[Health inequalities in Panama].
OBJECTIVE
To document socioeconomic inequalities in health and health services in Panama and thus create a baseline for the prospective monitoring of the impact of health policies on equity.


METHODS
Analysis of data from the 1997 Living Standards Measurement Survey, the 1990 National Population Census and birth registration data for 1996. The relative index of inequality and concentration coefficient were calculated for a wide range of indicators of out-of-pocket health expenditure, access, utilization and quality of health services and of health outcomes.


RESULTS
Large and statistically significant socioeconomic differences in many of the variables examined were detected, almost all of which favored the rich. The inequalities identified included qualitative factors such as the type of care received as well as quantitative factors such as travelling times and utilization rates. Some of the inequalities were concentrated among a small, very poor segment of the population whilst others were the result of gradually increasing advantage with increased levels of outcome.


CONCLUSIONS
The results obtained provide a valuable starting point for the Panamanian government from which it can identify the most serious inequalities in health and health service provision and develop policies to eliminate or reduce them. They also offer a baseline to monitor changes in the magnitude of these inequalities over time.
Sandiford
P
P
Institute for Health Sector Development, London, United Kingdom. peter@sandiford.net
Salvetto
M
M
D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D010176:Panama; D012935:Social Justice; D012959:Socioeconomic Factors