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The Dynamics of Healthcare Systems Segmentation: The institutional stratification of social groups in South America

Project description

Comparative and historical study of healthcare segmentation in South America

Healthcare system segmentation – dividing the patient population into segments according to needs, characteristics or behaviours – aims to enable healthcare tailored to specific needs. However, in differentiating healthcare ‘rights’, institutions can deepen existing disparities. With the support of the Marie Skłodowska-Curie Actions programme, the HESS project will conduct an extensive study of the emergence and development of healthcare system segmentation in 12 South American countries from a comparative and historical perspective. The project will evaluate inclusion and exclusion of certain social groups as well as changes over time. Furthermore, it will attempt to explain the factors contributing to the patterns observed. Its publicly available dataset will support future research.

Objective

Welfare states, in general, aim to mitigate social inequalities; however, in differentiating rights among social groups, their institutional architecture may further deepen pre-existing disparities. In the field of healthcare, this phenomenon has been coined as healthcare system segmentation; that is, the co-existence of different and independent healthcare arrangements, each of them targeting distinct social groups. Particularly prevalent in the Global South, healthcare system segmentation is largely neglected by the scholarship, and the few existing studies focus on contemporary manifestations of the phenomenon, while its origin, evolution, and reasons for existence remain unexplored. To fill this gap, the project (HESS) aims at investigating the emergence and development of healthcare system segmentation in twelve South American countries from a comparative and historical perspective. First, it will describe and analyse healthcare system segmentations (a) emergence and expansion, (b) inclusion and exclusion of social groups, (c) cross-country variation, and (d) temporal distribution. Second, it will explain whether the extent of segmentation observed within and across countries can be explained by economic, political, social, and/or policy-field specific factors. To do so, HESS will construct a novel dataset on the historical development of healthcare system segmentation in the region. This data will be made publicly available on a newly developed website, fostering further research in the domain. Adopting document analysis, descriptive statistics, and qualitative comparative analysis (QCA), the project will enrich theoretical and empirical understandings of welfare states and healthcare systems of the Global South, as well as provide guidance for policy-making, especially in light of the increasing global call for Universal Health Coverage put forth by the Sustainable Development Goals and most recently by the COVID-19 pandemic.

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Coordinator

UNIVERSITAT AUTONOMA DE BARCELONA
Net EU contribution
€ 165 312,96
Address
EDIF A CAMPUS DE LA UAB BELLATERRA CERDANYOLA V
08193 Cerdanyola Del Valles
Spain

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Region
Este Cataluña Barcelona
Activity type
Higher or Secondary Education Establishments
Links
Total cost
No data