wow-inequalities/02-data/intermediate/wos_sample/3c31af089b64977c365a5e4f326afc9d-esteves-roberto-j./info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Introduction: Brazil and Colombia have pursued extensive reforms of
their health care systems in the last couple of decades. The purported
goals of such reforms were to improve access, increase efficiency and
reduce health inequities. Notwithstanding their common goals, each
country sought a very different pathway to achieve them. While Brazil
attempted to reestablish a greater level of State control through a
public national health system, Colombia embraced market competition
under an employer-based social insurance scheme. This work thus aims to
shed some light onto why they pursued divergent strategies and what that
has meant in terms of health outcomes.
Methods: A critical review of the literature concerning equity
frameworks, as well as the health care reforms in Brazil and Colombia
was conducted. Then, the shortfall inequality values of crude mortality
rate, infant mortality rate, under-five mortality rate, and life
expectancy for the period 1960-2005 were calculated for both countries.
Subsequently, bivariate and multivariate linear regression analyses were
performed and controlled for possibly confounding factors.
Results: When controlling for the underlying historical time trend, both
countries appear to have experienced a deceleration of the pace of
improvements in the years following the reforms, for all the variables
analyzed. In the case of Colombia, some of the previous gains in
under-five mortality rate and crude mortality rate were, in fact,
reversed.
Conclusions: Neither reform seems to have had a decisive positive impact
on the health outcomes analyzed for the defined time period of this
research. This, in turn, may be a consequence of both internal
characteristics of the respective reforms and external factors beyond
the direct control of health reformers. Among the internal
characteristics: underfunding, unbridled decentralization and
inequitable access to care seem to have been the main constraints.
Conversely, international economic adversities, high levels of rural and
urban violence, along with entrenched income inequalities seem to have
accounted for the highest burden among external factors.'
affiliation: 'Esteves, RJF (Corresponding Author), Esplanada Minist, Secretariat Labor
\& Educ Management Hlth SGTES, Minist Hlth Brazil, Bloco G,Ed Sede,Sala 704, BR-70680350
Brasilia, DF, Brazil.
Esplanada Minist, Secretariat Labor \& Educ Management Hlth SGTES, Minist Hlth Brazil,
BR-70680350 Brasilia, DF, Brazil.'
article-number: '6'
author: Esteves, Roberto J. F.
author-email: resteves@mail.com
author_list:
- family: Esteves
given: Roberto J. F.
da: '2023-09-28'
doi: 10.1186/1475-9276-11-6
files: []
issn: 1475-9276
journal: INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH
keywords: 'Brazil; Colombia; health care reform; health care system; equity; health
inequities; comparative analysis; health policy'
keywords-plus: INEQUALITIES; POLICY
language: English
month: FEB 2
number-of-cited-references: '39'
papis_id: 241f5c4c0926abffc4a834ca30c32088
ref: Esteves2012questequity
times-cited: '18'
title: 'The quest for equity in Latin America: a comparative analysis of the health
care reforms in Brazil and Colombia'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000302479900001
usage-count-last-180-days: '0'
usage-count-since-2013: '15'
volume: '11'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2012'