Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries

Autores
Roberti, Javier Eugenio; Leslie, Hannah H.; Doubova, Svetlana V.; Ranilla, Jesús Medina; Mazzoni, Agustina; Espinoza, Laura; Calderón, Renzo; Arsenault, Catherine; Garcia Elorrio, Ezequiel; García, Patricia J.
Año de publicación
2024
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
The premise of health as a human right in Latin America has been challenged by health system fragmentation, quality gaps, a growing burden of chronic disease, sociopolitical upheaval, and the COVID-19 pandemic. We characterised inequities in health system quality in Colombia, Mexico, Peru, and Uruguay. We did a cross-sectional telephone survey with up to 1250 adults in each country. We created binary outcomes in coverage, user experience, system competence, and confidence in the system and calculated the slope index of inequality by income and education. Although access to care was high, only a third of respondents reported having a high-quality source of care and 25% of those with mental health needs had those needs met. Two-thirds of adults were able to access relevant preventive care and 42% of older adults were screened for cardiovascular disease. Telehealth access, communication and autonomy in most recent visit, reasonable waiting times, and receiving preventive health checks showed inequalities favouring people with a high income. In Uruguay, inequality between government and social security services explained a substantial proportion of disparities in preventive health access. In other study countries, inequalities were also substantial within government and social security subsectors. Essential health system functions are unequal in these four Latin American countries.
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Leslie, Hannah H.. University of California; Estados Unidos
Fil: Doubova, Svetlana V.. Instituto Mexicano de Seguridad Social; México
Fil: Ranilla, Jesús Medina. Universidad Peruana Cayetano Heredia;
Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Espinoza, Laura. Universidad Peruana Cayetano Heredia;
Fil: Calderón, Renzo. Universidad Peruana Cayetano Heredia; . McGill University; Canadá
Fil: Arsenault, Catherine. The George Washington University; Estados Unidos
Fil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: García, Patricia J.. Universidad Peruana Cayetano Heredia;
Materia
PUBLIC HEALTH
INEQUALITY
QUALITY OF CARE
LATIN AMERICA
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/266077
Acceder
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repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countriesRoberti, Javier EugenioLeslie, Hannah H.Doubova, Svetlana V.Ranilla, Jesús MedinaMazzoni, AgustinaEspinoza, LauraCalderón, RenzoArsenault, CatherineGarcia Elorrio, EzequielGarcía, Patricia J.PUBLIC HEALTHINEQUALITYQUALITY OF CARELATIN AMERICAhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3The premise of health as a human right in Latin America has been challenged by health system fragmentation, quality gaps, a growing burden of chronic disease, sociopolitical upheaval, and the COVID-19 pandemic. We characterised inequities in health system quality in Colombia, Mexico, Peru, and Uruguay. We did a cross-sectional telephone survey with up to 1250 adults in each country. We created binary outcomes in coverage, user experience, system competence, and confidence in the system and calculated the slope index of inequality by income and education. Although access to care was high, only a third of respondents reported having a high-quality source of care and 25% of those with mental health needs had those needs met. Two-thirds of adults were able to access relevant preventive care and 42% of older adults were screened for cardiovascular disease. Telehealth access, communication and autonomy in most recent visit, reasonable waiting times, and receiving preventive health checks showed inequalities favouring people with a high income. In Uruguay, inequality between government and social security services explained a substantial proportion of disparities in preventive health access. In other study countries, inequalities were also substantial within government and social security subsectors. Essential health system functions are unequal in these four Latin American countries.Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Leslie, Hannah H.. University of California; Estados UnidosFil: Doubova, Svetlana V.. Instituto Mexicano de Seguridad Social; MéxicoFil: Ranilla, Jesús Medina. Universidad Peruana Cayetano Heredia;Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Espinoza, Laura. Universidad Peruana Cayetano Heredia;Fil: Calderón, Renzo. Universidad Peruana Cayetano Heredia; . McGill University; CanadáFil: Arsenault, Catherine. The George Washington University; Estados UnidosFil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: García, Patricia J.. Universidad Peruana Cayetano Heredia;Elsevier2024-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/266077Roberti, Javier Eugenio; Leslie, Hannah H.; Doubova, Svetlana V.; Ranilla, Jesús Medina; Mazzoni, Agustina; et al.; Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries; Elsevier; The Lancet Global Health; 12; 1; 1-2024; 145-1552214-109XCONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://linkinghub.elsevier.com/retrieve/pii/S2214109X23004886info:eu-repo/semantics/altIdentifier/doi/10.1016/S2214-109X(23)00488-6info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:25:03Zoai:ri.conicet.gov.ar:11336/266077instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:25:03.415CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries
title Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries
spellingShingle Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries
Roberti, Javier Eugenio
PUBLIC HEALTH
INEQUALITY
QUALITY OF CARE
LATIN AMERICA
title_short Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries
title_full Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries
title_fullStr Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries
title_full_unstemmed Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries
title_sort Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries
dc.creator.none.fl_str_mv Roberti, Javier Eugenio
Leslie, Hannah H.
