Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil

Irene Garcia-Subirats, Ingrid Vargas, Amparo Susana Mogollón-Pérez, Pierre De Paepe, Maria Rejane Ferreira da Silva, Jean Pierre Unger, María Luisa Vázquez

    Resultado de la investigación: Contribución a RevistaArtículo

    37 Citas (Scopus)

    Resumen

    There are few comprehensive studies available on barriers encountered from the initial seeking of healthcare through to the resolution of the health problem; in other words, on access in its broad domain. For Colombia and Brazil, countries with different healthcare systems but common stated principles, there have been no such analyses to date. This paper compares factors that influence access in its broad domain in two municipalities of each country, by means of a cross-sectional study based on a survey of a multistage probability sample of people who had had at least one health problem within the last three months (2163 in Colombia and 2155 in Brazil). The results reveal important barriers to healthcare access in both samples, with notable differences between and within countries, once differences in sociodemographic characteristics and health needs are accounted for. In the Colombian study areas, the greatest barriers were encountered in initial access to healthcare and in resolving the problem, and similarly when entering the health service in the Brazilian study areas. Differences can also be detected in the use of services: in Colombia greater geographical and economic barriers and the need for authorization from insurers are more relevant, whereas in Brazil, it is the limited availability of health centres, doctors and drugs that leads to longer waiting times. There are also differences according to enrolment status and insurance scheme in Colombia, and between areas in Brazil. The barriers appear to be related to the Colombian system's segmented, non-universal nature, and to the involvement of insurance companies, and to chronic underfunding of the public system in Brazil. Further research is required, but the results obtained reveal critical points to be tackled by health policies in both countries. © 2014 The Authors.
    Idioma originalEnglish (US)
    Páginas (desde-hasta)204-213
    Número de páginas10
    PublicaciónSocial Science and Medicine
    DOI
    EstadoPublished - ene 1 2014

    Huella dactilar

    Colombia
    cross-sectional study
    Brazil
    municipality
    Cross-Sectional Studies
    Delivery of Health Care
    Health
    health
    Sampling Studies
    Insurance Carriers
    insurance company
    Insurance Coverage
    authorization
    Health Policy
    Insurance
    health policy
    insurance
    Health Services
    health service
    Economics

    Citar esto

    Garcia-Subirats, Irene ; Vargas, Ingrid ; Mogollón-Pérez, Amparo Susana ; De Paepe, Pierre ; da Silva, Maria Rejane Ferreira ; Unger, Jean Pierre ; Vázquez, María Luisa. / Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil. En: Social Science and Medicine. 2014 ; pp. 204-213.
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    title = "Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil",
    abstract = "There are few comprehensive studies available on barriers encountered from the initial seeking of healthcare through to the resolution of the health problem; in other words, on access in its broad domain. For Colombia and Brazil, countries with different healthcare systems but common stated principles, there have been no such analyses to date. This paper compares factors that influence access in its broad domain in two municipalities of each country, by means of a cross-sectional study based on a survey of a multistage probability sample of people who had had at least one health problem within the last three months (2163 in Colombia and 2155 in Brazil). The results reveal important barriers to healthcare access in both samples, with notable differences between and within countries, once differences in sociodemographic characteristics and health needs are accounted for. In the Colombian study areas, the greatest barriers were encountered in initial access to healthcare and in resolving the problem, and similarly when entering the health service in the Brazilian study areas. Differences can also be detected in the use of services: in Colombia greater geographical and economic barriers and the need for authorization from insurers are more relevant, whereas in Brazil, it is the limited availability of health centres, doctors and drugs that leads to longer waiting times. There are also differences according to enrolment status and insurance scheme in Colombia, and between areas in Brazil. The barriers appear to be related to the Colombian system's segmented, non-universal nature, and to the involvement of insurance companies, and to chronic underfunding of the public system in Brazil. Further research is required, but the results obtained reveal critical points to be tackled by health policies in both countries. {\circledC} 2014 The Authors.",
    author = "Irene Garcia-Subirats and Ingrid Vargas and Mogoll{\'o}n-P{\'e}rez, {Amparo Susana} and {De Paepe}, Pierre and {da Silva}, {Maria Rejane Ferreira} and Unger, {Jean Pierre} and V{\'a}zquez, {Mar{\'i}a Luisa}",
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    Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil. / Garcia-Subirats, Irene; Vargas, Ingrid; Mogollón-Pérez, Amparo Susana; De Paepe, Pierre; da Silva, Maria Rejane Ferreira; Unger, Jean Pierre; Vázquez, María Luisa.

