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La ley de cuidado inverso revisada: una perspectiva global
Richard Cookson1, Tim Doran2, Miqdad Asaria3
1Centre for Health Economics, University of York, York, England.
Lancet (London, England)
|February 28, 2021
Resumen
Las poblaciones socialmente desfavorecidas se enfrentan a una desigualdad en el acceso y la calidad de la atención sanitaria a nivel mundial. Abordar estas disparidades requiere una cobertura de salud universal integrada y una atención primaria centrada en la necesidad de reducir las desigualdades en salud.
Área de la Ciencia:
- Política de salud
- Economía de la salud
- Epidemiología social
Sus antecedentes:
- La persistente ley de atención inversa en los países de ingresos bajos y medios (LMIC) perjudica a los grupos socialmente desfavorecidos con mayores necesidades de salud.
- La ley de atención desproporcionada en los países de altos ingresos (HIC) proporciona más atención, pero de menor calidad e insuficiente, a las poblaciones desfavorecidas.
- Ambas leyes se derivan de las barreras financieras, el seguro fragmentado y las desigualdades sociales en la búsqueda de atención médica y la inversión.
Objetivo del estudio:
- Analizar las leyes de atención inversa y desproporcionada que afectan el acceso y la calidad de la atención médica para las poblaciones socialmente desfavorecidas.
- Identificar las causas subyacentes de estas leyes de atención, incluidos los factores financieros, sistémicos y sociales.
- Proponer medidas políticas para reducir las desigualdades en materia de salud.
Principales métodos:
- Revisión y síntesis de la literatura existente sobre el acceso a la atención sanitaria y la equidad en los PIM e ICH.
- Análisis de los factores causales que contribuyen a las leyes de atención inversa y desproporcionada.
- Examen de las posibles compensaciones en los objetivos de la política sanitaria.
Principales resultados:
- Las personas socialmente desfavorecidas reciben constantemente una atención sanitaria subóptima, ya sea insuficiente o de mala calidad, en relación con sus necesidades.
- Las barreras financieras, el seguro de salud fragmentado y las desigualdades sociales en la búsqueda de atención y la coinversión son factores clave.
- Las leyes de atención existentes exacerban las desigualdades en materia de salud, al no satisfacer las necesidades de las poblaciones vulnerables.
Conclusiones:
- La cobertura sanitaria universal integrada y el refuerzo de la atención primaria, asignada según las necesidades, pueden mejorar la salud de la población y reducir las disparidades.
- Las políticas y tecnologías sanitarias deben someterse a un análisis distributivo para garantizar la equidad y reducir las desigualdades en materia de salud.
- Abordar las causas profundas de la desigualdad en la distribución de la atención es crucial para lograr la equidad en la salud.
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