Equity in health care utilization in Chile

Alicia Núñez,Chunhuei Chi

doi:10.1186/1475-9276-12-58

Abstract

One of the most extensive Chilean health care reforms occurred in July 2005, when the Regime of Explicit Health Guarantees (AUGE) became effective. This reform guarantees coverage for a specific set of health conditions. Thus, the purpose of this study is to provide timely evidence for policy makers to understand the current distribution and equity of health care utilization in Chile.The authors analyzed secondary data from the National Socioeconomic Survey (CASEN) for the years 1992–2009 and the 2006 Satisfaction and Out-of-Pocket Payment Survey to assess equity in health care utilization using two different approaches. First, we used a two-part model to estimate factors associated with the utilization of health care. Second, we decomposed income-related inequalities in medical care use into contributions of need and non-need factors and estimated a horizontal inequity index.Findings of this empirical study include evidence of inequities in the Chilean health care system that are beneficial to the better-off. We also identified some key factors, including education and health care payment, which affect the utilization of health care services. Results of this study could help researchers and policy makers identify targets for improving equity in health care utilization and strengthening availability of health care services accordingly.

Highlights

A high level of health status and a fair distribution of health care are both common goals that most societies and governments seek to pursue [1]
This study focuses on health care utilization as a proxy measure of access, i.e. individuals who used the health care services during a year
Two-part model for the Encuesta de Caracterización Socioeconómica Nacional (CASEN) survey We use a two-part model to assess which factors are playing an important role in explaining inequity in health care use

Summary

Introduction

A high level of health status and a fair distribution of health care are both common goals that most societies and governments seek to pursue [1]. Guaranteeing access to health care services is one step that helps to preserve a good health status, which is one of a government’s responsibilities, as stated in the World Health Organization Constitution [2]. Chile agrees with these objectives as well. The importance of this investigation is that it seeks to measure the existence of inequity, and enables comparison across time periods and identifies factors that affect equity Findings from this empirical study will provide timely evidence for policy makers to understand the current distribution and equity of health care utilization, and strengthen the availability and equity of health care services . The last section contains the main conclusions drawn from this study

Background

Results

Discussion

Limitations

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