Seguimiento de cobertura sanitaria universal con equidad en Chile entre 2000 y 2011 usando las Encuestas CASEN

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 and Methods: We evaluat...

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Autores principales:	Frenz,Patricia, Delgado Becerra,Iris, Villanueva Pabón,Loreto, Kaufman,Jay S, Muñoz Porras,Fernando, Navarrete Couble,María Soledad
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2013
Materias:	Chile Health care reform Healthcare disparities Health systems, plans Universal coverage
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000900001
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spelling	oai:scielo:S0034-988720130009000012014-09-02Seguimiento de cobertura sanitaria universal con equidad en Chile entre 2000 y 2011 usando las Encuestas CASENFrenz,PatriciaDelgado Becerra,IrisVillanueva Pabón,LoretoKaufman,Jay SMuñoz Porras,FernandoNavarrete Couble,María Soledad Chile Health care reform Healthcare disparities Health systems, plans Universal coverage 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 and Methods: 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.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.141 n.9 20132013-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000900001es10.4067/S0034-98872013000900001
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Chile Health care reform Healthcare disparities Health systems, plans Universal coverage
spellingShingle	Chile Health care reform Healthcare disparities Health systems, plans Universal coverage Frenz,Patricia Delgado Becerra,Iris Villanueva Pabón,Loreto Kaufman,Jay S Muñoz Porras,Fernando Navarrete Couble,María Soledad Seguimiento de cobertura sanitaria universal con equidad en Chile entre 2000 y 2011 usando las Encuestas CASEN
description	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 and Methods: 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.
author	Frenz,Patricia Delgado Becerra,Iris Villanueva Pabón,Loreto Kaufman,Jay S Muñoz Porras,Fernando Navarrete Couble,María Soledad
author_facet	Frenz,Patricia Delgado Becerra,Iris Villanueva Pabón,Loreto Kaufman,Jay S Muñoz Porras,Fernando Navarrete Couble,María Soledad
author_sort	Frenz,Patricia
title	Seguimiento de cobertura sanitaria universal con equidad en Chile entre 2000 y 2011 usando las Encuestas CASEN
title_short	Seguimiento de cobertura sanitaria universal con equidad en Chile entre 2000 y 2011 usando las Encuestas CASEN
title_full	Seguimiento de cobertura sanitaria universal con equidad en Chile entre 2000 y 2011 usando las Encuestas CASEN
title_fullStr	Seguimiento de cobertura sanitaria universal con equidad en Chile entre 2000 y 2011 usando las Encuestas CASEN
title_full_unstemmed	Seguimiento de cobertura sanitaria universal con equidad en Chile entre 2000 y 2011 usando las Encuestas CASEN
title_sort	seguimiento de cobertura sanitaria universal con equidad en chile entre 2000 y 2011 usando las encuestas casen
publisher	Sociedad Médica de Santiago
publishDate	2013
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872013000900001
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Seguimiento de cobertura sanitaria universal con equidad en Chile entre 2000 y 2011 usando las Encuestas CASEN

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