Characterization of the expressed and effective demand for oncology services under the explicit health guarantees of the Chilean public health system.

Introduction: Efficient and effective cancer management is a priority for the Chilean healthcare system. In recent years, significant progress has been made through public policies integrating management at different levels (micro, meso, and macro). However, gaps between the population's needs, service availability, and effective demand may impact health outcomes.

Objective: To describe the national effective demand for prioritized cancer services within the Chilean public healthcare system.

Methods: A descriptive comparative analysis was conducted using data from the public sector Health Guarantees Management Information System between 2018 and 2022. The rates of new cases granted health guarantees by intervention type and the analysis of delayed guarantees were performed.

Results: A total of 3.8 million new cases of explicit health guarantees and 3.9 million fulfilled opportunity guarantees were included. The rates of primary treatment opportunity guarantee by tracer intervention declined in 2020 and 2021, while delayed guarantees showed an increasing trend throughout the entire period. Effective demand varied across cancer types. Breast cancer, preventive cholecystectomy, and gastric cancer exhibited the largest sex-based differences in new cases and primary treatment. Delayed guarantees were similar between sexes, except for breast cancer.

Conclusions: This study provides valuable insights into the demand for cancer services in Chile and the performance of the public healthcare system concerning sex and cancer type, highlighting the impact of the COVID-19 pandemic. The findings emphasize the need to strengthen the public system's response capacity to reduce gaps and improve equity in oncological care.