Health Care In Chile Research Articles

Stigma toward people with mental disorders in mental healthcare in Chile.

This research aimed to determine the stigma toward people with mental illness among mental health personnel and identify individual, professional, and contextual predictors. A descriptive, cross-sectional, and correlational design was used. The sample consisted of 218 mental health personnel working in Outpatient Psychiatric Units belonging to hospitals and Community Mental Health Centers in Chile. Stigma was evaluated using a scale of humanized treatment, a scale of social distance, and a scale of attitudes in health personnel. In addition, sociodemographic and professional information was collected from mental health personnel and contextual information, particularly the type of outpatient mental health center and the technical-administrative unit that groups all the health centers in a territory. It was found that mental health personnel, in general terms, present low levels of stigma expressed in behaviors of comfort and support toward users, a desire for closeness and social interaction, and reduced stigmatizing beliefs and attitudes of infantilization toward individuals with MHPs. However, intimacy and trust were lower than expected.Only educational levels and health centers were related to stigma. The low levels of stigma may be due to the evolution of this phenomenon and the country's mental health policies.

Social participation in Chile's healthcare system: Reflective contributions from bioethics.

Social participation in health is related to the ability of collectives to intervene in the healthcare system. From a bioethical perspective, the relevance of social participation in health has been emphasized due to its positive effects at the level of social groups, the healthcare structure, and democratic political systems. To ensure social participation in health, bioethics advocates for the incorporation of deliberation as a tool for making binding decisions. The aim of this essay is to reflect on social participation in the history of Chile's healthcare system from a bioethical perspective. The main reflections indicate that participation is consultative in nature, lacking deliberation and, therefore, the distribution of power. Additionally, social participation has been redefined under the label of "citizen," promoting an instrumental, individual, and client-oriented character in healthcare. To subvert this situation, it is necessary to incorporate bioethical reflections into the healthcare structure to enable communities to consistently influence the healthcare system.

Public Policies and Type of Insurance Are Associated With the Burden of Bladder Cancer–Related Inpatient Health Care in Chile: A Two-Decade Analysis

ObjectiveTo quantify changes in the burden of bladder cancer (BC) inpatient health care in Chile between 2001 and 2019, focusing on the impact of public policies and the type of medical insurance (public or private) held by patients.MethodsWe retrospectively collected national data on hospital discharges and calculated raw and adjusted hospitalization rates for the period of 2001 to 2019 categorized by sex and age. Additionally, we analyzed length of hospital stays, outcomes of surgical interventions, and discharge conditions based on the type of medical insurance — public: FONASA; private: ISAPRE. We also evaluated the impact of public policies such as the GES (“garantías explícitas en salud”) program, which ensures opportunities and access to medical attention, financial protection, and quality of care for a subset of diseases.ResultsA total of 34 100 hospital discharges were analyzed. Most patients were men (71%), and median age was 69 years. Of the patients, 91.3% had some kind of medical insurance, either private or public. Within this subset, 71.3% had public medical insurance (FONASA) and 23.2% had private medical insurance (ISAPRE). Patients on FONASA had significantly higher levels of overall surgery-related mortality (0.83% vs. 0.2%) and significantly longer median hospital stays (4 days vs. 2 days) compared to patients on ISAPRE. Following the implementation of the GES program in 2013, we observed an increase in transurethral resections and a reduction in radical cystectomies among publicly insured patients.ConclusionsThe type of medical insurance has a significant impact on the burden of BC-related inpatient health care in Chile, reflecting a significant disparity in terms of health care. The implementation of public policies such as the GES program can play a key role in reducing this gap between public and private medical insurance systems, especially in underdeveloped countries.

Main barriers to services linked to voluntary pregnancy termination on three grounds in Chile.

