Translating Evidence to Policy – the Chilean Health Benefits Plan Development Process

Health Systems’ Global (HSG)’s Translating Evidence into Action Working Group will host a webinar exploring Chile’s use of evidence in the design of their Universal Access with Explicit Guarantees (AUGE) health benefit plan (HBP) and reflecting on factors that can facilitate and hinder the process of evidence-based design.

The focus of this webinar is the use of evidence to inform policy. During the webinar we will consider the trade-offs and criteria through which evidence is filtered into the design process, and reflect on the factors, stakeholders, and implementation processes that influence when and how evidence is used in the development of an HBP.

Background 
Many low- and middle-income countries grappling with the design of their HBPs have applied lessons learned from Chile to their own contexts—amongst its peers, Chile is known for its relatively effective health system, where health outcomes are achieved at a fairly low cost. However, Chile faced many challenges along the way. A series of reforms in the late 20th century led to an unequal health system where socioeconomic status essentially dictated level of care and services received—poor and low-income citizens used public insurance with long waiting lists and low quality services, while higher income citizens used private insurance to access higher quality services. Individuals in both the public and private systems reported inadequate financial protection. To address these challenges, the Government of Chile established the AUGE HBP to guarantee equitable access to quality services and financial protection, as part of a comprehensive reform process. Evidence was used to determine the initial contents of the HBP through intentional, legally determined processes. This experience in designing the HBP established a culture of evidence-based decision-making in Chile’s health system.