Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for Argentina
Abstract Background The high fragmentation and decentralization in the provision of health care services that characterizes Argentina’s health system, as well as the economic and social inequalities, challenge the achievement of the Universal Health Coverage (UHC). The objective of this study is to...
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12939-020-01168-6 |
| _version_ | 1819076714022567936 |
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| author | Alfredo Palacios Natalia Espinola Carlos Rojas-Roque |
| author_facet | Alfredo Palacios Natalia Espinola Carlos Rojas-Roque |
| author_sort | Alfredo Palacios |
| collection | DOAJ |
| description | Abstract Background The high fragmentation and decentralization in the provision of health care services that characterizes Argentina’s health system, as well as the economic and social inequalities, challenge the achievement of the Universal Health Coverage (UHC). The objective of this study is to measure socioeconomic-related inequality and horizontal inequity in the use of health care services in Argentina as well as identify the factors that contribute to these disparities. Methods The 2013 National Risk Factor Survey, developed by the Ministry of Health of Argentina, was used to measure socioeconomic-related inequality and inequity in the use of health care services through concentration curves, the Erreygers concentration index, and the index of horizontal inequity. Econometric micro-decomposition was applied to estimate the contribution of each determining factor to inequality in the use of health care services. Results The Erreygers concentration index for the use of health care services was 0.1223, evidencing pro-rich inequalities. By adding variables of health care needs, the horizontal inequity index was 0.1296. Non-need factors such as education and health coverage with social security increase pro-rich inequality. Conclusions The Argentine health system shows pro-rich inequality in the use of health care services. It is necessary to design strategies to improve articulation between the three coverage subsectors and national, provincial, and municipal governments to keep the commitment of “not leaving anyone behind.” The results showed here could provide lessons for countries with similar contexts and challenges in public health. |
| first_indexed | 2024-12-21T18:45:41Z |
| format | Article |
| id | doaj.art-d6f3892a8f5b404c8e46aa857ed75cd8 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-12-21T18:45:41Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-d6f3892a8f5b404c8e46aa857ed75cd82022-12-21T18:53:54ZengBMCInternational Journal for Equity in Health1475-92762020-07-0119111410.1186/s12939-020-01168-6Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for ArgentinaAlfredo Palacios0Natalia Espinola1Carlos Rojas-Roque2Institute for Clinical Effectiveness and Health Policy (IECS)Institute for Clinical Effectiveness and Health Policy (IECS)Institute for Clinical Effectiveness and Health Policy (IECS)Abstract Background The high fragmentation and decentralization in the provision of health care services that characterizes Argentina’s health system, as well as the economic and social inequalities, challenge the achievement of the Universal Health Coverage (UHC). The objective of this study is to measure socioeconomic-related inequality and horizontal inequity in the use of health care services in Argentina as well as identify the factors that contribute to these disparities. Methods The 2013 National Risk Factor Survey, developed by the Ministry of Health of Argentina, was used to measure socioeconomic-related inequality and inequity in the use of health care services through concentration curves, the Erreygers concentration index, and the index of horizontal inequity. Econometric micro-decomposition was applied to estimate the contribution of each determining factor to inequality in the use of health care services. Results The Erreygers concentration index for the use of health care services was 0.1223, evidencing pro-rich inequalities. By adding variables of health care needs, the horizontal inequity index was 0.1296. Non-need factors such as education and health coverage with social security increase pro-rich inequality. Conclusions The Argentine health system shows pro-rich inequality in the use of health care services. It is necessary to design strategies to improve articulation between the three coverage subsectors and national, provincial, and municipal governments to keep the commitment of “not leaving anyone behind.” The results showed here could provide lessons for countries with similar contexts and challenges in public health.http://link.springer.com/article/10.1186/s12939-020-01168-6InequalityInequityHealth care disparitiesUtilization of health careArgentina |
| spellingShingle | Alfredo Palacios Natalia Espinola Carlos Rojas-Roque Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for Argentina International Journal for Equity in Health Inequality Inequity Health care disparities Utilization of health care Argentina |
| title | Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for Argentina |
| title_full | Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for Argentina |
| title_fullStr | Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for Argentina |
| title_full_unstemmed | Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for Argentina |
| title_short | Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for Argentina |
| title_sort | need and inequality in the use of health care services in a fragmented and decentralized health system evidence for argentina |
| topic | Inequality Inequity Health care disparities Utilization of health care Argentina |
| url | http://link.springer.com/article/10.1186/s12939-020-01168-6 |
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