Inequities in Mental Health Care After Health Care System Reform in Chile

Bibliographic Data

ID11018032
AuthorsRicardo Araya (0000-0002-0420-5148, Ricardo Araya and Glyn Lewis are with the Division of Psychiatry, University of Bristol, Bristol, England. Graciela Rojas and Rosemarie Fritsch are with Clinica Psiquiatrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile. Richard Frank is with the Department of Health Care Policy, Harvard University, Cambridge, Mass.), Graciela Rojas (0000-0002-9577-7415, Ricardo Araya and Glyn Lewis are with the Division of Psychiatry, University of Bristol, Bristol, England. Graciela Rojas and Rosemarie Fritsch are with Clinica Psiquiatrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile. Richard Frank is with the Department of Health Care Policy, Harvard University, Cambridge, Mass.), Rosemarie Fritsch (0000-0001-7694-1470, Ricardo Araya and Glyn Lewis are with the Division of Psychiatry, University of Bristol, Bristol, England. Graciela Rojas and Rosemarie Fritsch are with Clinica Psiquiatrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile. Richard Frank is with the Department of Health Care Policy, Harvard University, Cambridge, Mass.), Robert G Frank (0000-0003-1551-7072, Universidad de Magallanes), Richard Frank (0000-0001-5927-1217, Ricardo Araya and Glyn Lewis are with the Division of Psychiatry, University of Bristol, Bristol, England. Graciela Rojas and Rosemarie Fritsch are with Clinica Psiquiatrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile. Richard Frank is with the Department of Health Care Policy, Harvard University, Cambridge, Mass.), Glyn Lewis (0000-0001-5205-8245, Ricardo Araya and Glyn Lewis are with the Division of Psychiatry, University of Bristol, Bristol, England. Graciela Rojas and Rosemarie Fritsch are with Clinica Psiquiatrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile. Richard Frank is with the Department of Health Care Policy, Harvard University, Cambridge, Mass.)
Year2006
Volume96
Issue1
Pages109-113
Publication date2006-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2004.055715
PMID16317207
PMCIDPMC1470439
OpenAlexW2153788518
LanguageEN
Citations received8
References cited18

Objectives. We compared differences in mental health needs and provision of mental health services among residents of Santiago, Chile, with private and public health insurance coverage. Methods. We conducted a cross-sectional survey of a random sample of adults. Presence of mental disorders and use of health care services were assessed via structured interviews. Individuals were classified as having public, private, or no health insurance coverage. Results. Among individuals with mental disorders, only 20% (95% confidence interval [CI]=16%, 24%) had consulted a professional about these problems. A clear mismatch was found between need and provision of services. Participants with public insurance coverage exhibited the highest prevalence of mental disorders but the lowest rates of consultation; participants with private coverage exhibited exactly the opposite pattern. After adjustment for age, income, and severity of symptoms, private insurance coverage (odds ratio [OR]=2.72; 95% CI=1.6, 4.6) and higher disability level (OR=1.27, 95% CI=1.1, 1.5) were the only factors associated with increased frequency of mental health consultation. Conclusions. The health reforms that have encouraged the growth of the private health sector in Chile also have increased risk segmentation within the health system, accentuating inequalities in health care provision

Confidence interval · Economic growth · Environmental health · Family medicine · Health care · Logistic regression · Mental health · Mental health care · Odds · Odds ratio · Private sector · Psychiatry · Public health · Healthcare Systems and Reforms · Medicine · Mental Health Treatment and Access · Nursing · Primary Care and Health Outcomes · Gerontology

Tools

Open DOISci-HubOpen Access