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dc.contributor.author
Yavich, Natalia
dc.contributor.author
Báscolo, Ernesto Pablo
dc.contributor.author
Haggerty, Jeannie
dc.date.available
2018-07-18T21:51:41Z
dc.date.issued
2016-06
dc.identifier.citation
Yavich, Natalia; Báscolo, Ernesto Pablo; Haggerty, Jeannie; Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care; Oxford University Press; Family Practice; 33; 3; 6-2016; 249-260
dc.identifier.issn
0263-2136
dc.identifier.uri
http://hdl.handle.net/11336/52632
dc.description.abstract
Background: Most Latin American health systems are comprised of public (PubS), social security (SSS) and private (PrS) subsystems. These subsystems coexist, causing health care fragmentation and population segmentation. Objective: To estimate the extent of subsystem cross-coverage in a geographically bounded population (Rosario city) and to compare the subsystems' performance on primary health care (PHC) dimensions. Methods: Through a cross-sectional, interviewer-administered survey to a representative sample (n = 822) of the Rosario population, we measured the percentage of cross-coverage (people with usual source of care in one subsystem but also covered by another subsystem) and the health services' performance by core PHC dimensions, as reported by each subsystem's usual users. We compared the subsystems' performance using chi-square analysis and one-way analysis of variance testing. We analyzed whether the observed differences were coherent with the predominant institutional and organizational features of each subsystem. Results: Overall, 39.3% of the population was affiliated with the PubS, 44.8% with the SSS and 15.9% with the PrS. Cross-coverage was reported by 40.6% of respondents. The performance of the PubS was weak on accessibility but strong on person-and-community-oriented care, the opposite of the PrS. The SSS combined the strengths of the other two subsystems. Conclusion: Rosario's health system has a high percentage of cross-coverage, contributing to issues of fragmentation, segmentation, financial inequity and inefficiency. The overall performance of the SSS was better than that of the PrS and PubS, though each subsystem had a particular performance pattern with areas of strength and weakness that were consistent with their institutional and organizational profiles.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Oxford University Press
dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by/2.5/ar/
dc.subject
Access
dc.subject
And Evaluation
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Health Care Quality
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Health Services Research
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Integrated Health Care Systems
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Latin America
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Primary Health Care
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Public Health
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Otras Ciencias Sociales
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Otras Ciencias Sociales
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CIENCIAS SOCIALES
dc.title
Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2018-07-18T20:43:42Z
dc.identifier.eissn
1460-2229
dc.journal.volume
33
dc.journal.number
3
dc.journal.pagination
249-260
dc.journal.pais
Reino Unido
dc.journal.ciudad
Oxford
dc.description.fil
Fil: Yavich, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; Argentina
dc.description.fil
Fil: Báscolo, Ernesto Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario; Argentina. Universidad Nacional de Rosario. Centro de Estudios Interdisciplinarios; Argentina
dc.description.fil
Fil: Haggerty, Jeannie. McGill University; Canadá
dc.journal.title
Family Practice
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://academic.oup.com/fampra/article/33/3/249/1750001
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1093/fampra/cmw043