Pedro Ypanaqué-Luyo1, Mônica Martins2. 1. Dirección de Servicios de Salud, Ministerio de Salud, Lima, Perú 2. Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Abstract
OBJECTIVES: Describe the profile of need and patterns of use of outpatient health services in populations who are enrolled and non-enrolled in a health insurance program in Peru. MATERIALS AND METHODS: Descriptive cross-sectional study using data from the 2011 National Household Survey. The data were divided into five groups: persons enrolled in the Social Health Insurance (ESSALUD), Integral Health Insurance (SIS), Health Insurance of the Armed Forces and Police Force (AF-PF), Private Health Insurances (SPS) and the uninsured. RESULTS: People insured and enrolled in ESSALUD were more likely to use outpatient services than uninsured people and those enrolled in SIS. SIS members mainly attended health centers and small health posts (47.1%), while other insurance members mainly used hospitals and private hospitals. The uninsured used as their first choice pharmacies and drugstores (46.7%) in order to solve their health problems. In all insurances, out-of-pocket payment was made for the consultation, medications and tests. The perception of "not serious" was the main reason for not seeking care in the insured (40.0%) and uninsured (41.4%); however the lack of money showed an important difference between insured (10.6%) and uninsured (16.3%). CONCLUSIONS: The outpatient health services utilization profile of the Peruvian population expresses differences that relate to enrollment in and type of insurance.
OBJECTIVES: Describe the profile of need and patterns of use of outpatient health services in populations who are enrolled and non-enrolled in a health insurance program in Peru. MATERIALS AND METHODS: Descriptive cross-sectional study using data from the 2011 National Household Survey. The data were divided into five groups: persons enrolled in the Social Health Insurance (ESSALUD), Integral Health Insurance (SIS), Health Insurance of the Armed Forces and Police Force (AF-PF), Private Health Insurances (SPS) and the uninsured. RESULTS:People insured and enrolled in ESSALUD were more likely to use outpatient services than uninsured people and those enrolled in SIS. SIS members mainly attended health centers and small health posts (47.1%), while other insurance members mainly used hospitals and private hospitals. The uninsured used as their first choice pharmacies and drugstores (46.7%) in order to solve their health problems. In all insurances, out-of-pocket payment was made for the consultation, medications and tests. The perception of "not serious" was the main reason for not seeking care in the insured (40.0%) and uninsured (41.4%); however the lack of money showed an important difference between insured (10.6%) and uninsured (16.3%). CONCLUSIONS: The outpatient health services utilization profile of the Peruvian population expresses differences that relate to enrollment in and type of insurance.
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