Public health, Private health | Profile

Public or private system? How do Argentines choose their access to health? The considerations to be evaluated are several: sex, city, studies, infrastructure, proximity, doctors and nurses. The “Study on access and perception of health in Argentina”, by the Colsecor Foundation, tells of the relationship of Argentines with the health systems.

To start: one in four Argentines only uses the public health system. This is 26% of those surveyed, who, therefore, access health for free. At the other extreme, 32%, or what is the same, three out of ten Argentines, have a social or prepaid service and only use the private health system.

According to these data, there are more Argentines who exclusively use the private system than those who only use the public one. However, the majority of residents in the country, 34%, have a social or prepaid service and use one service or another without distinction.

In the same way, differences are noted according to the size of the cities. In the smallest cities, with less than 10,000 inhabitants, 41% affirm that, even having social work, they use the public or private service indistinctly. But among those who live in large cities, with more than 100,000 inhabitants, only 29% use the service without distinction.

In large cities, even with prepaid, 41% use the private health system more frequently, compared to 23% who use the paid service in small towns. This means that in the largest cities the private system is chosen more than in smaller towns.

Other differences: between sexes. “The private health system is chosen more by men (36%) than by women (30%). (…) Women have more free access to health since they use the public service more than men, 29% and 21% respectively”, indicates the study.

Free is also the option most mentioned by those between the ages of 25 and 39. While this age group accesses health for free in 40%, those who are 60 years of age or older indicate this option in 15%. Also by age: 40% of people aged 60 or over use the private system, compared to those between 25 and 39 years of age.

And if we talk regarding studies, those who completed the university level choose the paid system in 44%, compared to 17% among those who have not completed high school.

Therefore, the type of Argentine who uses the private health system the most are men, aged 60 or over, in large cities and with completed university studies.

Health is first. “78% of the population did not change the way they access health for economic reasons,” says Colsecor. To arrive at this statement, the question was: “Thinking regarding the last year and because of the cost or inflation, have you changed the way you access the health service?”

Among those who did make changes, 14% said they went from a social or prepaid plan to a cheaper one (compared to 5% of young people and 6% of people aged 60 or over); 6% affirmed that before they paid for medical practices in a private way and that now they access them through the public service; and 7% explained that they had a social or prepaid plan and began to use the public system.

The research indicates: “Cost and inflation affect women more than men.” Not only is the same product more expensive in a pink version, such as a razor that costs approximately $500 for them, for them it costs regarding $650; but rather all intimate hygiene products, wipes, tampons and others, are added to the basic basket of women. Not to mention if you count makeup, nail polish and waxing, among many other things.

Back in the study: men changed less than women since, in 84% of them, they did not make changes in their access to health in the last year, while in 74% women did not make changes. “Thus, it seems that women are more affected by cost and inflation than men,” concludes the research.

The change, inflation has also affected more those between 25 and 39 years of age, who indicated that 65% had not changed, compared to 87% of young people between 15 and 24 years of age who did not make changes, or 82% of people 60 years of age or older indicate that they have not changed.

Within the most affected group, between 25 and 39 years old, 14% indicate that they changed their social work for a cheaper one; 10% said that they paid for medical practices in a private way and now some do them in the public service; and 7% explained that they had a prepaid account and began to use the public system.

The same happens with the level of education. Those who have completed university studies have changed less than those who did not complete high school.

Perceptions. “In the ‘general’ perception of the health service, what is private is barely valued better than what is public”, they affirm. The average was achieved from twelve aspects investigated. The result was a 66% approval of the private, compared to a 61% approval of the public. The nurses were better evaluated than the doctors. And in the private system, doctors are better evaluated than in the free system.

In the public system, doctors have an approval level of 76% (23% evaluated as very good and 53% as good), and nurses 84% ​​(28% as very good and 56% as good). In the private system, the approval of the first group of professionals, doctors, amounts to 83% (20% evaluated them as very good and 63% as good), while nurses have an approval of 82% (24% very good and 58% good).

Where private centers win is in digital access, equipment and specialties. Argentines express a 63% positive assessment of digital access in the private system (12% indicated that access is very good and 51% that it is good), compared to 45% approval in the public system.

Regarding the equipment, 71% of people rate it positively in the private system, compared to 55% in the public one. And regarding access to medical specialties, the respondents make a positive assessment of 64% of the private system (14% as very good and 50% as good); compared to 54% of the public system (12% very good and 42% good).

In attention, infrastructure and shift, the valuation of the private remains ahead of the public. 72% of those surveyed have a favorable opinion regarding the infrastructure of the private service (15% very good and 57% good), compared to 65% of positive evaluation for the public system (17% very good and 48% good).

If the question is regarding the availability of shifts, the two are pretty even, and with a low positive rating. five out of ten Argentines believe that the availability of private clinics is good; and four out of ten look favorably on the same appearance in public hospitals. The same: 51% indicate approval for the private system (7% value this availability as very good and 44% as good), while the positive assessment for the public service is 39% (8% very good and 31% good ).

Regarding dignified care, the private system obtained 71% approval (16% as very good and 55% as good) and the public system had a 68% positive response (20% very good and 48% good).

Finally, regarding the feeling of comprehensive coverage, just over five out of ten Argentines (55%, of which 10% is very good and 45% good) believe that the private system is good; and just under five out of ten (49%, of which 9% is very good and 40% is good) believe that the public is good.

However, despite all the victories of the private, the public is far superior in the delivery of medicines. Regarding the availability of free or discounted medicines, 59% (17% very good and 42% good) evaluated the public system positively, compared to 47% (9% very good and 38% good) regarding the private one.

The public also has an advantage in the proximity of the centers of private homes, with a 73% good evaluation for the public (18% very good and 55% good), compared to 68% for the private (12% very good). and 56% good).

Reasons. When respondents were asked: “What are the main reasons that lead you to choose or use a particular health center?”, almost half of Argentines (48%) indicated that the main cause is because they receive the social work or prepaid.

Then, the following answers were mentioned: 34% said that when choosing the first thing they take into account is that the health center is accessible and close to them; 31% because they have the specialty they need there; and 28% because it is free or low cost.

In addition, there are those who prioritize good care (15%); others the good infrastructure and the optimal endowment of equipment (14%), and others the high quality (12%).

Finally, one in ten chooses the center because “it has a lot of availability of shifts”; 6% because “it was recommended”; and only 2% because “it has clear biosafety measures”.

The report

Those responsible for the Study on access and perception of health in Argentina, of the Colsecor Foundation, are Mario Riorda, director of the Master’s Degree in Political Communication at the Austral University; Griselda Ibaña, director of the Federal Institute of Government, of the Catholic University of Córdoba; and Mónica Cingolani, dean of the Faculty of Political Science and International Relations, also of the Catholic University of Córdoba.

To arrive at the published results, surveys were conducted between November 11 and 27, 2022. Data collection was carried out online through CAWI (Computer Assisted Web Interview) technology. The sample of localities was designed in four non-proportional strata, according to the size of the city: approximately 350 cases per stratum, and a total of 1,480 cases. The estimated margin of error does not exceed +/- 2.55% in any case. The implementation was carried out by Dicen Consulting and Projection Consultants.

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