Income-related inequality in health and health care utilization in Chile, 2000 - 2009

Vásquez, Felipe; Paraje, Guillermo; Estay, Manuel

doi:10.1590/s1020-49892013000200004

Cited by 72 publications

(79 citation statements)

References 16 publications

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“…In a group of 18 OECD countries, the prevalence-adjusted HEI for doctor visits varied from zero in the U.K. to 0.14 in Canada and 0.20 in the U.S.; for dentist visits the HEI varied from 0.07 in Switzerland to 0.15 in the U.K. and 0.3 in Canada and the U.S. (data from 2008 and 2009) [42]. On the other hand, unadjusted HEI for doctor visits and hospitalizations were respectively 0.079 and 0.015 in Chile [43] and 0.091and 0.036 in Colombia [44] (data from 2008 and 2009). However, comparing our results with those from other countries is problematic due to the different measures of socioeconomic position used; for instance, the studies on OECD countries and Chile used household income and the study on Colombia used household expenditure.…”

Section: Discussionmentioning

confidence: 99%

Changes in health care inequity in Brazil between 2008 and 2013

Mullachery

Silver

Macinko

2016

Int J Equity Health

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BackgroundBrazil has made progress towards a more equitable distribution of health care, but gains may be threatened by economic instability resulting from the 2008 global financial crisis. This study measured predictors of health care utilization and changes in horizontal inequity between 2008 and 2013.MethodData were from two nationally representative surveys that measured a variety of sociodemographic, health behaviors and health care indicators. We used Poisson regression models to estimate adjusted prevalence ratios and the Horizontal Equity Index (HEI) standardized by health needs to measure inequity in the utilization of doctor and dentist visits, hospitalizations and reporting of a usual source of care (USC) for those 18 and older. To estimate the HEI, we ranked the population from the poorest to the richest using a wealth index. We also decomposed the HEI into its different components and assessed changes from 2008 to 2013.ResultsThe population proportion with doctor and dentist visits in the past year and a USC increased between 2008 and 2013, while hospitalizations declined. In 2013, pro-rich inequity in doctor visits increased significantly while the distribution of hospitalizations shifted from pro-rich in 2008 to neutral in 2013. Dentist visits were highly pro-rich and USC was slightly pro-rich; the distribution of dentist visits and USC did not change over time. Health need was a strong predictor of health care utilization regardless of the type of coverage (public or private). Education, wealth, and private health plans were associated with the pro-rich orientation of doctor and dentist visits. Private health plans contributed to the pro-rich orientation of all outcomes, while the Family Health Strategy contributed to the pro-poor orientation of all outcomes.ConclusionThe results of this study support the claim that Brazil’s population continued to see absolute gains in access to care despite recent economic crises. However, gains in equity have slowed and may even decline if investments are not maintained as the country enters deeper financial and political crises.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-016-0431-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Changes in health care inequity in Brazil between 2008 and 2013

Mullachery

Silver

Macinko

2016

Int J Equity Health

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“…This is relevant, since schooling was a factor associated with UDHS, probably because lack of education makes it difficult to obtain a formal paid employment and therefore have limited access to dental health services. [27][28][29] Another associated factor was being a beneficiary of the "Programa Oportunidades", one of the most important programs in the country, which includes among its benefits, dental care. However, only one third of the PW and OA have such support.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the use of dental health services in primary care in northeastern Mexico

et al. 2016

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Abstract:In Mexico, as in many other Latin American countries, the use of dental health services (UDHS) has been scarcely studied, especially the one related with groups that are considered at risk in certain areas. The aim of this study was to evaluate the factors associated with UDHS in an at risk population in primary care. Material and Methods: Cross-sectional study, involving students (T), pregnant women (PW), workers (W) and older adults (OA) (n=368). Variables such as the use of dental health services and factors such as geographical, economic, and organizational barriers were measured. Descriptive statistics, Chi Square test and multivariate binary logistic regression analysis were used. Results: 40.2% (95% CI 30.2-50.2) of the W group had a history of UDHS in primary care, 20% (95% CI 11.8-28.2) of the PW group had spent more than a year without visiting the dentist and 33% (95% CI 23.7-43.9) had been treated at a private dental care service. Level of schooling, occupation, federal support from "Programa Oportunidades" and access to dental care services (p<0.01) were factors associated with UDHS, independent of potential confounders. Conclusion: The health system should guarantee health care by offering comprehensive dental health services and removing organizational barriers to promote a more equitable access to dental care.

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“…Pero, como han indicado otros investigadores, persisten grandes diferencias en utilización entre quienes poseen y no poseen recursos [20][21][22] . Los datos CASEN no permiten atribuir resultados a políticas específicas, pero el análisis en el tiempo, antes y después de la reforma, da cuenta del progreso en los objetivos planteados.…”

Section: Discussionunclassified