The determinants of the health status in a developing country: results form the colombian case (original) (raw)
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The Determinants of The Health Status in a Developing Country: results from the Colombian Case
2005
This paper tries to find empirical evidence of the health determinants, as a measure of health capital in a developing country after a deep reform of its health-care sector. It follows the Grossman model (1972) and also takes, besides individual and socioeconomic variables, institutional factors of the health sector. Two surveys from 1997 and 2000 in Colombia, with a subjective (self-report) health status of the individuals, and information about the health system affiliation type, were used. The estimation method is an order probit model. At the end, the results show an important connection between individual, institutional and socioeconomic variables with the health status of a person in Colombia. The effect of the type of access to medical care strengths the inequities in health outcome.
Factores sociodemográficos y de salud asociados a la institucionalización de personas dependientes
Revista Española de Salud Pública, 2010
OBJECTIVE: The objective of this study is to identify factors associated with mortality, with emphasis on gender and age differences. METHODS: This is a cross-sectional study, which uses data from the FIBRA-2008-2009 network in Campinas, State of São Paulo, Brazil, with information on non-institutionalized residents of the urban area and the Mortality Information System. The dependent variable has been death, in 2013. The associations have been tested by odds ratio (OR) and their 95% confidence intervals, and the analyses have been conducted using the program Stata 12.0. RESULTS: Average age has been 72.3 years, 69.3% have been women, and 8.9% have died. We have found greater OR for mortality in individuals aged ≥ 75 years, classified as pre-frail or frail, and in those who have reported heart disease. CONCLUSIONS: In this study, the analysis of specific subgroups has allowed us to better understand the relationship between the factors associated with death in the elderly. With the exception of age, strategies based on primary and secondary care, focused on priority groups, can have a positive impact on the reduction of mortality among the elderly.
Colombian health care system: results on equity for five health dimensions, 2003 - 2008
Revista Panamericana de Salud Pública, 2013
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.
2014
OBJECTIVE: To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS: This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in hours) in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS: The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS: Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services.
An approximation to the standard of living index: the colombian case
BORRADORES DE …, 2001
This document seeks to show the main properties of a standard of living index using the theoretical approach of Amartya Sen. We establish the link among concepts such as: welfare, well-being, agency achievement and standard of living. Optimal scaling methodology was fundamental in order to test the properties on the Colombian case. These properties are Monotonicity, No independence of irrelevant alternatives, Concavity, Informativity and Substituibility.
Comunicaciones en Estadísticas, 2016
This study proposes the design of a poverty index using a multivariate approach to create an alternative indicator that combines the bene?ts of the already existing indexes. The construction of such index is based on the data supplied by the Third National Survey of Family Budgets (NFPS) 2004-2005 that contains information on socioeconomic variables of Venezuelan households. We defined eight (8) dimensions with characteristics of households and from there we created an index, which summarizes the information of the different dimensions for measuring poverty. Keywords: poverty rate, national survey of family budgets, principal component analysis, multiple correspondence analysis. Resumen El presente estudio propone diseñar uníndiceuníndice de pobreza usando un enfoque mul-tivariante, para crear un indicador alternativo que conjugue las bondades de losíndices losíndices existentes. La construcción de dichó ındice se basó en los datos suministra-dos por la III Encuesta Nacional de Presupuestos Familiares(ENPF) 2004-2005, donde hay información concerniente a las variables socioeconómicas de los hogares venezolanos. Se definieron ocho (8) dimensiones con características pertinentes al 1 Luzardo, M., Márquez, V., Segovia, H., Rangel. K. Multivariate poverty index based on the Third National Household Budget Survey 2004-2005. Comunicaciones en Estadística, 9(2), 187-210.
Ciencia & saude coletiva, 2018
Comparison can be an important resource for identifying trends or interventions that improve the quality of health services. Although Portugal and Spain have accumulated important knowledge in primary health care-PHC driven national systems, the Ibero-American countries have not been object of comparative studies. This paper presents an assessment using an analytical dashboard created by the Ibero-American Observatory on Policies and Health Systems. It discusses aspects that have stood out in monitoring the service systems of Argentina, Brazil, Colombia, Spain, Paraguay, Peru, and Portugal throughout the 21st century's first decade. Forty-five indicators and time series showing the highest completeness degree divided into social determinants, conditions and performance were analyzed. Three trends are common to almost all countries: overweight increase, negative trade balance for pharmaceutical products, and an increase in health system expenditure. This convergence trend reveals...
El Trimestre Económico, 2019
We analyze the effects that the expansion of Seguro Popular (SP), Mexico’s universal health insurance program, has had on the human and material resources needed to meet the new demand. Unlike previous evaluations, we use Sanitary Jurisdictions (SJs) as units of analysis and operationalize SP’s intervention as a continuous treatment indicator (relative number of recipients). Estimates using a variety of propensity score approaches suggest that, on the average, SP has effectively had a positive impact on Mexico’s health resources. However, quantile and interaction treatment effects suggest that the program may be leaving behind some of the most vulnerable geographical areas.