Reflexiones sobre el proceso de reforma sanitaria (1993-2013) y participación social en Perú

Eibenschutz, Catalina; Valdivia, Alexandro Saco; González, Silvia Tamez; Gatica, Xareni Zafra; Villegas, Raquel Maria Ramírez

doi:10.5935/0103-1104.20140077

“…Perú, por su parte, lanzó el seguro integral de salud (SIS) en 2002 con la integración de varios programas de cobertura. Impulsó el llamado “aseguramiento universal” desde 2009 con incrementos importantes en la adscripción al SIS, que adquirió un nuevo impulso a partir de la última reforma de 2013 ( 27 ), junto con un aumento del gasto público, pero en forma menos pronunciada que el caso anterior. En ambos casos, se lograron caídas importantes en los GBS nacional, que lo llevaron por debajo del promedio regional con una participación de 23,2% y 29,2%, respectivamente, en 2018.…”

Section: Discussionunclassified

Objetivos de Desarrollo Sostenible: impacto de la falta de protección financiera en salud en países de América Latina y el Caribe

Cid

¹

,

Flores²,

Riego

³

et al. 2021

Revista Panamericana De Salud Pública

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Objetivo. Determinar el impacto del gasto de bolsillo en salud en los hogares, los niveles de protección financiera y su desigualdad según variables relevantes en países de la Región. Se indaga su evolución y relación con el uso de servicios del sistema de salud. Métodos. Se recopila información descriptiva comparada acerca del gasto de bolsillo, su incidencia en la población, y su peso y composición en el consumo de los hogares. Se presentan indicadores de protección financiera en el nivel nacional y su distribución por quintiles de consumo total de hogares y por género. Se contrastan con un indicador de cobertura de servicios. Resultados. Los indicadores de gasto de bolsillo y protección financiera son deficientes pero diferenciados entre los países. Se identifica la composición del gasto en salud para un subgrupo de ellos y existen gradientes significativos cuando se estudian las desigualdades. Para algunos casos, se muestran cambios en el tiempo y posibles asociaciones con los niveles de cobertura de servicios. Discusión. La desprotección financiera afecta a una gran parte de la población, se configuran grupos de países con dificultades mayores que otros, con preponderancia de gasto en medicamentos y exposición mayor de grupos en situaciones de vulnerabilidad, como los más pobres y las mujeres, lo que denota una gran inequidad. Se identifican políticas de algunos países que pueden asociarse con la evolución de la protección financiera. Para reemplazar el gasto de bolsillo, barrera para el acceso, los países necesitan aumentar el gasto público mediante el financiamiento de los sistemas de salud en transformación hacia la salud universal.

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“…However, this process is still being implemented and many citizens do not have health insurance yet 47 . This leads to a lack of access to medical services and a high prevalence of ISM in Peru 48,49 .…”

Section: Discussionmentioning

confidence: 99%

Factors associated with self-medication in users of drugstores and pharmacies in Peru: an analysis of the National Survey on User Satisfaction of Health Services, ENSUSALUD 2015

