Page 174 - GHES-2-4

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

Table 7. Average effective financial coverage (%) of face‑to‑face medical consultations in plans without restricted coverage by
Isapre (2022)
Health service Colmena Cruz Vida Nueva Banmédica Consalud Whole
Blanca Tres Masvida system
Pediatric and adolescent psychiatry specialty medical consultation 49.0 24.4 47.2 26.5 35.7 36.6
Specialty medical consultation in adult psychiatry 56.6 27.1 47.1 28.1 41.9 40.1
Clinical psychologist consultation (45 sessions) 62.3 56.1 42.3 64.9 45.7 58.5 55.0
Specialty medical consultation in emergency medicine 51.7 62.5 48.2 68.3 54.4 53.3 56.4
Specialty medical consultation in adult neurology 54.7 66.0 53.2 57.8 56.2 58.5 57.7
Specialty medical consultation in internal medicine 56.9 66.5 55.8 61.6 55.0 59.5 59.2
Dermatology specialty medical consultation 58.3 68.4 54.6 60.9 55.0 59.5 59.4
Otolaryngology specialty medical consultation 59.5 70.1 59.7 61.6 61.4 62.0 62.4
Ophthalmology specialty medical consultation 58.0 68.8 56.1 69.3 57.9 65.2 62.6
Specialty medical consultation in traumatology and orthopedics 59.7 69.6 59.8 63.0 61.0 64.0 62.8
Specialty medical consultation in pediatrics 62.3 71.1 59.5 69.1 61.2 65.0 64.7
General medicine consultation 65.2 74.3 59.6 65.9 63.5 62.0 65.1
Urology specialty medical consultation 61.8 71.4 61.1 66.0 65.0 66.1 65.2
Obstetrics and gynecology specialty medical consultation 65.9 72.7 62.1 72.7 64.3 68.7 67.7
Source: Superintendence of Health, Claims Services Master File.

Table 8. Average effective financial coverage (%) of face‑to‑face medical consultations in plans with restricted coverage by Isapre
(2022)
Health service Colmena Cruz Vida Nueva Banmédica Consalud Whole
Blanca Tres Masvida system
Pediatric and adolescent psychiatry specialty medical consultation 22.8 32.1 28.6 23.6 27.7 33.3 28.0
Specialty medical consultation in adult psychiatry 28.9 32.2 32.5 27.1 31.0 33.2 30.8
Clinical psychologist consultation (45 sessions) 30.9 34.5 32.6 27.5 34.3 26.4 31.0
Specialty medical consultation in emergency medicine 53.3 61.0 43.0 60.3 51.6 57.0 54.4
Specialty medical consultation in adult neurology 56.2 60.1 59.3 48.2 56.0 59.7 56.6
Dermatology specialty medical consultation 59.1 63.6 59.5 52.5 57.4 61.8 59.0
Specialty medical consultation in internal medicine 58.9 62.3 60.4 56.3 57.6 60.6 59.3
Ophthalmology specialty medical consultation 60.3 66.0 62.1 62.3 59.3 67.6 62.9
Specialty medical consultation in traumatology and orthopedics 62.1 66.2 65.2 57.2 62.6 66.0 63.2
Otolaryngology specialty medical consultation 61.9 67.5 64.3 59.6 62.0 65.5 63.5
Obstetrics and gynecology specialty medical consultation 64.1 68.5 63.7 61.7 63.6 68.6 65.0
Specialty medical consultation in pediatrics 64.1 69.0 63.9 62.0 63.3 68.0 65.1
General medicine consultation 67.1 70.3 61.3 61.8 64.1 65.9 65.1
Urology specialty medical consultation 64.1 68.3 65.8 63.4 64.6 68.1 65.7
Source: Superintendence of Health, Claims Services Master File.

have the lowest average effective coverage among specialty specialties analyzed (both in plans without coverage
consultations. restriction and plans with restricted coverage). The most
Analyzing the consultations associated with telemedicine significant differences in favor of telemedicine consultations
(Tables 9 and 10) shows the same phenomenon observed are precisely those associated with MH. The same result is
in 2021, where systematically higher coverage is found obtained when analyzing this result by Isapre (except for
concerning face-to-face medical consultations in all the pediatric psychiatry consultations in Cruz Blanca).

Volume 2 Issue 4 (2024) 8 https://doi.org/10.36922/ghes.3408