Abstract
OBJECTIVETo analyze the main predictors of access to medicines for persons who experienced acute health conditions.METHODSThis was a cross-sectional analytic study, based on data from household surveys. We examined the predictors of: (1) seeking care for acute illness in the formal health care system and (2) obtaining all medicines sought for the acute condition.RESULTSThe significant predictors of seeking health care for acute illnesses were urban geographic location, head of household with secondary school education or above, age under 15, severity of illness perceived by the respondent, and having health insurance. The most important predictor of obtaining full access to medicines was seeking care in the formal health care system. People who sought care in the formal system were three times more likely to receive all the medicines sought (OR 3.0, 95%CI 2.3;4.0). For those who sought care in the formal health system, the strongest predictors of full access to medicines were seeking care in the private sector, having secondary school education or above, and positive perceptions of quality of health care and medicines in public sector health facilities. For patients who did not seek care in the formal health system, full access to medicines was more likely in Honduras or Nicaragua than in Guatemala. Urban geographic location, higher economic status, and male gender were also significant predictors.CONCLUSIONSA substantial part of the population in these three countries sought and obtained medicines outside of the formal health care system, which may compromise quality of care and pose a risk to patients. Determinants of full access to medicines inside and outside the formal health care system differ, and thus may require different strategies to improve access to medicines.
Highlights
Acute health conditions are characterized by a sudden onset of symptoms, typical course of illness, and finite duration if the illness is self-limiting or effectively treated.Patients are more likely to self-treat acute health conditions, especially those that are frequent
The countries studied met the following criteria: presented important challenges to achieving the Millennium Objective goals related to maternal mortality and access to health care; had access to medicine in the country technical cooperation agenda with Panamerican Health Organization (PAHO)/World Health Organization (WHO); had public health sectors with limited resources, uncertain service quality, and low coverage of basic public health services; were members of the Central America Free Trade Agreement (CAFTA)
Guatemala had the lowest proportion of households reporting acute condition and the lowest average number of reported recent acute conditions
Summary
Acute health conditions are characterized by a sudden onset of symptoms, typical course of illness, and finite duration if the illness is self-limiting or effectively treated. Patients are more likely to self-treat acute health conditions, especially those that are frequent. Access to medicines – a component of access to health – is considered a fundamental human right by the World Health Organization (WHO) and many national constitutions. Access to medicines is essential to achieving optimal health outcomes in a broad group of health conditions. Health expenditures are estimated to account for 33.0% of all household expenditures in the Latin America and Caribbean region and most of overall health expenditures is on medicines.[20] High out-of-pocket expenses on medicines and high prices in the region represent important barriers in access to medicines.[20] a United Nations General Assembly, 55 Section.
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