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Colombian health care system: results on equity for five health dimensions, 2003 - 2008

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Date
2013
Author
Ruiz Gómez, Fernando
Zapata Jaramillo, Teana
Garavito Beltrán, Liz
Metadata
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Abstract
OBJECTIVE: To assess the change in five health equity dimensions for the Colombian health system: health condition, social health insurance coverage, health services utilization, quality, and health expenditure. METHODS: A common standardization methodology was used to assess equity in countries in the western hemisphere. Data come from the Colombian Life Quality Survey. After indirect standardization, concentration indices and horizontal inequity were estimated. A decomposition analysis was developed. Aggregate household monthly expenditure per equivalent adult was considered as the standard of living. RESULTS: Results show important progress in equity with regard to social health insurance affiliation, access to medicine and curative services, and perception of the quality of health care service. Important gaps persist, which affect poorer populations, especially their perception of having a bad health condition and their access to preventive medical and dental services. CONCLUSIONS: The Colombian model needs to advance in implementing preventive public health strategies to cope with increasing demand concomitant with increased social insurance coverage. The population's access to total services in cases of chronic illness and oral health services must increase and benefit plans must be integrated while preserving the recorded achievements in equity. Decomposition of the concentration index shows that inequities are mostly explained by socioeconomic variables and not by health-related factors.(AU)
 
OBJETIVO: Evaluar la evolución de la equidad en el sistema de salud colombiano, según cinco dimensiones: condición de salud, cobertura del seguro social de salud, utilización de los servicios de salud, calidad y gasto en salud. MÉTODOS: Se utilizó una metodología común de estandarización para evaluar la equidad en países del continente americano. Los datos se tomaron de la Encuesta de Calidad de Vida de 2003 y 2008. Después de la estandarización indirecta se estimaron los índices de concentración y de inequidad horizontal. Se aplicó un análisis de descomposición; se estimó el nivel de vida a partir del gasto agregado mensual del hogar por adulto equivalente. RESULTADOS: La equidad aumentó notablemente con respecto a la afiliación al seguro social de salud, el acceso a los servicios médicos y curativos, y la percepción de la calidad del servicio de atención sanitaria. Persisten aún considerables brechas, que afectan a las poblaciones más pobres, especialmente en su percepción de tener problemas de salud y su acceso a servicios preventivos médicos y odontológicos. CONCLUSIONES: Se requiere avanzar en la aplicación de las estrategias de salud pública preventivas en Colombia para afrontar el aumento de la demanda ocasionado por la mayor cobertura del seguro social. Debe mejorarse el acceso de la población a servicios integrales en los casos de enfermedades crónicas y a servicios de salud bucodental, y los planes de beneficios deben integrarse sin afectar a los logros en equidad ya registrados. Las inequidades se explican mejor por las variables socioeconómicas que por los factores relacionados con la salud.(AU)
 
Series
Rev Panam Salud Publica;33(2),feb. 2013
Subject
Equity in Health; Health Systems; Equity in Access; Health Economics; Health Policy; Colombia; Equidad en Salud; Sistemas de Salud; Equidad en el Acceso; Economía de la Salud; Política de Salud; Colombia; Assistência à Saúde; Colômbia; Assistência à Saúde; Assistência à Saúde; Gastos em Saúde; Nível de Saúde; Disparidades nos Níveis de Saúde; Disparidades em Assistência à Saúde; Seguro Saúde; Estudos Longitudinais; Qualidade da Assistência à Saúde; Questionários; Fatores de Tempo; Equidad, Salud y Desarrollo Humano; Equidade, Saúde e Desenvolvimento Humano; Equity, Health and Human Development
URI
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892013000200005
https://iris.paho.org/handle/10665.2/9211
Citation
Ruiz Gómez, Fernando,Zapata Jaramillo, Teana,Garavito Beltrán, Liz (2013) Colombian health care system: results on equity for five health dimensions, 2003 - 2008. Rev Panam Salud Publica;33(2) 107-115,feb. 2013. Retrieved from http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892013000200005
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  • Pan American Journal of Public Health

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