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Equity in the use of private hospitals contracted by a compulsory insurance scheme in the city of Rio de Janeiro, Brazil, in 1986.

Maria Travassos Veras, Claudia (1992) Equity in the use of private hospitals contracted by a compulsory insurance scheme in the city of Rio de Janeiro, Brazil, in 1986. PhD thesis, London School of Economics and Political Science (United Kingdom).

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Abstract

The Brazilian Health Care System involves a large variety of sources of finance and methods of organising medical care. Inpatient care in the country is mainly financed by a compulsory insurance scheme - INAMPS. The most relevant providers of inpatient care for INAMPS are contracted private hospitals which are reimbursed on a prospective payment scheme. Hospitals' claims - AIH forms are processed by a central computer system. This study aimed to investigate inequalities in health care in Brazil - more specifically, to assess inequalities in the use of contracted private hospitals in the city of Rio de Janeiro in 1986. The main hypothesis was that contracted private hospitals would be treating selective groups within the population and that the pattern of use of these services would vary across social groups. This investigation was based on data originated from the AIH forms and a study was conducted to assess the reliability of these data. Contracted private hospitals were shown to treat a limited and selective share of the health care market in the city of Rio de Janeiro - split between the areas of maternity and geriatric care using low technology. Variations in the patterns of use between the social groups are discussed in relation to age and sex distribution, case-mix, process and outcome of care. The explanatory role of the social variable (payment status) was tested. Payment status was shown to be a significant variable in explaining variations in use between patients. The less prestigious social groups, such as the unemployed, appeared less likely to receive appropriate care. Variations between the payment groups could also be the result of supply-induced demand or even fraud.

Item Type: Thesis (PhD)
Uncontrolled Keywords: Health Sciences, Health Care Management, Latin American Studies
Sets: Collections > ProQuest Etheses
URI: http://etheses.lse.ac.uk/id/eprint/2431

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