Epidemiology, Evidence Synthesis and Technology Management, Instituto de Evaluación Tecnológica en Salud (IETS), Bogotá, Colombia.
Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, England.
Int J Equity Health. 2023 Feb 7;22(1):28. doi: 10.1186/s12939-022-01818-x.
Some reports suggest there are differences in health needs between the population affiliated to the subsidized health insurance scheme (SS) and those affiliated to the contributory health insurance scheme (CS) in Colombia. The objective of this study was to identify the epidemiological profile of the population affiliated to the SS in Colombia and to compare the main epidemiological features of the SS to the CS.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology, the search was carried out from 1993, with no other restriction. The information was synthesized into five categories according to the most important risk populations. We estimated combined incidences from epidemiological surveillance data, prevalence ratio, and other measures to estimate the difference between the studied groups. A 95% confidence interval was considered. A random effects model was used weighted by the inverse of the variance of the cumulative incidence calculated for each disease. The risk of bias was assessed using the Joanna Briggs Institute's critical appraisal tools.
A total of 16,236 articles were identified; 14,972 were excluded after title and abstract screening, 725 articles were verified as full text, and finally 268 articles were included. The relative risk of non-communicable and communicable diseases was lower in the SS than in the CS (RR: 0.37 and 0.72, respectively, p-value < 0.05). However, the risk of presenting obstetric and maternal conditions in the SS versus the CS was RR 1.55 for frequent conditions during early childhood, and for other diseases it was RR 1.28 with a p-value of < 0.05. The use of health services was different by scheme, with less demand, access, and provision being found in health services in the SS.
This study allowed us to conclude that there are differences in the incidence, prevalence, and use of health services between health affiliation schemes (SS and CS) in Colombia, thereby assisting in decision-making for stakeholders.
PROSPERO Registration number CRD42021279234.
一些报告表明，在哥伦比亚，参加补贴健康保险计划（SS）的人群与参加缴费健康保险计划（CS）的人群在健康需求方面存在差异。本研究的目的是确定参加 SS 的人群的流行病学特征，并比较 SS 与 CS 的主要流行病学特征。
根据系统评价和荟萃分析的首选报告项目（PRISMA）方法，从 1993 年开始进行搜索，没有其他限制。根据最重要的风险人群，将信息分为五类。我们从流行病学监测数据中估计了合并发病率、患病率比和其他指标，以估计研究组之间的差异。考虑了 95%置信区间。使用随机效应模型，对每个疾病计算的累积发病率的倒数进行加权。使用 Joanna Briggs 研究所的批判性评价工具评估偏倚风险。
共确定了 16236 篇文章；经过标题和摘要筛选后，排除了 14972 篇，验证了 725 篇全文，最终纳入了 268 篇文章。与 CS 相比，SS 中非传染性和传染性疾病的相对风险较低（RR：0.37 和 0.72，p 值均<0.05）。然而，与 CS 相比，SS 中产妇和围产期疾病的风险更高，RR 为 1.55（RR：0.37 和 0.72，p 值均<0.05）。不同计划的卫生服务利用情况也不同，SS 中的卫生服务需求、获得和提供较少。
本研究表明，在哥伦比亚，健康保险计划（SS 和 CS）之间在发病率、患病率和卫生服务利用方面存在差异，这有助于利益相关者做出决策。
PROSPERO 注册号 CRD42021279234。
