociodemográficas. RESULTADOS Las neoplasias fueron la tercera causa de egresos hospitalarios en inmigrantes y la séptima en chilenos. La tasa ajustada de egresos hospitalarios por cáncer fue mayor en chilenos que en inmigrantes, y estos presentaron menor cantidad de días de hospitalización y mayor proporción de intervenciones quirúrgicas. En el grupo de inmigrantes, los egresos hospitalarios por cáncer corresponderán principalmente a pacientes pertenecientes al sistema privado (46%) y en chilenos a pacientes en el sistema público (71,1%). Se observó una amplia diferencia en la proporción de egresos hospitalarios por cáncer correspondientes a pacientes sin previsión de salud entre ambas poblaciones (22,6%: inmigrantes, 1,0%: chilenos). En ambas poblaciones, los tres cánceres que se presentaron con mayor frecuencia fueron: (i) tejidos linfáticos, órganos hematopoyéticos y tejidos afines, (ii) órganos digestivos y (iii) cáncer de mama. CONCLUSIONES Se deben considerar modelos de atención diferenciada en inmigrantes, creando programas específicos de información, cobertura y protección frente al cáncer. Es necesario generar más información sobre esta problemática a nivel local e internacional.

16.
Rev. saúde pública (Online) ; 52: 36, 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-903521

RESUMO

ABSTRACT OBJECTIVE To compare cancer hospital morbidity among the local population and the immigrant population in Chile. METHODS This is a prevalence study based on the analysis of hospital discharges of all the health centers of Chile. Cancer hospital discharges were characterized in 2012 according to the migratory status. The crude and specific rates of hospital morbidity for this cause were estimated for the analysis of their association with migratory status using zero-inflated negative binomial regression, adjusted for sociodemographic variables. RESULTS The neoplasms were the third cause of hospital discharges for immigrants and the seventh one for Chileans. The adjusted rate of cancer hospital discharges was higher for Chileans than immigrants, and the latter had fewer days of hospitalization and greater proportion of surgical interventions. In the group of immigrants, cancer hospital discharges mainly corresponded to patients belonging to the private system (46%), and in the group of Chileans they mainly corresponded to patients in the public system (71.1%). We observed a large difference in the proportion of cancer hospital discharges for patients with no health insurance between the two populations (22.6%: immigrants, 1.0%: Chileans). In both populations, the three most frequent types of cancer were: (i) lymphoid tissue, hematopoietic organs, and related tissues, (ii) digestive organs, and (iii) breast cancer. CONCLUSIONS Models of differentiated care should be considered for immigrants, with the creation of specific programs of information, coverage, and protection against cancer. More information on this problem must be generated at the local and international level.


RESUMEN OBJETIVO Comparar la morbilidad hospitalaria por cáncer entre población local e inmigrante en Chile. MÉTODOS Estudio de prevalencia basado en el análisis de egresos hospitalarios de todos los centros de Chile. Se caracterizaron los egresos hospitalarios por cáncer en 2012 según condición migratoria. Se estimaran las tasas brutas y específicas de morbilidad hospitalaria por esta causa, para finalmente analizar su asociación con el estatus migratorio mediante una regresión binomial negativa inflada por ceros ajustada por variables sociodemográficas. RESULTADOS Las neoplasias fueron la tercera causa de egresos hospitalarios en inmigrantes y la séptima en chilenos. La tasa ajustada de egresos hospitalarios por cáncer fue mayor en chilenos que en inmigrantes, y estos presentaron menor cantidad de días de hospitalización y mayor proporción de intervenciones quirúrgicas. En el grupo de inmigrantes, los egresos hospitalarios por cáncer corresponderán principalmente a pacientes pertenecientes al sistema privado (46%) y en chilenos a pacientes en el sistema público (71,1%). Se observó una amplia diferencia en la proporción de egresos hospitalarios por cáncer correspondientes a pacientes sin previsión de salud entre ambas poblaciones (22,6%: inmigrantes, 1,0%: chilenos). En ambas poblaciones, los tres cánceres que se presentaron con mayor frecuencia fueron: (i) tejidos linfáticos, órganos hematopoyéticos y tejidos afines, (ii) órganos digestivos y (iii) cáncer de mama. CONCLUSIONES Se deben considerar modelos de atención diferenciada en inmigrantes, creando programas específicos de información, cobertura y protección frente al cáncer. Es necesario generar más información sobre esta problemática a nivel local e internacional.