After decades of absolute criminalization, on September 14, 2017, Chile decriminalized voluntary termination of pregnancy (VTP) when there is a life risk to the pregnant woman, lethal incompatibility of the embryo or fetus of genetic or chromosomal nature, and pregnancy due to rape. The implementation of the law reveals multiple barriers hindering access to the services provided by the law. To identify and analyze, using the Tanahashi Model, the main barriers to the implementation of law 21,030 in public health institutions. This article contributes to the follow-up of this public policy, making visible the obstacles that violate women's rights of women to have dignified access to abortion and that affect the quality of health care in Chile. Qualitative design, following the postpositivist paradigm. The sample consisted of relevant actors directly related to pregnancy termination. Snowball sampling and semi-structured interviews were used. Grounded theory was used through inductive coding, originating categories regrouped into meta-categories following Tanahashi's model. The rigor criteria of transferability, dependability, credibility, authenticity, and epistemological theoretical adequacy were used. The identity of the participants and the confidentiality of the information were protected. From January 2021 to October 2022, 62 interviews were conducted with 20 members of the psychosocial support team; 18 managers; 17 members of the biomedical health team; 4 participants from of civil society, and three women users. The main obstacles correspond to availability barriers, accessibility barriers, acceptability barriers, contact barriers, and effectiveness barriers. Barriers to access abortion under three grounds violate the exercise of women's sexual and reproductive rights. It is urgent to carry out actions of control and follow-up of this public policy to the corresponding entities.

Diagnosis of the implementation of nursing care management for closed healthcare in Chile

Introduction: the social role of nurses in 1997 is defined, nursing care management being established via the general administrative regulation Nº 19. The implementation of assistant directorships for nursing care management becomes relevant in the results for both the patients and the nursing team. Goal: describe the degree of implementation of the general administrative regulation Nº 19 for close care at Chile’s medium-and-high-complexity public health establishments. Methods: a quantitative, descriptive, cross-sectional study was developed. With a convenience-intended sample of 56 centers, using an instrument to gather evidence of characteristics of Regulation Nº 19. Results: 75,0 % have an Assistant Directorship for Care Management and 3,57 % do not have any. High-complexity hospitals averaged 6,83 characteristics and medium complexity averaged 6,69 characteristics. The characteristics with the highest degree of fulfillment were those related to powers to grant safe care, the definition of job profiles corresponding to the structure, policies on communication with other offices, and having a set of care indicators for decision-making. Conclusion: there is a disparity in implementation, a National Nursing Directorship dependent on the Ministry of Health with a supervising role and generating standardized policies, protocols, and guidelines to support the implementation is required to achieve care with a sense of social and universal justice

Teledermatología sincrónica en tiempos de Covid-19. Percepción del dermatólogo

Teledermatology (TD) is a remote medical care tool that experienced a great boom during the COVID19 pandemic, resulting in an increase in both, the number of remote consultations and the number of dermatologists who practice it. Several studies have reported a high degree of satisfaction among patients attended by this method. However, few studies have done so in dermatologists. We set out to investigate the experience of Chilean dermatologists with the tool by means of an online survey. Results. A total of 156 surveys were completed. The number of dermatologists using TD increased from 19.9% to 80.8% during the pandemic. They cited the absence of the physical examination-dermatoscopy as the main limitation to developing TD and reported feeling more comfortable with some pathologies. Dermatologists feel moderately comfortable and confident with the tool, however, they experienced varying degrees of stress and frustration. Only 40.8% plan to continue using TD in the future. Conclusion. Synchronous TD has clear limitations, however, these should emerge as an opportunity to consider in its development and its platforms, in order to generate a more comfortable tool for more dermatologists and thus extend its use, as an important tool for equal access to health care in Chile.

Accreditation of Quality in Primary Health Care in Chile: Perception of the Teams from Accredited Family Healthcare Centers.

This study aimed to investigate the perception of the health teams belonging to the Family Healthcare Centers (CESFAMs) that are accredited, regarding the process of implementation and the achievement of accreditation. A qualitative approach was applied, with contributions from grounded theory, through the technique of individual in-depth interviews and focus groups. The interviews were carried out in nine accredited CESFAMs. For the presentation, organization and analysis of the data, Atlas.ti V9 software was used. From the results, derived from the open phase of the analysis, obtained from the opinions of the participants, a total of 26 categories emerged relating to the facilitating and hindering factors of the process. From the axial phase, it was possible to establish central categories that were related to quality management policies, the structure of Primary Health Care (PHC), participation and co-construction, and leadership and change management. In conclusion, the discourse of the teams reveals the need to have necessary conditions for the accreditation process, which are mainly related to training, characteristics of the types of leadership and teamwork in harmony with the process. Finally, the study reveals a gap in the community participation in this process, which suggests continuing this line of research.

