Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care

Autores
Yavich, Natalia; Báscolo, Ernesto Pablo; Haggerty, Jeannie
Año de publicación
2016
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Most Latin American health systems are comprised of public (PubS), social security (SSS) and private (PrS) subsystems. These subsystems coexist, causing health care fragmentation and population segmentation. Objective: To estimate the extent of subsystem cross-coverage in a geographically bounded population (Rosario city) and to compare the subsystems' performance on primary health care (PHC) dimensions. Methods: Through a cross-sectional, interviewer-administered survey to a representative sample (n = 822) of the Rosario population, we measured the percentage of cross-coverage (people with usual source of care in one subsystem but also covered by another subsystem) and the health services' performance by core PHC dimensions, as reported by each subsystem's usual users. We compared the subsystems' performance using chi-square analysis and one-way analysis of variance testing. We analyzed whether the observed differences were coherent with the predominant institutional and organizational features of each subsystem. Results: Overall, 39.3% of the population was affiliated with the PubS, 44.8% with the SSS and 15.9% with the PrS. Cross-coverage was reported by 40.6% of respondents. The performance of the PubS was weak on accessibility but strong on person-and-community-oriented care, the opposite of the PrS. The SSS combined the strengths of the other two subsystems. Conclusion: Rosario's health system has a high percentage of cross-coverage, contributing to issues of fragmentation, segmentation, financial inequity and inefficiency. The overall performance of the SSS was better than that of the PrS and PubS, though each subsystem had a particular performance pattern with areas of strength and weakness that were consistent with their institutional and organizational profiles.
Fil: Yavich, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; Argentina
Fil: Báscolo, Ernesto Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; Argentina
Fil: Haggerty, Jeannie. McGill University; Canadá
Materia
ACCESS
AND EVALUATION
HEALTH CARE QUALITY
HEALTH SERVICES RESEARCH
INTEGRATED HEALTH CARE SYSTEMS
LATIN AMERICA
PRIMARY HEALTH CARE
PUBLIC HEALTH
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:11336/52632
Acceder
id CONICETDig_3eaad48b9ba006a50f406b5a843aa5c4
oai_identifier_str oai:ri.conicet.gov.ar:11336/52632
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health careYavich, NataliaBáscolo, Ernesto PabloHaggerty, JeannieACCESSAND EVALUATIONHEALTH CARE QUALITYHEALTH SERVICES RESEARCHINTEGRATED HEALTH CARE SYSTEMSLATIN AMERICAPRIMARY HEALTH CAREPUBLIC HEALTHhttps://purl.org/becyt/ford/5.9https://purl.org/becyt/ford/5Background: Most Latin American health systems are comprised of public (PubS), social security (SSS) and private (PrS) subsystems. These subsystems coexist, causing health care fragmentation and population segmentation. Objective: To estimate the extent of subsystem cross-coverage in a geographically bounded population (Rosario city) and to compare the subsystems' performance on primary health care (PHC) dimensions. Methods: Through a cross-sectional, interviewer-administered survey to a representative sample (n = 822) of the Rosario population, we measured the percentage of cross-coverage (people with usual source of care in one subsystem but also covered by another subsystem) and the health services' performance by core PHC dimensions, as reported by each subsystem's usual users. We compared the subsystems' performance using chi-square analysis and one-way analysis of variance testing. We analyzed whether the observed differences were coherent with the predominant institutional and organizational features of each subsystem. Results: Overall, 39.3% of the population was affiliated with the PubS, 44.8% with the SSS and 15.9% with the PrS. Cross-coverage was reported by 40.6% of respondents. The performance of the PubS was weak on accessibility but strong on person-and-community-oriented care, the opposite of the PrS. The SSS combined the strengths of the other two subsystems. Conclusion: Rosario's health system has a high percentage of cross-coverage, contributing to issues of fragmentation, segmentation, financial inequity and inefficiency. The overall performance of the SSS was better than that of the PrS and PubS, though each subsystem had a particular performance pattern with areas of strength and weakness that were consistent with their institutional and organizational profiles.Fil: Yavich, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; ArgentinaFil: Báscolo, Ernesto Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; ArgentinaFil: Haggerty, Jeannie. McGill University; CanadáOxford University Press2016-06info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/52632Yavich, Natalia; Báscolo, Ernesto Pablo; Haggerty, Jeannie; Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care; Oxford University Press; Family Practice; 33; 3; 6-2016; 249-2600263-21361460-2229CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/fampra/article/33/3/249/1750001info:eu-repo/semantics/altIdentifier/doi/10.1093/fampra/cmw043info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T10:10:56Zoai:ri.conicet.gov.ar:11336/52632instacron: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:34982025-09-03 10:10:56.954CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care
title Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care
spellingShingle Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care
Yavich, Natalia
ACCESS
AND EVALUATION
HEALTH CARE QUALITY
HEALTH SERVICES RESEARCH
INTEGRATED HEALTH CARE SYSTEMS
LATIN AMERICA
PRIMARY HEALTH CARE
PUBLIC HEALTH
title_short Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care
