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Article ; Online: Health Systems, Aging, and Inequity: An Example from Chile.

Villalobos Dintrans, Pablo

International journal of environmental research and public health

2020 Volume 17, Issue 18

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Aged ; Aged, 80 and over ; Aging ; Chile ; Government Programs ; Health Expenditures ; Healthcare Disparities ; Humans ; Medical Assistance
Language	English
Publishing date	2020-09-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph17186546
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Article ; Online: The Economic Value of Caregiving in Chile.

Villalobos Dintrans, Pablo / Gazmuri, Javiera / Velasco, Carolina

Journal of aging & social policy

2023 , Page(s) 1–18

Abstract: Population aging will increase the demand for long-term care services. Many countries, including Chile, have not implemented comprehensive responses to address these demands, relying on informal care. This article aims to estimate the economic value of ... ...

Abstract	Population aging will increase the demand for long-term care services. Many countries, including Chile, have not implemented comprehensive responses to address these demands, relying on informal care. This article aims to estimate the economic value of caregiving in Chile, contributing to filling a gap in the literature and the policy debate. Economic value is estimated using replacement and opportunity cost approaches using two nationally representative databases: one survey on time use (to estimate hours of caregiving) and one on socioeconomic characterization (to identify caregivers and wages). Regressions for the determinants of caregiving effort and wages in the formal labor market are used to calculate the market value of caregiving time. Results show that the yearly value of caregiving ranges between US$266 million (when assuming a wage equal to the minimum wage for all caregivers) and US$4,946 million (when replacing all caregivers with nurses), i.e. between 0.11% and 1.95% of the country's gross domestic product. The analysis provides several estimations of the economic value of caregivers in Chile and, even considering these calculations can be underestimated, the results show the need to highlight and value the contribution of caregivers and implement policies to address the increase in long-term care needs in the country.
Language	English
Publishing date	2023-11-22
Publishing country	England
Document type	Journal Article
ZDB-ID	1046396-3
ISSN	1545-0821 ; 0895-9420
ISSN (online)	1545-0821
ISSN	0895-9420
DOI	10.1080/08959420.2023.2284576
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Article ; Online: Human Resources for Care in Latin America and the Caribbean: Current Needs and Future Demands.

Villalobos Dintrans, Pablo / Oliveira, Déborah / Stampini, Marco

Journal of the American Medical Directors Association

2023 Volume 25, Issue 2, Page(s) 232–236

Abstract: Objectives: To estimate the current gap and the necessary supply of human resources for care (HRC) for older people experiencing severe care dependence in Latin America and the Caribbean (LAC).: Design: Simulation study using previous estimations of ... ...

Abstract	Objectives: To estimate the current gap and the necessary supply of human resources for care (HRC) for older people experiencing severe care dependence in Latin America and the Caribbean (LAC). Design: Simulation study using previous estimations of severe care dependence for LAC countries. Setting and participants: Older people (aged 65+) experiencing severe care dependence in 26 countries of LAC. Methods: We calculated the current gap and the necessary supply of HRC in 2020, 2035, and 2050 assuming a mix of complementary human resources, in line with regional standards for long-term care (LTC) schemes, and differing levels of care coverage. Results: Considering 100% coverage of LTC services for the population aged 65+ experiencing severe care dependence, the region will need almost 5 million people working full-time in the sector. This figure is expected to increase to more than 14 million by 2050. Nurse assistants and nurses will be the professional profiles in highest demand. In addition, the region requires 2 million rehabilitation professionals in 2020, and this figure will increase to more than 6 million in 2050. Conclusions and implications: The rapid aging process in LAC will bring several challenges and opportunities to the region. Countries should start designing strategies to reduce the current gaps of HRC to meet older people's care needs in the coming years, in terms of both quantity and competencies, to help ensure that their human rights are met.
MeSH term(s)	Humans ; Aged ; Latin America/epidemiology ; Caribbean Region/epidemiology ; Workforce
Language	English
Publishing date	2023-10-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2023.08.026
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Article ; Online: Financing networks of care: a cross-case analysis from six countries.

Villalobos Dintrans, Pablo / Roder-DeWan, Sanam / Wang, Huihui

BMJ open

2023 Volume 13, Issue 11, Page(s) e072304

Abstract: Objectives: Describe experiences of countries with networks of care's (NOCs') financial arrangements, identifying elements, strategies and patterns.: Design: Descriptive using a modified cross-case analysis, focusing on each network's financing ... ...

