Page 176 - GHES-2-4

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

Table 11. Average effective financial coverage (%) of bed days in plans without restricted coverage by Isapre (2022)
Health service Colmena Cruz Vida Nueva Banmédica Consalud Whole
Blanca Tres Masvida system
Psychiatric hospitalization bed days 72.4 16.9 44.7
Adult hospitalization in ICU bed days 69.5 44.6 57.1
Adult hospitalization in ITU bed days 80.9 46.6 43.8 57.1
Obstetrics and gynecology hospitalization bed days (1 bed with bathroom) 62.9 52.6 62.6 59.4
Integral adult hospitalization in ICU bed days 63.6 77.0 60.6 77.9 70.4 69.9
Integral adult hospitalization in ITU bed days 70.9 75.5 68.7 72.5 65.7 70.7
Obstetrics integral hospitalization bed days (1 bed) 72.6 73.9 70.6 77.1 76.9 74.2
Medicine and specialties hospitalization bed days (1 bed with bathroom) 77.6 82.3 69.9 67.5 74.3
Integral basic care hospitalization bed days (1 bed) 75.2 73.5 78.7 71.3 76.6 75.1
Surgery hospitalization bed days (1 bed with bathroom) 75.1 100.0 87.6
Source: Superintendence of Health, Claims Services Master File.
Abbreviations: ICU: Intensive care unit; ITU: Intermediate treatment unit.
Table 12. Average effective financial coverage (%) of bed days in plans with restricted coverage, according to Isapre (2022)

Health service Colmena Cruz Vida Nueva Banmédica Consalud Whole
Blanca Tres Masvida system
Psychiatric hospitalization bed days 20.9 22.3 5.8 16.8 75.0 9.3 25.0
Adult hospitalization in ICU bed days 73.9 78.1 75.8 70.4 55.0 49.3 67.1
Obstetric integral hospitalization bed days (1-bed ward) 25.0 88.0 79.9 58.2 77.1 75.0 67.2
Adult hospitalization in ITU bed days 74.3 76.9 78.8 58.5 75.7 61.2 70.9
Adult integral hospitalization in ITU bed days 80.6 80.2 66.5 74.8 60.3 72.5
Integral basic care hospitalization bed days (1-bed ward) 70.0 85.0 78.8 70.9 74.7 66.7 74.4
Integral adult hospitalization in ICU bed days 81.7 77.8 75.3 71.0 67.8 74.7
Surgery hospitalization bed days (1 bed with bathroom) 79.1 85.0 71.3 79.0 75.9 63.5 75.7
Obstetrics and gynecology hospitalization bed days (1 bed with bathroom) 80.5 75.4 82.9 79.9 89.5 59.2 77.9
Medicine and specialties hospitalization bed days (1 bed with bathroom) 84.5 87.2 75.2 80.9 79.5 77.3 80.8
Source: Superintendence of Health, Claims Services Master File.
Abbreviations: ICU: Intensive care unit; ITU: Intermediate treatment unit.

As mentioned above, in 2021, sick leaves for mental prevalence (e.g., in terms of the burden of disease due to
disorders exhibited the lowest proportion of authorized depressive disorders and anxiety disorders) (Li et al., 2022).
sick leaves among all diagnostic groups. This group was the Regarding this study, the same phenomenon is
only one where the proportion of rejected/authorized sick observed when analyzing the average effective coverage
leaves exceeded that of authorized sick leaves, which was in face-to-face medical consultations for 2021 (Table A1):
further accentuated in 2022. The proportion of authorized consultations associated with MH have the lowest effective
sick leaves associated with MH again exhibited the financial coverage among all medical specialties, where
lowest percentages among all diagnoses. This proportion coverage for women is slightly lower than for men. The
decreased even more in 2021, when only 1 of 5 (20%) same pattern is repeated when analyzing telemedicine
processed sick leaves were authorized and 4 of 5 (80%)
processed were rejected or reduced. These figures again consultations (Table A2): although consultations associated
represent the highest proportion among all diagnoses with MH have a higher level of coverage concerning face-
(followed by musculoskeletal sick leaves with 50.8%). to-face consultations, telemedicine consultation of MH is
the lowest concerning the other specialties, and its coverage
3.3. Analysis by gender is higher for men.
Regarding MH, analysis by gender is relevant because the For 2022, face-to-face medical consultations
figures indicate different realities in terms of incidence and (Tables A3 and A4) in plans without restricted coverage

Volume 2 Issue 4 (2024) 10 https://doi.org/10.36922/ghes.3408