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
em Es
| LILACS
| ID: lil-699676
Biblioteca responsável:
CL1.1
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Reforma dos Serviços de Saúde
/
Cobertura Universal do Seguro de Saúde
/
Acessibilidade aos Serviços de Saúde
/
Necessidades e Demandas de Serviços de Saúde
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
/
Equity_inequality
Limite:
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
America do sul
/
Chile
Idioma:
Es
Revista:
Rev. méd. Chile
Assunto da revista:
MEDICINA
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Chile
País de publicação:
Chile