Relationship between universal health insurance benefits and prostate cancer mortality in Colombia.

Autor: Mejia E; Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA., Lewis AGC; Department of Global Health, School of Public Health, Boston University, Boston, MA, USA., Garcés-Palacio IC; Epidemiology group, School of Public Health, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia. icristina.garces@udea.edu.co., Hernandez DM; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA., Chamberlain RM; Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA., Soliman AS; Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2024 Sep 30; Vol. 24 (1), pp. 2667. Date of Electronic Publication: 2024 Sep 30.
DOI: 10.1186/s12889-024-20117-4
Abstrakt: Purpose: Prostate cancer is the most common cause for cancer mortality among men in Colombia. Law 100, in 1993, created a contributory regime (private insurance) and subsidized regime (public insurance) in which the subsidized regime had fewer benefits. However, Ruling T760 in July 2012 mandated that both systems must offer equal quality and access to healthcare. This study examines the impact of this change on prostate cancer mortality rates before and after 2012.
Methodology: Prostate cancer mortality records from 2006 to 2020 were collected from Colombia's National Administrative Department of Statistics (DANE). Crude mortality was calculated by health insurance for different geographic areas and analyzed for changes between 2006 and 2012 and 2013-2020. Join-Point regressions were used to analyze trends by health insurance.
Results: Crude mortality rates in the contributory regime had a non-statistically significant decrease from 2006 to 2012 (AAPC= -1.32%, P = 0.14, 95% CI= -3.12, 0.52). In contrast, between 2013 and 2020 there was a non-statistically significant increase in crude mortality (AAPC 1.10%, P = 0.07, 95% CI= -0.09, 2.31). Comparatively, crude mortality in the subsidized regime, from 2006 to 2012, increased with a statistically significant AAPC of 2.51% (P < 0.001, 95% CI = 1.21, 3.83). From 2013 to 2020, mortality continued to increase with statistically significant AAPC of 5.52% (P < 0.001, 95% CI = 4.77, 6.27). Compared to their crude mortality differences from 2006 to 2020, from 2013 to 2020, the departments of Atlántico, Córdoba, Sucre, Arauca, Cesar, and Cauca had the highest rates in prostate cancer mortality in the subsidized regime compared to the contributory regime.
Conclusion: Ruling T760 did not positively impact prostate cancer mortality, particularly of men in the subsidized regime.
(© 2024. The Author(s).)
Databáze: MEDLINE
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