CABIESES VALDES, BALTICA BEATRIZ
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CABIESES VALDES, BALTICA BEATRIZ
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bcabieses@udd.cl
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15829003900

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Understanding Therapeutic Trajectories of Adults With Lung Cancer in Chile: A Multi-Methods Study of Time to Diagnosis and Perceived Experience

2023 , CABIESES VALDES, BALTICA BEATRIZ , Carla Campaña , OBACH KING, ALEXANDRA ALICE , VEZANNI, FRANCISCA , Manuel Espinoza , Marcela Oyarte

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Adequate housing as a social determinant of the health of international migrants and locals in Chile between 2013 and 2022

2024 , Alice Blukacz , Marcela Oyarte , CABIESES VALDES, BALTICA BEATRIZ

Abstract Background Adequate housing is a fundamental right and a social determinant of health. It also represents a historically contentious topic in Latin America. Migratory flows to Chile have become increasingly precarious in the past few years, limiting opportunities for adequate housing, with potential repercussions on the health of international migrants and the general population. This study aims to analyse adequate housing as a social determinant of health among international migrants and locals between 2013 and 2022 in Chile. Methods Observational cross-sectional study based on repeated versions of the nationally representative Socioeconomic Characterization Survey in Chile. Adequate housing indicators adapted from the United Nations Housing Rights Programme guidelines were analyzed with relation to individual health, distinguishing between the local and international migrant populations. Logistic regression models were fitted for housing indicators with migration as the main independent variable and for short-term and long-term healthcare needs in locals and immigrants with housing as the main dependent variables. Models were adjusted for sociodemographic variables and considered the complex sample design. Results Descriptive findings indicated higher availability of services and infrastructure among international migrants, and a disadvantage for habitability, location, and affordability by quintiles compared to locals. Logistic regression models, adjusting for demographic variables, revealed significant associations between migration status and overcrowding (OR 6.14, 2022), poor housing materiality (OR 5.65, 2022) and proximity to healthcare centres (OR 1.4, 2022) compared to locals. Experiencing hazardous situations consistently predicted short-term healthcare needs in both migrants (OR = 1.4, 2022) and locals (OR = 2.8, 2022). Overcrowding predicted both long and short-term healthcare needs among locals across the years and long term needs among migrants in 2013 and 2015. Conclusions We found significant inequities in adequate housing between migrant populations and locals in Chile, and some inequities among both populations based on structural socioeconomic deprivation. Experiencing hazardous situations emerged as a social determinant of health among international migrants in 2022, potentially suggesting growing challenges related to social exclusion in urban areas. However, limitations such as exclusion criteria of the survey and sample sizes for data on the migrant population potentially suggest that housing challenges and their impact on health are underestimated.

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Chile necesita mejores estadísticas y mayor cobertura en tamizaje de retinopatía diabética

2017 , Trinidad Covarrubias , Marcela Oyarte , CABIESES VALDES, BALTICA BEATRIZ , Marcelo Coria

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Health and Migration: A Comparative Descriptive Analysis of Hospital Discharges in the Foreign and Chilean Populations

2017 , Lorenzo Agar Corbinos , DELGADO BECERRA, OROZIMBA IRIS , Marcela Oyarte , CABIESES VALDES, BALTICA BEATRIZ

La migración es un reconocido determinante social, con amplio impacto en la salud pública. Chile es uno de los países que presenta mayores cifras de crecimiento de la migración en Latinoamérica; pese a esto, son pocos los datos estadísticos oficiales en relación con la prevalencia de enfermedades o condiciones de salud de los inmigrantes. Este artículo tiene como propósito aportar al conocimiento de la salud de los inmigrantes externos en Chile, con foco en la morbilidad hospitalaria. Estudio observacional y de corte transversal. Análisis de datos sobre hospitalizaciones (egresos hospitalarios) en Chile, año 2012, a través de tasas específicas, cifras absolutas y distribuciones porcentuales –con y sin considerer los egresos relacionados con embarazos partos o puerperio– según variables demográficas, territoriales y previsión de salud, en población chilena y extranjera. 

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Hospitalizations for cancer in international migrants versus local population in Chile [Hospitalizaciones por cáncer en migrantes internacionales y población local en Chile]

2018 , Marcela Oyarte , DELGADO BECERRA, OROZIMBA IRIS , Víctor Pedrero , Lorenzo Agar , CABIESES VALDES, BALTICA BEATRIZ

OBJECTIVE: To compare cancer hospital morbidity among the local population and the immigrant population in Chile. METHODS: This is a prevalence study based on the analysis of hospital discharges of all the health centers of Chile. Cancer hospital discharges were characterized in 2012 according to the migratory status. The crude and specific rates of hospital morbidity for this cause were estimated for the analysis of their association with migratory status using zero-inflated negative binomial regression, adjusted for sociodemographic variables. RESULTS: The neoplasms were the third cause of hospital discharges for immigrants and the seventh one for Chileans. The adjusted rate of cancer hospital discharges was higher for Chileans than immigrants, and the latter had fewer days of hospitalization and greater proportion of surgical interventions. In the group of immigrants, cancer hospital discharges mainly corresponded to patients belonging to the private system (46%), and in the group of Chileans they mainly corresponded to patients in the public system (71.1%). We observed a large difference in the proportion of cancer hospital discharges for patients with no health insurance between the two populations (22.6%: immigrants, 1.0%: Chileans). In both populations, the three most frequent types of cancer were: (i) lymphoid tissue, hematopoietic organs, and related tissues, (ii) digestive organs, and (iii) breast cancer. CONCLUSIONS: Models of differentiated care should be considered for immigrants, with the creation of specific programs of information, coverage, and protection against cancer. More information on this problem must be generated at the local and international level.

