title: Gaps In Primary Care And Health System Performance In Six Latin American And Caribbean Countries.
abstract: The rapid demographic and epidemiological transitions occurring in Latin America and the Caribbean have led to high levels of noncommunicable diseases in the region. In addition to reduced risk factors for chronic conditions, a strong health system for managing chronic conditions is vital. This study assessed the extent to which populations in six Latin American and Caribbean countries receive high-quality primary care, and it examined the relationship between experiences with care and perceptions of health system performance. We applied a validated survey on access, use, and satisfaction with health care services to nationally representative samples of the populations of Brazil, Colombia, El Salvador, Jamaica, Mexico, and Panama. Respondents reported considerable gaps in the ways in which primary care is organized, financed, and delivered. Nearly half reported using the emergency department for a condition they considered treatable in a primary care setting. Reports of more primary care problems were associated with worse perceptions of health system performance and quality and less receipt of preventive care. Urgent attention to primary care performance is required as the region's population continues to age at an unprecedented rate.
authors: James Macinko (jmacinko@ucla.edu) is a professor in the Department of Health Policy and Management and the Department of Community Health Sciences, Fielding School of Public Health, at the University of California, Los Angeles.
authors: James
authors: J
authors: Macinko
authors: Frederico C. Guanais is a principal health specialist at the Inter-American Development Bank in Lima, Peru.
authors: Frederico C
authors: FC
authors: Guanais
authors: Pricila Mullachery is a PhD candidate in the Department of Nutrition, Food Studies, and Public Health at New York University, in New York City.
authors: Pricila
authors: P
authors: Mullachery
authors: Geronimo Jimenez is a research associate at the Lee Kong Chian School of Medicine, Nanyang Technological University, in Singapore.
authors: Geronimo
authors: G
authors: Jimenez
mesh_terms: D017691:Caribbean Region; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D038622:Internationality; D007843:Latin America; D008297:Male; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires
keywords: International/global health studies; Organization and Delivery of Care; Public Health