Abstract	Objectives: Describe experiences of countries with networks of care's (NOCs') financial arrangements, identifying elements, strategies and patterns. Design: Descriptive using a modified cross-case analysis, focusing on each network's financing functions (collecting resources, pooling and purchasing). Setting: Health systems in six countries: Argentina, Australia, Canada, Singapore, the United Kingdom and the USA. Participants: Large-scale NOCs. Results: Countries differ in their strategies to implement and finance NOCs. Two broad models were identified in the six cases: top-down (funding centrally designed networks) and bottom-up (financing individual projects) networks. Despite their differences, NOCs share the goal of improving health outcomes, mainly through the coordination of providers in the system; these results are achieved by devoting extra resources to the system, including incentives for network formation and sustainability, providing extra services and setting incentive systems for improving the providers' performance. Conclusions: Results highlight the need to better understand the financial implications and alternatives for designing and implementing NOCs, particularly as a strategy to promote better health in low- and middle-income settings.
MeSH term(s)	Humans ; United Kingdom ; Argentina ; Australia ; Canada ; Singapore ; Healthcare Financing
Language	English
Publishing date	2023-11-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-072304
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Article ; Online: Panorama de la dependencia en Chile: avances y desafíos.

Villalobos Dintrans, Pablo

Revista medica de Chile

2019 Volume 147, Issue 1, Page(s) 83–90

Abstract: Chile is facing a process of rapid aging which poses several challenges. Among these challenges is the increase of dependency in the population. Despite its relevance, the topic has not been prioritized in the agenda. One explanation for this low- ... ...

Title translation	Dependency in Chile. Advances and challenges.
Abstract	Chile is facing a process of rapid aging which poses several challenges. Among these challenges is the increase of dependency in the population. Despite its relevance, the topic has not been prioritized in the agenda. One explanation for this low-priority is the lack of information on the concept of dependency. This article shows that, in fact, no consensus exists in Chile on how to define and measure dependency. Additionally, it provides an updated estimation of dependency in the country, aiming to foster further debate on the topic.
MeSH term(s)	Adolescent ; Adult ; Age Distribution ; Age Factors ; Aged ; Aged, 80 and over ; Chile/epidemiology ; Disability Evaluation ; Disabled Persons/statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Sex Distribution ; Time Factors ; Young Adult
Language	Spanish
Publishing date	2019-03-19
Publishing country	Chile
Document type	Journal Article
ZDB-ID	732136-3
ISSN	0717-6163 ; 0034-9887
ISSN (online)	0717-6163
ISSN	0034-9887
DOI	10.4067/S0034-98872019000100083
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Article ; Online: Designing Long-Term Care Systems: Elements to Consider.

Villalobos Dintrans, Pablo

Journal of aging & social policy

2019 Volume 32, Issue 1, Page(s) 83–99

Abstract: Population aging presents huge challenges for most countries around the world. In this context, long-term care systems appear as a feasible solution to the multidimensional issues arising from demographic change. However, designing a long-term care ... ...

Abstract	Population aging presents huge challenges for most countries around the world. In this context, long-term care systems appear as a feasible solution to the multidimensional issues arising from demographic change. However, designing a long-term care system is complex. This article presents a structure to analyze long-term care systems based on four components: beneficiaries, benefits, providers, and financing. It uses the experience of three countries to illustrate the many choices available when designing the system, emphasizing the need to understand each component and their interactions. The analysis highlights the existence of several alternatives when designing and implementing long-term care systems.
MeSH term(s)	Delivery of Health Care/organization & administration ; Germany ; Health Planning/organization & administration ; Health Policy ; Long-Term Care/organization & administration ; Netherlands ; Population Dynamics ; Republic of Korea
Language	English
Publishing date	2019-10-30
Publishing country	England
Document type	Journal Article
ISSN	1545-0821
ISSN (online)	1545-0821
DOI	10.1080/08959420.2019.1685356
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Article ; Online: Is aging a problem?: Dependency, long-term care, and public policies in Chile.

Dintrans, Pablo Villalobos

Revista panamericana de salud publica = Pan American journal of public health

2018 Volume 42, Page(s) e168

Abstract: Chile is facing changes associated with the demographic transition. So far, these challenges have been framed as age related. This has contributed to approaching a broad set of issues from a narrow perspective. The focus on aging has fragmented a ... ...

Abstract	Chile is facing changes associated with the demographic transition. So far, these challenges have been framed as age related. This has contributed to approaching a broad set of issues from a narrow perspective. The focus on aging has fragmented a multidisciplinary problem into different parts-particularly health and social policies-with different actors dealing with it from the perspective of their own sector. This process has generated an incomplete picture, preventing the definition and measurement of dependency and long-term care, and hindering a coordinated response to these issues. This article advocates for a change in the definition of the problem, by adopting the concept of long-term care, in order to gain a deeper and more comprehensive perspective on the issues arising from the situation that Chile is experiencing.
Language	English
Publishing date	2018-12-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	1376934-0
ISSN	1680-5348 ; 1020-4989
ISSN (online)	1680-5348
ISSN	1020-4989
DOI	10.26633/RPSP.2018.168
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Article ; Online: COVID-19 en Chile: análisis de su impacto por olas y regiones.

