Colombian health care system: results on equity for five health dimensions, 2003 - 2008 Análisis de la equidad en cinco dimensiones del sistema de salud de Colombia, 2003 - 2008

• Main Authors: Fernando Ruiz Gómez, Teana Zapata Jaramillo, Liz Garavito Beltrán
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2013
• Subjects: Equidad en salud; sistemas de salud; equidad en el acceso; economía de la salud; política de salud; Colombia; Equity in health; health systems; equity in access; health economics; health policy; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doaj.org/article/ff584467609d46658ae5bb258a8c1e84

OBJECTIVE: To assess the change in five health equity dimensions for the Colombian health system: health condition, social health insurance coverage, health services utilization, quality, and health expenditure. METHODS: A common standardization methodology was used to assess equity in countries in the western hemisphere. Data come from the Colombian Life Quality Survey. After indirect standardization, concentration indices and horizontal inequity were estimated. A decomposition analysis was developed. Aggregate household monthly expenditure per equivalent adult was considered as the standard of living. RESULTS: Results show important progress in equity with regard to social health insurance affiliation, access to medicine and curative services, and perception of the quality of health care service. Important gaps persist, which affect poorer populations, especially their perception of having a bad health condition and their access to preventive medical and dental services. CONCLUSIONS: The Colombian model needs to advance in implementing preventive public health strategies to cope with increasing demand concomitant with increased social insurance coverage. The population's access to total services in cases of chronic illness and oral health services must increase and benefit plans must be integrated while preserving the recorded achievements in equity. Decomposition of the concentration index shows that inequities are mostly explained by socioeconomic variables and not by health-related factors. OBJETIVO: Evaluar la evolución de la equidad en el sistema de salud colombiano, según cinco dimensiones: condición de salud, cobertura del seguro social de salud, utilización de los servicios de salud, calidad y gasto en salud. MÉTODOS: Se utilizó una metodología común de estandarización para evaluar la equidad en países del continente americano. Los datos se tomaron de la Encuesta de Calidad de Vida de 2003 y 2008. Después de la estandarización indirecta se estimaron los índices de concentración y de inequidad ...