Equidad en el Acceso a Servicios de Salud en Antioquia, Colombia

Mejía-Mejía, Aurelio; Sánchez-Gandur, Andrés F.; Tamayo-Ramírez, Juan C.

doi:10.1590/s0124-00642007000100004

Cited by 52 publications

(37 citation statements)

References 9 publications

(6 reference statements)

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“…Los estudios de los determinantes de la utilización en Colombia y Brasil se basan en encuestas poblacionales nacionales 7-10 o de áreas geográ-ficas determinadas 11,12 , y analizan la utilización por la población general 7 o por colectivos específicos 13,14 . La mayoría no diferencia según el nivel asistencial utilizado, aunque cabe esperar que los determinantes sean distintos 15 , y los que analizan un nivel de atención se centran en colectivos específicos como enfermos crónicos 16 o personas mayores 17 .…”

Section: Introductionunclassified

Determinantes del uso de distintos niveles asistenciales en el Sistema General de Seguridad Social en Salud y Sistema Único de Salud en Colombia y Brasil

et al. 2014

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Section: Introductionunclassified

Determinantes del uso de distintos niveles asistenciales en el Sistema General de Seguridad Social en Salud y Sistema Único de Salud en Colombia y Brasil

et al. 2014

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“…Furthermore, studies in both countries that do not distinguish between the types of activity identify that the higher the individual’s socioeconomic level, the higher the probability that the medical visit was for preventive rather than curative reasons [7,28,35]. This cycle, in which the poor (lower-income, subsidized scheme and uninsured individuals in Colombia, and those without a private health plan in Brazil) have worse health and worse access to curative health care and preventive activities, makes them particularly vulnerable and may be related to worse health outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…There are also studies available for both countries analyzing equity in the utilization of the health services, mostly based on national surveys of the general population: the Quality of Life Survey ( Encuesta de Calidad de Vida, ECV) and the Demography and Health Survey ( Encuesta de Demografía y Salud , EDS) in Colombia, and the National Household Sample Survey (Pesquisa Nacional de Amostra por Domicilios , PNAD) in Brazil. These studies indicate that, irrespective of need, individuals of a higher socioeconomic status – higher income [5,7,24-27], higher level of education [23,25,28,29] or more favorable working conditions (stable employment) [30] – make greater use of the health services. In Brazil, people who have private medical insurance are shown to be more likely to use the health services [31].…”

Section: Introductionmentioning

confidence: 99%

“…Only one study has been found for Colombia which differentiates utilization according to care levels [7] and there are none for Brazil. Likewise, equity in access to preventive services [28,35,36] is a little explored subject matter. In Colombia, analyses also tend to focus on the differences between those covered by the SGSSS –either in general [24] or in the subsidized scheme [37,38]- and the uninsured, whilst studies comparing the use of services in the different insurance schemes are rare and give conflicting results [27,28,39].…”

Section: Introductionmentioning

confidence: 99%

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Inequities in access to health care in different health systems: a study in municipalities of central Colombia and north-eastern Brazil

García-Subirats

Vargas

Mogollón-Pérez

et al. 2014

Int J Equity Health

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IntroductionHealth system reforms are undertaken with the aim of improving equity of access to health care. Their impact is generally analyzed based on health care utilization, without distinguishing between levels of care. This study aims to analyze inequities in access to the continuum of care in municipalities of Brazil and Colombia.MethodsA cross-sectional study was conducted based on a survey of a multistage probability sample of people who had had at least one health problem in the prior three months (2,163 in Colombia and 2,167 in Brazil). The outcome variables were dichotomous variables on the utilization of curative and preventive services. The main independent variables were income, being the holder of a private health plan and, in Colombia, type of insurance scheme of the General System of Social Security in Health (SGSSS). For each country, the prevalence of the outcome variables was calculated overall and stratified by levels of per capita income, SGSSS insurance schemes and private health plan. Prevalence ratios were computed by means of Poisson regression models with robust variance, controlling for health care need.ResultsThere are inequities in favor of individuals of a higher socioeconomic status: in Colombia, in the three different care levels (primary, outpatient secondary and emergency care) and preventive activities; and in Brazil, in the use of outpatient secondary care services and preventive activities, whilst lower-income individuals make greater use of the primary care services. In both countries, inequity in the use of outpatient secondary care is more pronounced than in the other care levels. Income in both countries, insurance scheme enrollment in Colombia and holding a private health plan in Brazil all contribute to the presence of inequities in utilization.ConclusionsTwenty years after the introduction of reforms implemented to improve equity in access to health care, inequities, defined in terms of unequal use for equal need, are still present in both countries. The design of the health systems appears to determine access to the health services: two insurance schemes in Colombia with different benefits packages and a segmented system in Brazil, with a significant private component.

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“…Dicho acceso busca que las necesidades sean resueltas completamente para favorecer el bienestar, el potencial de desarrollo y la calidad de vida. Desde esta perspectiva, las barreras de acceso a servicios de salud pueden clasificarse, según su tipo, en geográficas, económicas, culturales-sociales y organizacionales (12).…”

Section: Introductionunclassified

Acción de tutela y barreras de acceso a servicios de salud en labio y/o paladar hendido

Restrepo

Córdoba

González

et al. 2016

Rev. Colomb. Enferm.

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La investigación busca identificar barreras de acceso a servicios de salud para la atención integral de pacientes con labio y/o paladar hendido (LPH) a partir del análisis de acciones de tutela relacionadas con esta condición en un periodo de veinte años: 1994-2014. Se identificaron tutelas interpuestas por familiares de niños con LPH; se construyó una matriz para organizar los datos más relevantes (motivos de tutela, fallo y consideraciones para este); posteriormente, se hizo un análisis para identificar las barreras y la manera como la justicia resuelve la solicitud. En total, se analizaron once fallos de tutela. El principal motivo para interponerlas fue la negación por parte de la entidad promotora de salud de tratamientos para LPH por no encontrarse incluidos en el plan de atención en salud (catalogados como estéticos) o por falta de infraestructura para su atención. Cinco de ellas fueron negadas por razones administrativas o procedimentales, por dificultades en la afiliación a una entidad de salud o porque cesaron los efectos que motivaron la tutela. En las tutelas aceptadas, se obliga a realizar la atención integral, considerando la garantía del derecho a la salud en conexidad con los derechos a la vida, la dignidad y los derechos de los niños. Conclusión: la principal barrera de atención para pacientes con LPH se relaciona con el hecho de que algunos tratamientos no están incluidos en el plan de atención en salud de Colombia; por tanto la acción de tutela, a la luz del derecho a la salud, permite aclarar imprecisiones del Sistema General de Seguridad Social y superar las barreras en la atención de individuos con labio y/o paladar hendido.

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Equidad en el Acceso a Servicios de Salud en Antioquia, Colombia

Cited by 52 publications

References 9 publications

Determinantes del uso de distintos niveles asistenciales en el Sistema General de Seguridad Social en Salud y Sistema Único de Salud en Colombia y Brasil

Determinantes del uso de distintos niveles asistenciales en el Sistema General de Seguridad Social en Salud y Sistema Único de Salud en Colombia y Brasil

Inequities in access to health care in different health systems: a study in municipalities of central Colombia and north-eastern Brazil

Acción de tutela y barreras de acceso a servicios de salud en labio y/o paladar hendido

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