Portfolio of Services for the Manager Assistance Network Healthcare in Chile

Objective: Identify the difficulties that Health Services administrators face when defining their clinical and administrative environments and identifying specific activities of Network Managers. Method: An exploratory qualitative study was carried out involving 32 health services managers and four former post-reform undersecretaries in Chile, where a legal reform was implemented that redefined their role in a new context. The category "Health Network Administrator" was created to evaluate the impact of the reform on the Development of healthcare services, considering five key categories: Health Network Management, Clinical-care coordination of providers, Economic management of the health network, Development of human resources for the health network and Investment management in the health network. Results: They indicate that eighteen differentiated services are the responsibility of the Network Manager. Some of these services require flexibility in the exchange, redistribution, and transaction of resources between members of the networks, which may require review in the current legal framework, especially in the financial and human resources areas. Conclusion: It postpones the discussion on the administrative reform of providers in Chile, emphasising the need to define specific objectives for managers that distinguish them from other actors in the health productive chain.

Reducing stigma toward mental illness and substance use issues in primary health care in Chile: Protocol of a cluster controlled trial study.

Chile is implementing a Community Mental Health Model with a strong role of primary health care (PHC). PHC has great potential to early detection and provision of accessible and coordinated services to people who present mental illness and/or substance use issues (MISUI). However, stigma toward people with MISUI among PHC professionals is a significant barrier to accessing good quality of care. A wealth of literature supports the importance of reducing stigma for this population. The main goal of this research project is to determine the effectiveness of a comprehensive anti-stigma intervention in reducing stigmatizing attitudes and behaviors among PHC providers toward individuals with MISUI in the Chilean context, using Centros de Salud Familiar (CESFAMs) as the point of intervention. The intervention is based on an initiative that was previously developed in Canada and then also pilot-tested in Lima, Peru, with the Center for Addiction and Mental Health (Ontario, Canada). The model will be culturally adapted with CESFAM PHC provider and user inputs to be relevant and valid to Chile. The 18-month intervention includes five (5) components that are simultaneously implemented in CESFAMs: (1) Develop a Team of Local Champions in each intervention CESFAM, comprising PHC providers and users; (2) Analysis of Internal CESFAM Policies, Procedures, and Protocols to determine areas of improvement in service delivery for individuals with MISUI; (3) Raising Awareness of stigma toward MISUI using various forms of media within the CESFAM; (4) Innovative Contact-Based Education workshops on anti-stigma and recovery principles, co-lead by academic/clinical trainers and a person with lived experience of MISUI; and (5) Recovery-Based Arts, a multi-week arts workshop for PHC providers and users to produce artwork related to MISUI and recovery, culminating in an exhibition to showcase artwork for the CESFAM providers, users, and community. The expected intervention outcomes are the following: Participation in the experimental group will result in a significant decrease in stigmatizing attitudes among PHC providers toward individuals with MISUI compared with the control group as measured by the Chilean version of the Opening Minds Scale for Health Care Providers Scale (OMS-HC); Participation in the experimental group will result in a significant decrease of PHC users experiences of stigma conveyed by PHC providers compared with the control group as measured by the Internalized Stigma of Mental Illness (ISMI) scale, validated for the Chilean population. The changes in attitudes and behaviors within the experimental group will be sustained over time as measured at 6 months-follow-up. To evaluate the effectiveness of this 18-month intervention, a 4-year, two-arm, cluster-randomized controlled trial is proposed, with CESFAMs being the unit of randomization (or "cluster"). Implementation Science approach will be taken to measure relevant implementation outcomes for each component of the intervention, and through qualitative data collection with CESFAM providers and authorities. Data analysis will be carried out using SAS 9.4 (specifically, using POC MIXED and PROC GENMOD) and R 3.5. Mixed-effect modeling will used for both PHC provider and user data, which will include individuals and CESFAMs as random effects and group (intervention/control) as fixed effects. This study represents a new stage of relevant and innovative research in mental health and stigma in Chile that will contribute to improving access and quality of care for people with MISUI. Evaluating the impact of the intervention model and its implementation will provide the necessary tools to scale the intervention up to other CESFAMs across Chile. [www.ClinicalTrials.gov], identifier [NCT05578066].

Accreditation of professional skills and their relationship with quality in health

Quality in health is measured through indicators, which show its status, considering its different attributes, one of them being professional competence. The importance of the certification of the development of competencies in the training process of future health professionals and its impact on the quality of services, poses a challenge and has great relevance at the level of individual providers, professional societies and higher education institutions. The accreditation of professional competencies is a necessary element to promote the improvement of the quality of health care in Chile, so the certification of these scientific-technical competencies could become one more tool for assuring the quality of health care

Systematization of initiatives in sexual and reproductive health about good practices criteria in response to the COVID-19 pandemic in primary health care in Chile.

