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Addressing health inequalities in Latin America: the role of social protection.解决拉丁美洲的健康不平等问题:社会保护的作用。
Cien Saude Colet. 2020 May;25(5):1587-1598. doi: 10.1590/1413-81232020255.32802019. Epub 2020 May 8.
2
Inequalities in health by regime of affiliation to the health system in events of obligatory notification, Colombia, 2015.2015年哥伦比亚,在强制通报事件中,按与卫生系统的隶属关系划分的健康不平等情况。
Biomedica. 2019 Dec 1;39(4):737-747. doi: 10.7705/biomedica.4453.
3
Racism and Health: Evidence and Needed Research.种族主义与健康:证据与研究需求。
Annu Rev Public Health. 2019 Apr 1;40:105-125. doi: 10.1146/annurev-publhealth-040218-043750. Epub 2019 Feb 2.
4
Racial and Ethnic Disparities in Health Insurance Coverage: Dynamics of Gaining and Losing Coverage over the Life-Course.医疗保险覆盖范围中的种族和族裔差异:一生过程中获得和失去保险覆盖的动态变化
Popul Res Policy Rev. 2017 Apr;36(2):181-201. doi: 10.1007/s11113-016-9416-y. Epub 2016 Oct 15.
5
Ethnicity and Health in Colombia: What Do Self-Perceived Health Indicators Tell Us?哥伦比亚的种族与健康:自我感知健康指标告诉了我们什么?
Ethn Dis. 2016 Apr 21;26(2):147-56. doi: 10.18865/ed.26.2.147.
6
[Determinants 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].[哥伦比亚健康社会保障综合系统和巴西统一卫生系统中不同医疗保健层级使用情况的决定因素]
Gac Sanit. 2014 Nov-Dec;28(6):480-8. doi: 10.1016/j.gaceta.2014.05.010. Epub 2014 Jul 19.
7
[Access to health care in Colombia].[哥伦比亚的医疗保健服务获取情况]
Rev Salud Publica (Bogota). 2010 Oct;12(5):701-12. doi: 10.1590/s0124-00642010000500001.
8
Unhealthy and uninsured: exploring racial differences in health and health insurance coverage using a life table approach.不健康和没有保险:使用生命表方法探索健康和健康保险覆盖方面的种族差异。
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9
The Sociology of Discrimination: Racial Discrimination in Employment, Housing, Credit, and Consumer Markets.《歧视社会学:就业、住房、信贷和消费市场中的种族歧视》
Annu Rev Sociol. 2008 Jan 1;34:181-209. doi: 10.1146/annurev.soc.33.040406.131740.
10
Colombia's universal health insurance system.哥伦比亚的全民健康保险制度。
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[哥伦比亚医疗保险中的种族不平等:一项横断面研究 哥伦比亚医疗保险中的种族不平等:一项横断面研究]

[Ethnic-racial inequity in health insurance in Colombia: a cross-sectional studyIniquidades étnico-raciais no seguro de saúde na Colômbia: um estudo transversal].

作者信息

Viáfara-López Carlos Augusto, Palacios-Quejada Glenda, Banguera-Obregón Alexander

机构信息

Departamento de Economía, Universidad del Valle Cali Colombia Departamento de Economía, Universidad del Valle, Cali, Colombia.

Consultora independiente Bogotá Colombia Consultora independiente, Bogotá, Colombia.

出版信息

Rev Panam Salud Publica. 2021 Jan 22;45:e18. doi: 10.26633/RPSP.2021.18. eCollection 2021.

DOI:10.26633/RPSP.2021.18
PMID:33500690
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7820510/
Abstract

OBJECTIVE

Characterize the relationship between ethnic-racial inequity and type of health insurance in Colombia.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

描述哥伦比亚种族不平等与医疗保险类型之间的关系。

方法

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。

结果

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)。

结论

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。