Department of Management Control and Information System, University of Chile, Santiago, Chile.
Department of Chemistry, University of Chile, Santiago, Chile.
Health Expect. 2022 Feb;25(1):254-263. doi: 10.1111/hex.13371. Epub 2021 Oct 8.
Previous research has used proxy variables or a unique construct to quantify healthcare access. However, there is a need for a different model that can handle this multivariable problem. This study seeks to develop a way to measure access to the local healthcare system with higher local resolution.
A new survey was developed based on communitarian claims, following a behavioural model and an ontological framework. The survey was used to identify local barriers to healthcare services and the local preferences for priority settings. The results were analysed using multiattribute utility functions and individual weights were assigned by a panel of experts. National and regional indexes of access to healthcare were developed.
The survey contained seven modules and 104 questions. It was conducted on 1885 participants at 42 rural and 231 urban locations in three regions of Chile. The total disutility of the identified barriers to healthcare access at the national level was low (0.1448; values ranged between 0 and 1, with 1 representing a higher barrier) and was higher in the northern region (0.1467). The barriers associated with the health-policy component showed the highest disutility value, and specific barriers for each community were identified.
These results have the potential to improve health decision-making in Chile and can be used to assess the impacts of new health policy reforms. Although this model was tested in Chile, it can be adapted for use in any other country.
Participants contributed to this study by completing a survey, participating in general talks and receiving brochures with the results obtained from this study.
先前的研究使用代理变量或独特的构念来量化医疗保健的可及性。然而，需要一种不同的模型来处理这个多变量问题。本研究旨在开发一种能够以更高的本地分辨率衡量对本地医疗保健系统的可及性的方法。
基于社区主张，本研究遵循行为模型和本体框架，开发了一项新的调查。该调查用于确定医疗服务的本地障碍和本地优先事项设置的偏好。使用多属性效用函数分析结果，并由专家组为每个个体分配权重。制定了国家和区域医疗保健可及性指数。
调查包含七个模块和 104 个问题。在智利三个地区的 42 个农村和 231 个城市地点，对 1885 名参与者进行了调查。国家一级医疗保健可及性确定障碍的总不便利度较低（0.1448；值在 0 到 1 之间，1 代表更高的障碍），北部地区较高（0.1467）。与卫生政策部分相关的障碍显示出最高的不便利度值，并且为每个社区确定了具体的障碍。
这些结果有可能改善智利的卫生决策，并可用于评估新卫生政策改革的影响。虽然该模型在智利进行了测试，但它可以适用于任何其他国家。
参与者通过完成调查、参加一般性讨论和接收本研究结果的小册子，为本研究做出了贡献。
