Top

Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-09-2018 | Original Article

The Impact of Universal Health Care Programmes on Improving ‘Realized Access’ to Care for Depression in Chile

Authors: Ricardo Araya, Pedro Zitko, Niina Markkula

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 5/2018

Abstract

Universal health care programmes have the potential to reduce treatment gaps. We explored the potential impact of an equity-oriented universal health care programme on access to care for depression, hypertension and diabetes using data from two nationally representative health surveys in Chile. The likelihood a depressed individual had accessed health care appears to have increased significantly after the programme was introduced whereas those for hypertension and diabetes remained unchanged. Depressed women seem to have benefited mostly from the programme. Universal health care programmes for depression could substantially increase coverage and reduce inequities in access to health care in middle-income countries.

Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter?. Journal of Health and Social Behavior. https://doi.org/10.2307/2137284.PubMedCrossRef

Andrade, L. H., Alonso, J., Mneimneh, Z., Wells, J. E., Al-Hamzawi, A., Borges, G., … Kessler, R. C. (2014). Barriers to mental health treatment: Results from the WHO World Mental Health surveys. Psychological Medicine, 44(6), 1303–1317. https://doi.org/10.1017/s0033291713001943.CrossRefPubMed

Araya, R., Lewis, G., Rojas, G., & Fritsch, R. (2003). Education and income: Which is more important for mental health? Journal of Epidemiology and Community Health, 57(7), 501–505.CrossRefPubMedPubMedCentral

Araya, R., Rojas, G., Fritsch, R., Acuna, J., & Lewis, G. (2001). Common mental disorders in Santiago, Chile: Prevalence and socio-demographic correlates. British Journal of Psychiatry, 178, 228–233.CrossRefPubMed

Araya, R., Rojas, G., Fritsch, R., Frank, R., & Lewis, G. (2006). Inequities in mental health care after health care system reform in Chile. American Journal of Public Health, 96(1), 109–113. https://doi.org/10.2105/ajph.2004.055715.CrossRefPubMedPubMedCentral

Atun, R., Aydın, S., Chakraborty, S., Sümer, S., Aran, M., Gürol, I., … Akdağ, R. (2013). Universal health coverage in Turkey: Enhancement of equity. The Lancet, 382(9886), 65–99. https://doi.org/10.1016/S0140-6736(13)61051-X.CrossRef

Barbui, C., Girlanda, F., Ay, E., Cipriani, A., Becker, T., & Koesters, M. (2014). Implementation of treatment guidelines for specialist mental health care. The Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD009780.pub2.CrossRefPubMed

Barros, A. J., Ronsmans, C., Axelson, H., Loaiza, E., Bertoldi, A. D., Franca, G. V., … Victora, C. G. (2012). Equity in maternal, newborn, and child health interventions in Countdown to 2015: A retrospective review of survey data from 54 countries. The Lancet, 379(9822), 1225–1233. https://doi.org/10.1016/s0140-6736(12)60113-5.CrossRef

Becerril-Montekio, V., de Reyes, J., D., & Manuel, A. (2011). The health system of Chile. Salud Publica de Mexico, 53(Suppl 2), s132–s143.PubMed

Bitran, R., Escobar, L., & Gassibe, P. (2010). After Chile’s health reform: Increase in coverage and access, decline in hospitalization and death rates. Health Affairs (Millwood), 29(12), 2161–2170. https://doi.org/10.1377/hlthaff.2010.0972.CrossRef

Bleich, S. N., Jarlenski, M. P., Bell, C. N., & LaVeist, T. A. (2012). Health inequalities: Trends, progress, and policy. Annual Review of Public Health, 33, 7–40.CrossRefPubMedPubMedCentral

Bromet, E., Andrade, L. H., Hwang, I., Sampson, N. A., Alonso, J., de Girolamo, G., … Kessler, R. C. (2011). Cross-national epidemiology of DSM-IV major depressive episode. BMC Medicine, 9, 90. https://doi.org/10.1186/1741-7015-9-90.CrossRefPubMedPubMedCentral

Brugha, T. S., Bebbington, P. E., Singleton, N., Melzer, D., Jenkins, R., Lewis, G., … Meltzer, H. (2004). Trends in service use and treatment for mental disorders in adults throughout Great Britain. British Journal of Psychiatry, 185, 378–384. https://doi.org/10.1192/bjp.185.5.378.CrossRefPubMed

Chisholm, D., Flisher, A. J., Lund, C., Patel, V., Saxena, S., Thornicroft, G., & Tomlinson, M. (2007). Scale up services for mental disorders: A call for action. The Lancet, 370(9594), 1241–1252. https://doi.org/10.1016/s0140-6736(07)61242-2.CrossRef

Chisholm, D., Sanderson, K., Ayuso-Mateos, J. L., & Saxena, S. (2004). Reducing the global burden of depression. The British Journal of Psychiatry, 184(5), 393–403.CrossRefPubMed

