Inequality in Access to Healthcare: A Latin American Perspective
DOI:
https://doi.org/10.56294/saludcyt2023355Keywords:
Latin America, Accessibility to Health Services, Social InequalityAbstract
Introduction: inequality in access to healthcare is a significant issue globally, with disparities in access to health services, health outcomes, and health-related behaviors. Latin America is known for its income and wealth inequality, and perceptions of inequality in health services during the COVID-19 pandemic are crucial to consider in formulating public policies in this sector.
Objective: to determine the factors associated with the perception of inequality and access to health services in Latin America in 2020.
Methods: the study uses data from the 2020 Latinobarómetro and focuses on socio-demographic, perception, and access to health services factors. Three supervised learning algorithms were used: logit regression with Lasso regularization algorithm, decision tree, and random forests.
Results: the study found that the factors associated with the perception of inequality and access to health services in Latin America in 2020 include age, education, income, health insurance, and type of healthcare facility used.
Conclusions: the study provides valuable insights into the perception of inequality associated with access to health systems in Latin America, one of the world's most unequal regions. Public policies addressing this issue would positively influence Latin Americans' objective and subjective quality of life. However, there is a need for more consensus on appropriate indicators for measuring access to health, and more studies analyzing access to health services during the pandemic and users' perception are necessary
References
1. Premachandra B, Lewis Jr NA. Do we report the information that is necessary to give psychology away? A scoping review of the psychological intervention literature 2000–2018. Perspect Psychol Sci. 2022;17(1):226-238. https://doi.org/10.1177/1745691621990665.
2. Stantcheva S. Understanding tax policy: How do people reason? Q J Econ. 2021;136(4):2309-2369. https://doi.org/10.1093/qje/qjab033.
3. Diez Roux AV, Barrientos-Gutierrez T, Caiaffa WT, Miranda JJ, Rodriguez D, Sarmiento OL, et al. Urban health and health equity in Latin American cities: what COVID-19 is teaching us. Cities Health. 2021;5(sup1):S140-S144. https://doi.org/10.1080/23748834.2020.1809788.
4. Ramírez Lozano JP, Bridshaw Araya LC, Brito Ochoa MP. Latin American female academic perceptions about the COVID pandemic’s impact on gender equity and within-country inequality. Manag Res J Iberoam Acad Manag. 2022;20(2):169-192. https://doi.org/10.1108/MRJIAM-10-2021-1242.
5. Tuczyńska M, Matthews-Kozanecka M, Baum E. Accessibility to non-COVID health services in the world during the COVID-19 pandemic. Front Public Health. 2021;9:760795. https://doi.org/10.3389/fpubh.2021.760795.
6. Vázquez ML, Vargas I, Oliver A, Espinel V, Ronda E, Sanz-Barbero B, et al. Access to health services for non-Covid-19 causes during the pandemic. A literature review. Eur J Public Health. 2021;31(Supplement_3):ckab165-349. https://doi.org/10.1093/eurpub/ckab165.349.
7. Latinobarómetro Corporation. Chile. Corporación Latinobarómetro; 2021. https://www.latinobarometro.org/latContents.jsp.
8. Jachimowicz JM, Davidai S, Goya-Tocchetto D, Szaszi B, Day MV, Tepper SJ, Phillips LT, Mirza MU, Ordabayeva N, Hauser OP. Inequality in researchers’ minds: Four guiding questions for studying subjective perceptions of economic inequality. J Econ Surveys. 2022;1-20. https://doi.org/10.1111/joes.12507.
9. Kelly-Irving M, Ball WP, Bambra C, Delpierre C, Dundas R, Lynch J, McCartney G, Smith K. Falling down the rabbit hole? Methodological, conceptual and policy issues in current health inequalities research. Crit Public Health. 2022;1-11. https://doi.org/10.1080/09581596.2022.2036701.
