Effects of the social security reform in colombia on equity to access and use of health services

In order to evaluate the effects of the new health system upon the equity to access and use of the health services, two cross sections of the population were compared: before Law 100 of 1993, which created the General System for Social Security in Health-SGSSS-, and after the law was passed. The cha...

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Autores:
Jaramillo, Iván
Martínez, Rafael
Olaya, Sonia
Reynales, Jairo
Uribe, Camilo
Castaño, Ramón A.
Garzón, Edgar
Almeida, Célia M.
Travassos, Claudia
Basto, Fernando
Angarita, Janeth
Céspedes, Juan Eduardo
Tipo de recurso:
Article of journal
Fecha de publicación:
2000
Institución:
Universidad Nacional de Colombia
Repositorio:
Universidad Nacional de Colombia
Idioma:
spa
OAI Identifier:
oai:repositorio.unal.edu.co:unal/32257
Acceso en línea:
https://repositorio.unal.edu.co/handle/unal/32257
http://bdigital.unal.edu.co/22337/
Palabra clave:
61 Ciencias médicas; Medicina / Medicine and health
equidad
servicios
salud
acceso
utilización
Rights
openAccess
License
Atribución-NoComercial 4.0 Internacional
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oai_identifier_str oai:repositorio.unal.edu.co:unal/32257
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network_name_str Universidad Nacional de Colombia
repository_id_str
dc.title.spa.fl_str_mv Effects of the social security reform in colombia on equity to access and use of health services
title Effects of the social security reform in colombia on equity to access and use of health services
spellingShingle Effects of the social security reform in colombia on equity to access and use of health services
61 Ciencias médicas; Medicina / Medicine and health
equidad
servicios
salud
acceso
utilización
title_short Effects of the social security reform in colombia on equity to access and use of health services
title_full Effects of the social security reform in colombia on equity to access and use of health services
title_fullStr Effects of the social security reform in colombia on equity to access and use of health services
title_full_unstemmed Effects of the social security reform in colombia on equity to access and use of health services
title_sort Effects of the social security reform in colombia on equity to access and use of health services
dc.creator.fl_str_mv Jaramillo, Iván
Martínez, Rafael
Olaya, Sonia
Reynales, Jairo
Uribe, Camilo
Castaño, Ramón A.
Garzón, Edgar
Almeida, Célia M.
Travassos, Claudia
Basto, Fernando
Angarita, Janeth
Céspedes, Juan Eduardo
dc.contributor.author.spa.fl_str_mv Jaramillo, Iván
Martínez, Rafael
Olaya, Sonia
Reynales, Jairo
Uribe, Camilo
Castaño, Ramón A.
Garzón, Edgar
Almeida, Célia M.
Travassos, Claudia
Basto, Fernando
Angarita, Janeth
Céspedes, Juan Eduardo
dc.subject.ddc.spa.fl_str_mv 61 Ciencias médicas; Medicina / Medicine and health
topic 61 Ciencias médicas; Medicina / Medicine and health
equidad
servicios
salud
acceso
utilización
dc.subject.proposal.spa.fl_str_mv equidad
servicios
salud
acceso
utilización
description In order to evaluate the effects of the new health system upon the equity to access and use of the health services, two cross sections of the population were compared: before Law 100 of 1993, which created the General System for Social Security in Health-SGSSS-, and after the law was passed. The changes in the distribution of an indicator of equity in access to health care services, the affiliation to the General System for Social Security in Health, were assessed. Additionally, two groups were compared in the 1997 cross section, affiliated and non-affiliated to the SGSSS, in order to assess the changes in the equity of use of hospital services and health care services in general. The results obtained show that between 1993 and 1997 the coverage of the SGSSS increased from 23% to 57%. This increase in coverage was more dramatic amongst the poorest sectors of the population: in the homes of people in the lowest tenth percentile of income the coverage increased from 3.1% to 43.7%, and the index of concentration of affiliation to the SGSSS decreased by half: from 0.34 to 0.17. By contrast, the indicators of concentration corresponding to the use of health services varied very little even after the adjustments by age, gender and needs. These results suggest a positive impact of the SGSSS on the inequities of access to health services, but the effects upon the inequities of use of health services are not clear.
