Distancia al centro de atención en salud y mortalidad durante los primeros años de vida: Revisión sistemática y Metaanálisis

Diego Fernando Rojas Gualdrón, Beatriz Caicedo Velásquez

Resumen


Introducción. Si bien se han logrado avances considerables en la reducción de la mortalidad en la niñez, los avances han mostrado importantes desigualdades entre los territorios. La distancia entre el lugar de residencia de los menores y el centro de atención en salud más cercano se ha identificado como uno de los factores que puede explicar tales diferencias.

Objetivo. Actualizar las revisiones sistemáticas sobre el efecto de la distancia a los centros de atención en salud  en la mortalidad de menores de cinco años con artículos publicados hasta mayo de 2015.

Método. Revisión sistemática con metaanálisis según recomendaciones de PRISMA. Se estimó un modelo de efectos aleatorios y se realizaron análisis de sesgo y de heterogeneidad de las estimaciones.

Resultados. Residir a más de 5 km del centro de atención de salud se asocia con un mayor riesgo de muerte en los periodos perinatal OR 2,76 (IC95% 1,80 – 4,23), neonatal OR 1,62 (IC95% 1,33 – 1,96), infantil OR 1,31 (IC95% 1,16 – 1,48), durante la niñez OR 1,57 (IC95% 1,29 – 1,92) y en todos los grupos de edad OR 1,63 (IC95% 1,41 – 1,88).

Discusión. Se resalta la importancia de considerar una distribución geográfica de los centros de atención en salud que permita a los menores residentes en áreas remotas menores riesgos de muerte durante los primeros años de vida.

Palabras clave


Accesibilidad a los servicios de salud, Disparidades en atención de salud, Área sin atención médica, Mortalidad infantil, Metanálisis

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Referencias


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