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

Objective. To measure and explain income-related inequalities in health and health care utilization in the period 2000-2009 in Chile, while assessing variations within the country and determinants of inequalities. Methods. Data from the National Socioeconomic Characterization Survey for 2000, 2003,...

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Publicado en:Pan American Journal of Public Health Vol. 33; no. 2; pp. 98 - 107
Autores principales: Vásquez, Felipe, Paraje, Guillermo, Estay, Manuel
Formato: Artículo
Publicado: World Health Organization Feb2013
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2013
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      pub: World Health Organization
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        atl: Income-related inequality in health and health care utilization in Chile, 2000-2009.
      aug:
        au:
          Vásquez, Felipe
          Paraje, Guillermo
          Estay, Manuel
        affil:
          Facultad de Economía y Negocios, Universidad del Desarrollo, Concepción, Chile
          Escuela de Negocios, Universidad Adolfo Ibáñez, Santiago, Chile
          Departamento de Economía, Universidad de Concepción, Concepción, Chile
      su:
        Chile
        Health services accessibility
        Health status indicators
        Income
        Health insurance
        Health policy
        Self-evaluation
        Socioeconomic factors
        Educational attainment
        Health equity
        Cross-sectional method
        Hospital emergency services
        Questionnaires
        Research funding
        Descriptive statistics
      sug:
        subj:
          Health services accessibility
          Health status indicators
          Income
          Health insurance
          Health policy
          Self-evaluation
          Socioeconomic factors
          Educational attainment
          Health equity
          Cross-sectional method
          Chile
          Direct individual life, health and medical insurance carriers
          Direct group life, health and medical insurance carriers
          Administration of Public Health Programs
          Hospital emergency services
          Questionnaires
          Research funding
          Descriptive statistics
      keyword:
        equity in access
        equity in health
        health economics
        Health inequalities
        Chile
        Desigualdades en la salud
        economía de la salud
        equidad en el acceso
        equidad en salud
        equity in access
        equity in health
        health economics
        Health inequalities
        Chile
        Desigualdades en la salud
        economía de la salud
        equidad en el acceso
        equidad en salud
      ab: Objective. To measure and explain income-related inequalities in health and health care utilization in the period 2000-2009 in Chile, while assessing variations within the country and determinants of inequalities. Methods. Data from the National Socioeconomic Characterization Survey for 2000, 2003, and 2009 were used to measure inequality in health and health care utilization. Income-related inequality in health care utilization was assessed with standardized concentration indices for the probability and total number of visits to specialized care, generalized care, emergency care, dental care, mental health care, and hospital care. Self-assessed health status and physical limitations were used as proxies for health care need. Standardization was performed with demographic and need variables. The decomposition method was applied to estimate the contribution of each factor used to calculate the concentration index, including ethnicity, employment status, health insurance, and region of residence. Results. In Chile, people in lower-income quintiles report worse health status and more physical limitations than people in higher quintiles. In terms of health service utilization, pro-rich inequities were found for specialized and dental visits with a slight pro-rich utilization for general practitioners and all physician visits. All pro-rich inequities have decreased over time. Emergency room visits and hospitalizations are concentrated among lower-income quintiles and have increased over time. Higher education and private health insurance contribute to a pro-rich inequity in dentist, general practitioner, specialized, and all physician visits. Income contributes to a pro-rich inequity in specialized and dentist visits, whereas urban residence and economic activity contribute to a pro-poor inequity in emergency room visits. Conclusions. The pattern of health care utilization in Chile is consistent with policies implemented in the country and in the intended direction. The significant income inequality in the use of specialized and dental services, which favor the rich, deserves policy makers' attention and further investigation related to the quality of these services.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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