publishDate 2000
dc.date.issued.spa.fl_str_mv 2000
dc.date.accessioned.spa.fl_str_mv 2019-06-26T15:11:52Z
dc.date.available.spa.fl_str_mv 2019-06-26T15:11:52Z
dc.type.spa.fl_str_mv Artículo de revista
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url https://repositorio.unal.edu.co/handle/unal/32257
http://bdigital.unal.edu.co/22337/
dc.language.iso.spa.fl_str_mv spa
language spa
dc.relation.spa.fl_str_mv http://revistas.unal.edu.co/index.php/revsaludpublica/article/view/18934
dc.relation.ispartof.spa.fl_str_mv Universidad Nacional de Colombia Revistas electrónicas UN Revista de Salud Pública
Revista de Salud Pública
dc.relation.ispartofseries.none.fl_str_mv Journal of Public Health; Vol. 2, núm. 2 (2000); 145 -164 Revista de Salud Pública; Vol. 2, núm. 2 (2000); 145 -164 0124-0064
dc.relation.references.spa.fl_str_mv Jaramillo, Iván and Martínez, Rafael and Olaya, Sonia and Reynales, Jairo and Uribe, Camilo and Castaño, Ramón A. and Garzón, Edgar and Almeida, Célia M. and Travassos, Claudia and Basto, Fernando and Angarita, Janeth and Céspedes, Juan Eduardo (2000) Effects of the social security reform in colombia on equity to access and use of health services. Journal of Public Health; Vol. 2, núm. 2 (2000); 145 -164 Revista de Salud Pública; Vol. 2, núm. 2 (2000); 145 -164 0124-0064 .
dc.rights.spa.fl_str_mv Derechos reservados - Universidad Nacional de Colombia
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.license.spa.fl_str_mv Atribución-NoComercial 4.0 Internacional
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dc.rights.accessrights.spa.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv Atribución-NoComercial 4.0 Internacional
Derechos reservados - Universidad Nacional de Colombia
http://creativecommons.org/licenses/by-nc/4.0/
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.mimetype.spa.fl_str_mv application/pdf
dc.publisher.spa.fl_str_mv Revista de Salud Pública
institution Universidad Nacional de Colombia
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spelling Atribución-NoComercial 4.0 InternacionalDerechos reservados - Universidad Nacional de Colombiahttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Jaramillo, Ivánd3bd722a-b17d-43fe-ad97-e4fe54ed3b87300Martínez, Rafael5cbe39cf-faea-4c8f-877b-67eef45c37ee300Olaya, Sonia06d54161-81bb-4e66-a9df-03d0999bdc74300Reynales, Jairo76f5af58-cd73-423d-b59c-ebac95fa6d91300Uribe, Camilo8df44f11-6baa-4d79-a23b-1cd81a9c95fe300Castaño, Ramón A.d682c6b5-99a2-47ef-a469-89eb6aabd2f3300Garzón, Edgare7f9cd70-d8ac-4b20-ae64-8bdaea601c97300Almeida, Célia M.28f68b31-cbe4-4885-9212-5b3947d28b0f300Travassos, Claudia5f003019-91aa-42c7-9540-5e7625368f5a300Basto, Fernandof59eb094-1184-42f2-82fc-2f3a0651b367300Angarita, Janethac3015d6-88e3-4862-bdad-1a722022b89a300Céspedes, Juan Eduardo29095da6-b223-4aed-abb6-5e17874eff333002019-06-26T15:11:52Z2019-06-26T15:11:52Z2000https://repositorio.unal.edu.co/handle/unal/32257http://bdigital.unal.edu.co/22337/In order to evaluate the effects of the new health system upon the equity to access and use of the health services, two cross sections of the population were compared: before Law 100 of 1993, which created the General System for Social Security in Health-SGSSS-, and after the law was passed. The changes in the distribution of an indicator of equity in access to health care services, the affiliation to the General System for Social Security in Health, were assessed. Additionally, two groups were compared in the 1997 cross section, affiliated and non-affiliated to the SGSSS, in order to assess the changes in the equity of use of hospital services and health care services in general. The results obtained show that between 1993 and 1997 the coverage of the SGSSS increased from 23% to 57%. This increase