Health Insurance Scheme: Main Contributor to Inequalities in COVID-19 Mortality in Colombia.

Publisher: American Public Health Association Country of Publication: United States NLM ID: 1254074 Publication Model: Print Cited Medium: Internet ISSN: 1541-0048 (Electronic) Linking ISSN: 00900036 NLM ISO Abbreviation: Am J Public Health Subsets: MEDLINE

Publication: Washington, DC : American Public Health Association
Original Publication: New York [etc.]

COVID-19*; Adult ; Colombia/epidemiology ; Health Status Disparities ; Humans ; Insurance, Health ; Retrospective Studies ; Socioeconomic Factors

Objectives. To quantify socioeconomic inequalities in COVID-19 mortality in Colombia and to assess the extent to which type of health insurance, comorbidity burden, area of residence, and ethnicity account for such inequalities. Methods. We analyzed data from a retrospective cohort of COVID-19 cases. We estimated the relative and slope indices of inequality (RII and SII) using survival models for all participants and stratified them by age and gender. We calculated the percentage reduction in RII and SII after adjustment for potentially relevant factors. Results. We identified significant inequalities for the whole cohort and by subgroups (age and gender). Inequalities were higher among younger adults and gradually decreased with age, going from RII of 5.65 (95% confidence interval [CI] = 3.25, 9.82) in participants younger than 25 years to RII of 1.49 (95% CI = 1.41, 1.58) in those aged 65 years and older. Type of health insurance was the most important factor, accounting for 20% and 59% of the relative and absolute inequalities, respectively. Conclusions. Significant socioeconomic inequalities exist in COVID-19 mortality in Colombia. Health insurance appears to be the main contributor to those inequalities, posing challenges for the design of public health strategies. ( Am J Public Health . 2022;112(S6):S586-S590. https://doi.org/10.2105/AJPH.2021.306637).

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Date Created: 20220817 Date Completed: 20220819 Latest Revision: 20230912

20230912

PMC9382140

10.2105/AJPH.2021.306637

35977331