title_full Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care
title_fullStr Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care
title_full_unstemmed Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care
title_sort Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care
dc.creator.none.fl_str_mv Yavich, Natalia
Báscolo, Ernesto Pablo
Haggerty, Jeannie
author Yavich, Natalia
author_facet Yavich, Natalia
Báscolo, Ernesto Pablo
Haggerty, Jeannie
author_role author
author2 Báscolo, Ernesto Pablo
Haggerty, Jeannie
author2_role author
author
dc.subject.none.fl_str_mv ACCESS
AND EVALUATION
HEALTH CARE QUALITY
HEALTH SERVICES RESEARCH
INTEGRATED HEALTH CARE SYSTEMS
LATIN AMERICA
PRIMARY HEALTH CARE
PUBLIC HEALTH
topic ACCESS
AND EVALUATION
HEALTH CARE QUALITY
HEALTH SERVICES RESEARCH
INTEGRATED HEALTH CARE SYSTEMS
LATIN AMERICA
PRIMARY HEALTH CARE
PUBLIC HEALTH
purl_subject.fl_str_mv https://purl.org/becyt/ford/5.9
https://purl.org/becyt/ford/5
dc.description.none.fl_txt_mv Background: Most Latin American health systems are comprised of public (PubS), social security (SSS) and private (PrS) subsystems. These subsystems coexist, causing health care fragmentation and population segmentation. Objective: To estimate the extent of subsystem cross-coverage in a geographically bounded population (Rosario city) and to compare the subsystems' performance on primary health care (PHC) dimensions. Methods: Through a cross-sectional, interviewer-administered survey to a representative sample (n = 822) of the Rosario population, we measured the percentage of cross-coverage (people with usual source of care in one subsystem but also covered by another subsystem) and the health services' performance by core PHC dimensions, as reported by each subsystem's usual users. We compared the subsystems' performance using chi-square analysis and one-way analysis of variance testing. We analyzed whether the observed differences were coherent with the predominant institutional and organizational features of each subsystem. Results: Overall, 39.3% of the population was affiliated with the PubS, 44.8% with the SSS and 15.9% with the PrS. Cross-coverage was reported by 40.6% of respondents. The performance of the PubS was weak on accessibility but strong on person-and-community-oriented care, the opposite of the PrS. The SSS combined the strengths of the other two subsystems. Conclusion: Rosario's health system has a high percentage of cross-coverage, contributing to issues of fragmentation, segmentation, financial inequity and inefficiency. The overall performance of the SSS was better than that of the PrS and PubS, though each subsystem had a particular performance pattern with areas of strength and weakness that were consistent with their institutional and organizational profiles.
Fil: Yavich, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; Argentina
Fil: Báscolo, Ernesto Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; Argentina
Fil: Haggerty, Jeannie. McGill University; Canadá
description Background: Most Latin American health systems are comprised of public (PubS), social security (SSS) and private (PrS) subsystems. These subsystems coexist, causing health care fragmentation and population segmentation. Objective: To estimate the extent of subsystem cross-coverage in a geographically bounded population (Rosario city) and to compare the subsystems' performance on primary health care (PHC) dimensions. Methods: Through a cross-sectional, interviewer-administered survey to a representative sample (n = 822) of the Rosario population, we measured the percentage of cross-coverage (people with usual source of care in one subsystem but also covered by another subsystem) and the health services' performance by core PHC dimensions, as reported by each subsystem's usual users. We compared the subsystems' performance using chi-square analysis and one-way analysis of variance testing. We analyzed whether the observed differences were coherent with the predominant institutional and organizational features of each subsystem. Results: Overall, 39.3% of the population was affiliated with the PubS, 44.8% with the SSS and 15.9% with the PrS. Cross-coverage was reported by 40.6% of respondents. The performance of the PubS was weak on accessibility but strong on person-and-community-oriented care, the opposite of the PrS. The SSS combined the strengths of the other two subsystems. Conclusion: Rosario's health system has a high percentage of cross-coverage, contributing to issues of fragmentation, segmentation, financial inequity and inefficiency. The overall performance of the SSS was better than that of the PrS and PubS, though each subsystem had a particular performance pattern with areas of strength and weakness that were consistent with their institutional and organizational profiles.
publishDate 2016
dc.date.none.fl_str_mv 2016-06
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/11336/52632
Yavich, Natalia; Báscolo, Ernesto Pablo; Haggerty, Jeannie; Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care; Oxford University Press; Family Practice; 33; 3; 6-2016; 249-260
0263-2136
1460-2229
CONICET Digital
CONICET
url http://hdl.handle.net/11336/52632
identifier_str_mv Yavich, Natalia; Báscolo, Ernesto Pablo; Haggerty, Jeannie; Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care; Oxford University Press; Family Practice; 33; 3; 6-2016; 249-260
0263-2136
1460-2229
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://academic.oup.com/fampra/article/33/3/249/1750001
info:eu-repo/semantics/altIdentifier/doi/10.1093/fampra/cmw043
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
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
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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score 13.13397

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