@article{article,
  author = {Hilari{\'o}n-Gait{\'a}n L and D{\'\i}az-Jim{\'e}nez D and Cotes-Cantillo K and Casta{\~n}eda-Orjuela C},
  title = {Inequalities in health by regime of affiliation to the health system in events of obligatory notification, Colombia, 2015},
  abstract = {Introducci{\'o}n. Las desigualdades en salud se generan por diferencias en las condiciones sociales y econ{\'o}micas, lo cual influye en el riesgo de enfermar y la forma de enfrentar la enfermedad.
Objetivo. Evaluar las desigualdades sociales en salud en Colombia, utilizando el tipo de afiliaci{\'o}n al sistema de salud como un par{\'a}metro representativo (proxy) de la condici{\'o}n socioecon{\'o}mica.
Materiales y m{\'e}todos. Se trata de un an{\'a}lisis descriptivo y retrospectivo en el que se calcularon las tasas espec{\'\i}ficas de incidencia, ajustadas por edad y sexo, para eventos de notificaci{\'o}n obligatoria, utilizando el r{\'e}gimen de afiliaci{\'o}n (subsidiado o contributivo) como variable representativa del nivel socioecon{\'o}mico. Las estimaciones se hicieron a nivel departamental para el 2015. Las desigualdades sociales se calcularon en t{\'e}rminos de brechas absolutas y relativas.
Resultados. Se evidencian desigualdades sociales en la ocurrencia de eventos de notificaci{\'o}n obligatoria, las cuales desfavorecen a la poblaci{\'o}n afiliada al r{\'e}gimen subsidiado. En esta poblaci{\'o}n, se reportaron 82,31 casos m{\'a}s de malaria Plasmodium falciparum por 100.000 afiliados, que los notificados en el r{\'e}gimen contributivo. Respecto a la brecha relativa, el pertenecer al r{\'e}gimen subsidiado se asocia con un aumento de 31,74 veces del riesgo de morir por desnutrici{\'o}n en menores de cinco a{\~n}os. Otros eventos tambi{\'e}n presentaron profundas desigualdades, como los relacionados con la salud sexual y reproductiva (mortalidad materna, s{\'\i}filis gestacional y s{\'\i}filis cong{\'e}nita), las enfermedades infecciosas y las enfermedades transmisibles relacionadas con la pobreza (lepra y tuberculosis).
Conclusi{\'o}n. El tipo de afiliaci{\'o}n al Sistema General de Seguridad Social en Salud en Colombia es un buen indicador del nivel socioecon{\'o}mico, y es un factor predictor de mayor morbilidad y mortalidad prematura asociada con los factores determinantes sociales de la salud.


<p>Introduction: Inequalities in the health field are caused by the differences in the social and economic conditions, that influence the disease risk and the measures taken to treat the disease.
Objective: We aimed to estimate the social inequalities in health in Colombia, according to the type of affiliation to the health system as a proxy of socioeconomic status.
Materials and methods: We conducted a retrospective descriptive analysis calculating incidence rates age and sex adjusted for all mandatory reporting events using the affiliation regime (subsidized and contributory) as a socioeconomic proxy. Estimates were made at departmental level for 2015. Social inequalities were calculated in terms of absolute and relative gaps.
Results: We found social inequalities in the occurrence of mandatory reporting events in population affiliated to the Colombian subsidized regime (poor population).
In this population, 82.31 cases of Plasmodium falciparum malaria per 100,000 affiliates were reported more than those reported in the contributory regime. Regarding the relative gap, belonging to the subsidized regime increased by 31.74 times the risk of dying from malnutrition in children under 5 years of age.
Other events such as those related to sexual and reproductive health (maternal mortality, gestational syphilis and congenital syphilis); neglected diseases and communicable diseases related to poverty (leprosy and tuberculosis), also showed profound inequalities.
Conclusion: In Colombia there are inequalities by regime of affiliation to the health system. Measured socioeconomic status was a predictor of increased morbidity and premature mortality.</p>},
  year = {2019},
  journal = {Biomedica : revista del Instituto Nacional de Salud},
  volume = {39},
  pages = {737-747},
  month = {01/2019},
  issn = {0120-4157},
  url = {https://revistabiomedica.org/index.php/biomedica/article/view/4453},
  doi = {10.7705/biomedica.4453},
  language = {eng},
}