Inequalities in access to health care for people with disabilities in Chile: the limits of universal health coverage

Figures & data

Table 1. Comparison of socioeconomic, demographic, and health characteristics of Chilean adults with and without disability.

Parameter	People with disability (N = 7,459)		People without disability (N = 68,695)
	n	%	n	%
Gender
Male (n = 25,477)	2,537	34.00	22,940	33.39
Female (n = 50,677)	4,922	66.00	45,755	66.61
	Pearson χ^2(1) = 1.157, p < .282
Age (mean)	63.00	SD = 15.97	46.99	SD = 16.81
18–30 (n = 13,937)	297	3.98	13,640	19.86
31–45 (n = 20,131)	742	9.95	19,389	28.22
46–65 (n = 27,711)	2,875	38.54	24,836	36.15
66+ (n = 14,375)	3,545	47.53	10,830	15.77
	Pearson χ^2(3) = 5.400, p < .000
Geographical location
Urban (n = 60,465)	5,841	78.31	54,624	79.52
Rural (n = 15,689)	1,618	21.69	14,071	20.48
	Pearson χ^2(1) = 6.009, p < .014
Civil status
Married (n = 32,231)	3,022	40.51	29,209	42.52
Living with or in a relationship (n = 12,531)	670	8.98	11,861	17.27
Separated, annulled or divorced (n = 7,273)	782	10.48	6,491	9.45
Widowed (n = 6,260)	1,564	20.97	4,696	6.84
Single (n = 17,859)	1,421	19.05	16,438	23.93
	Pearson χ^2(4) = 2.000, p < .000
Income
1st quintile (n = 15,233)	2,434	32.63	12,799	18.63
2nd quintile (n = 15,229)	1,716	23.01	13,513	19.67
3rd quintile (n = 15,231)	1,399	18.76	13,832	20.14
4th quintile (n = 15,231)	1,140	15.28	14,091	20.51
5th quintile (n = 15,230)	770	10.32	14,460	21.05
	Pearson χ^2(4) = 1.200, p < .000
Health self-assessment
Bad (n = 6,004)	1,967	26.37	4,037	5.88
Neither good nor bad (n = 31,415)	4,031	54.04	27,384	39.86
Good (n = 38,735)	1,461	19.59	37,274	54.26
	Pearson χ^2(2) = 5.500, p < .000
Health provider
FONASA (n = 64,968)	6,909	92.63	58,059	84.52
Armed forces (n = 1,704)	170	2.28	1,534	2.23
ISAPREs (n = 7,427)	251	3.37	7,176	10.45
Out-of-pocket (n = 2,055)	129	1.73	1,926	2.80
	Pearson χ^2(3) = 426.638, p < .000

Table 2. Comparison of barriers to accessing health services for Chilean adults with and without disability (unadjusted and adjusted ORs).

Parameters	n	%	Unadjusted OR 95% CI	Adjusted OR^* 95% CI
Difficulty in arriving at health facility (Yes: n = 4,390)
People without disability	3,027	4.41	1.0	1.0
People with disability	1,363	18.27	4.718 (4.392–5.068)	2.952 (2.724–3.199)
Difficulty in obtaining a doctor’s appointment (Yes: n = 13,359)
People without disability	10,946	15.93	1.0	1.0
People with disability	2,413	32.35	2.449 (2.319–2.586)	1.825 (1.718–1.939)
Difficulty in being attended (Yes: n = 9,599)
People without disability	7,831	11.40	1.0	1.0
People with disability	1,768	23.70	2.354 (2.216–2.500)	1.720 (1.609–1.839)
Difficulty in paying for treatment due to cost (Yes: n = 4,047)
People without disability	3,197	4.65	1.0	1.0
People with disability	850	11.40	2.601 (2.395–2.825)	1.911 (1.743–2.094)
Difficulty in obtaining medicine (Yes: n = 5,157)
People without disability	4,083	5.94	1.0	1.0
People with disability	1,074	14.40	2.636 (2.448–2.840)	1.844 (1.696–2.004)

Note: There were no open-ended questions in the survey, allowing people to expand on the kind of difficulties they face while accessing health services.

^* Adjusted for age, sex and other variables presented in Table 1.

^** All p values are p < .000 (for χ² tests of association, unadjusted and adjusted OR).

Table 3. Barriers to health care on the basis of health provider affiliation (unadjusted and adjusted ORs).

		Armed forces		ISAPRE		Out-of-pocket
		Unadjusted OR	Adjusted OR^a	Unadjusted OR	Adjusted OR^a	Unadjusted OR	Adjusted OR^a
(1)	Without disability	.476^***	.760	.247^***	.477^***	.698^**	.813
	With disability	.515^*	.576^*	.304^***	.458^**	.667	.698
(2)	Without disability	.408^***	.517^***	.217^***	.313^***	.478^***	.557^***
	With disability	.535^**	.631^*	.305^***	.349^***	.604^*	.615^*
(3)	Without disability	.425^***	.527^***	.185^***	.262^***	.613^***	.710^***
	With disability	.576^*	.641^*	.252^***	.277^***	.842	.878
(4)	Without disability	.602^**	.740	.511^***	.736^***	1.166	1.347^**
	With disability	.910	.993	1.229	1.391	2.500^***	2.570^***
(5)	Without disability	.438^***	.525^***	.324^***	.454^***	.696^**	.814
	With disability	.888	.901	.902	.944	1.090	1.128

Reference: FONASA.

Notes: (1): faced difficulty in arriving at health facility/ (2): faced difficulty in obtaining a doctor’s appointment/ (3): faced difficulty in being attended/ (4): faced difficulty in paying for treatment due to cost/ (5): faced difficulty in obtaining medicine.

^a Adjusted for age, sex and other variables presented in Table 1.

^* p < .05

^** p < .01

^*** p < .001.

FONASA. (2015). Boletín estadístico 2013–2014 [Statistical bulletin 2013–2014]. Retrieved from https://www.fonasa.cl/sites/fonasa/institucional/archivos

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