Determinantes del uso de distintos niveles asistenciales en el Sistema General de Seguridad Social en Salud y Sistema Único de Salud en Colombia y Brasil

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

    Resultado de la investigación: Contribución a RevistaArtículo

    11 Citas (Scopus)

    Resumen

    © 2014.Objective: To compare the use of different healthcare levels, and its determinants, in two different health systems, the General System of Social Security in Health (GSSSH) and the Unified Health System (UHS) in municipalities in Colombia and Brazil. Methods: A cross-sectional study was carried out, based on a population survey in two municipalities in Colombia (n. =. 2163) and two in Brazil (n. =. 2155). Outcome variables consisted of the use of primary care services, outpatient secondary care services, and emergency care in the previous 3 months. Explanatory variables were need and predisposing and enabling factors. Bivariate and multivariate logistic regression analyses were performed by healthcare level and country. Results: The determinants of use differed by healthcare level and country: having a chronic disease was associated with a greater use of primary and outpatient secondary care in Colombia, and was also associated with the use of emergency care in Brazil. In Colombia, persons enrolled in the contributory scheme more frequently used the services of the GSSSH than persons enrolled with subsidized contributions in primary and outpatient secondary care and more than persons without insurance in any healthcare level. In Brazil, the low-income population and those without private insurance more frequently used the UHS at any level. In both countries, the use of primary care was increased when persons knew the healthcare center to which they were assigned and if they had a regular source of care. Knowledge of the referral hospital increased the use of outpatient secondary care and emergency care. Conclusions: In both countries, the influence of the determinants of use differed according to the level of care used, emphasizing the need to analyze healthcare use by disaggregating it by level of care.
    Idioma originalEnglish (US)
    Páginas (desde-hasta)480-488
    Número de páginas9
    PublicaciónGaceta Sanitaria
    DOI
    EstadoPublished - ene 1 2014

    Huella dactilar

    Colombia
    Secondary Care
    Ambulatory Care
    Delivery of Health Care
    Brazil
    Emergency Medical Services
    Health
    Social Security
    Insurance
    Causality
    Primary Health Care
    Poverty
    Chronic Disease
    Referral and Consultation
    Cross-Sectional Studies
    Logistic Models
    Regression Analysis
    Population

    Citar esto

    Garcia-Subirats, Irene ; Vargas Lorenzo, Ingrid ; Mogollón-Pérez, Amparo Susana ; De Paepe, Pierre ; da Silva, Maria Rejane Ferreira ; Unger, Jean Pierre ; Vázquez Navarrete, María Luisa. / Determinantes del uso de distintos niveles asistenciales en el Sistema General de Seguridad Social en Salud y Sistema Único de Salud en Colombia y Brasil. En: Gaceta Sanitaria. 2014 ; pp. 480-488.
    @article{f923a743c53944ccb048c2df1746852a,
    title = "Determinantes del uso de distintos niveles asistenciales en el Sistema General de Seguridad Social en Salud y Sistema {\'U}nico de Salud en Colombia y Brasil",
    abstract = "{\circledC} 2014.Objective: To compare the use of different healthcare levels, and its determinants, in two different health systems, the General System of Social Security in Health (GSSSH) and the Unified Health System (UHS) in municipalities in Colombia and Brazil. Methods: A cross-sectional study was carried out, based on a population survey in two municipalities in Colombia (n. =. 2163) and two in Brazil (n. =. 2155). Outcome variables consisted of the use of primary care services, outpatient secondary care services, and emergency care in the previous 3 months. Explanatory variables were need and predisposing and enabling factors. Bivariate and multivariate logistic regression analyses were performed by healthcare level and country. Results: The determinants of use differed by healthcare level and country: having a chronic disease was associated with a greater use of primary and outpatient secondary care in Colombia, and was also associated with the use of emergency care in Brazil. In Colombia, persons enrolled in the contributory scheme more frequently used the services of the GSSSH than persons enrolled with subsidized contributions in primary and outpatient secondary care and more than persons without insurance in any healthcare level. In Brazil, the low-income population and those without private insurance more frequently used the UHS at any level. In both countries, the use of primary care was increased when persons knew the healthcare center to which they were assigned and if they had a regular source of care. Knowledge of the referral hospital increased the use of outpatient secondary care and emergency care. Conclusions: In both countries, the influence of the determinants of use differed according to the level of care used, emphasizing the need to analyze healthcare use by disaggregating it by level of care.",
    author = "Irene Garcia-Subirats and {Vargas Lorenzo}, Ingrid 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 Navarrete}, {Mar{\'i}a Luisa}",
    year = "2014",
    month = "1",
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    doi = "10.1016/j.gaceta.2014.05.010",
    language = "English (US)",
    pages = "480--488",
    journal = "Gaceta Sanitaria",
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    Determinantes del uso de distintos niveles asistenciales en el Sistema General de Seguridad Social en Salud y Sistema Único de Salud en Colombia y Brasil. / Garcia-Subirats, Irene; Vargas Lorenzo, Ingrid; Mogollón-Pérez, Amparo Susana; De Paepe, Pierre; da Silva, Maria Rejane Ferreira; Unger, Jean Pierre; Vázquez Navarrete, María Luisa.

