Aging & Social Change: Ninth Interdisciplinary Conference

Abstract

This ecological study assesses ischemic heart disease (IHD) mortality disparities according to the Colombian health system affiliation regime (contributive-CR- and subsidized regime–SR). Information on deaths caused by IHD from 2012 to 2016 according to age and social security regime affiliation was taken from the National Administrative Department of Statistics-database: vital-statistics section. Mortality rates of reference countries were extracted from the WHO-Mortality Database. Global and specific mortality rates for each regime were estimated from the respective mortality cases for every 100,000 members of the same regime per department-year. Age-standardized mortality rates (SMR) for each regime from 2012 to 2016 were calculated. Disparities in health were quantified through attributable fraction (AF) calculation. The highest SMR was found in Tolima (214 cases per-100,000 affiliates in CR-318 in SR). The lowest SMR was found in Chocó, probably due to under-reporting. La Guajira was the only department to have a better AF in the SR. Both regimes showed average SMR higher than 100 per-100,000 habitants: more than twice the best international rates. From 2012 to 2016, AF for IHD in Colombia was higher for SR. There was no significant increasing or decreasing tendency in the AF-gap. This study provides perspective on the magnitude of the disparities in IHD care in Colombia and suggests there was no change in the inequality gap from 2012 to 2016. The results suggest patients in the SR are at disadvantage and tend to have worse health outcomes. Further research is needed to clarify probable causes.