Doubova, Svetlana V.
Ranilla, Jesús Medina
Mazzoni, Agustina
Espinoza, Laura
Calderón, Renzo
Arsenault, Catherine
Garcia Elorrio, Ezequiel
García, Patricia J.
author Roberti, Javier Eugenio
author_facet Roberti, Javier Eugenio
Leslie, Hannah H.
Doubova, Svetlana V.
Ranilla, Jesús Medina
Mazzoni, Agustina
Espinoza, Laura
Calderón, Renzo
Arsenault, Catherine
Garcia Elorrio, Ezequiel
García, Patricia J.
author_role author
author2 Leslie, Hannah H.
Doubova, Svetlana V.
Ranilla, Jesús Medina
Mazzoni, Agustina
Espinoza, Laura
Calderón, Renzo
Arsenault, Catherine
Garcia Elorrio, Ezequiel
García, Patricia J.
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv PUBLIC HEALTH
INEQUALITY
QUALITY OF CARE
LATIN AMERICA
topic PUBLIC HEALTH
INEQUALITY
QUALITY OF CARE
LATIN AMERICA
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv The premise of health as a human right in Latin America has been challenged by health system fragmentation, quality gaps, a growing burden of chronic disease, sociopolitical upheaval, and the COVID-19 pandemic. We characterised inequities in health system quality in Colombia, Mexico, Peru, and Uruguay. We did a cross-sectional telephone survey with up to 1250 adults in each country. We created binary outcomes in coverage, user experience, system competence, and confidence in the system and calculated the slope index of inequality by income and education. Although access to care was high, only a third of respondents reported having a high-quality source of care and 25% of those with mental health needs had those needs met. Two-thirds of adults were able to access relevant preventive care and 42% of older adults were screened for cardiovascular disease. Telehealth access, communication and autonomy in most recent visit, reasonable waiting times, and receiving preventive health checks showed inequalities favouring people with a high income. In Uruguay, inequality between government and social security services explained a substantial proportion of disparities in preventive health access. In other study countries, inequalities were also substantial within government and social security subsectors. Essential health system functions are unequal in these four Latin American countries.
Fil: Roberti, Javier Eugenio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Leslie, Hannah H.. University of California; Estados Unidos
Fil: Doubova, Svetlana V.. Instituto Mexicano de Seguridad Social; México
Fil: Ranilla, Jesús Medina. Universidad Peruana Cayetano Heredia;
Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Espinoza, Laura. Universidad Peruana Cayetano Heredia;
Fil: Calderón, Renzo. Universidad Peruana Cayetano Heredia; . McGill University; Canadá
Fil: Arsenault, Catherine. The George Washington University; Estados Unidos
Fil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: García, Patricia J.. Universidad Peruana Cayetano Heredia;
description The premise of health as a human right in Latin America has been challenged by health system fragmentation, quality gaps, a growing burden of chronic disease, sociopolitical upheaval, and the COVID-19 pandemic. We characterised inequities in health system quality in Colombia, Mexico, Peru, and Uruguay. We did a cross-sectional telephone survey with up to 1250 adults in each country. We created binary outcomes in coverage, user experience, system competence, and confidence in the system and calculated the slope index of inequality by income and education. Although access to care was high, only a third of respondents reported having a high-quality source of care and 25% of those with mental health needs had those needs met. Two-thirds of adults were able to access relevant preventive care and 42% of older adults were screened for cardiovascular disease. Telehealth access, communication and autonomy in most recent visit, reasonable waiting times, and receiving preventive health checks showed inequalities favouring people with a high income. In Uruguay, inequality between government and social security services explained a substantial proportion of disparities in preventive health access. In other study countries, inequalities were also substantial within government and social security subsectors. Essential health system functions are unequal in these four Latin American countries.
publishDate 2024
dc.date.none.fl_str_mv 2024-01
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/266077
Roberti, Javier Eugenio; Leslie, Hannah H.; Doubova, Svetlana V.; Ranilla, Jesús Medina; Mazzoni, Agustina; et al.; Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries; Elsevier; The Lancet Global Health; 12; 1; 1-2024; 145-155
2214-109X
CONICET Digital
CONICET
url http://hdl.handle.net/11336/266077
identifier_str_mv Roberti, Javier Eugenio; Leslie, Hannah H.; Doubova, Svetlana V.; Ranilla, Jesús Medina; Mazzoni, Agustina; et al.; Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries; Elsevier; The Lancet Global Health; 12; 1; 1-2024; 145-155
2214-109X
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://linkinghub.elsevier.com/retrieve/pii/S2214109X23004886
info:eu-repo/semantics/altIdentifier/doi/10.1016/S2214-109X(23)00488-6
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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