    En: Gaceta Sanitaria, 01.01.2014, p. 480-488.

    Resultado de la investigación: Contribución a RevistaArtículo

    TY - JOUR

    T1 - Determinantes del uso de distintos niveles asistenciales en el Sistema General de Seguridad Social en Salud y Sistema Único de Salud en Colombia y Brasil

    AU - Garcia-Subirats, Irene

    AU - Vargas Lorenzo, Ingrid

    AU - Mogollón-Pérez, Amparo Susana

    AU - De Paepe, Pierre

    AU - da Silva, Maria Rejane Ferreira

    AU - Unger, Jean Pierre

    AU - Vázquez Navarrete, María Luisa

    PY - 2014/1/1

    Y1 - 2014/1/1

    N2 - © 2014.Objective: To compare the use of different healthcare levels, and its determinants, in two different health systems, the General System of Social Security in Health (GSSSH) and the Unified Health System (UHS) in municipalities in Colombia and Brazil. Methods: A cross-sectional study was carried out, based on a population survey in two municipalities in Colombia (n. =. 2163) and two in Brazil (n. =. 2155). Outcome variables consisted of the use of primary care services, outpatient secondary care services, and emergency care in the previous 3 months. Explanatory variables were need and predisposing and enabling factors. Bivariate and multivariate logistic regression analyses were performed by healthcare level and country. Results: The determinants of use differed by healthcare level and country: having a chronic disease was associated with a greater use of primary and outpatient secondary care in Colombia, and was also associated with the use of emergency care in Brazil. In Colombia, persons enrolled in the contributory scheme more frequently used the services of the GSSSH than persons enrolled with subsidized contributions in primary and outpatient secondary care and more than persons without insurance in any healthcare level. In Brazil, the low-income population and those without private insurance more frequently used the UHS at any level. In both countries, the use of primary care was increased when persons knew the healthcare center to which they were assigned and if they had a regular source of care. Knowledge of the referral hospital increased the use of outpatient secondary care and emergency care. Conclusions: In both countries, the influence of the determinants of use differed according to the level of care used, emphasizing the need to analyze healthcare use by disaggregating it by level of care.

    AB - © 2014.Objective: To compare the use of different healthcare levels, and its determinants, in two different health systems, the General System of Social Security in Health (GSSSH) and the Unified Health System (UHS) in municipalities in Colombia and Brazil. Methods: A cross-sectional study was carried out, based on a population survey in two municipalities in Colombia (n. =. 2163) and two in Brazil (n. =. 2155). Outcome variables consisted of the use of primary care services, outpatient secondary care services, and emergency care in the previous 3 months. Explanatory variables were need and predisposing and enabling factors. Bivariate and multivariate logistic regression analyses were performed by healthcare level and country. Results: The determinants of use differed by healthcare level and country: having a chronic disease was associated with a greater use of primary and outpatient secondary care in Colombia, and was also associated with the use of emergency care in Brazil. In Colombia, persons enrolled in the contributory scheme more frequently used the services of the GSSSH than persons enrolled with subsidized contributions in primary and outpatient secondary care and more than persons without insurance in any healthcare level. In Brazil, the low-income population and those without private insurance more frequently used the UHS at any level. In both countries, the use of primary care was increased when persons knew the healthcare center to which they were assigned and if they had a regular source of care. Knowledge of the referral hospital increased the use of outpatient secondary care and emergency care. Conclusions: In both countries, the influence of the determinants of use differed according to the level of care used, emphasizing the need to analyze healthcare use by disaggregating it by level of care.

    U2 - 10.1016/j.gaceta.2014.05.010

    DO - 10.1016/j.gaceta.2014.05.010

    M3 - Article

    SP - 480

    EP - 488

    JO - Gaceta Sanitaria

    JF - Gaceta Sanitaria

    SN - 0213-9111

    ER -