Background: More than 20 years of health sector reform had emphasized privatization and decentralization, with complicated results for Chile. In March 2000, a newly-installed government identified equity as the principle goal for health policy.
Purpose: We characterize the geographic variability of selected health-related parameters in Chile, and assess Chile's information base for measuring health inequities.
Data: We used government-collected data, aggregated by municipality, region, or health district, to examine 4 dimensions of equity: health status; health determinants; health system resources; and, health services utilization.
Methods: This is a cross-sectional ecological study estimating the extent of variation across politically-defined units using simple statistics (medians, ranges and ratios), and correlations. We evaluated the adequacy of Chile’s database for assessing health equity qualitatively.
Results: We found substantial variations in all indicators examined, including large disparities in total mortality; health determinants including income, education and housing; and in both financing and use of health services. Central government financing levels did not compensate for low local investment in health in poor areas. Data now available for characterizing health and health-related indicators is limited in suitability, quality, and/or accessibility.
Conclusions: Much needs to be done to develop Chile’s information base to support an effective national health equity policy. Recommendations are presented for improving that database and prioritizing further research on inequities. However, this study confirms that widespread and significant inequities in health and its determinants exist now, arguing for near-term interventions to improve the health status of the worst-off Chileans.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Identify at least two major policy decisions affecting the health sector in Chile since 1973. 2. Discuss the kinds of limitations which exist today in studying health-related inequities in Chile. 3. Address the significance of current health inequities in Chile.
Keywords: International Health, Health Care Reform
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.