Ethnic-racial inequity in health insurance in Colombia: a cross-sectional study

Viáfara-López, Carlos Augusto; Palacios-Quejada, Glenda; Banguera-Obregón, Alexander

doi:10.26633/rpsp.2021.77

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…One summary of the measures that have been commonly used includes life expectancy; mortality (from specific diseases); access, location, and quality differences for facilities; maternal and infant health and mortality measures; and measures of sanitation and nutrition [ 31 ]. Other studies have taken different approaches, such as evaluating health insurance coverage among demographic groups [ 32 ] and using Likert scales for self-perceived health, such as the WHO five-item instrument in which respondents answer a single question giving a rating of their own health on a scale ranging from excellent to poor [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluating Health Inequality in Five Caribbean Basin Countries Using EQ-5D-5L

Bailey

Janssen

Alladin

et al. 2022

Appl Health Econ Health Policy

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Background EQ-5D-5L is a standardized health outcomes instrument that can be added to national surveys to measure inequality in health outcomes. The aim of this study was to produce baseline values of health inequality using EQ-5D-5L for five countries in the Caribbean Basin region based on national surveys in 2012-2014. Methods The EQ-5D-5L questionnaire was included in adult population surveys of Barbados, Belize, Colombia, Jamaica and Trinidad and Tobago. EQ-5D-5L measures were calculated for demographic groups using stratifiers from the World Health Organization's PROGRESS-Plus framework, and generalized linear models were used to test for association between EQ-5D-5L and the PROGRESS-Plus variables. Ordered logit models were used to obtain odds ratios for the effect of the PROGRESS-Plus variables on reporting problems on the EQ-5D-5L dimensions. The Kakwani index was calculated for each country. Results Data were obtained for representative samples in each country, giving a combined total of 11,284 respondents. Different patterns of inequality were observed among the five countries. The biggest drivers of inequality were age and gender, and the biggest EQ-5D factors were self-care in Belize and pain/discomfort in the other four countries. Conclusion This study demonstrated that the EQ-5D-5L instrument can easily be added to national surveys. Inequality measures from this study can be used as baseline values for comparisons with future similar surveys in these five countries to infer changes in health inequality as measured by EQ-5D outcomes. These can be used to track the performance of policy initiatives aimed at specific demographic groups. Key Points for Decision MakersEQ-5D-5L is a standardized health outcomes instrument that can be added to national surveys to measure inequality in health outcomes.This study provides baseline values of inequality measures using EQ-5D-5L for five countries against which comparisons can be made with data from future studies.These can be used to track the performance of policy initiatives aimed at specific demographic groups.

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Section: Discussionmentioning

confidence: 99%

Evaluating Health Inequality in Five Caribbean Basin Countries Using EQ-5D-5L

Bailey

Janssen

Alladin

et al. 2022

Appl Health Econ Health Policy

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“…Geographic inequalities in access still persist, although most states already provide almost all procedures. Thus, in Vianna’s words, the “everything for everybody” gives way to the “best for everybody”, granting benefits to all and not hurting the equality principle [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Ethnic-Regional Differences in the Allocation of High Complexity Spending in Brazil: Time Analysis 2010–2019

Martins

Reis

Chaoubah

et al. 2023

IJERPH

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The following paper presents as a research problem the ethnic-regional differences in the allocation of high complexity spending in Brazil in an analysis from 2010 to 2019. This is a descriptive research in which a generalized linear model (GLM) was developed to analyze these hospital expenditures with high complexity procedures. The total spending on high complexity procedures in Brazil has increased over the past decade. The study shows that the lowest average expenditures are found in the North and Northeast regions. When comparing the spending between different ethnicities, it was observed that the only decrease between the years 2010 and 2019 was in the amount spent on procedures in indigenous people. The spending on male patients was significantly higher compared to female patients. The highest expenditures, on the other hand, are concentrated in the regions of state capitals favoring the strengthening of hub municipalities. Geographic inequalities in access still persist, even with most states already offering almost all procedures. The Brazilian territory is very heterogeneous and needs to organize its health system by regions, therefore integrated public policies and economic and social development are urgently needed.

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“…This finding provides strong data, as this is the capital city with better health access and reporting systems. Therefore, the general decreasing risk in most departments in Colombia, one of the endemic countries, may be strongly affected by the underreporting of the disease throughout the country, suggesting that the risk may be even greater than expected, for example, inadequate reporting technique could explain that San Andrés does not have new cases reported [ 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the association between precipitation and population cases of ocular toxoplasmosis in Colombia

et al. 2022

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Background Previous studies suggest a relationship between precipitation and ocular toxoplasmosis (OT) reactivation and congenital toxoplasmosis infection. We aimed to investigate the relationship between precipitation and the frequency of new OT cases in Colombia from 2015 to 2019. Methodology This retrospective cohort study analyzed data obtained from a claims-based database created by the Colombian Ministry of Health and national registries of precipitation of the Institute of Hydrology, Meteorology, and Environmental Studies. We estimated the daily number of OT cases, interpolating data from the average number of annual cases from 2015 to 2019. Then, we compared exposures (mean daily precipitation) in the case period in which the events (interpolated OT new cases) occurred by a quasi-Poisson regression, combined with a distributed lag non-linear model to estimate the non-linear and lag–response curve. Principal findings In the 5-year analysis, there were 1,741 new OT cases. Most of the cases occurred in 2019, followed by 2015 and 2018. New OT cases among departments were significantly different (P< 0.01). The cumulative exposure-response curve was decreasing for most departments. Nevertheless, in Chocó, Bogotá, Cesar, Cauca, and Guajira, when a certain amount of precipitation accumulates, the relative risk (RR) increases, which was contrary to the pattern observed in the other regions. The response curves to the one-day lag showed that precipitation influences the RR; however, the trends vary by department. Finally, an increasing trend in the number of cases was directly proportional to precipitation in Guajira, Atlántico, Norte de Santander, Santander, Caquetá and Quindío (r = 0.84; P< 0.05). Conclusions Precipitation influenced the RR for new OT cases. However, varying trends among geographical regions (departments) lead us to hypothesize that other sociodemographic, behavioral, and environmental variables, such as wind and water contamination, could influence the RR.

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Ethnic-racial inequity in health insurance in Colombia: a cross-sectional study

Cited by 6 publications

References 25 publications

Evaluating Health Inequality in Five Caribbean Basin Countries Using EQ-5D-5L

Evaluating Health Inequality in Five Caribbean Basin Countries Using EQ-5D-5L

Ethnic-Regional Differences in the Allocation of High Complexity Spending in Brazil: Time Analysis 2010–2019

Exploring the association between precipitation and population cases of ocular toxoplasmosis in Colombia

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