Factores asociados a los desplazamientos de la demanda en salud en Perú, 2007-2021: un modelo discreto de privatización e informalización

Introduction: This study aims to identify the factors associated with changes in the demand for healthcare services in Peru during the period 2007-2021. Objective: To analyze the transformations that occurred in the demand for healthcare services and the pattern of utilization in Peru during the period 2007-2021, with the purpose of identifying independent explanatory variables for this evolution. Methodology: This is an explanatory quantitative study that employs fixed-effects linear regression coefficients and the Chow test. Comprehensive national databases were constructed using annual National Household Surveys. Trends in the Peruvian healthcare system were identified, Pearson correlation coefficients were analyzed between selected variables, and seven regression equations were applied to assess them. Results: The regression coefficients demonstrated the impact of public expenditure and waiting times for pharmacy consultations, as well as the opening of new private level I establishments and their influence on healthcare waiting times and the Ministry of Health (Minsa), as well as on the quality of care, perceptions of mistreatment, and lack of trust in providers. Similarly, these factors influenced the increase in pharmacy consultations and in the private primary care sector. Conclusion: This study, based on the Peruvian case, provides information about a possible evolution in low-income and high-informality countries towards deinstitutionalized and more fragmented healthcare systems.