Introduction The COVID- 19 pandemic discontinued sexual and reproductive health care in Chile and the world. The national focus on hospital care led primary care teams to respond in natural and diverse ways. Understanding the factors involved in this process may improve future responses from the judgment of good practices. Therefore, this study aimed to identify and systematize sexual and reproductive health initiatives raised by primary care teams in response to the COVID- 19 pandemic in Chile. Methods We systematically evaluated initiatives and practices in sexual and reproductive health in prima-ry care between June 2020 and November 2021. This study was developed in three methodological phases: a review of documents, a collection of experiences through an electronic instrument sent to the 29 health services in Chile, and in-depth interviews. According to best practice criteria, mapping and characterizing the initiatives and critical discourse analysis of narratives and interviews were carried out. Results Forty-one initiatives from 19 health services were identified, mainly from the South Central macro zone and urban areas. In these areas, care was recognized. These practices were relevant, aligned with their objectives, rapidly implemented, and used novel strategies through new technologies. However, these initiatives had little intercultural relevance or evaluation. Perceived success was related to motivation, leadership, and institutional and community resilience. The adaptability of initiatives emerged as a new need and criterion of analysis. Conclusion The lessons learned from these initiatives invite us to consider health care teams' mental health, their relationship with the community, the use of new technologies, the evaluation of practices considering satisfaction, cross- cutting approaches, and their adaptability. In all, these aspects may improve primary care response in sexual and reproductive health to new crises.

The Right to Health of Migrant Children in Chile

The exercise of the right to health for the child population in Chile is a complex issue since some structural difficulties mainly affect migrant children. In order to account for the barriers that migrant children experience in the exercise of this right, a review of the current regulations is presented, showing that international treaties and administrative regulations (decrees, official documents, among others) fail to overcome the barriers they face, given their double condition of vulnerability, due to their age and ethnic-”racial”-national origin. In addition, 31 girls and boys between six and 17 years of age in the metropolitan region were interviewed using a qualitative methodology. Finally, some of their experiences are analyzed in light of previous research on the migrant population’s access to health care in Chile, raising some reflections on the particular consequences for migrant children concerning the barriers to access to the national health system.

Investigating public values in health care priority \u2013 Chileans\xb4 preference for national health care

BackgroundThis study aims to assess preferences and values for priority setting in healthcare in Chile through an original and innovative survey method. Based on the answers from a previous survey that look into the barriers the Chilean population face, this study considers the preferences of the communities overcoming those barriers. As a result six programs were identified: (1) new infrastructure, (2) better healthcare coverage, (3) increasing physicians/specialists, (4) new informatics systems, (5) new awareness healthcare programs, and (6) improving availability of drugs.MethodsWe applied an innovative survey method developed for this study to sample subjects to prioritize these programs by their opinion and by allocating resources. The survey also asked people’s preferences for a distributive justice principle for healthcare to guide priority setting of services in Chile. The survey was conducted with a sample of 1142 individuals.ResultsMore than half of the interviewees (56.4%) indicated a single program as their first priority, while 20.1% selected two of them as their first priority. To increase the number of doctors/specialists and improve patient-doctor communication was the program that obtained the highest priority. The second and third priorities correspond to improving and investing in infrastructure and expanding the coverage of healthcare insurances. Additionally, the results showed that equal access for equal healthcare is the principle selected by the majority to guide distributive justice for the Chilean health system.ConclusionsThis study shows how a large population sample can participate in major decision making of national health policies, including making a choice of a distributive justice principle. Despite the complexity of the questions asked, this study demonstrated that with an innovative method and adequate guidance, average population is capable of engaging in expressing their preferences and values. Results of this study provide policy-makers useful community generated information for prioritizing policies to improve healthcare access.

Individual and structural barriers to Latin American refugees and asylum seekers' access to primary and mental healthcare in Chile: A qualitative study.

