Maria Isabel Nunez Hernandez
University of the Andes, ChilePresentation Title:
Evaluation of the explicit health guarantees program for breast cancer in Chile, 20 Years after its enactment.
Abstract
In July 2004, Law No. 19,966 was enacted, creating the General Regime of Explicit Health Guarantees (GES), then known as AUGE (Universal Access with Explicit Guarantees).
The objective was to guarantee equitable access to a set of priority health problems through legal guarantees of opportunity, access, quality, and financial protection. In January 2005, breast cancer was incorporated into the GES. Through Supreme Decree No. 44/2004, it was one of the first 25 health problems covered. Upon entering the GES program, breast cancer was defined as: "Breast cancer in people 15 years of age and older, with a suspected diagnosis."
The program covers the following stages:
1. Suspected diagnosis (mammography, biopsy)
2. Diagnostic confirmation
3. Comprehensive treatment: Surgery, chemotherapy, radiotherapy, and hormone therapy
4. Follow-up, palliative care, and rehabilitation
5. Guarantees of access, timeliness, and financial protection.
Twenty years after its creation, it is necessary to evaluate its effectiveness in public health in Chile. The objective of this study is to evaluate compliance with the Explicit Health Guarantees for breast cancer in Chile and to determine some of the reasons for this compliance. A descriptive cross-sectional study based on the analysis of official and public databases in Chile.
The GES has represented a significant advance in diagnostic timeliness, access to treatment, and in reducing breast cancer mortality in Chile. However, gaps persist—more than 20% do not begin treatment within the timeframe—and a diagnostic delay occurs in almost 60% of cases, according to recent reports. Improving deadline compliance is key to strengthening the effectiveness of the GES.
Biography
Isabel Nunez is a Nurse-Midwife from the Catholic University of Chile, a master’s degree in health services administration from the University of the Andes and a PHD in science from the University of Sao Paulo. She is Senior lecture at the Universidad de Los Andes where she works as a research professor. Her line of research is women's health. During the Pandemic, together with a team of researchers from the university, she won a FONIS, (National Health Research Fund) investigating the effect of maternal stress due to COVID on breastfeeding and child development.
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