The Impact of Universal Health Care Programmes on Improving ‘Realized Access’ to Care for Depression in Chile

  • Ricardo Araya
  • Pedro Zitko
  • Niina Markkula
Original Article


Universal health care programmes have the potential to reduce treatment gaps. We explored the potential impact of an equity-oriented universal health care programme on access to care for depression, hypertension and diabetes using data from two nationally representative health surveys in Chile. The likelihood a depressed individual had accessed health care appears to have increased significantly after the programme was introduced whereas those for hypertension and diabetes remained unchanged. Depressed women seem to have benefited mostly from the programme. Universal health care programmes for depression could substantially increase coverage and reduce inequities in access to health care in middle-income countries.


Universal coverage Scaling up Treatment gap Depressive disorders Non-communicable diseases 



We would like to thank the Epidemiology and Statistics and Health Information from the Health Planning Division at the Chilean Ministry of Health for providing access to the data. We thank Dr. Mary de Silva for valuable suggestions on an earlier version of this manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The surveys were approved by local ethical committees including the Ethics Committee of the Chilean Ministry of Health and the Ethics Committee of the Faculty of Medicine, Pontificia Universidad Catolica de Chile. Written informed consent was obtained from all adult interviewees. Individuals with ages between 16 and 18 years provided assent and parents were requested to provide written consent. The Ethics Committees approved all consent procedures. More information can be found in


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Copyright information

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Authors and Affiliations

  1. 1.Health Service & Population Research Department, IoPPNKing’s CollegeLondonUK
  2. 2.Department of Public Health, Faculty of MedicinePontificia Universidad Católica de ChileSantiagoChile
  3. 3.Unit of Healthcare StudiesComplejo Asistencial Barros LucoSantiagoChile
  4. 4.Faculty of Medicine Clínica AlemanaUniversidad del DesarrolloSantiagoChile
  5. 5.Centre for Global Mental Health and Primary Care Research, Health Service & Population Research (PO36), Institute of Psychiatry, Psychology & Neuroscience, David Goldberg CentreKing’s College LondonLondonUK

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