In 2022, the number of electronic medical licenses (LMEs) issued in both isapres and Fonasa was 10,022,943, which means an increase of 13.8% compared to 8,808,755 LMEs issued in 2021. Meanwhile, medical licenses issued reached 9,283,961, representing an increase of 14.7% compared to 2021.
This comes from the 2022 annual report on electronic medical license (LME) issuers, prepared by the Social Security Superintendence (Suseso), where it shows that about 93% of LME issued in 2022 are declared by medical controllers. Date document was created.
Of course, the figures shown in the study do not include paper-issued medical licenses, which, Suesso estimates, could account for about 2% of the total in 2022, and 5% in 2021, so they are strictly There are no comparable years, but approximate variations can be obtained.
Of the licenses that have been announced, the document shows that 78.5% correspond to FONASA (7,286,284), compared to 21.5% (1,997,677) in isapres. Something similar happened in 2021, where 79.4% were from Fonasa and 20.6% from Isapress.
Looking at the main groups of diagnoses where apparent SCI were concentrated, it is found that those associated with mental disorders, COVID-19, musculoskeletal diseases and respiratory diseases represent approximately 70% of the total apparent SCI for 2021 and 2022.
In 2022, mental disorders will lead at 29.7% of the total, followed by COVID-19 (16.8%), musculoskeletal (16%), respiratory (9.4%), trauma (5.8%), digestive (3.7%), infectious and parasitic (3.2%), nervous system (2.7%), and other diagnoses (12.6%).
“Diagnoses associated with Covid-19 and musculoskeletal diseases present a decrease in their proportion in 2022. Respiratory diseases, on the other hand, show an increase in 2022, where the latter increased by more than 2 times from the value of 2021”, towards the document indicates.
Overall, “the three regions with the highest proportion of SCI in both years were the metropolitan area, Valparaíso and Biobio, which is consistent with the country’s population distribution. For their part, the three regions with the lowest participation in both years were Aisen, Arica y Parinacota and Magallanes”, the report said.
The report also evaluates professionals who issue medical licenses, but this section excludes LMEs issued by health professionals who have the authority to issue a high volume of licenses linked to Covid-19 from Cerme de Salud is “and, if applicable, the Parent Preventive Medicine License (LMPP)”, the report says.
And it adds that “With this restriction, the number of professionals debarred for the year 2021 is 2,130 and for the year 2022 is 2,047, which issued 1,108,279 and 769,673 LMEs respectively.”
Under this scenario, the number of LMEs with announcements that are part of the analysis correspond to 6,987,591 for 2021 and 8,514,288 for 2022. These were provided by 38,869 and 43,635 health professionals in 2021 and 2022 respectively. This means an average of 180 annual licenses per health professional in 2021 and 195 in 2022.
On the other hand, the number of workers with LME is 2,320,885 for 2021 and 2,922,696 for 2022. This means that there were an average of three LMEs per year per employee who took medical leave.
Looking at the cumulative relative frequency of the number of issuances to health professionals by licensure tranche for the year 2022, a high concentration is observed in the licensure range of less than 200 (76.0% of professionals). In contrast, 1% of professionals issue between 1,600 and 2,499 LMEs per year (440); 0.4% issue between 2,500 and 4,999 LMEs per year (178) and 0.1% professionally issue more than 5,000 LMEs during the year (41)”, the document states.
However, the document states that “There is a disparity between the number of professionals, the number of authorized LMEs, and estimated SIL spending. In other words, 1.5% of health professionals issue 19.2% of authorized LMEs, which equates to 20% of estimated SIL spending.
The foregoing, given that the report separates the LME’s numbers with the announcement into four segments. The first tranche is for professionals who issued less than 1,600 LMEs in 2022. Here 98.5% are professionals, who concentrate 80.8% of authorized LME and 80.0% of estimated SIL spending. The average number of days per license for this section is 12.9.
The second tranche is for professionals who released between 1,600 and 2,499 LMEs in 2022. They account for 1% of professionals, concentrate 9.8% of authorized licenses and 9.1% of estimated SIL spending. The average number of days per license for this section is 13.2.
The third tranche is for those who issue between 2,500 and 4,999 LMEs. Here 0.4% are professionals, they concentrate 6.5% of authorized LMEs and 7.2% of SIL spending. The average number of days per license for this section is 17.1.
The fourth tranche is for those who issue 5,000 LME or more. They represent 0.1% of professionals, have 3% of authorized LMEs and 3.7% of estimated SIL spend. The average number of days per license for this section is 20.7.
“It is observed that as the LME tranche increases, the number of professionals decreases and the average number of license days increases,” the report concludes. It also shows that there was a slight decline in the total number of authorized days in 2022 from 14.8 authorized days in 2021 to 13.5 authorized days in 2022.
It also states that “there is a directly proportional relationship between licenses and categories of LMEs associated with mental disorders. Thus, by the year 2021, in the segment of professionals issuing fewer than 1,600 LMEs per year, 23.7% of total authorized LMEs are mental disorders.” This percentage rises to 84.9% for professionals who issue more than 5,000 LMEs a year. The opposite is observed for the rest of the diagnoses, an advance for large classes of SCI. as reduces their participation.
Similarly, it ensures that “although estimated LIS spending increases in 2022, the proportion of diagnoses involving mental disorders remains close to 40% of total estimated LIS spending for both years.” With respect to 2021, on the other hand, Diagnoses for COVID-19, Infectious Diseases, Digestive Diseases and Respiratory Diseases represent a proportion of the increase in estimated SIL expenditure.The proportion of increase in Respiratory Diseases is almost twice that of the estimated LIS expenditure.
Looking at the LME along with announcements issued by health professionals, by specialty and section of the LME, the document shows that with an increase in classes, the proportion of LMEs in the “general practitioner” category increases for both the year 2021 and 2022. They correspond to medical professionals who do not register any speciality.
“For the year 2022, it can be seen that for the first tranche, 64.6% were issued by the general practitioner category, reaching 95.6% of LMEs in the last tranche,” he says. Additionally, “not all SCI associated with diagnoses of mental disorders issued by professionals related to Section 4 were issued by general practitioners and other specialties, not by psychiatrists,” they concluded.
In 2021, 77.3% of all health professionals were Chilean citizens. In 2022 they were 76.4%. But in fact, before giving any figures on the matter, Suesso clarifies in the report that “the data presented below does not in any case seek to stigmatize foreign professionals, but rather relevant figures to know in a particular context.” Public discussions in this regard developed in recent times. In addition, the contribution of immigrants to our country and many health professionals in general and public health in particular has been recognised.
It then shows that by distributing the total EBF by the nationality of the health professional,” it can be seen that by the year 2022, of the total LMEs issued by Chilean professionals, 87.8% will belong to professionals who issue less than 1,600 LMEs per year and, consequently, 12.2% to professionals who They issue 1,600 and more LMEs. a year. In the case of foreign professionals, these figures correspond to 67.2% and 32.8%, respectively. In other words, foreign professionals who belong to the categories of 1,600 and more LMEs per year are the same issues LME almost 3 times more than Chilean professionals for classes”, says the report.
And they concluded that “an increasing correlation is observed between the proportion of foreign professionals and the increase in LME tranches. Thus, 23.1% of professionals issuing less than 1,600 LMEs have foreign nationalities, which accounts for a total representing 9,918. At the peak, 87.8% of professionals issuing more than 5,000 LMEs are foreign, which equates to 36 professionals.
