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dc.creatorGarcia-Subirats, Irene 
dc.creatorVargas Lorenzo, Ingrid 
dc.creatorMogollón-Pérez, Amparo Susana 
dc.creatorDe Paepe, Pierre 
dc.creatorFerreira da Silva, Maria Rejane 
dc.creatorPierre Unger, Jean 
dc.creatorVázquez Navarrete, María Luisa 
dc.date.accessioned2018-11-21T17:14:53Z
dc.date.available2018-11-21T17:14:53Z
dc.date.created2014
dc.date.issued2014 
dc.identifier.issnISSN 0213-9111
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/18722
dc.descriptionObjetivo: Analizar comparativamente la utilización de servicios de los distintos niveles asistenciales y sus determinantes, de dos sistemas de salud diferentes, Sistema General de Seguridad Social en Salud (SGSSS) y Sistema Único de Salud (SUS), en municipios de Colombia y Brasil. Métodos: Estudio transversal basado en encuesta poblacional en dos municipios de Colombia (n = 2163) y dos de Brasil (n = 2155). Variables resultado: utilización de los servicios de atención primaria, especializada y urgencias en los últimos 3 meses. Variables explicativas: necesidad, factores capacitantes y predisponentes. Análisis bivariado y regresiones logísticas multivariadas por nivel asistencial y país. Resultados: Los determinantes de la utilización varían según el nivel asistencial y el país. Padecer una enfermedad crónica se asocia a un mayor uso de atención primaria y especializada en Colombia, y además a las urgencias en Brasil. En Colombia, los afiliados al régimen contributivo utilizan más los servicios del SGSSS que los del subsidiado en atención primaria y especializada, o que los no asegurados en cualquier nivel; en Brasil, la población de baja renta y sin seguro privado hace un mayor uso del SUS en cualquier nivel de atención. En ambos países, conocer el centro de salud asignado y tener una fuente regular de atención incrementa el uso de la atención primaria y el conocimiento del hospital de referencia, el de especializada y urgencias. Conclusiones: La influencia de los determinantes del uso difiere según el nivel de atención utilizado en ambos países, por lo que se subraya la necesidad de analizarlo desagregando por nivel asistencial.
dc.description.abstractObjective: To compare the use of different healthcare levels, and its determinants, in two different health systems, the General System of Social Security in Health (GSSSH) and the Unified Health System (UHS) in municipalities in Colombia and Brazil. Methods: A cross-sectional study was carried out, based on a population survey in two municipalities in Colombia (n. =. 2163) and two in Brazil (n. =. 2155). Outcome variables consisted of the use of primary care services, outpatient secondary care services, and emergency care in the previous 3 months. Explanatory variables were need and predisposing and enabling factors. Bivariate and multivariate logistic regression analyses were performed by healthcare level and country. Results: The determinants of use differed by healthcare level and country: having a chronic disease was associated with a greater use of primary and outpatient secondary care in Colombia, and was also associated with the use of emergency care in Brazil. In Colombia, persons enrolled in the contributory scheme more frequently used the services of the GSSSH than persons enrolled with subsidized contributions in primary and outpatient secondary care and more than persons without insurance in any healthcare level. In Brazil, the low-income population and those without private insurance more frequently used the UHS at any level. In both countries, the use of primary care was increased when persons knew the healthcare center to which they were assigned and if they had a regular source of care. Knowledge of the referral hospital increased the use of outpatient secondary care and emergency care. Conclusions: In both countries, the influence of the determinants of use differed according to the level of care used, emphasizing the need to analyze healthcare use by disaggregating it by level of care. © 2014.
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.relation.ispartofGaceta Sanitaria, ISSN: 0213-9111, Vol. 28/No. 6 (2014) pp. 480-488
dc.relation.urihttps://ac.els-cdn.com/S0213911114001629/1-s2.0-S0213911114001629-main.pdf?_tid=9af4d6bb-af1c-4427-95cd-4ca8f78672e8&acdnat=1540057644_4e6f78e33b83e0ff88bee5bf98816518
dc.rights.uri
dc.subjectBrazil
dc.subjectColombia
dc.subjectEmergency Care
dc.subjectHealth Services/Utilization
dc.subjectPrimary Health Care
dc.subjectSecondary Care
dc.subjectSocioeconomic Factors
dc.subject.lembAtención primaria de la salud
dc.subject.lembServicios de salud
dc.subject.lembUrgencias médicas
dc.titleDeterminantes del uso de distintos niveles asistenciales en el Sistema General de Seguridad Social en Salud y Sistema Único de Salud en Colombia y Brasil
dc.typearticle
dc.title.alternativeDeterminants of the use of different healthcare levels in the General System of Social Security in Health in Colombia and the Unified Health System in Brazil
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.subject.decsAdolescent
dc.subject.decsAdult
dc.subject.decsAged
dc.subject.decsAmbulatory Care
dc.subject.decsBrazil
dc.subject.decsChild
dc.subject.decsChronic Disease
dc.subject.decsColombia
dc.subject.decsComparative Study
dc.subject.decsCross-Sectional Study
dc.subject.decsEmergency Health Service
dc.subject.decsEpidemiology
dc.subject.decsHealth Care Delivery
dc.subject.decsHealth Service
dc.subject.decsHuman
dc.subject.decsInfant
dc.subject.decsInsurance
dc.subject.decsMiddle Aged
dc.subject.decsOrganization And Management
dc.subject.decsPatient Attitude
dc.subject.decsPoverty
dc.subject.decsPreschool Child
dc.subject.decsPrimary Health Care
dc.subject.decsPublic Health
dc.subject.decsResidential Care
dc.subject.decsSocial Security
dc.subject.decsSocioeconomics
dc.subject.decsStatistics And Numerical Data
dc.subject.decsUtilization
dc.subject.decsYoung Adult
dc.subject.decsAdolescent
dc.subject.decsAdult
dc.subject.decsAged
dc.subject.decsAmbulatory Care
dc.subject.decsBrazil
dc.subject.decsCatchment Area (Health)
dc.subject.decsChild
dc.subject.decsChild, Preschool
dc.subject.decsChronic Disease
dc.subject.decsColombia
dc.subject.decsCross-Sectional Studies
dc.subject.decsEmergency Medical Services
dc.subject.decsHealth Services
dc.subject.decsHealth Services Accessibility
dc.subject.decsHumans
dc.subject.decsInfant
dc.subject.decsInsurance Coverage
dc.subject.decsMiddle Aged
dc.subject.decsNational Health Programs
dc.subject.decsPatient Acceptance Of Health Care
dc.subject.decsPoverty
dc.subject.decsPrimary Health Care
dc.subject.decsSampling Studies
dc.subject.decsSocial Security
dc.subject.decsSocioeconomic Factors
dc.subject.decsYoung Adult
dc.type.spaArtículo
dc.rights.accesoAbierto (Texto Completo)
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.source.bibliographicCitation(1993), de 23 de diciembre, por la cual se crea el Sistema de Seguridad Social Integral y se dictan otras disposiciones
dc.rights.cchttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.creator.googleGarcia-Subirats, Irene
dc.creator.googleVargas Lorenzo, Ingrid
dc.creator.googleMogollón-Pérez, Amparo Susana
dc.creator.googleDe Paepe, Pierre
dc.creator.googleFerreira da Silva, Maria Rejane
dc.creator.googlePierre Unger, Jean
dc.creator.googleVázquez Navarrete, María Luisa


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