Vigilancia del acceso a la salud en Chile: un sistema de indicadores para monitoreo multidimensional

Resumen

Background: A health system is successful when it maintains a healthy population and provides health services that are effective, equitable and safe. Aim: To design a system based on specific indicators to monitor equity in health care access in Chile. Material and methods: Primary information about five dimensions of access to health was collected, namely health policies, characteristics of the health system, characteristics of the population at risk, utilization of health services and consumer satisfaction. Subsequently, inequalities in access between different social groups were identified. Finally, after collecting and filtering access indicators used in other systems and existing literature, the most relevant ones were selected to monitor each identified barrier. Results: A system composed of 26 indicators, classified in the five dimensions of the framework was devised. It allows us to monitor those barriers with a greater impact on the population. For some specific indicators, population groups were disaggregated to carry out specific surveillances. Conclusions: The design of a multidimensional monitoring system for health access allows us to complement measures usually focused on a specific concept of access (such as utilization, coverage, etc.) with other dimensions. It includes those barriers that are relevant for the Chilean population. It also allows comparisons with other health systems and the generation of evidence to improve public policies.