BackgroundSuicide affects people from different backgrounds, ethnical groups, socio-economic status and geographical locations. In Latin America, suicide reports arescarce, specially in Andean countries. In Ecuador, very few reports have partially described this phenomenon, nonetheless, estimation of the burden of disease (BoD) hasnever been reported in the country.MethodsA country-wide comparison was performed using the Ministry of Public Health’s national databases of overall mortality, Hospital Discharges Database, and the Population Census of the National Institute of Census and Statistics (INEC). The study variables analyzed were age, geographical distribution to provincial level, sex, means of suicide, educational attainment, marital status and mortality. Linear Regression and relative Risk analysis were used to predict outcome and the likelihood that suicide occur among study variables.ResultsIn the last 15 years, 13,024 suicides were officially reported. Men were 3 times more likely than women to die by suicide. The overall age-adjusted suicide ratio in Ecuador corresponds to 7.1 per 100,000 per year. The sex-specific rates were 5.3 in women and 13.2 in men. The primary mean of suicide was hanging X70 (51.1%), followed by self-poisoning X68-X69 (35.2%) and firearms X72-X74 (7.6%). Provinces located at higher altitude reported higher rates than those located at sea level (9 per 100,000 vs 4.5 per 100.000). The total economic loss due to suicide was estimated to be $852.6 million during the 15 years’ analysis.ConclusionsThis is the first geodemographic study exploring the complete burden of suicide in Ecuador and one of the very few in Latin-America. In the last 15 years of available data, Ecuador ranks above the regional average with an adjusted suicide rate of 7.1 per 100,000 inhabitants. An important finding is that Suicide affects rather younger populations, adding more than 10,000 years of premature years of life lost (YYL) between 2001 and 2015, becoming the first and fourth leading cause of death among adolescent women and men respectively.Suicide affects people from different backgrounds, socioeconomic status and educational attainment. The mean of suicide changed over time showing that gun and pesticides related deaths decreased significantly since 2001, while hanging and suffocation increased in more than 50%.
Objective: To determine whether there is a relationship between access to health systems and out-of-pocket spending with socio demographic characteristics in Ecuador. Methods:Retrospective analysis of national level data on household medical expenditure from the National Survey of Household Income and Expenditure in Urban and Rural Houses conducted by the Ecuadorian National Institute of Statistics and Census Databases as well as other scientific, institutional, technical-administrative datasets.Results: Families in the lowest percentile of poverty spend proportionally more out-of-pocket on pharmaceutical drugs than wealthier families. Furthermore, the lowest income deciles have no access to private health coverage. Populations from the bigger cities have more access to health care services than smaller rural cities. In Ecuador, 71% of pharmaceutical products are imported and 8% of the total of drugs are generic. Conclusions:Despite efforts by the current government, health access remains uneven, as indicated by drug access and out-of-pocket expenses per family. Poorer families have higher relative health expenditures for drugs than families with higher incomes, although poorer families have no access to private insurances.
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