title: [Universal health coverage assessment based on national socioeconomic characterization surveys].
abstract: BACKGROUND
  The Chilean health reform aimed to expand universal health coverage (UHC) with equity.
  
  
  OBJECTIVE
  To analyze progress in health system affiliation, attended health needs (health visit for a recent problem) and direct payment for services, between 2000 and 2011.
  
  
  METHODS
  We evaluated these outcomes for adults aged 20 years or older, analyzing databases of five National Socioeconomic Characterization Surveys. Using logistic regression models for no affiliation and unattended needs, we estimated odds ratios (OR) and prevalences, adjusted for socio-demographic characteristics.
  
  
  RESULTS
  The unaffiliated population decreased from 11.0% (95% confidence interval (CI) 10.6-11.4) in 2000 to 3.0% (95% CI 2.8-3.2) in 2011. According to the model, self-employed workers had a higher adjusted prevalence of no affiliation: 27.4% (95% CI 24.1-30.6) in 2000 and 7.8% (95% CI: 5.9-9.7) in 2011. The level of unmet needs decreased from 33.5% (95% CI 31.8-35.1) to 9.1% (95% CI 8.1-10.1) in this period. Not being affiliated to the health system was associated with higher unmet needs in the adjusted model. Indigent affiliates, entitled to free care in the public system, reported payments for general and specialist visits in a much lower proportion than other groups. However, direct payments for visits increased for this group during the decade.
  
  
  CONCLUSIONS
  Concurrent with the introduction of new health and social policies, we observed significant progress in health system enrolment and attended health needs. However, the percentage of impoverished people who made direct payments for services increased.
authors: Patricia
authors: P
authors: Frenz
authors: Iris
authors: I
authors: Delgado Becerra
authors: Loreto
authors: L
authors: Villanueva Pabón
authors: Jay S
authors: JS
authors: Kaufman
authors: Fernando
authors: F
authors: Muñoz Porras
authors: María Soledad
authors: MS
authors: Navarrete Couble
mesh_terms: D000328:Adult; D002677:Chile; D005260:Female; D018166:Health Care Reform; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D019472:Universal Health Insurance / Q000706:statistics & numerical data*