Public versus private treatment of chronic diseases in seniors: Argentina, Brazil, Chile and Uruguay

Abstract

This article measures differences in the likelihood of treatment of chronic diseases in elders across types of coverage (private, public and social security) in four major Latin American cities: Buenos Aires (Argentina), Sao Paulo (Brazil), Santiago (Chile) and Montevideo (Uruguay). We used a logistic regression to estimate the odds ratio for treatment of chronic diseases carried by individuals with public, private and social security coverage. The data were from the Survey on health, well-being and aging in Latin America and the Caribbean (SABE) conducted in 1999 and 2000. We find a strong association between possession of public coverage only and treatment failure of chronic diseases in elders in Argentina. We find no significant association for Brazil, Chile and Uruguay. In Buenos Aires, access to private or social security coverage is a necessity for elders because the public sector fails to provide proper treatment. In the remaining cities, private or social security coverage provides similar coverage for chronic diseases in elders compared with the public sector. For this group of countries, the main difference between the former and the latter seems to be in terms of 'luxurious' characteristics, such as the quality of the facilities and waiting times.

Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent

“…Studies included in our review consistently reported an increased prevalence of diabetes with age. Diabetes care challenges specific to this age group include risk of obesity or undernutrition [42,56], increased risk for disability [57], economic barriers to appropriate access to health care [42], disruption in funding of health insurance [275], disparate completion of diabetes care guidelines based on health insurance coverage [276], inequalities in access to and utilization of health care services [277][278][279], complex medical care needs and frailty [280], cultural beliefs, mental health, and lack of family or social support [281], among others. Prevention of diabetes and its complications and reliable continuity of care and social support [282] need to be especially tailored for this population across the region.…”

Examining Adherence Among Challenging Patients in Public and Private HIV Care in Argentina

“…The setting in which health care is delivered may interact with patient characteristics, which may interact with each other, and the combination may influence the patient’s health outcomes [14]. These patient differences are especially important to understand among those non-adherent to care, which may need targeted support to achieve optimal health [15]. …”

The role of the private sector in noncommunicable disease prevention and management in low- and middle-income countries: a series of systematic reviews and thematic syntheses

“…The private sector is the main provider of primary healthcare services for NCD treatment in many LMICs (Berendes et al, 2011 ; Bigdeli et al, 2016 ; Elias et al, 2018 ; Mukherjee et al, 2011 ). They are often depended on for more specialized NCD care (Elias et al, 2018 ; Lewis et al, 2015 ; Pandian et al, 2007 ) are more likely to diagnose and manage NCDs compared to public health systems (Cataife, 2012 ) and have a greater ability to provide access to necessary medications (Bhuvan et al, 2019 ; Bissell et al, 2016 ; Syed et al, 2018 ).…”

“…The private sector in LMICs contributes to NCD management by offering infrastructure such as hospitals, laboratories for testing, and pharmacies beyond those offered by the government (Angwenyi et al, 2020 ; Ben Romdhane et al, 2015 ; Polanczyk & Ribeiro, 2009 ; Rawal et al, 2020 ; Wearne et al, 2019 ). Private sector infrastructure is also often more equipped and ready to provide general and more specialized NCD-related care (Angwenyi et al, 2020 ; Bhojani et al, 2012 ; Bintabara et al, 2018 ; Cataife, 2012 ; Polanczyk & Ribeiro, 2009 ; Smith & Rabadan-Diehl, 2016 ; Wearne et al, 2019 ).…”

“…Nine studies were considered high quality, six medium quality, and seven low quality (Appendix D). Studies were primarily downgraded for insufficient mention of ethics and bias (Abraham et al, 2009 ; Agarwal, 2005 ; Ashigbie et al, 2020 ; Atre, 2015 ; Balasubramaniam et al, 2014 ; Bhojani et al, 2012 ; Bissell et al, 2016 ; Cataife, 2012 ; Dabare et al, 2014 ; Mukherjee et al, 2011 ; Pandian et al, 2007 ; Polanczyk & Ribeiro, 2009 ; Rawal et al, 2020 , 2020 ; Subramanian et al, 2018 ; Syed et al, 2018 ; Wearne et al, 2019 ; Wirtz et al, 2018 ) and incomplete description of sampling (Abraham et al, 2009 ; Agarwal, 2005 ; Ashigbie et al, 2020 ; Atre, 2015 ; Balasubramaniam et al, 2014 ; Bhojani et al, 2012 ; Bissell et al, 2016 ; Cataife, 2012 ; Dabare et al, 2014 ; Pandian et al, 2007 ; Polanczyk & Ribeiro, 2009 ; Subramanian et al, 2018 ; Syed et al, 2018 ; Wearne et al, 2019 ).…”