Monitoring and Evaluating Progress towards Universal Health Coverage in Chile

Aguilera, Ximena; Castillo-Laborde, Carla; Ferrari, Manuel Nájera-De; Delgado, Iris; Ibáñez, Ciro

doi:10.1371/journal.pmed.1001676

Cited by 42 publications

(57 citation statements)

References 4 publications

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“…Other countries focus much more on noncommunicable disease–related interventions, such as Brazil [6], Chile [7], Singapore [13], and Thailand [16], which is largely done through specific national surveys and facility data. While the differences in epidemiology are an important contributor to those differences, a comprehensive health information system will be needed in all countries in the future to monitor progress towards UHC.…”

Section: Country Monitoringmentioning

confidence: 99%

Monitoring Progress towards Universal Health Coverage at Country and Global Levels

et al. 2014

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Section: Country Monitoringmentioning

confidence: 99%

Monitoring Progress towards Universal Health Coverage at Country and Global Levels

et al. 2014

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“…AUGE establishes the mandatory health coverage for all individuals, regardless of their levels of contribution. This feature is considered one of the main achievements of the reform (4, 27, 40). It was the first example of a rights-based social guarantee in Latin America that provides operational definitions of health care entitlements (44).…”

Section: Resultsmentioning

confidence: 99%

“…Currently, different surveys allow us to disaggregate data by gender, socioeconomic status, and minority groups; however, this is not the case for administrative registries. In a previous study, about universal health coverage (UHC) in Chile, we described the shortcomings of the MOH registries, which impede to assess equity in health coverage for many public health programs, such as vaccination, TB, HIV-AIDS, ante-natal care, and healthy child control (4) . …”

Section: Discussionmentioning

confidence: 99%

From instinct to evidence: the role of data in country decision-making in Chile

Aguilera

Espinosa-Marty

Castillo-Laborde

et al. 2017

Global Health Action

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BackgroundThe Chilean health system has undergone profound reforms since 1990, while going through many political upheavals, and faced demographic, health, and economic transformations. The full information requirements to develop an evidence-informed process implied the best possible use of available data, as well as efforts for improving the information systems.ObjectiveTo examine, from a historical perspective, the use of data during the health reforms undertaken in Chile since 1990, and to identify the factors that have determined its utilization and improvement.DesignA qualitative methodological approach was followed to review the case study of the Chilean experience with data on decision-making. We use as the primary source our first-hand experience as officials of the Ministry of Health (MOH) and the Ministry of Finance during the reform period considered. Second, a literature review was conducted, using documents from official sources, historical accounts, books, policy reports, and articles about the reform process, looking for the use of data.FindingsThe Chilean health care reform process was intensive in utilization and production of information. In this context, the MOH conducted several studies, from the burden of disease, efficacy of interventions, cost-effectiveness, out-of-pocket payments, and fiscal impact to social preferences, among others. Policy and prioritization frameworks developed by international agencies influenced the use of data and the studies’ agenda.ConclusionsHealth systems in Latin America have struggled to adapt to changing health needs caused by demographic transition and economic growth. Health reforms in Chile provide lessons of this sustained effort, based on data and scientific grounds, with lights and shadows. Tradition, receptiveness to foreign ideas, and benchmarking with international data determined this approach, facilitated by the political influence of physicians and other technocrats. Besides, internationally comparable statistics are shown to play a significant role in policy debate.

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“…The coverage must guarantee health benefits to a universe of patients who need such care or health services, and not only to those who are registered. In Chile, the coverage of noncommunicable diseases is lower than that of other diseases, especially when measuring effective coverage 19 ; for this reason it is fundamental to work on coverage of pathologies such as DM2. The Average of diabetics patients with metabolic control in 2011-2013, at the national level is 41.77%, but when considering the prevalence of DM2, it is evident that less than 20% reach the Universal Effective Health Coverage (17.69%).…”

Section: Discussionmentioning

confidence: 99%

Effective Universal Coverage of Diabetes Mellitus Type 2 in Chile

Guerrero-Núñez

Süazo

Henríquez

2017

Rev. Latino-Am. Enfermagem

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Objective:determine the prevalence of Effective Universal Coverage of Diabetes Mellitus Type 2 in Chile and its relation with the variables: Health Care Coverage of Diabetes Mellitus Type 2; Average of diabetics with metabolic control in 2011-2013; Mortality Rate for Diabetes Mellitus; and Percentage of nurses participating in the Cardiovascular Health Program. Method:cross-sectional descriptive study with ecological components that uses documentary sources of the Ministry of Health. It was established that there is correlation between the Universal Effective Coverage of Diabetes Mellitus Type 2 and the independent variables; it was applied the Pearson Coefficient, being significant at the 0.05 level. Results:in Chile Universal Health Care Coverage of Diabetes Mellitus Type 2 (HbA1c<7% estimated population) is less than 20%; this is related with Mortality Rate for Diabetes Mellitus and Percentage of nurses participating in the Cardiovascular Health Program, being significant at the 0.01 level. Conclusion:effective prevalence of Universal Health Coverage of Diabetes Mellitus Type 2 is low, even though some regions stand out in this research and in the metabolic control of patients who participate in health control program; its relation with percentage of nurses participating in the Cardiovascular Health Program represents a challenge and an opportunity for the health system.

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Monitoring and Evaluating Progress towards Universal Health Coverage in Chile

Abstract: This paper by Ximena Paz Aguilera and colleagues is a country case study for the Universal Health Coverage Collection, organized by WHO. It illustrates progress towards UHC and its monitoring and evaluation in Chile. Please see later in the article for the Editors' Summary

Cited by 42 publications

References 4 publications

Monitoring Progress towards Universal Health Coverage at Country and Global Levels

Monitoring Progress towards Universal Health Coverage at Country and Global Levels

From instinct to evidence: the role of data in country decision-making in Chile

Effective Universal Coverage of Diabetes Mellitus Type 2 in Chile

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