Chisholm, D., Sweeny, K., Sheehan, P., Rasmussen, B., Smit, F., Cuijpers, P., & Saxena, S. (2016). Scaling-up treatment of depression and anxiety: A global return on investment analysis. Lancet Psychiatry, 3(5), 415–424. https://doi.org/10.1016/s2215-0366(16)30024-4.CrossRefPubMed

De Silva, M. J., Lee, L., Fuhr, D. C., Rathod, S., Chisholm, D., Schellenberg, J., & Patel, V. (2014). Estimating the coverage of mental health programmes: A systematic review. International Journal of Epidemiology, 43(2), 341–353. https://doi.org/10.1093/ije/dyt191.CrossRefPubMedPubMedCentral

Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P., … Chatterji, S. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA, 291(21), 2581–2590.CrossRefPubMed

Eaton, J., McCay, L., Semrau, M., Chatterjee, S., Baingana, F., Araya, R., … Saxena, S. (2011) Scale up of services for mental health in low-income and middle-income countries. The Lancet, 378(9802), 1592–1603. https://doi.org/10.1016/S0140-6736(11)60891-X.CrossRef

Ewig, C., & Palmucci, G. A. (2012). Inequality and the politics of social policy implementation: Gender, age and Chile’s 2004 health reforms. World Development. https://doi.org/10.1016/j.worlddev.2012.05.033.CrossRef

Ferrari, A. J., Charlson, F. J., Norman, R. E., Patten, S. B., Freedman, G., Murray, C. J., … Whiteford, H. A. (2013a). Burden of depressive disorders by country, sex, age, and year: Findings from the global burden of disease study 2010. PLoS Medicine, 10(11), e1001547. https://doi.org/10.1371/journal.pmed.1001547.CrossRefPubMedPubMedCentral

Ferrari, A. J., Somerville, A., Baxter, A. J., Norman, R. E., Patten, S. B., Vos, T., & Whiteford, H. A. (2013b). Global variation in the prevalence and incidence of major depressive disorder: A systematic review of the epidemiological literature. Psychological Medicine, 43(3), 471–481.CrossRefPubMed

Jorm, A. (2011). The population impact of improvements in mental health services: The case of Australia. British Journal of Psychiatry, 199(6), 443–444. https://doi.org/10.1192/bjp.bp.111.097956.CrossRefPubMed

Jorm, A. F., Patten, S. B., Brugha, T. S., & Mojtabai, R. (2016). Scaling-up of treatment of depression and anxiety. The Lancet Psychiatry, 3(7), 603. https://doi.org/10.1016/s2215-0366(16)30095-5.CrossRefPubMed

Kessler, R., Andrews, G., Mroczek, D. K., Ustun, B., & Wittchen, H. (1998). The World Health Organization composite international diagnostic interview short-form (CIDI-SF). Methods in Psychatric Research, 7, 171–185.CrossRef

Markkula, N., Zitko, P., Pena, S., Margozzini, P., & Retamal, C. P. (2017). Prevalence, trends, correlates and treatment of depression in Chile in 2003 to 2010. Social Psychiatry and Psychiatric Epidemiology. https://doi.org/10.1007/s00127-017-1346-4.CrossRefPubMed

Ministerio de Salud de Chile. (2001). Guia Clinica para la atencion primaria: La depresion, deteccion, diagnostico y tratamiento. Santiago: Ministerio de Salud.

Ministerio de Salud de Chile. (2003). Resultados de Primera Encuesta Nacional de Salud. Santiago: Ministerio de Salud.

Ministerio de Salud de Chile. (2007). Informe Final Estudio de Carga de Enfermedad y Carga Atribuible. Santiago: Ministerio de Salud.

Ministerio de Salud de Chile. (2010). Informe Encuesta Nacional de Salud 2009–2010. Santiago: Ministerio de Salud.

Minoletti, A., Sepúlveda, R., & Horvitz-Lennon, M. (2012). Twenty years of mental health policies in Chile. International Journal of Mental Health, 41(1), 21–37. https://doi.org/10.2753/IMH0020-7411410102.CrossRef

Moreno-Serra, R., & Smith, P. C. (2012). Does progress towards universal health coverage improve population health? The Lancet, 380(9845), 917–923. https://doi.org/10.1016/s0140-6736(12)61039-3.CrossRef

Noordam, R., Aarts, N., Verhamme, K. M., Sturkenboom, M. C. M., Stricker, B. H., & Visser, L. E. (2015). Prescription and indication trends of antidepressant drugs in the Netherlands between 1996 and 2012: A dynamic population-based study. European Journal of Clinical Pharmacology, 71(3), 369–375. https://doi.org/10.1007/s00228-014-1803-x.CrossRefPubMed

