Health outcomes, utilization, and equity in Chile: an evolution from 1990 to 2015 and the effects of the last health reform.
Public Health
; 178: 38-48, 2020 Jan.
Article
en En
| MEDLINE
| ID: mdl-31605807
ABSTRACT
OBJECTIVE:
Chile is an attractive case study because of the deep political changes that it underwent over a short period of time from a universal health service (60s), through a neoliberal reform (70s) and onto a series of legislative reforms (80s-90s). This article aims to explore and assess the evolution of health outcomes, equity, and utilization in Chile through the last period of these reforms (1990-2015). STUDYDESIGN:
Standardized health equity analysis.METHODS:
We conducted a standardized economic analysis on health equity and healthcare utilization using the ADePT software (by the World Bank) and using data from the Chilean National Socio-economic Survey. We evaluated trends of health equity and examined concentration curves of health utilization of healthcare services and health outcomes such as children/elder/pregnant nutritional status, self-reported health, and physical limitations.RESULTS:
Health outcomes such as nutritional problems in children and pregnant women were concentrated among the poor, while others such as high-relevance health conditions were similar for poorest and richest households. The concentration indexes for health outcomes suggested that income makes the distribution pro-poor. However, the opposite was true for age, in which the probability of health problems among rich individuals increased with age. The concentration curves for utilization of healthcare services showed that dental visits, laboratory exams, specialty visits, and hospitalizations were concentrated on the richest households, while the use of emergency services and preventive medicine were highly concentrated among poor individuals.CONCLUSIONS:
Although a positive trend in the increase of healthcare service use among income groups was observed, a significant impact of the latest health reform was not observed.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Aceptación de la Atención de Salud
/
Estado de Salud
/
Reforma de la Atención de Salud
/
Equidad en Salud
Límite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
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Child, preschool
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Female
/
Humans
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Infant
/
Male
País como asunto:
America do sul
/
Chile
Idioma:
En
Año:
2020
Tipo del documento:
Article