Is Equity of Access to Health Care Achievable in Latin America?

Araújo, Gabriela Tannus Branco de; Caporale, Joaquín; Stefani, Stephen; Pinto, Diana M.; Caso, Antonio

doi:10.1016/j.jval.2011.05.037

Cited by 11 publications

(33 citation statements)

References 1 publication

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“…The Argentine health-care system includes three independent sectors: public, social security, and private (prepaid) 20. OSPERYH (Obra Social del Personal de Edificios de Renta y Horizontal) is a health-management organization that belongs to the social security sector.…”

Section: Introductionmentioning

confidence: 99%

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina

González¹,

Elgart²,

Calvo³

et al. 2013

CEOR

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PurposeTo measure the impact of a diabetes and cardiovascular risk factors program implemented in a social security institution upon short- and long-term clinical/metabolic outcomes and costs of care.MethodsObservational longitudinal cohort analysis of clinical/metabolic data and resource use of 300 adult male and female program participants with diabetes before (baseline) and 1 and 3 years after implementation of the program. Data were obtained from clinical records (Qualidiab) and the administration’s database.ResultsThe implementation of the program in “real world” conditions resulted in an immediate and sustainable improvement of the quality of care provided to people with diabetes incorporated therein. We also recorded a more appropriate oral therapy prescription for hyperglycemia and cardiovascular risk factors (CVRFs), as well as a decrease of events related to chronic complications. This improvement was associated with an increased use of diagnostic and therapeutic resources, particularly those related to pharmacy prescriptions, not specifically used for the control of hyperglycemia and other CVRFs.ConclusionThe implementation of a diabetes program in real-world conditions results in a significant short- and long-term improvement of the quality of care provided to people with diabetes and other CVRFs, but simultaneously increased the use of resources and the cost of diagnostic and therapeutic practices. Since controlled studies have shown improvement in quality of care without increasing costs, our results suggest the need to include management-control strategies in these programs for appropriate medical and administrative feedback to ensure the simultaneous improvement of clinical outcomes and optimization of the use of resources.

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Section: Introductionmentioning

confidence: 99%

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina

González¹,

Elgart²,

Calvo³

et al. 2013

CEOR

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“…We developed this category with those values more commonly identified as guiding principles of health systems in the papers reviewed [21][22][23][24][25]. We made a distinction in this category between the core and intermediate values to…”

Section: Goal-related Valuesmentioning

confidence: 99%

A framework for explaining the role of values in health policy decision-making in Latin America: a critical interpretive synthesis

Vélez

Wilson

Lavis

et al. 2020

Health Res Policy Sys

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Background Although values underpin the goals pursued in health systems, including how health systems benefit the population, it is often not clear how values are incorporated into policy decision-making about health systems. The challenge is to encompass social/citizen values, health system goals, and financial realities and to incorporate them into the policy-making process. This is a challenge for all health systems and of particular importance for Latin American (LA) countries. Our objective was to understand how and under what conditions societal values inform decisions about health system financing in LA countries. Methods A critical interpretive synthesis approach was utilised for this work. We searched 17 databases in December 2016 to identify articles written in English, Spanish or Portuguese that focus on values that inform the policy process for health system financing in LA countries at the macro and meso levels. Two reviewers independently screened records and assessed them for inclusion. One researcher conceptually mapped the included articles, created structured summaries of key findings from each, and selected a purposive sample of articles to thematically synthesise the results across the domains of agenda-setting/prioritisation, policy development and implementation. Results We identified 5925 references, included 199 papers, and synthesised 68 papers. We identified 116 values and developed a framework to explain how values have been used to inform policy decisions about financing in LA countries. This framework has four categories – (1) goal-related values (i.e. guiding principles of the health system); (2) technical values (those incorporated into the instruments adopted by policy-makers to ensure a sustainable and efficient health system); (3) governance values (those applied in the policy process to ensure a transparent and accountable process of decision-making); and (4) situational values (a broad category of values that represent competing strategies to make decisions in the health systems, their influence varying according to the four factors). Conclusions It is an effort to consolidate and explain how different social values are considered and how they support policy decision-making about health system financing. This can help policy-makers to explicitly incorporate values into the policy process and understand how values are supporting the achievement of policy goals in health system financing. Trial registration The protocol was registered with PROSPERO, ID=CRD42017057049.