Ayala, Andrés / Dintrans, Pablo Villalobos / Elorrieta, Felipe / Maddaleno, Matilde / Vargas, Claudio / Iturriaga, Andrés

Revista medica de Chile

2024 Volume 151, Issue 3, Page(s) 269–279

Abstract: Background: The effects of COVID-19 in Chile changed over time and among regions.: Aim: To identify patterns in the impact and evolution of COVID-19 for each wave generated between 2020 and 2022 at the 16 regions of the country.: Material and ... ...

Title translation	The impact of the different waves of COVID-19 pandemic in Chile across regions.
Abstract	Background: The effects of COVID-19 in Chile changed over time and among regions. Aim: To identify patterns in the impact and evolution of COVID-19 for each wave generated between 2020 and 2022 at the 16 regions of the country. Material and methods: Several indicators related to the pandemic, their evolution and their consequences for the health system and the health of the population were calculated. Results: There are differences in the evolution of the infection across the regions of the country, as well as heterogeneity between waves. Specifically, the second wave in Chile was identified as the one with the greatest impact, with a national death rate of 123.5 deaths per 100,000 inhabitants and 66.4% intensive care unit occupancy rate due to COVID-19. Performing a geographic analysis, it was possible to find systematic patterns, for example, between regions with higher immunization rates and lower rates of lethality, such as the cases of Ñuble and Atacama regions. Conclusions: These results emphasize the need to consider regional differences and the temporal context for the elaboration of strategies to the efficient management of a pandemic.
MeSH term(s)	Humans ; COVID-19 ; Chile/epidemiology ; Pandemics ; Intensive Care Units ; Research Design
Language	Spanish
Publishing date	2024-01-31
Publishing country	Chile
Document type	English Abstract ; Journal Article
ZDB-ID	732136-3
ISSN	0717-6163 ; 0034-9887
ISSN (online)	0717-6163
ISSN	0034-9887
DOI	10.4067/s0034-98872023000300269
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Article ; Online: Why Health Reforms Fail: Lessons from the 2014 Chilean Attempt to Reform.

Villalobos Dintrans, Pablo

Health systems and reform

2019 Volume 5, Issue 2, Page(s) 134–144

Abstract: In 2014, Chile started a process to reform its private health insurance scheme. A commission was created and released a report with recommendations, but no changes have been introduced yet. This article analyzes that reform process. The analysis included ...

Abstract	In 2014, Chile started a process to reform its private health insurance scheme. A commission was created and released a report with recommendations, but no changes have been introduced yet. This article analyzes that reform process. The analysis included document review and interviews with key stakeholders involved in the process. Results show that although the Commission failed in producing the intended changes, it contributed to opening the debate regarding the Chilean health system, making explicit the different positions on the issue. The analysis shows that the reform did not advance because of the lack of basic consensus on the Commission's role, scope, and main purpose among stakeholders. Previous reforms highlight the relevance of time and information in creating a successful reform process.
MeSH term(s)	Chile ; Delivery of Health Care/economics ; Delivery of Health Care/legislation & jurisprudence ; Health Care Reform/history ; History, 21st Century ; Humans ; Insurance, Health/economics ; Insurance, Health/legislation & jurisprudence
Language	English
Publishing date	2019-05-10
Publishing country	United States
Document type	Historical Article ; Journal Article
ISSN	2328-8620
ISSN (online)	2328-8620
DOI	10.1080/23288604.2019.1589916
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Article ; Online: Informal caregivers in Chile: the equity dimension of an invisible burden.

Villalobos Dintrans, Pablo

Health policy and planning

2019 Volume 34, Issue 10, Page(s) 792–799

Abstract: Population aging is driving a process of increase in long-term care needs in Chile and many countries around the world. In this context, this article asks about the consequences of this increase in informal caregivers, emphasizing the inequity issues ... ...

Abstract	Population aging is driving a process of increase in long-term care needs in Chile and many countries around the world. In this context, this article asks about the consequences of this increase in informal caregivers, emphasizing the inequity issues arising from these changes. Using the CASEN 2017 survey, caregivers are identified and matched to people with long-term care needs. Results show that most caregivers are women, and a large fraction of them are also elderly; this is similar to what has been found previously in developed countries. Caregivers have fewer opportunities than non-caregivers, which translates into lower income-generating ability and higher poverty. The nature of these tasks creates a vicious cycle in which people get trapped with increasing needs and fewer resources to meet them. Important differences arise between caregivers and the rest of the population. Even more concerning is that these disparities are avoidable to some extent, adding an equity dimension to the problem. This emphasizes the need for the generation of policies that will support caregivers and meet their needs.
MeSH term(s)	Aging ; Caregivers ; Chile ; Female ; Healthcare Disparities/economics ; Humans ; Long-Term Care/economics ; Male ; Middle Aged ; Poverty ; Surveys and Questionnaires
Language	English
Publishing date	2019-10-10
Publishing country	England
Document type	Journal Article
ZDB-ID	632896-9
ISSN	1460-2237 ; 0268-1080
ISSN (online)	1460-2237
ISSN	0268-1080
DOI	10.1093/heapol/czz120
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