[Challenges of Updating the Family Health Plan in Chile (2024)]

The Family Health Plan (FHP) outlines healthcare interventions to be implemented at the primary healthcare level (PHC) and serves as a basis plan for calculating transfers to this level of care. Its updates align with the current technical and programmatic guidelines from the Ministry of Health (MINSAL), although they are not necessarily explicitly linked to the regulatory coverage instruments established by MINSAL, showing significant differences between these and its own definitions. As such, the FHP presents particular challenges for its coordinated updating alongside other coverage systems.

To develop a structural and normative classification of the healthcare interventions included in the FHP.

From a disaggregated list of interventions included in the latest FHP decree, we classified those corresponding to each coverage system. We also identified those interventions to be carried out in PHC that are not included in the FHP. Finally, we classified the services according to whether they constituted a public health good, a service within the general guarantee system, a service within a system of explicit guarantees (GES), or a minimum PHC service.

A total of 220 interventions to be carried out in PHC were identified, of which only 176 were recorded in the FHP. The majority of interventions in the FHP (80) did not have an explicit relationship with any coverage system. Of the 44 interventions that should be provided in PHC but are not included in the FHP, eleven corresponded to GES interventions.

The interventions included in the FHP originate from diverse regulatory frameworks, which facilitates discrepancies between some of these coverage regimes and the FHP.