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Acceso a salud de migrantes internacionales en pandemia en Chile: resultados de encuesta cuantitativa

2023 , CABIESES VALDES, BALTICA BEATRIZ , Marcela Oyarte , Maria Ines Alvarez , Alice Blukacz , OBACH KING, ALEXANDRA ALICE , CARREÑO CALDERON, ALEJANDRA ANGELICA , Edward Mezones , Claudio Osses

El objetivo del estudio fue analizar barreras de acceso a la atención de salud en Chile reportadas por migrantes internacionales residentes en la región metropolitana del país y factores asociados. Para ello, se aplicó una encuesta en formato digital sobre vulnerabilidades y recursos de comunidades migrantes en Chile para enfrentar la pandemia SARS-CoV-2. Se realizó análisis descriptivo y estratificado por variables demográficas, socioeconómicas, tipo de previsión de salud y estatus migratorio. Como resultados, inmigrantes provenientes de Haití reportaron el mayor porcentaje de barreras de acceso a la atención en salud, esto tras ajustar por variables sociodemográficas y estatus migratorio.

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Health inequality gap in inmigrant versus local children in Chile

2017 , CABIESES VALDES, BALTICA BEATRIZ , Macarena Chepo , Marcela Oyarte , Niina Markkula , Patricia Bustos , Víctor Pedrero , DELGADO BECERRA, OROZIMBA IRIS

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Plasticity in the interoceptive system

2017 , Trinidad Covarrubias , Marcela Oyarte , CABIESES VALDES, BALTICA BEATRIZ , Marcelo Coria , CARLOS MADRID

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Breast cancer diagnosis and staging in Chile: A non-randomized survey-based study to assess frequency and delays

2024 , Carla Campaña , Marcela Oyarte , CABIESES VALDES, BALTICA BEATRIZ , OBACH KING, ALEXANDRA ALICE

Introduction Breast cancer progression involves physiological mechanisms such as metastasis. Delays in diagnosis and treatment increase the risk of mortality and are associated with barriers to healthcare access. In Chile, breast cancer is highly prevalent, and early diagnosis has improved, although disparities in the disease evolution persist. This study characterized diagnostic and staging tests, waiting times, and sociodemographic profiles to identify delays and inequities in care. Methods Survey study. Using a non-probabilistic sample, a questionnaire was applied in an encrypted platform with prior informed consent. The instrument collected data on requested tests, associated times, staging, and sociodemographic characteristics. These variables were analyzed using descriptive statistics, tests of association, confidence intervals, and comparison tests using bootstrapping. Results A sample of 263 persons was obtained. The most requested tests were biopsy (99.62%) and blood tests (80.23%). The median number of tests requested was six (Q1:4, Q3:8), with a mean of 5.87 (standard deviation: 2.24). No significant differences were observed in the percentage of persons from whom the total number of examinations were requested according to the studied variables. The day-hour-result intervals ranged from 1 to 365 days. The median day-hour-result of the biopsy was 15 days (Q1:10, Q3:30). People between 40 and 49 years old, non-residents of the capital city, belonging to income quintile I, with high school education, from the public health system, with late-stage diagnosis had higher median day-hour-result in biopsy. There was no significant difference in the number of requested tests according to staging (I and II, or III and IV). Conclusions Biopsy in Chile is the test of choice for diagnostic confirmation in breast cancer. Other tests are requested regardless of the diagnosis stage, contrary to the recommendations of clinical guidelines. Cancer prognosis is crucial, especially in countries with greater inequalities.

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Unequal Access and Use of Health Care Services among Settled Immigrants, Recent Immigrants, and Locals: A Comparative Analysis of a Nationally Representative Survey in Chile

2022 , Marcela Oyarte , CABIESES VALDES, BALTICA BEATRIZ , Isabel Rada , Alice Blukacz , Manuel Espinoza , Edward Mezones-Holguin

Globally, and particularly in the Latin American region, international migration continues to grow. Access and use of health care services by migrants vary according to their country of origin and residence time. We aimed to compare the access and use of health care services between international migrants (including settled migrants from Peru, Argentina, Bolivia, Ecuador; Emerging migrants from Venezuela, Dominican Republic, Colombia, Haiti; and migrants from other countries) and the Chilean population. After performing a secondary data analysis of population-based nationally representative surveys (CASEN 2011–2017), access and use patterns (insurance, complementary insurance, non-consultation, and non-treatment coverage) were described and compared among settled immigrants, recent emerging immigrants, others, and locals. Immigrants had a significantly higher uninsured population compared to locals. Specifically, in CASEN 2017, 19.27% of emerging (95% CI: 15.3–24.1%), 11.79% of settled (95% CI: 10.1–13.7%), and 2.25% of locals (95% CI: 2.1–2.4%) were uninsured. After 2013, settled and recent emerging migrants showed higher percentages of non-consultation. Collaborative and interculturally relevant strategies from human rights and equity perspectives are needed. Initiatives with a particular focus on recent immigrants can contribute to reducing the existing disparities in health care access and use with locals due to lack of insurance and treatment coverage.

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