The medical journal The Lancet ranked Chile, for the second consecutive year, as one of the 50 countries with the best results in access and quality. Despite being a leader in the region, There are still challenges what overcome to have a much more robust public health system.
32 considered preventable and avoidable diseases mortality rates, studied in 195 countries, they returned to give Chile the best evaluation of the region in access to health. This was revealed by an extensive study published in the British medical journal The Lancet last may, that for the second consecutive year it puts the country where 49 in assessing the quality of the system, being overcome in the Americas only by Canada, in the post 14; United States, in the 29; and Puerto Rico, 38.
Stop that, more than 100 researchers, with funding from the Bill & Melinda Gates Foundation, they applied the rate of quality and access to health (HAQ for its acronym in English) for each of these pathologies, from diseases such as diphtheria - were believed eradicated but which has re-emerged on the continent- to tumors of slow progress as type skin cancer nonmelanoma.
Regarding the methodology used, Annabella Arredondo, the Faculty of Medicine of the University academic. Andrés Bello and a public health specialist, He explains that the researchers established a scale ranging from 0 to 100, or poor to adequate care. To better isolate the potential effects of access and quality of the underlying patterns of risk behaviours, says Arredondo, They standardized the disease risk of deaths and cause-specific. And when it came to cancers, relying on expanded the Global Burden of Disease data (GBD 2016), they used reasons for incidence mortality, rather than to provide risk-standardized mortality rates one more sign of the effects of access and survival.
Iceland is in the first place, and other European countries completed the top 5. This time, Chile registered an overall score of 78 on the scale and added two points compared to the previous year. The answer is in the positive evolution of the access and treatment of some diseases, while others lowered your credit score (see table).
The Deputy Director of the Center for advanced studies of chronic diseases (ACCDIS), Catterina Ferreccio, explains that, in general, the study shows that the local system is high coverage. Or that people can get to the hospital. In addition, the specialist highlights the progress that has taken the country in the ranking, compared with the figures of 1990, When was HAQ 58,8. This is due to the development of the population and to the hospital infrastructure, to which people have access to vehicles and better roads, added to the interest of Governments to reduce the gap in health technology, designates.
The leap that had testicular cancer, 19 to 71, It is perhaps the item to look with more attention and expectation to the future, considered Ferreccio, due to its incidence. "It can be better than that they estimated and this increases mortality", even if you have good access to health care", holds.
From the inclusion of some cancers in the explicit health guarantees regime (GES), low-income patients have managed to have more timely access to treatment, recalls specialist. In spite of that, waiting lists are still a headache. But in the case of testicular cancer, at least until last year, it was much less than other tumors, It details a report the Secretariat for welfare networks then to Congress. In the public sector, 11.622 opportunity GES guarantees that were delayed to May 31, 2017, This type of cancer was less delays when registered: just 1,4%, front of the cervical (44%) or breast (16%).
The fact that type skin cancer melanoma is a score so low also responds to the incidence, explains the Deputy Director of ACCDIS, and he adds that the scenario could improve with alert and prevention. "In Chile, This cancer is associated with arsenic. The figure does not mean that we have a problem of access but more disease, especially in remote locations, where people arrives late to the query", holds.
The head of the Department of management Integral of Cancer of the Ministry of health (Minsal), Maria Ines Romero, has another explanation: direct exposure to solar radiation. However, share the vision of Ferreccio about what needs to be done to correct it, enhancing prevention, especially in sectors where the exposure to the Sun is a working condition that cannot be negotiated.
While the study shows that leukemia lowered his score of 54-40, Minsal spokeswoman explains that the scenario is more complex address, because there is only one type and all have different prognoses according to age. It is exemplified by official figures: acute lymphoblastic leukemia (LLA) in less than 15 years has improved its forecast since the implementation of the national children's program of antineoplastic drugs (PINDA) in 1988, "increasing survival from 39% to 80% and up to 90% in low risk leukemias". For Ferreccio, the low score is only a sign that the disease grows at high speed. "Then the coverage is insufficient", ensures. Similar opinion has the Dra. Berta Cerda, Deputy Director of the National Cancer Institute (INC), who says that even with access guaranteed by GES, Unable to provide access to 100% of the cases for non-specialists.
Airam Fernández, Diario Financiero