Access to medicines for acute illness in middle income countries in Central America

Abstract

OBJECTIVETo analyze the main predictors of access to medicines for persons who experienced acute health conditions.METHODSThis was a cross-sectional analytic study, based on data from household surveys. We examined the predictors of: (1) seeking care for acute illness in the formal health care system and (2) obtaining all medicines sought for the acute condition.RESULTSThe significant predictors of seeking health care for acute illnesses were urban geographic location, head of household with secondary school education or above, age under 15, severity of illness perceived by the respondent, and having health insurance. The most important predictor of obtaining full access to medicines was seeking care in the formal health care system. People who sought care in the formal system were three times more likely to receive all the medicines sought (OR 3.0, 95%CI 2.3;4.0). For those who sought care in the formal health system, the strongest predictors of full access to medicines were seeking care in the private sector, having secondary school education or above, and positive perceptions of quality of health care and medicines in public sector health facilities. For patients who did not seek care in the formal health system, full access to medicines was more likely in Honduras or Nicaragua than in Guatemala. Urban geographic location, higher economic status, and male gender were also significant predictors.CONCLUSIONSA substantial part of the population in these three countries sought and obtained medicines outside of the formal health care system, which may compromise quality of care and pose a risk to patients. Determinants of full access to medicines inside and outside the formal health care system differ, and thus may require different strategies to improve access to medicines.

Acesso da população brasileira adulta a medicamentos prescritos

“…According to the literature, the monetary expenditure to guarantee the access to medications leads the income to be compromised, and penalizes mostly the poorer population 22 , once this expenditure constitutes most of the expenses with health among individuals with lower purchase power 23 . Therefore, the findings in this study are in accordance with the evidence available, showing the importance of the purchase capacity as a limiting factor for obtaining the drugs 10,14,24,25 .…”

“…Regarding the demographic variables, there are diverging results referring to the association between access and the gender of the individual. Lack of significant association 16 and higher chances of partial access among women 24 , similarly to the finding observed in Brazil in this study, were found in the literature. Besides, non-white individuals presented more chances of not accessing the medicines, as demonstrated in other studies 12 .…”

“…The adjusted analysis for the evaluation of the factors associated with the access to medication reinforces the existing inequalities in access, verified in other studies 4,10,13,16,24 , given the observation of significant differences in the prevalence rates in relation to sociodemographic conditions.…”

Health Policy on the pages of Revista de Saúde Pública

“…The authors indicated the need to strengthen the national productive sector, with emphasis on drugs not protected by patents. On the other hand, the access and use of medicines have been studied in the most diverse scenarios: older adults in urban area of the Northeast region 21 ; people with disabilities in São Paulo 18 ; quilombola population 59 ; and in Central America 30 . The studies also approached the following topics: Pharmaceutical Assistance in the PHC scenario 67 ; prices and availability of medicines in the Popular Pharmacy Program of Brazil 79 ; and Policy of Medication Price Regulation 64 .…”

Barriers in household access to medicines for chronic conditions in three Latin American countries

“…This study results pointed out that overall more than 70 % of the individuals with chronic condition sough care in the formal health system. The literature points out that in an acute condition, this percentage is lower, less than 50 % [ 12 ] and 30 % [ 23 ] sought care for acute conditions, being the perception of severity one of the associated factors [ 12 , 23 ].…”