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“…This situation has encouraged us to review published evidence on diabetes prevalence, control, cost of care and outcomes, and to discuss how diabetes fits in the Argentinian health care system and policy. The Argentinian health care system includes three independent sectors: the public, the social security and the private (pre-paid) sectors [ 2 ]. The public sector is mainly financed through taxes and provides universal access to free health care to nearly 16 million people (mostly unemployed and low-income population who are not insured through social security or private sector) through primary care units and hospitals with different levels of complexity [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…The Argentinian health care system includes three independent sectors: the public, the social security and the private (pre-paid) sectors [ 2 ]. The public sector is mainly financed through taxes and provides universal access to free health care to nearly 16 million people (mostly unemployed and low-income population who are not insured through social security or private sector) through primary care units and hospitals with different levels of complexity [ 2 ]. It includes different kinds of disease management programmes for the ambulatory treatment of chronic diseases with free supply of drugs through public entities; however, not all chronic diseases are fully covered.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, the private sector is financed through prepaid medical plans; it covers about 3.2 million people and operates in a similar manner as the social security sector. The magnitude of coverage depends on the plan selected by the individual: the lowest-cost plan considers the MHP as the standard reference for the minimum level of coverage required [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Diabetes in Argentina: cost and management of diabetes and its complications and challenges for health policy

2013

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BackgroundDiabetes is an expensive disease in Argentina as well as worldwide, and its prevalence is continuously rising affecting the quality of life of people with the disease and their life expectancy. It also imposes a heavy burden to the national health care budget and on the economy in the form of productivity losses.AimsTo review and discuss a) the reported evidence on diabetes prevalence, the degree of control, the cost of care and outcomes, b) available strategies to decrease the health and economic disease burden, and c) how the disease fits in the Argentinian health care system and policy. Finally, to propose evidence-based policy options to reduce the burden of diabetes, both from an epidemiological as well as an economic perspective, on the Argentinian society. The evidence presented is expected to help the local authorities to develop and implement effective diabetes care programmes.MethodologyA comprehensive literature review was performed using databases such as MEDLINE, EMBASE and LILACS (Latin American and Caribbean Health Sciences). Literature published from 1980 to 2011 was included. This information was complemented with grey literature, including data from national and provincial official sources, personal communications and contacts with health authorities and diabetes experts in Argentina.ResultsOverall diabetes prevalence increased from 8.4% in 2005 to 9.6% 2009 at national level. In 2009, diabetes was the seventh leading cause of death with a mortality rate of 19.2 per 100,000 inhabitants, and it accounted for 1,328,802 DALYs lost in the adult population, mainly affecting women aged over fifty. The per capita hospitalisation cost for people with diabetes was significantly higher than for people without the disease, US$ 1,628 vs. US$ 833 in 2004. Evidence shows that implementation of combined educative interventions improved quality of care and outcomes, decreased treatment costs and optimised the use of economic resources.ConclusionsBased on the evidence reviewed, we believe that the implementation of structured health care programmes including diabetes education at every level, could improve quality of care as well as its clinical, metabolic and economic outcomes. If implemented across the country, these programmes could decrease the disease burden and optimise the use of human and economic resources.

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Is Equity of Access to Health Care Achievable in Latin America?

Cited by 11 publications

References 1 publication

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina

A framework for explaining the role of values in health policy decision-making in Latin America: a critical interpretive synthesis

Diabetes in Argentina: cost and management of diabetes and its complications and challenges for health policy

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