Viáfara-López Carlos Augusto, Palacios-Quejada Glenda, Banguera-Obregón Alexander
Departamento de Economía, Universidad del Valle Cali Colombia Departamento de Economía, Universidad del Valle, Cali, Colombia.
Consultora independiente Bogotá Colombia Consultora independiente, Bogotá, Colombia.
Rev Panam Salud Publica. 2021 Jan 22;45:e18. doi: 10.26633/RPSP.2021.18. eCollection 2021.
Characterize the relationship between ethnic-racial inequity and type of health insurance in Colombia.
Cross-sectional study based on data from the 2019 Quality of Life Survey. We analyzed the type of health insurance (contributory, subsidized, or none) and its relationship to ethnic-racial status and predisposing variables (sex, age, marital status), demographic variables (area and region of residence), and socioeconomic variables (education, type of employment, income, and unmet basic needs) through simple and multivariate regression analyses. Association between ethnic-racial status and type of health insurance was estimated using odds ratios (OR) and their 95% confidence intervals, through a multinomial logistic model.
A statistically significant association was found between ethnic-racial status and type of health insurance. In comparison with the contributory system, the probabilities of being a member of the subsidized system were 1.8 and 1.4 times greater in the indigenous population (OR = 1.891; 95%CI: 1.600-2.236) and people of African descent (OR = 1.415; 95%CI: 1.236-1.620), respectively ( <0.01) than in the population group that did not identify as belonging to one of those ethnic-racial groups.
There is an association between ethnic-racial status and type of insurance in the contributory and subsidized health systems in Colombia. Ethnic-racial status is a structural component of inequity in access to health services and heightens the disadvantages of people and population groups with low socioeconomic status.
描述哥伦比亚种族不平等与医疗保险类型之间的关系。
基于2019年生活质量调查数据进行横断面研究。我们通过简单和多变量回归分析,分析了医疗保险类型(缴费型、补贴型或无保险)及其与种族地位和诱发变量(性别、年龄、婚姻状况)、人口统计学变量(居住地区和区域)以及社会经济变量(教育程度、就业类型、收入和未满足的基本需求)之间的关系。通过多项逻辑模型,使用比值比(OR)及其95%置信区间来估计种族地位与医疗保险类型之间的关联。
种族地位与医疗保险类型之间存在统计学上的显著关联。与缴费型保险体系相比,土著人口(OR = 1.891;95%CI:1.600 - 2.236)和非裔人口(OR = 1.415;95%CI:1.236 - 1.620)加入补贴型保险体系的概率分别比未认定属于这些种族群体之一的人群高出1.8倍和1.4倍(<0.01)。
在哥伦比亚的缴费型和补贴型医疗体系中,种族地位与保险类型之间存在关联。种族地位是卫生服务获取不平等的一个结构性因素,加剧了社会经济地位低下的个人和群体的劣势。