BackgroundSince 2010 there has been a growing population of refugees and asylum seekers in Latin America. This study sought to investigate the perceived experiences and healthcare needs of refugees and asylum seekers of Latin American origin in Chile in order to identify main barriers to healthcare and provide guidance on allied challenges for the public healthcare system.MethodsDescriptive qualitative case study with semi-structured interviews applied to refugees and asylum seekers (n = 8), healthcare workers (n = 4), and members of Non-Governmental Organizations and religious foundations focused on working with refugees and asylum seekers in Chile (n = 2).ResultsAlthough Chilean law guarantees access to all levels of healthcare for the international migrant population, the specific healthcare needs of refugees and asylum seekers were not adequately covered. Primary care and mental healthcare were the most required types of service for participants, yet they appeared to be the most difficult to access. Difficulties in social integration -including access to healthcare, housing, and education- upon arrival and lengthy waiting times for legal status of refugees also presented great barriers to effective healthcare provision and wellbeing. Healthcare workers and members of organizations indicated the need for more information about refugee and asylum-seeking populations, their rights and conditions, as well as more effective and tailored healthcare interventions for them, especially for emergency mental healthcare situations.ConclusionsAll participants perceived that there was disinformation among institutional actors regarding the healthcare needs of refugees and asylum seekers in Chile. They also perceived that there were barriers to access to primary care and mental healthcare, which might lead to overuse of emergency services. This study highlights a sense of urgency to protect the social and healthcare needs of refugees and asylum seekers in Latin America.

Surface Electromyography in Clinical Practice. A Perspective From a Developing Country.

Surface electromyography (sEMG) has long been used in research, health care, and other fields such as ergonomics and brain-machine interfaces. In health care, sEMG has been employed to diagnose as well as to treat musculoskeletal disorders, pelvic floor dysfunction, and post-stroke motor deficits, among others. Despite the extensive literature on sEMG, the clinical community has not widely adopted it. We believe that in developing countries, such as Chile, this phenomenon may be explained by several interacting barriers. First, the socioeconomics of the country creates an environment where only high cost-effective treatments are routinely applied. Second, the majority of the sEMG literature on clinical applications has not extensively translated into decisive outcomes, which interferes with its applicability in low-income contexts. Third, clinical training on rehabilitation provides inadequate instruction on sEMG. And fourth, accessibility to equipment (i.e., affordability, availability, portability) may constitute another barrier, especially among developing countries. Here, we analyze socio-economic indicators of health care in Chile and comment on current literature about the use of sEMG in rehabilitation. Then we analyze the curricula of several physical therapy schools in Chile and report some estimations of the training on sEMG. Finally, we analyze the accessibility of some available sEMG devices and show that several match predefined criteria. We conclude that in developing countries, the insufficient use of sEMG in health might be explained by a shortage of evidence showing a crucial role in specific outcomes and the lack of training in rehabilitation-related careers, which interact with local socioeconomic factors that limit the application of these techniques.

Tackling segmentation to advance universal health coverage: analysis of policy architectures of health care in Chile and Uruguay

BackgroundWith the turn of the century, most countries in Latin America witnessed an increased concern with universalism and redistribution. In the health sector, this translated into a wide range of reforms to advance Universal Health Coverage (UHC) that, however, have had to cope with health systems that stratified the population since their foundation and the further segmentation inherited by market-oriented policies in the 1980s and 1990s.Studies on social welfare stress the relevance of cross-class alliances between the middle and working classes to reach universal and sustainable social benefits. Consequently, the endurance of separate health schemes across groups of the population in most countries in Latin America may seriously hamper the efforts towards UHC.AimThis article addresses the potential of current policy architectures of health care to tackle segmentation between social classes in access to health services in two of the best performers of health coverage in the region, namely Chile and Uruguay.MethodsThe article is a comparative case study based on a literature review and applies an analytical framework that links universal outputs to the policy architectures of health care. The study assesses universal outputs in terms of coverage, generosity and financial protection, identifying equity gaps in each of these dimensions across groups of the population.FindingsLatest processes of reform for UHC in Chile and Uruguay perform highly regarding population coverage. Nevertheless, equity gaps in access to quality services and financial protection remain. In both countries, such gaps relate to the eligibility criteria. In Chile, segmentation is reinforced by the persistence of separated pools of resources that hinder solidarity. Besides, the significant role of private actors and differences in quality between public and private service providers continue to push middle and upper-middle classes to private options. Uruguay’s health reform reinforced the public system and promoted financial solidarity by pooling and progressively allocating resources. Despite this, fragmentation in service provision continues the segmentation of access to health care.ConclusionsThe study shows differences in the options of reforms for UHC in Chile and Uruguay and the relevance of policy architectures to reverse, or conversely deepen, segmentation across groups of the population.

