Abstract
Background: The aim of this study was to examine the influence of healthcare coverage in the access to orthopedic surgery in a country with a dual (private/public) healthcare system. We hypothesize that differential access would exist according to the type of healthcare coverage. This difference would accentuate when analyzing access to elective orthopedic surgery.
Methods: A cross-sectional, population-based design was used to investigate orthopedic surgery rates in Chile during 2016. The rates of orthopedic surgeries provided under the private and public healthcare systems were calculated per 1,000 beneficiaries, as based on data collected from the Hospital Discharge Registry provided by the Chilean Ministry of Health. ICD-10 diagnoses were classified as urgent or elective, categories into which the public/private surgery rates were also sorted.
Results: The overall rate of orthopedic surgery was 7.54 per 1000 inhabitants in 2018. Patients covered under private insurance had an orthopedic surgery rate 2.23 times higher than patients within the public system. This difference became more accentuated when sorting by elective surgeries, with private healthcare having a rate 2.97 times higher than public healthcare.
Conclusions: Access disparity to orthopedic surgical care existed between the private and public healthcare systems in Chile. Disparity in access became greater when separately analyzing the rates of elective and urgent orthopedic surgeries.
Level of evidence: III