    En: Social Science and Medicine, 01.01.2014, p. 204-213.

    Resultado de la investigación: Contribución a RevistaArtículo

    TY - JOUR

    T1 - Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil

    AU - Garcia-Subirats, Irene

    AU - Vargas, Ingrid

    AU - Mogollón-Pérez, Amparo Susana

    AU - De Paepe, Pierre

    AU - da Silva, Maria Rejane Ferreira

    AU - Unger, Jean Pierre

    AU - Vázquez, María Luisa

    PY - 2014/1/1

    Y1 - 2014/1/1

    N2 - There are few comprehensive studies available on barriers encountered from the initial seeking of healthcare through to the resolution of the health problem; in other words, on access in its broad domain. For Colombia and Brazil, countries with different healthcare systems but common stated principles, there have been no such analyses to date. This paper compares factors that influence access in its broad domain in two municipalities of each country, by means of a cross-sectional study based on a survey of a multistage probability sample of people who had had at least one health problem within the last three months (2163 in Colombia and 2155 in Brazil). The results reveal important barriers to healthcare access in both samples, with notable differences between and within countries, once differences in sociodemographic characteristics and health needs are accounted for. In the Colombian study areas, the greatest barriers were encountered in initial access to healthcare and in resolving the problem, and similarly when entering the health service in the Brazilian study areas. Differences can also be detected in the use of services: in Colombia greater geographical and economic barriers and the need for authorization from insurers are more relevant, whereas in Brazil, it is the limited availability of health centres, doctors and drugs that leads to longer waiting times. There are also differences according to enrolment status and insurance scheme in Colombia, and between areas in Brazil. The barriers appear to be related to the Colombian system's segmented, non-universal nature, and to the involvement of insurance companies, and to chronic underfunding of the public system in Brazil. Further research is required, but the results obtained reveal critical points to be tackled by health policies in both countries. © 2014 The Authors.

    AB - There are few comprehensive studies available on barriers encountered from the initial seeking of healthcare through to the resolution of the health problem; in other words, on access in its broad domain. For Colombia and Brazil, countries with different healthcare systems but common stated principles, there have been no such analyses to date. This paper compares factors that influence access in its broad domain in two municipalities of each country, by means of a cross-sectional study based on a survey of a multistage probability sample of people who had had at least one health problem within the last three months (2163 in Colombia and 2155 in Brazil). The results reveal important barriers to healthcare access in both samples, with notable differences between and within countries, once differences in sociodemographic characteristics and health needs are accounted for. In the Colombian study areas, the greatest barriers were encountered in initial access to healthcare and in resolving the problem, and similarly when entering the health service in the Brazilian study areas. Differences can also be detected in the use of services: in Colombia greater geographical and economic barriers and the need for authorization from insurers are more relevant, whereas in Brazil, it is the limited availability of health centres, doctors and drugs that leads to longer waiting times. There are also differences according to enrolment status and insurance scheme in Colombia, and between areas in Brazil. The barriers appear to be related to the Colombian system's segmented, non-universal nature, and to the involvement of insurance companies, and to chronic underfunding of the public system in Brazil. Further research is required, but the results obtained reveal critical points to be tackled by health policies in both countries. © 2014 The Authors.

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    DO - 10.1016/j.socscimed.2014.01.054

    M3 - Article

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    EP - 213

    JO - Social Science and Medicine

    JF - Social Science and Medicine

    SN - 0277-9536

    ER -