17.
Rev. chil. pediatr ; 88(6): 707-716, dic. 2017. tab, graf
Artigo em Espanhol | LILACS-Express | ID: biblio-900041

RESUMO

Resumen Introducción: Los niños y jóvenes migrantes internacionales enfrentan diferentes retos en salud en comparación con la población local, en particular si se enfrentan a ambientes inseguros o a condi ciones sociales adversas. Este estudio busca identificar brechas existentes en resultados de salud de la niñez entre población migrante internacional y chilena. Métodos: Este estudio analiza tres fuentes de información: (i)Nacer en Chile: Datos de consulta antenatal recolectados de los registros electrónicos de las mujeres usuarias del programa Chile Crece Contigo, de todos los centros de salud familiar (CESFAM) de administración municipal de la comuna de Recoleta el año 2012; (ii)Crecer en Chile: Datos de encuesta poblacional "Caracterización Socioeconómica Nacional" CASEN 2013 y (iii)En-fermar en Chile: Datos de todos los egresos hospitalarios de 2012, proporcionada por el departamento de estadística e información en salud (DEIS) del Ministerio de Salud. Resultados: (i) Nacer en Chile: Hay mayor proporción de inmigrantes con riesgo biopsicosocial (62,3% vs 50,1% en chilenas) y con ingreso tardío al programa (63,1% vs 33,4%). Hay menos cesáreas en inmigrantes que en chilenas (24,2% vs 33,6%). (ii) Crecer en Chile: Existe una mayor proporción de niños migrantes fuera del sistema escolar y una mayor proporción en pobreza multidimensional (40% vs 23,2%). (iii) Enfermar en Chile: En migrantes entre 7-14 años es más frecuente egresar hospitalariamente por traumatismos/ otras causas externas (23,6% vs 16,7% en chilenos). Conclusiones: Este estudio entrega nueva evi dencia sobre necesidades urgentes de salud de nuestros niños en Chile. Este es un imperativo ético, legal y moral, independiente de la condición migratoria.


Abstract Introduction: Children and young international migrants face different health challenges compa red with the local population, particularly if they live in insecure environments or adverse social conditions. This study seeks to identify gaps in health outcomes of children between immigrant and local population in Chile. Methods: This study analyses data from three sources: (i) Born in Chile: Electronic records of antenatal visits from all municipal antenatal clinics of Recoleta in 2012; (ii) Growing up in Chile: Population survey "National Socioeconomic Characterization" (CASEN) from 2013 and (iii) Getting sick in Chile: Data of all hospital discharges in 2012, provided by the department of statistics and health information (DEIS) of the Ministry of Health. Results: (I) Born in Chile: Im migrants more frequently have psychosocial risk (62.3% vs 50.1% in Chileans) and enter later into the program (63.1% vs 33.4% enter later than 14 weeks of pregnancy). All birth outcomes were better among immigrants (e.g. caesarean sections rates: 24.2% immigrants vs % Chileans). (ii) Growing up in Chile: A higher proportion of migrant children is outside the school system and lives in multidi mensional poverty (40% immigrants vs 23.2% Chileans). (iii) Getting sick in Chile: Injuries and other external causes were more frequent cause of hospitalisation among migrants (23.6%) than the local population (16.7%) aged between 7 and 14 years. Conclusions: Addressing the needs of the children in Chile, regardless of their immigration status, is an ethical, legal and moral imperative.

19.
Rev Peru Med Exp Salud Publica ; 34(2): 167-175, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-29177373

RESUMO

OBJECTIVES: To investigate the perceptions of primary health workers (PHW) about the challenges of health care for migrants. MATERIALS AND METHODS: A qualitative multicase study was conducted in eight communes of Chile, using the snowball technique, where 101 PHW and local authorities were recruited. Semi-structured interviews and focal groups were conducted, achieving information saturation. RESULTS: The findings were grouped into two major thematic axes: 1. Technical and administrative difficulties, and 2. Perception of cultural barriers. According to the PHW, although regulations have been established and health care strategies have been generated for the migrant population, these are mostly not stable or known to all PHW. They are also not easy to implement in the various realities investigated. The absence of records on the number of migrants accessing the health system makes it difficult to design specific interventions. Additionally, health care has complications, and the PHW do not necessarily have tools that allow them to provide a care that is culturally sensitive to the needs of the migrant community. CONCLUSIONS: The findings put into question the new challenges in health that Chile is facing in the face of the growing migrant population. The needs perceived by PHW are: stability and clarity in the regulations in force in relation to access and provision of services, training in regulations and the concrete way in which they should operate, and sensitization in cultural competence.


Assuntos
Atitude do Pessoal de Saúde , Assistência à Saúde , Migrantes , Adulto , Idoso , Chile , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
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