Urrunaga-Pastor

¹

,

Benítes-Zapata

²

,

Mezones‐Holguín

³

2020

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Background: Irresponsible self-medication is a problem for health systems in developing countries. We aimed to estimate the frequency of self-medication and associated factors in users of drugstores and pharmacies in Peru. Methods: We performed a secondary data analysis of the 2015 National Survey on User Satisfaction of Health Services (ENSUSALUD), a two-stage probabilistic sample of all regions of Peru. Non self-medication (NSM), responsible self-medication (RSM) and irresponsible self-medication (ISM) were defined as the outcome categories. Demographic, social, cultural and health system variables were included as covariates. We calculated relative prevalence ratios (RPR) with their 95% confidence intervals (95%CI) using crude and adjusted multinomial logistic regression models for complex samples with NSM as the referent category. Results: 2582 participants were included. The average age was 41.4 years and the frequencies of NSM, RSM and ISM were 25.2%, 23.8% and 51.0%; respectively. The factors associated with RSM were male gender (RPR: 1.35; 95%CI: 1.06-1.72), being between 40 and 59 years old (RPR: 0.53; 95%IC: 0.39-0.72), being 60 or older (RPR: 0.39; 95%IC: 0.25-0.59), not having health insurance (RPR: 1.89; 95%CI: 1.31-2.71) and living in the Highlands region (RPR: 2.27; 95%CI: 1.23-4.21). The factors associated with ISM were male gender (RPR: 1.41; 95%CI: 1.16-1.72), being between 40 and 59 years old (RPR: 0.68; 95%IC: 0.53-0.88), being 60 or older (RPR: 0.65; 95%IC: 0.48-0.88) and not having health insurance (RPR: 2.03; 95%CI: 1.46-2.83). Conclusion: Around half of the population practiced ISM, which was associated with demographic and health system factors. These outcomes are the preliminary evidence that could contribute to the development of health policies in Peru.

show abstract

“…However, this process is still being implemented and many citizens do not have health insurance yet. This leads to a lack of access to medical services and a high prevalence of ISM in Peru 44,45 .…”

Section: Discussionmentioning

confidence: 99%

Factors associated with self-medication in users of drugstores and pharmacies in Peru: an analysis of the National Survey on User Satisfaction of Health Services, ENSUSALUD 2015

Urrunaga-Pastor

¹

,

Benítes-Zapata

²

,

Mezones‐Holguín

³

2019

View full text Add to dashboard Cite

Background: Irresponsible self-medication is a problem for health systems in developing countries. We aimed to estimate the frequency of self-medication and associated factors in users of drugstores and pharmacies in Peru. Methods: We performed a secondary data analysis of the 2015 National Survey on User Satisfaction of Health Services (ENSUSALUD), a two-stage probabilistic sample of all regions of Peru. Non self-medication (NSM), responsible self-medication (RSM) and irresponsible self-medication (ISM) were defined as the outcome categories. Demographic, social, cultural and health system variables were included as covariates. We calculated relative prevalence ratios (RPR) with their 95% confidence intervals (95%CI) using crude and adjusted multinomial logistic regression models for complex samples with NSM as the referent category. Results: 2582 participants were included. The average age was 41.4 years and the frequencies of NSM, RSM and ISM were 25.2%, 23.8% and 51.0%; respectively. The factors associated with RSM were male gender (RPR: 1.35; 95%CI: 1.06-1.72), being between 40 and 59 years old (RPR: 0.53; 95%IC: 0.39-0.72), being 60 or older (RPR: 0.39; 95%IC: 0.25-0.59), not having health insurance (RPR: 1.89; 95%CI: 1.31-2.71) and living in the Highlands region (RPR: 2.27; 95%CI: 1.23-4.21). The factors associated with ISM were male gender (RPR: 1.41; 95%CI: 1.16-1.72), being between 40 and 59 years old (RPR: 0.68; 95%IC: 0.53-0.88), being 60 or older (RPR: 0.65; 95%IC: 0.48-0.88) and not having health insurance (RPR: 2.03; 95%CI: 1.46-2.83). Conclusion: Around half of the population practiced ISM, which was associated with demographic and health system factors. These outcomes are the preliminary evidence that could contribute to the development of health policies in Peru.

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Reflexiones sobre el proceso de reforma sanitaria (1993-2013) y participación social en Perú

Cited by 7 publications

References 3 publications

Objetivos de Desarrollo Sostenible: impacto de la falta de protección financiera en salud en países de América Latina y el Caribe

Objetivos de Desarrollo Sostenible: impacto de la falta de protección financiera en salud en países de América Latina y el Caribe

Factors associated with self-medication in users of drugstores and pharmacies in Peru: an analysis of the National Survey on User Satisfaction of Health Services, ENSUSALUD 2015

Factors associated with self-medication in users of drugstores and pharmacies in Peru: an analysis of the National Survey on User Satisfaction of Health Services, ENSUSALUD 2015

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