Barriers of access to oral health care among university students in southern Colombia, 2011. A multivariate analysis

Revista de la Facultad de Medicina

Rocha-Buelvas, Anderson¹  Hidalgo-Troya, Arsenio³  Hidalgo-Eraso, Ángela² 

[1] Universidad Antonio Narino, Bogotá, Colombia;Empresa Promotora de Salud EMSSANAR, Nariño, Colombia;Universidad Antonio Narino, Nariño, Colombia

关键词: Health services accessibility;    Equity in health;    Student health services;    Social determinants of health;    Oral health;    Colombia (MeSH).;   

DOI  :  10.15446/revfacmed.v62n4.43489

学科分类：医学（综合）

来源: Universidad Nacional de Colombia * Facultad de Medicina

【 摘 要 】

Antecedentes. El derecho a la salud es considerado un derecho humano fundamental, por tanto, es un principio para combatir las desigualdades –injustas e inmorales–. Así, es fundamental estudiar el proceso mediante el cual una necesidad de atención se satisface completamente. Objetivo. Analizar los determinantes de acceso a los servicios de salud bucal en estudiantes universitarios del municipio de Pasto.Materiales y métodos. En una muestra de 338 estudiantes universitarios se aplicó una encuesta confidencial utilizando un modelo comportamental de uso de servicios de salud.Resultados. Sobre los factores de capacidad, los estudiantes que respondieron tener mal estado de salud utilizaron más los servicios de salud bucal en el último año, mientras que los que reportaron estar insatisfechos con la apariencia de sus dientes utilizaron menos los servicios. Respecto a los factores de necesidad, los estudiantes que no tienen afectada su calidad de vida por incapacidad física y dolor físico utilizan menos los servicios de salud bucal. Los factores predisponentes no arrojaron resultados significativos. Conclusiones: Este estudio encontró que los factores de capacidad y de necesidades estaban asociados con la consulta odontológica reciente en estudiantes universitarios del municipio de Pasto. Palabras clave: Accesibilidad a los servicios de salud; Equidad en salud; Servicios de salud para estudiantes; Determinantes sociales de la salud; Salud bucal; Colombia (DeCS). Rocha-Buelvas A, Hidalgo-Troya A, Hidalgo-Eraso Á. Barreras de acceso a los servicios de salud bucal en estudiantes universitarios del sur de Colombia, 2011. Un analisis multivariado. Rev. Fac. Med. 2014;62(4):521-8. http://dx.doi.org/10.15446/revfacmed.v62n4.43489Introduction Despite the existence of very concrete cases in Colombia that have shown that inequity in oral health services in the population is persistent, studies that have examined inequalities in access and use of oral health services suggest positive advances in aspects like financing, affiliation to the system, and potential access. This, however, is not the case for real access to services (1-5). As a result, to analyze access to health services, research in public health has leaned on Andersen’s behavioral model of health service use. This model should be analyzed based on the current use of health care services and user satisfaction with them.While research into social inequity in oral health is substantial in developed countries, it is scarce in developing countries. This inequity can be seen in Colombia where structural problems with oral health care are not very different between regions, and where educational level, occupation, the lack of money, and insurance, among other factors, can all constitute barriers of access to health services. As such, a representation of the university population in southern Colombia is the object of this study because, in addition to being rarely approached and studied, it is diverse, given that it is made up of individuals from varying socioeconomic strata, ethnic groups, and urban and rural areas of southwestern Colombia.It is worth mentioning that, from the theoretical-operational field, the model identifies the influence both of individual variables (behavioral) and contextual variables (physical, political, or the economic environment). This happens through the identification of the individuals’ determinant factors of access to health care that can affect the reception of medical or dental care (9). These factors include predisposing factors (inherent to the patient and independent of their pathology), mediating or enabling factors (that facilitate or obstruct the use of health services and that are susceptible to changes in health policies), and need factors (the perception of and severity of the symptoms of the disease).Thus, in practical terms, it is important to analyze these determinant factors with statistical models and to confirm the "inverse care law" (10) that states that populations with greater health needs receive less care, while healthier groups receive more care. These affirmations have been complemented with more recent theories such as what has been called the "inequality paradox" (11), which highlights the existence of subgroups within the subpopulations that, due to the social characteristics that they share, are subject high health risk factors. The identification of groups that are potentially vulnerable to risks is a fundamental aspect in the scientific and political approach to health inequities. Herein lies the importance of this kind of study.Materials and me

【 授权许可】

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