Understanding public perception of the need for major change in Latin American healthcare systems

Abstract

The opinions and experiences of the public regarding health services are valuable insights into identifying opportunities to improve healthcare systems. We analyzed the 2012-2013 Public Opinion Health Policy Survey carried out in Brazil (n = 1486), Colombia (n = 1485), El Salvador (n = 1460), Jamaica (n = 1480), México (n = 1492) and Panama (n = 1475). In these countries between 82 and 96% of participants perceived that their health systems needed fundamental changes. The most frequent barrier to access to healthcare was lack of the primary medical home, difficulties in obtaining medical care during the weekends and financial barriers. Type of health insurance and challenges in obtaining medical care during the weekends were associated with an increased opinion for the need for fundamental changes in healthcare systems, whereas having a primary medical home showed a protective effect. Focusing on tackling organizational and financial barriers and ensuring access to a primary medical home should be placed on the agenda of Latin American countries.

Patient-centered primary care and self-rated health in 6 Latin American and Caribbean countries: Analysis of a public opinion cross-sectional survey

“…We performed a secondary analysis of a recent (2013) public opinion survey focusing on perceptions and experiences with healthcare systems in 6 LAC countries: Brazil, Colombia, El Salvador, Jamaica, Mexico, and Panama. The detailed methodology of this survey was previously reported elsewhere [ 10 , 22 , 23 ]. In each country, the survey included a nationally representative urban sample of the population that comprised between 1,500 and 1,506 adults per country.…”

“…Prior to seeing the data, we identified the public opinion survey as a unique resource to test associations of healthcare quality and SRH in a representative, multi-country sample. We then reviewed the literature on patient-centered PC and identified 5 key domains (contact with clinic, time spent with provider, patient–provider communication, technical quality and solving problems, and healthcare coordination) relevant for patient-centered healthcare [ 10 , 23 , 25 , 26 ]; we mapped items from the survey to these domains and created single-item summaries as well as an overall score. We defined covariates based on relevance to health status and healthcare utilization.…”

“…The survey specified that PC is care provided by the doctors or other health professionals (i.e., nurses, social workers) at the family doctor’s practice or clinic. We selected items related to PC that fall into the domains of patient-centered healthcare identified in the literature [ 10 , 23 , 25 , 26 ] and organized them by domain:…”

“…All other PC variables were measured on a 5-options Likert scale and categorized as 1 = yes (“always” or “often”) and 0 = no (“sometimes,” “rarely or never,” and “not sure”). The decision to categorize the variables this way was based on previous studies [ 10 , 23 , 25 , 26 ]. We calculated OPCE as the arithmetic mean of these items, following the recommendation of previous research on the use of patient experience surveys to assess service provision [ 27 ].…”

Movimentos de reforma do sistema de saúde do Distrito Federal: a conversão do modelo assistencial da Atenção Primária à Saúde

“…Increased access was the main focus during the development of norms of Ordinance n. 77/2017. Studies have shown that the poorest population suffers the greatest difficulties regarding access to health services 14 , and that there is significant demand for longer PHC working hours, including weekend availability 6,34 . Therefore, It was decided to expand the hours of the larger units to operate from 7 am to 7 pm, without interruption, and also on Saturdays from 7 am to 12 noon, with the possibility of operating until 10 pm.…”