Horizontal inequity in the use and access to health care in Uruguay
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(2020) 19:127
RESEARCH
Open Access
Horizontal inequity in the use and access to health care in Uruguay Cecilia González* and Patricia Triunfo
Abstract Background: In 2007 Uruguay began a reform in the health sector towards the construction of a National Integrated Health System (SNIS), based on public insurance with private and public provision. The main objective of the reform was to universalize access to health services. Methods: Data comes from the first National Health Survey conducted in 2014 and available since 2016. Concentration indices are calculated for different indicators of use and access to medical services, for the population 18 years of age and older, and for different subgroups (age, sex, region and type of coverage). The indices are decomposed into need and non-need variables and the contribution of each of them to total inequality is analyzed. Horizontal inequity is calculated. Results: Results show pro-rich inequality for medical consultations, medical analysis, medication use and nonaccess due to costs. Type of health coverage is the variable that explains most of the inequality: private coverage is pro-rich while public coverage is pro-poor. Income does not appear as significant to explain inequality, except for access issues. From the population subgroups’ analysis, there is no evidence of inequality for the group of 60 years old or more. On the other hand, studies such as Pap Smear and prostate, which may be associated with preventive studies,, shows pro-rich inequality and, in both cases, the main contribution is given by income. Conclusions: The analysis of health inequity shows pro-rich inequity in medical consultations, medical analysis, medication use and lack of access due to costs. The type of health coverage explains these inequalities; in particular, private coverage is pro-rich. These results suggest that the type of health coverage are capturing the income factor, since higher income individuals will be more likely to be treated in the private system. Keywords: Health inequality, Concentration index, Uruguay JEL: I100, I180, I190 JEL: I100, I180, I190
* Correspondence: [email protected] Departamento de Economía, Facultad de Ciencias Sociales, Universidad de la República, Montevideo, Uruguay © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyr
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