10. Pérez RA, Tejada CAO, Triaca LM, Bertoldi AD, dos Santos AMA. Socioeconomic inequality in health in older adults in Brazil. Dialogues Health. 2022;1:100009. https://doi.org/10.1016/j.dihel.2022.100009.
11. Mpinga EK, Chastonay P. Satisfaction of patients: a right to health indicator? Health Policy. 2011;100(2-3):144-150. https://doi.org/10.1016/j.healthpol.2010.08.020.
12. Hu S, Das D. Quality of life among older adults in China and India: Does productive engagement help? Soc Sci Med. 2019;229:144-153. https://doi.org/10.1016/j.socscimed.2018.
13. McNamee P, Mendolia S. Changes in health-related quality of life: a compensating income variation approach. Appl Econ. 2019;51(6):639-650. https://doi.org/10.1080/00036846.2018.1504160.
14. Skevington SM, Böhnke JR. How is subjective well-being related to quality of life? Do we need two concepts and both measures? Soc Sci Med. 2018;206:22-30. https://doi.org/10.1016/j.socscimed.2018.04.010.
15. Vuković M, Gvozdenović BS, Gajić T, Gajić BS, Jakovljević M, McCormick BP. Validation of a patient satisfaction questionnaire in primary health care. Public Health. 2012;126(8):710-718. https://doi.org/10.1016/j.puhe.2012.03.008.
16. Bilal U, Hessel P, Perez-Ferrer C, Michael YL, Alfaro T, Tenorio-Mucha J, et al. Life expectancy and mortality in 363 cities of Latin America. Nat Med. 2021;27:463-470. https://doi.org/10.1038/s41591-020-01231-8
17. Belloni A, Chernozhukov V, Wei Y. Post-selection inference for generalized linear models with many controls. J Bus Econ Stat. 2016;34:606–619. https://doi.org/10.1080/07350015.2016.116
18. James G, Witten D, Hastie T, Tibshirani R. An introduction to statistical learning. Springer; 2013.
19. Zhang Mengmeng, Liu Yi′an, Song Ping. Applications of partial connection clustering algorithm and random forest algorithm in radar signal sorting. Laser Optoelectron Prog. 2019;56(6):062804. https://doi.org/10.3788/LOP56.062804.
20. Stata Statistical Software. Release 17. StataCorp LLC; 2021.
21. Pérez-Romero S, Gascón-Cánovas JJ, Salmerón-Martínez D, Parra-Hidalgo P, Monteagudo-Piqueras O. Sociodemographic characteristics and geographical variability related to patient satisfaction in Primary Care. J Care Qual. 2016;31(5):300-308. https://doi.org/10.1097/JCQ.0000000000000157.
22. Olden K. The Inaugural Olden Distinguished Lecture: economic inequality and health disparities. Environ Health Perspect. 2021;129(4):041001.
23. Goyenechea M. Subsidiary status, segmentation and inequality in the Chilean health system. Cuad Méd Soc. 2019;59(2):7-12.
24. Fuentes-García A. The cry of inequities: Social explosion and health in Chile. Rev Chil Salud Pública. 2019;23(2):93-94. https://doi.org/10.5354/0719-5281.2019.53715
25. Hilarión-Gaitán L, Díaz-Jiménez D, Cotes-Cantillo K, Castañeda-Orjuela C. Health inequalities according to affiliation regime and events notified to the Surveillance System (Sivigila) in Colombia, 2015. Biomedica. 2019;39(4):737-747. https://doi.org/10.7705/biomedica.4453
26. Almeida-Filho ND. Health inequalities: new theoretical perspectives. Collective Health. 2020;16:e2751. https://doi.org/10.1590/1414-462x202000010275
27. Alves ADL, Santos RD. Social protection: outlining considerations about the system of neighboring Uruguay. Serviço Social & Sociedade. 2021;142:264-284. http://doi.org/10.1590/0101-6628.052
Published
Issue
Section
License
Copyright (c) 2023 Carolina Henao, Jenny Paola Lis-Gutiérrez, Melissa Lis-Gutiérrez (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