Patel, V., Boyce, N., Collins, P. Y., Saxena, S., & Horton, R. (2011) A renewed agenda for global mental health. The Lancet, 378(9801), 1441–1442. https://doi.org/10.1016/S0140-6736(11)61385-8.CrossRef

Patten, S. B., Brandon-Christie, J., Devji, J., & Sedmak, B. (2000). Performance of the composite international diagnostic interview short form for major depression in a community sample. Chronic Diseases in Canada, 21(2), 68–72.PubMed

Patten, S. B., Williams, J. V., Lavorato, D. H., Fiest, K. M., Bulloch, A. G., & Wang, J. (2015). The prevalence of major depression is not changing. The Canadian Journal of Psychiatry, 60(1), 31–34.CrossRefPubMed

Shengelia, B., Tandon, A., Adams, O. B., & Murray, C. J. (2005). Access, utilization, quality, and effective coverage: An integrated conceptual framework and measurement strategy. Social Science & Medicine, 61(1), 97–109. https://doi.org/10.1016/j.socscimed.2004.11.055.CrossRef

Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J. W., Patel, V., & Silove, D. (2014). The global prevalence of common mental disorders: A systematic review and meta-analysis 1980–2013. International Journal of Epidemiology, 43(2), 476–493. https://doi.org/10.1093/ije/dyu038.CrossRefPubMedPubMedCentral

The Lancet. (2014). Global mental health: Policy, progress, and prospects. The Lancet, 384(9959), 1999. https://doi.org/10.1016/S0140-6736(14)62318-7.

The Oregon Health Insurance Experiment. Health Affairs Health Policy Brief, July 16, 2015. https://doi.org/10.1377/hpb20150716.236899.

Valdivieso, D. V., & Montero, L. J. (2010). Health care reform in Chile: 2005 to 2009. Revista Medica De Chile, 138(8), 1040–1046.PubMed

Vicente, B., Kohn, R., Rioseco, P., Saldivia, S., Baker, C., & Torres, S. (2004). Population prevalence of psychiatric disorders in Chile: 6-month and 1-month rates. British Journal of Psychiatry, 184, 299–305.CrossRefPubMed

Vicente, B., Kohn, R., Rioseco, P., Saldivia, S., Levav, I., & Torres, S. (2006). Lifetime and 12-month prevalence of DSM-III-R disorders in the Chile psychiatric prevalence study. American Journal of Psychiatry, 163(8), 1362–1370. https://doi.org/10.1176/appi.ajp.163.8.1362.CrossRefPubMed

Victora, C., Vaughan, J. P., Barros, F. C., Silva, A. C., & Tomasi, E. (2000). Explaining trends in inequities: Evidence from Brazilian child health studies. The Lancet, 356, 1093–1098.CrossRef

Victora, C. G., Barros, A. J., Axelson, H., Bhutta, Z. A., Chopra, M., Franca, G. V., … Boerma, J. T. (2012). How changes in coverage affect equity in maternal and child health interventions in 35 Countdown to 2015 countries: An analysis of national surveys. The Lancet, 380(9848), 1149–1156. https://doi.org/10.1016/s0140-6736(12)61427-5.CrossRef

Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., … Murray, C. J. (2013). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2163–2196. https://doi.org/10.1016/s0140-6736(12)61729-2.CrossRef

Wang, P. S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Borges, G., Bromet, E. J., … Wells, J. E. (2007). Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. The Lancet, 370(9590), 841–850. https://doi.org/10.1016/s0140-6736(07)61414-7 CrossRef

World Bank. (2008). Realizing rights through social guarantees: An analysis of new approaches to social policy in Latin America and South Africa. Retrieved from Washington DC http://siteresources.worldbank.org/EXTSOCIALDEV/Resources/3177394-1168615404141/3328201-1192042053459/Chile.pdf?resourceurlname=Chile.pdf.

Title: The Impact of Universal Health Care Programmes on Improving ‘Realized Access’ to Care for Depression in Chile
Authors: Ricardo Araya
Pedro Zitko
Niina Markkula
Publication date: 01-09-2018
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 5/2018
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-018-0864-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Impact of Universal Health Care Programmes on Improving ‘Realized Access’ to Care for Depression in Chile

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2018

Perceived Need for Treatment and Engagement in Mental Health Services Among Community-Referred Racial/Ethnic Minority Adolescents

Provider-Associated Measurement Error in Routine Outcome Monitoring in Community Mental Health

Clinical Supervision of Mental Health Professionals Serving Youth: Format and Microskills

Attitudes of Austrian Psychotherapists Towards Process and Outcome Monitoring

Cost-Effectiveness of a Behavioral Psychosocial Treatment Integrated Across Home and School for Pediatric ADHD-Inattentive Type

Utilization of Mental Health Services by Preschool-Aged Children with Private Insurance Coverage