Ypanaqué-Luyo Pedro, Martins Mônica
Dirección de Servicios de Salud, Ministerio de Salud, Lima, Perú
Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Rev Peru Med Exp Salud Publica. 2015 Jul-Sep;32(3):464-70.
Describe the profile of need and patterns of use of outpatient health services in populations who are enrolled and non-enrolled in a health insurance program in Peru.
Descriptive cross-sectional study using data from the 2011 National Household Survey. The data were divided into five groups: persons enrolled in the Social Health Insurance (ESSALUD), Integral Health Insurance (SIS), Health Insurance of the Armed Forces and Police Force (AF-PF), Private Health Insurances (SPS) and the uninsured.
People insured and enrolled in ESSALUD were more likely to use outpatient services than uninsured people and those enrolled in SIS. SIS members mainly attended health centers and small health posts (47.1%), while other insurance members mainly used hospitals and private hospitals. The uninsured used as their first choice pharmacies and drugstores (46.7%) in order to solve their health problems. In all insurances, out-of-pocket payment was made for the consultation, medications and tests. The perception of "not serious" was the main reason for not seeking care in the insured (40.0%) and uninsured (41.4%); however the lack of money showed an important difference between insured (10.6%) and uninsured (16.3%).
The outpatient health services utilization profile of the Peruvian population expresses differences that relate to enrollment in and type of insurance.
描述秘鲁参加和未参加医疗保险计划人群的门诊医疗服务需求概况及使用模式。
采用2011年全国住户调查数据进行描述性横断面研究。数据分为五组：参加社会医疗保险（ESSALUD）、综合医疗保险（SIS）、武装部队和警察部队医疗保险（AF-PF）、私人医疗保险（SPS）的人员以及未参保人员。
参加ESSALUD保险的人群比未参保人员和参加SIS保险的人群更有可能使用门诊服务。SIS成员主要前往健康中心和小型卫生站（47.1%），而其他保险成员主要使用医院和私立医院。未参保人员为解决健康问题首选药房和药店（46.7%）。在所有保险类型中，咨询、药物和检查均需自掏腰包付费。“病情不严重”的认知是参保人员（40.0%）和未参保人员（41.4%）不寻求医疗服务的主要原因；然而，资金短缺在参保人员（10.6%）和未参保人员（16.3%）之间存在显著差异。
秘鲁人群的门诊医疗服务利用概况显示出与参保情况和保险类型相关的差异。
