Inequalities in access to healthcare for people with disabilities in Chile: the limits of universal health coverage

We analysed cross-sectional data collected as part of the National Socioeconomic Characterisation Survey (2013) in Chile, in order to explore if there are differences in access to healthcare between adult Chileans with and without disability. The study included 7,459 Chilean adults with disability and 68,695 people without disability. Logistic regressions were performed in order to determine the adjusted odds ratios for the associated variables. We found that despite universal health coverage, Chileans with disabilities are more likely to report worse access to healthcare, even when controlling for socioeconomic and demographic variables, including age, gender, and income. Specifically, they are more likely to face greater difficulty arriving at a health facility, obtaining a doctor’s appointment, being attended to in a health facility, paying for treatment due to cost, and obtaining necessary medicine. Both people with and without disability are more likely to face difficulties in accessing health services if they are affiliated with the public health provider, an indication of the economic factors at play in accessing healthcare. This study shows that universal health coverage does not always lead to accessibility of health services and underlines the disadvantaged position of disabled people in Chile in accessing health services. While efforts have been made recently to improve equity in healthcare access, disability in Chile poses an additional burden on people’s access to healthcare, emphasising the necessity for policy to address this perpetual cycle of disadvantage for disabled people