Determinants of physician services utilization among public insured elderly in Chile

Abstract

Recent estimations have established that elderly population in Chile account for 26% of the population. Elderly are main consumers of health services and are considered as a vulnerable sector of the society. For that reason, since the year 2004, Chilean government has provided health services free of charge to the elderly beneficiaries of the public insurance when they use public sector services. Despite this policy, in the year 2006 only 44% of the elderly have used physician services from the public sector when they needed physician services. The objective of the study was to identify the determinants of physician services utilization by elderly beneficiaries of the public insurance system in Chile and to analyze the determinants of private versus public physicians’ utilization among this same group. For the previous purpose, a sample of 2,281 elderly beneficiaries of the public insurance was taken from the Social Protection Survey 2006. The factors that determine health services utilization where selected from Andersen’s Model of Individual Determinants of Health Services utilization and were modified accordingly to the Chilean reality. Two logistic models where estimated. One used as dependent variable the use or non-use of physician services. The second used as dependent variable the use of private versus public physicians. As significant variables of physician services utilization were found sex (being female), high educational level, residing in the 7th, 9th and 10th region of the country, own perception of health status, diagnoses of chronic conditions and dependency in daily life activities. As significant variables in the use of private versus public physicians were found being female, having a high educational level, the amount of pension, living in the 5th Region, bad perception of health status and diagnoses of chronic conditions. The results indicate that there is a relation between socioeconomic factors and the use of health services. Because of this, policy makers and health care providers should consider individual characteristics when planning services for the elderly.