Universidad de Chile, Santiago, Chile.
Universidad Andres Bello, Santiago, Chile.
Inquiry. 2021 Jan-Dec;58:469580211020187. doi: 10.1177/00469580211020187.
This article presents an exploratory model to classify public attitudes towards health systems financing and organization. It comprises 5 factors (pay-as-you-use, solidarity, willingness to contribute, mixed financing, and public provision) measured by 17 indicators, selected through Exploratory Structural Equation Modeling (ESEM) applied to a sample of Chilean adults. Based on this model, cluster analysis proposed 2 groups: "Taxes-public" and "Insurance-choice," representing 47% and 53% of interviewees, respectively. The results show differences between groups concerning the evaluation of both health care providers and insurers. The second cluster tends to evaluate them more harshly, showing less willingness to contribute further, less solidarity, more agreement with the current financing arrangement in terms of the mixture and its insurance (as opposed to purchasing of service based on health problems), and more support for choice of provider. These results highlight the need to consider people's attitudes in the public discussion of health systems financing.
本文提出了一个探索性模型，用于对公众对卫生系统筹资和组织的态度进行分类。它由通过应用于智利成年人样本的探索性结构方程建模（ESEM）选择的 5 个因素（按使用付费、团结、缴费意愿、混合筹资和公共供应）组成，由 17 个指标衡量。基于该模型，聚类分析提出了 2 个群体：“税收-公共”和“保险选择”，分别代表受访者的 47%和 53%。结果表明，两组在对医疗服务提供者和保险公司的评价上存在差异。第二组往往更严厉地评价他们，表现出进一步缴费的意愿较低、团结程度较低、对当前筹资安排中混合因素及其保险（而非基于健康问题购买服务）的认同度较高，以及对提供者选择的支持度较高。这些结果强调了在公共讨论卫生系统筹资时需要考虑人们的态度。
