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Equidad en la cobertura sanitaria universal: ¿Se benefician igualmente las personas con discapacidad?
Szu-Han Chen1, Meng Jie Hsu2, Christy Pu1,2
1Department of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taiwan.
Resumen
Las personas con discapacidad en Taiwán experimentan una mayor utilización de la atención médica y beneficios netos bajo el Seguro Nacional de Salud (NHI). Sin embargo, los copagos más altos pueden compensar estas ganancias, con una protección financiera que varía según los ingresos.
Área de la Ciencia:
- Economía de la salud
- Política de salud pública
- Estudios sobre la discapacidad
Sus antecedentes:
- La cobertura sanitaria universal (CSU) se está expandiendo a nivel mundial.
- El Seguro Nacional de Salud (NHI) de Taiwán tiene como objetivo proporcionar una cobertura completa.
- La protección financiera de las personas con discapacidad en el marco de la cobertura sanitaria universal sigue siendo poco estudiada.
Objetivo del estudio:
- Analizar el beneficio financiero neto de la NHI de Taiwán para las personas con discapacidad.
- Comparar el beneficio neto de la NHI para las poblaciones con y sin discapacidad.
- Identificar los factores que influyen en el beneficio neto de las personas con discapacidad.
Principales métodos:
- Utilizado el registro nacional de discapacidad de Taiwán y los datos de reclamaciones de NHI (2014-2021).
- Se emparejó a 933.304 personas con discapacidad con controles sin discapacidad (proporción de 1:1).
- Beneficio neto definido como valor de la atención médica menos gastos individuales (primas y copagos); se empleó un modelo de dos partes.
Principales resultados:
- Las personas con discapacidad mostraron una utilización y un gasto significativamente mayores en todos los tipos de servicios (P < 0,001).
- Las prestaciones netas aumentaron con la gravedad de la discapacidad, desde 62.189 NTD (leve) hasta 461.346 NTD (muy grave), en comparación con 19.969 NTD para las personas sin discapacidad.
- A pesar de las mayores prestaciones, las personas con discapacidad se enfrentaron a mayores copagos, y los ingresos influyeron en los resultados netos de las prestaciones.
Conclusiones:
- El NHI de Taiwán ofrece cierta protección financiera a las personas con discapacidad.
- Los altos copagos pueden ser un obstáculo para las personas con discapacidad.
- El impacto redistributivo de las NHI varía según los grupos socioeconómicos, lo que pone de relieve las posibles desigualdades.
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