A Núñez1, C A Manzano2, C Chi3. 1. Department of Management Control and Information Systems, School of Economics and Business, Universidad de Chile, Diagonal Paraguay 257, Office 2004, Santiago, Chile. Electronic address: anunez@fen.uchile.cl. 2. Department of Chemistry, Faculty of Science, University of Chile, Las Palmeras 3425, Nunoa, RM, Chile; School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, USA. Electronic address: camanzano@sdsu.edu. 3. College of Public Health and Human Sciences, Oregon State University, 013 Milam Hall, Corvallis, OR, USA. Electronic address: chunhuei.chi@oregonstate.edu.
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). STUDY DESIGN: 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.
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). STUDY DESIGN: 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.
Authors: Akash Sharma; Nguyen Tran Minh Duc; Tai Luu Lam Thang; Nguyen Hai Nam; Sze Jia Ng; Kirellos Said Abbas; Nguyen Tien Huy; Ana Marušić; Christine L Paul; Janette Kwok; Juntra Karbwang; Chiara de Waure; Frances J Drummond; Yoshiyuki Kizawa; Erik Taal; Joeri Vermeulen; Gillian H M Lee; Adam Gyedu; Kien Gia To; Martin L Verra; Évelyne M Jacqz-Aigrain; Wouter K G Leclercq; Simo T Salminen; Cathy Donald Sherbourne; Barbara Mintzes; Sergi Lozano; Ulrich S Tran; Mitsuaki Matsui; Mohammad Karamouzian Journal: J Gen Intern Med Date: 2021-04-22 Impact factor: 6.473