Page 171 - GHES-2-4

Global Health Economics and
Sustainability
Evaluation of mental health law in Chile

Table 2. Average effective financial coverage (%) of face‑to‑face medical consultations by Isapre in 2021
Health service Colmena Cruz Vida Nueva Banmédica Consalud Whole
Blanca Tres Masvida system
Pediatric and adolescent psychiatry specialty medical consultation 20.7 31.6 27.6 21.5 26.7 33.4 26.9
Specialty medical consultation in adult psychiatry 21.9 31.0 32.2 24.3 29.8 34.3 28.9
Clinical psychologist consultation (45 sessions) 26.7 34.6 31.6 29.0 33.2 25.7 30.1
Specialty medical consultation in emergency medicine 51.6 61.0 38.2 52.3 49.7 52.8 50.9
Specialty medical consultation in adult neurology 54.6 59.9 57.8 50.5 55.0 58.8 56.1
Specialty medical consultation in internal medicine 57.2 60.7 59.0 54.6 56.7 59.1 57.9
Dermatology specialty medical consultation 57.3 62.5 58.6 51.5 56.8 61.3 58.0
Ophthalmology specialty medical consultation 57.8 64.5 60.7 60.6 58.0 67.6 61.5
Specialty medical consultation in traumatology and orthopedics 60.1 64.8 63.8 57.1 61.6 65.0 62.1
Specialty medical consultation in otorhinolaryngology 60.0 66.2 63.0 59.8 61.2 65.0 62.5
Specialty medical consultation in pediatrics 61.4 67.2 62.5 58.8 62.0 67.1 63.2
General medicine consultation 65.2 69.1 58.2 60.8 61.8 64.8 63.3
Obstetrics and gynecology specialty medical consultation 62.0 66.8 62.3 60.6 62.4 67.5 63.6
Urology specialty medical consultation 62.4 67.5 64.9 63.2 64.0 67.7 64.9
Source: Superintendence of Health, Claims Services Master File.

Table 3. Average effective financial coverage (%) of telemedicine medical consultations by Isapre in 2021
Health service Colmena Cruz Vida Nueva Banmédica Consalud Whole
Blanca Tres Masvida system
Specialty medical teleconsultation in pediatric and adolescent psychiatry 21.0 34.4 33.1 25.6 33.1 45.0 32.0
Teleconsultation of medical specialty in adult psychiatry 34.3 39.1 35.2 36.2 35.7 56.5 39.5
Telerehabilitation: clinical psychologist (45 sessions) 38.0 52.7 40.9 35.0 43.6 35.6 41.0
Teleconsultation of medical specialty in adult neurology 60.3 65.4 63.1 54.7 60.6 64.1 61.4
Teleconsultation of medical specialty in obstetrics and gynecology 63.5 74.2 58.9 57.5 60.2 68.9 63.9
Teleconsultation of medical specialty in internal medicine 64.9 66.8 63.8 61.6 61.9 66.0 64.2
Teleconsultation of medical specialty in pediatrics 63.9 72.6 63.7 58.5 63.3 69.2 65.2
Specialty medical consultation in adult gastroenterology 64.8 73.1 68.3 58.0 65.2 63.4 65.5
Teleconsultation of medical specialty in dermatology 64.7 77.2 66.6 59.1 65.6 68.2 66.9
General medicine teleconsultation 71.6 80.5 61.2 64.1 63.2 74.6 69.2
Source: Superintendence of Health, Claims Services Master File.

Regarding sick leave, the 21,331 law states that health In 2021, curative sick leaves (Tables 5 and 6) linked
care may not give rise to discrimination concerning to mental disorders (ICD-10 group F) were first in the
other illnesses in the rate of acceptance of sick leave. number of processed (497,952, or 28% of the total) and the
In this regard, the circular issued by the SoH does number of authorized sick leaves (175,146, or 14.4% of the
not refer to sick leave. In any case, this study analyzes total). However, sick leaves related to mental disorders also
whether any changes occurred due to the 21,331 law’s occupy the first place in rejected (235,285 or 63.7% of the
implementation. total) and reduced sick leaves (87,521 or 45.3%).
Sick leave is an element that distorts the financing Analyzing sick leaves within each diagnostic group
system because part of the funds allocated to health (7% according to the type of resolution reveals discouraging
mandatory in Chile) are used to pay for sick leave (which results that should concern the health sector, specifically for
in other countries is understood as a labor right and MH. Indeed, of the total number of sick leaves processed
financed exclusively by the employer); for Chile and MH, for MH, 64.8% are either rejected or reduced, i.e., two of
it is a particularly relevant issue. every three sick leaves processed for mental disorders are

Volume 2 Issue 4 (2024) 5 https://doi.org/10.36922/ghes.3408