Inequality of opportunity in health: evidence from Chile

Gallardo, Kevin; Varas, Liseth; Gallardo, Mauricio

doi:10.11606/s1518-8787.2017051007034

Cited by 20 publications

(16 citation statements)

References 19 publications

(38 reference statements)

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“…Two studies [39,40] used data on the use of services by older adults, so that comparability with our results may be limited. Despite this, our results on the determinants that most contribute to prorich inequalities (health coverage, education, and income) are similar to those reported by other studies at the local [38][39][40] and regional level, such as Brazil [59][60][61][62], Chile [63,64], Colombia [65,66], Ecuador [67,68] and Mexico [69].…”

Section: Discussionsupporting

confidence: 89%

Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for Argentina

Palacios

Espínola

Rojas‐Roque

2020

Int J Equity Health

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Background: The high fragmentation and decentralization in the provision of health care services that characterizes Argentina's health system, as well as the economic and social inequalities, challenge the achievement of the Universal Health Coverage (UHC). The objective of this study is to measure socioeconomic-related inequality and horizontal inequity in the use of health care services in Argentina as well as identify the factors that contribute to these disparities. Methods: The 2013 National Risk Factor Survey, developed by the Ministry of Health of Argentina, was used to measure socioeconomic-related inequality and inequity in the use of health care services through concentration curves, the Erreygers concentration index, and the index of horizontal inequity. Econometric micro-decomposition was applied to estimate the contribution of each determining factor to inequality in the use of health care services. Results: The Erreygers concentration index for the use of health care services was 0.1223, evidencing pro-rich inequalities. By adding variables of health care needs, the horizontal inequity index was 0.1296. Non-need factors such as education and health coverage with social security increase pro-rich inequality. Conclusions: The Argentine health system shows pro-rich inequality in the use of health care services. It is necessary to design strategies to improve articulation between the three coverage subsectors and national, provincial, and municipal governments to keep the commitment of "not leaving anyone behind." The results showed here could provide lessons for countries with similar contexts and challenges in public health.

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Section: Discussionsupporting

confidence: 89%

Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for Argentina

Palacios

Espínola

Rojas‐Roque

2020

Int J Equity Health

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“…Since the 21st century, differences in citizens' health levels across different regions and the analysis of associated influencing factors have gradually become the focus of a lot of research. For example, Murray et al [22], Willems et al [23], Skaftun et al [24], and other scholars used health indices such as mortality and morbidity to analyze differences in citizens' health levels across different regions of the world; and Brunello et al [25], Gallardo et al [26], Addison et al [27], Brown et al [28], and other scholars used health indices such as life expectancy, cancer mortality, obesity, and weight problems to measure differences in citizens' health levels across different regions. They further analyzed the influence of education, economy, family environment, and other factors on citizens' health levels.…”

Section: Literature Reviewmentioning

confidence: 99%

Spatio-Temporal Comprehensive Measurements of Chinese Citizens’ Health Levels and Associated Influencing Factors

Jin

Tang

et al. 2020

Healthcare

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Health is the basis of a good life and a guarantee of a high quality of life. Furthermore, it is a symbol of social development and progress. How to further improve the health levels of citizens and reduce regional differences in citizens’ health status has become a research topic of great interest that is attracting attention globally. This study takes 31 provinces (municipalities and autonomous regions) of China as the research object. Through using GIS (Geographic Information System) technology, the entropy method, spatial autocorrelation, stepwise regression, and other quantitative analysis methods, measurement models and index systems are developed in order to perform an analysis of the spatio-temporal comprehensive measurements of Chinese citizens’ health levels. Furthermore, the associated influencing factors are analyzed. It has important theoretical and practical significance. The conclusions are as follows: (1) Between 2002 and 2018, the overall health levels of Chinese citizens have generally exhibited an upward trend. Moreover, for most provinces, the health levels of their citizens have improved dramatically, although some provinces, such as Tianjin and Henan, showed a fluctuating downward trend, suggesting that the health levels of citizens in these regions displayed a tendency to deteriorate. (2) The health levels of citizens from China’s various provinces showed clear spatial distribution characteristics of clustering, as well as an obvious spatial dependence and spatial heterogeneity. As time goes by, the degree of spatial clustering with regard to citizens’ health levels tends to weaken. The health levels of Chinese citizens have developed a certain temporal stability, the overall health status of Chinese citizens shows a spatial differentiation of a northeast–southwest distribution pattern. (3) The average years of education and urbanization rate have a significant positive effect on the improvement of citizens’ health levels. The increase of average years of education and urbanization rate can promote the per capita income, which certainly could help improve citizens’ health status. The Engel coefficient, urban–rural income ratio, and amount of wastewater discharge all pose a significant negative effect on the improvement of citizens’ health levels, these three factors have played important roles in hindering the improvements of citizen health.

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“…11 The private system budget is almost three times higher per capita than the public system, 12 which is reflected in the different availability and reimbursement for some therapies, as we will discuss later. This problem of health inequality is well documented, 13,14 and there have been efforts to correct it through health reforms and public health spending: measured as percentage of the Chilean gross domestic product, public health spending has grown from to 6.6% in 2005 to 8.1% in 2017. 15,16 In very general terms, NSCLC management in Chile follows international guidelines, and can be outlined by stage as follows: stage I, surgery alone; stage II, surgery followed by adjuvant chemotherapy; stage III, definitive concurrent chemoradiation (which is the most frequent approach) and induction chemotherapy followed by surgery in select patients; and stage IV, chemotherapy and palliative care.…”

Section: Lung Cancer Management In Chilementioning

confidence: 99%