Time Prices and the Demand for Primary Health Care in Chile

In this paper we study the demand for primary health care in Chile. Particularly, we examine the demand for preventive care using a sample of urban children residents in the Metropolitan Region. Following Acton (1975), we assess the influence of time prices and several other socioeconomic and demographic factors on demand. Although not significant at conventional levels, the negative coefficient of travel time price would indicate that this non-monetary factor (and potentially other sources of time not controlled for in this study) could act, under certain circumstances, as a money price in discouraging demand. The magnitude of the travel time price elasticity is consistent with the range of time price elasticities found in high-income countries. The greatest impact on the probability of demand is found to be associated to food collection, nutritional status of the child and prescription of medicines. Among the nutritional conditions, undernourishment is the most important. The working status of the mother a d economic variables such as earned and non-earned income do not have a relevant impact on demand.

Educational expectations of professionals who teach in primary health care in Chile

ABSTRACTWith more emphasis on primary health care (PHC) both in the undergraduate and postgraduate curriculum, there is an increasing demand for high quality teaching in PHC centres. Professionals in low- and middle-income countries often have little training in teaching. Countries where family medicine is more highly developed may play an important role in supporting training the trainers in low and mid development countries. However, the needs of these PHC teachers may differ. We explored the needs of professionals who teach in PHC in Chile through an online survey and focus groups.All the domains of competence of a clinical educator were considered to be important for training by >83% of the questionnaire respondents. Ninety percent of the respondents agreed that PHC professionals should be permitted to attend courses about teaching; 79% preferred blended learning: a combination of face-to-face training and online education.Three themes emerged in the focus groups. 1) The specific role of the teacher in PHC. 2) The challenges faced by teachers in PHC. 3) Intuitive teaching. This was an unexpected emergent theme that reflected the desire of the teachers to analyse and reflect on their teaching.There are enthusiastic and dedicated professionals in PHC in Chile with a strong felt-need for teacher training.

Health care reform, adverse selection and health insurance choice

This paper builds and estimates a dynamic choice model to examine the impact on health insurance selection of Chile's GES health care reform. This program provides guarantees in coverage and benefits to several health conditions in the context of a market where public and private health insurers co-exist. Structural differences in premiums, benefits and out-of-pocket medical costs across systems may have caused adverse selection problems. Restrictions on pre-existing conditions in the private system mean that insurance selection could be a dynamic process in which current choices can affect future health insurance selection. In fact, estimation results suggest there is willingness to pay to have access to private insurance to those affected by pre-existing conditions. The GES reform may have also altered health insurance choices, as it seems to have significantly reduced out-of-pocket medical costs to people affected by the covered illnesses. Simulations show an increase in participation in the public system of about 3.8 percentage points due to the reform, which is stronger for younger, healthier and more educated individuals. Therefore, the reform may have eased adverse selection problems in Chile's health care system by drawing low-risk individuals towards the public system.

Towards universal coverage for international migrants in Chile: accessibility and acceptability indicators from a multi-methods study

ABSTRACT Background: Universal health coverage (UHC) is a major global public health goal. UHC means that all individuals and communities receive the health services they need without suffering financial hardship. Equitable UHC considers several minimum dimensions of access to healthcare, such as accessibility and acceptability. We aim to update data on accessibility and acceptability to healthcare for international migrants in Chile and to compare it to the Chilean-born population. Methods: Multi-methods study. For accessibility, we measured healthcare provision entitlement by international immigrants and compared them to the Chilean-born population, based on data from the anonymous national representative CASEN survey at different time points; 2013, 2015 and 2017. For acceptability, we collected and analysed qualitative data focussed on exploring the perceptions of the Chilean healthcare system according to immigrants and based on individual interviews that were conducted in Chile between 2015 and 2017. Results: In relation to accessibility, a growing proportion of immigrants has no healthcare provision, rising from 8,9% in 2013 to 18,6% in 2017. These rates are 3,5% higher than rates for Chileans without healthcare provision in 2013, and 4,4% higher amongst immigrants compared to Chileans in 2017. Regarding acceptability, immigrants report four main dimensions affecting their perception of care: administrative barriers to effective access to healthcare, interpersonal and cultural barriers to effective access to healthcare, perceived quality of care, and adequacy of healthcare delivery based on individual and cultural differences. Discussion: We found persistent unequal accessibility and acceptability to healthcare services in Chile in detriment of the international migrant population compared to the Chilean-born population. We found a significant gap in the percentage of people with no healthcare provision entitlement between migrants and Chileans, which grew over time. These findings raise concerns of inequitable access to healthcare in Chile based on migration status.