居住在巴西的流离失所委内瑞拉妇女获得医疗保健的机会、质量和财务风险保护:一项横断面研究

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES
Rodrigo Moreno-Serra , Ivan Ochoa-Moreno , Misael Anaya-Montes , Luis Cardoso Fernandes , Thaiza Gomes , Maria Do Carmo Leal , Cristóbal Cuadrado
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引用次数: 0

摘要

背景由于委内瑞拉的社会经济状况不断恶化,数百万委内瑞拉人流离失所。我们研究了巴西境内委内瑞拉移民妇女全民医保的关键领域:医疗服务的获取、医疗质量和财务风险保护。方法我们收集了博阿维斯塔市和马瑙斯市 2018 年至 2021 年期间移民到巴西的 2012 名 15-49 岁委内瑞拉妇女的原始数据,以及巴西妇女的二手数据。我们使用线性回归与熵平衡匹配来估算移民身份与医疗支出、利用率和质量指标之间的关联。研究结果我们的样本平均年龄为 29.5 岁(S.D. 8.9),64%(1286/2011)为混合种族,29%(577/2011)为白人,4%(71/2011)为黑人,3%(62/2011)为土著人,1%(15/2011)为其他种族。与巴西妇女相比,移民妇女的灾难性医疗支出发生率高出 9.5 个百分点 (pp) (95% CI: 6 pp-13 pp; p < 0.0001)。移民在求医时接受医疗保健的可能性要高 27 个百分点(95% CI:11 个百分点至 43 个百分点;p = 0.0008),但在过去三年中接受子宫颈抹片检查的可能性要低 37 个百分点(95% CI:-45 个百分点至-29 个百分点;p < 0.0001)。移民与非移民一样有可能在三个月内获得子宫颈抹片检查结果(95% CI:-9 pp 至 22 pp;P = 0.39),并获得临床适当的产前咨询(95% CI:-10 pp 至 40 pp;P = 0.23)。然而,未满足的性保健和生殖保健需求的潜在积压以及财务风险保护的不足需要政策关注。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Healthcare access, quality and financial risk protection among displaced Venezuelan women living in Brazil: a cross-sectional study

Background

Millions of Venezuelans have been displaced because of deteriorating socio-economic conditions in their country. We examine key domains of universal health coverage among migrant Venezuelan women in Brazil: healthcare access, care quality and financial risk protection.

Methods

We collected primary data on 2012 Venezuelan women aged 15–49 who migrated to Brazil between 2018 and 2021, in the cities of Boa Vista and Manaus, along with secondary data for Brazilian women. We used linear regression with entropy balance matching to estimate associations between migrant status and healthcare spending, utilisation and quality indicators.

Findings

Our sample had a mean age of 29.5 years (S.D. 8.9), 64% (1286/2011) of mixed ethnicity, 29% (577/2011) white, 4% (71/2011) black, 3% (62/2011) indigenous and 1% (15/2011) other ethnicities. Compared to Brazilian women, migrant women had 9.5 percentage points (pp) (95% CI: 6 pp–13 pp; p < 0.0001) higher catastrophic health expenditure incidence. Migrants were 27 pp (95% CI: 11 pp–43 pp; p = 0.0008) more likely to receive healthcare when sought, but 37 pp (95% CI: −45 pp to −29 pp; p < 0.0001) less likely to have had a pap smear in the last three years. Migrants were as likely as non-migrants to have received pap smear results within three months (95% CI: −9 pp to 22 pp; p = 0.39) and clinically appropriate antenatal consultations (95% CI: −10 pp to 40 pp; p = 0.23).

Interpretation

Migrant women in Brazil have relatively good healthcare access and quality outcomes. Yet a potential backlog of unmet sexual and reproductive healthcare needs and inadequate financial risk protection require policy attention.

Funding

UK Economic and Social Research Council (ES/T00441X/1).

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来源期刊
CiteScore
8.00
自引率
0.00%
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期刊介绍: The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.
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