Implementation of the explicit health guarantees program for the human immunodeficiency virus and its intervention in mortality in Chile
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Universidad Mayor, Chile
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A293
Background and Objectives: In 2004, Law 19966 in Chile, was enacted to establish the Explicit Health Guarantees (GES). This public policy was designed to facilitate access, coverage, and quality of health care for the population by guaranteeing all beneficiaries minimum benefits, timely, quality care and care protocols for a group of priority diseases due to their prevalence and mortality, including acquired immunodeficiency virus (HIV)/AIDS, intervening in prevalent mortality rates in the country. Objective: To describe the influence of the HIV/AIDS GES public policy on mortality rates in Chile. Methods: A quantitative, cross-sectional, and descriptive design was conducted, using interrupted time series, Newey-West estimator, 95% confidence. Sample: HIV deaths between 2000 and 2020 registered in the Chilean Statistical Office. Results: The median number of HIV deaths due to other infectious diseases was 241 person/year in the early 2000s. The average number of deaths associated with pregnancy complications was 3 person/year between 2000 and 2010. Deaths due to other specified diseases, have a maximum of 109 person/year in 2015, and a minimum of 22 person-years in 2020. After the implementation of the program, there is an average decrease of 41 deaths/year. The access of public sector patients to the program is 100% in Chiles hospital network and first preventive care, starting in 2013. Conclusions: There was evidence of a reduction in mortality from HIV and related diseases between 2013 and 2020. The eradication of HIV deaths in pregnancy is total until 2020. A significant decrease in mortality was observed after the adjustment of the program in 2016 related to promotion and prevention actions. The impact of the intervention was measured through mortality, which does not include other relevant variables in the disease-death process, such as bio sociodemographic, socioeconomic, and geographic factors.