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[智利的卫生系统与医院利用情况,1952 - 2020年:趋势、改革及转折点 智利的卫生系统与医院服务利用情况,1952 - 2020年:趋势、改革及转折点]

[Health system and hospital utilization in Chile, 1952-2020: trends, reforms, and inflection pointsSistema de saúde e utilização de serviços hospitalares no Chile, 1952-2020: tendências, reformas e pontos de inflexão].

作者信息

Matus-López Mauricio

机构信息

Universidad Pablo de Olavide, Sevilla, España. Universidad Pablo de Olavide Sevilla España.

出版信息

Rev Panam Salud Publica. 2025 Aug 1;49:e84. doi: 10.26633/RPSP.2025.84. eCollection 2025.

Abstract

OBJECTIVE

To collect and analyze longitudinal data on hospital discharges in Chile between 1952 and 2020, both at the national level and within the public subsystem. Patterns of change were identified in relation to the following key institutional milestones: the Curative Medicine Act of 1968, the creation of the National Health Services System in 1979, and the implementation of the Universal and Guaranteed Access Reform in 2005.

METHODS

A first-of-its-kind time series was constructed using official sources from the Ministry of Health and institutional documents. Indicators were calculated for the total number of discharges, discharge rates per thousand population, and comparisons with the United States. The analysis included exploratory graphics and construction of segmented regression models.

RESULTS

Hospital discharges rose steadily, with two periods mirroring robust expansion of the private sector: between 1982 and 1987 and between 2006 and 2019. Public provision of hospital services slowed or decreased with the 1979 reform and with the 2005 reform, although not with the 1968 reform.

CONCLUSION

This study provides empirical evidence on the long-term trajectory of Chilean hospital services and confirms a structural contrast between the country's major health system models and the differences in their reforms. It also underscores the need for long-term information to analyze the impact of health reforms.

摘要

目的

收集并分析1952年至2020年智利全国及公共子系统内医院出院情况的纵向数据。确定与以下关键制度里程碑相关的变化模式:1968年的《治疗医学法》、1979年国家卫生服务系统的创建以及2005年普遍和有保障的医疗服务改革的实施。

方法

利用卫生部的官方资料和机构文件构建了首个此类时间序列。计算了出院总数、每千人口出院率指标,并与美国进行了比较。分析包括探索性图表和分段回归模型的构建。

结果

医院出院人数稳步上升,有两个时期反映了私营部门的强劲扩张:1982年至1987年以及2006年至2019年。1979年改革和2005年改革后,公共医院服务的提供放缓或减少,不过1968年改革后并非如此。

结论

本研究提供了智利医院服务长期轨迹的实证证据,并证实了该国主要卫生系统模式之间的结构差异及其改革的不同之处。它还强调了需要长期信息来分析卫生改革的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dedb/12315926/41686a1c55d8/rpsp-49-e84-Figure1.jpg

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