in coverage was more dramatic amongst the poorest sectors of the population: in the homes of people in the lowest tenth percentile of income the coverage increased from 3.1% to 43.7%, and the index of concentration of affiliation to the SGSSS decreased by half: from 0.34 to 0.17. By contrast, the indicators of concentration corresponding to the use of health services varied very little even after the adjustments by age, gender and needs. These results suggest a positive impact of the SGSSS on the inequities of access to health services, but the effects upon the inequities of use of health services are not clear.Para evaluar los efectos del nuevo sistema de salud sobre la equidad en el acceso y la utilización de los servicios de salud, se compararon dos cortes transversales de la población antes de la Ley 100 de 1993 que creó el Sistema General de Seguridad Social en Salud-SGSSS y después de la misma. Se evaluaron los cambios en la distribución de un indicador de equidad en el acceso a los servicios de salud: afiliación al SGSSS; adicionalmente, se compararon dos grupos de población en el corte de 1997, afiliados y no afiliados al SGSSS, con el fin de evaluar los cambios en la distribución de dos indicadores de equidad en la utilización de servicios: hospitalización y uso de servicios de salud en general. Los resultados obtenidos, revelan que entre 1993 y 1997, la cobertura del SGSSS aumentó del 23 % al 57 %. El aumento en la cobertura fue más dramático entre los segmentos más pobres de la población: en los hogares del primer decil de ingresos la cobertura aumentó del 3,1 % al 43,7 %, y el índice de concentración en la distribución de la afiliación al SGSSS se redujo a la mitad: del 0,34 a 0,17. En cambio, los indicadores de concentración correspondientes a la utilización de servicios variaron muy poco inclusive luego del ajuste hecho por edad, género y necesidades. Estos resultados sugieren un impacto positivo del SGSSS sobre las inequidades en el acceso, pero los efectos sobre las inequidades en la utilización de los servicios de salud no son claros.application/pdfspaRevista de Salud Públicahttp://revistas.unal.edu.co/index.php/revsaludpublica/article/view/18934Universidad Nacional de Colombia Revistas electrónicas UN Revista de Salud PúblicaRevista de Salud PúblicaJournal of Public Health; Vol. 2, núm. 2 (2000); 145 -164 Revista de Salud Pública; Vol. 2, núm. 2 (2000); 145 -164 0124-0064Jaramillo, Iván and Martínez, Rafael and Olaya, Sonia and Reynales, Jairo and Uribe, Camilo and Castaño, Ramón A. and Garzón, Edgar and Almeida, Célia M. and Travassos, Claudia and Basto, Fernando and Angarita, Janeth and Céspedes, Juan Eduardo (2000) Effects of the social security reform in colombia on equity to access and use of health services. Journal of Public Health; Vol. 2, núm. 2 (2000); 145 -164 Revista de Salud Pública; Vol. 2, núm. 2 (2000); 145 -164 0124-0064 .61 Ciencias médicas; Medicina / Medicine and healthequidadserviciossaludaccesoutilizaciónEffects of the social security reform in colombia on equity to access and use of health servicesArtículo de revistainfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1http://purl.org/coar/version/c_970fb48d4fbd8a85Texthttp://purl.org/redcol/resource_type/ARTORIGINAL18934-61752-1-PB.pdfapplication/pdf300519https://repositorio.unal.edu.co/bitstream/unal/32257/1/18934-61752-1-PB.pdfe68de0ecf63a2a77e084ea990d207a3cMD51THUMBNAIL18934-61752-1-PB.pdf.jpg18934-61752-1-PB.pdf.jpgGenerated Thumbnailimage/jpeg6605https://repositorio.unal.edu.co/bitstream/unal/32257/2/18934-61752-1-PB.pdf.jpg58f946f6e677b903d8924e2f2b58e9beMD52unal/32257oai:repositorio.unal.edu.co:unal/322572022-12-05 23:05:40.363Repositorio Institucional Universidad Nacional de Colombiarepositorio_nal@unal.edu.co