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Calidad de vida relacionada a salud y alfabetización en salud en pacientes adultos en centros de atención primaria con afiliación al régimen subsidiado o contributivo en Colombia
Health-related quality of life and health literacy among adult primary care patients with subsidized or contributive health insurance in Colombia
Shea M. Lemleya,
Autor para correspondencia
smlemley@gmail.com

Autor para correspondencia.
, Sergio Castro-Díazb, Leonardo Cubillosa,c, Fernando Suárez-Obandob, William C. Torreya,c, José Miguel Uribe-Restrepod, Makeda Williamse, Lisa A. Marscha,c, Carlos Gómez-Restrepob,d,f
a Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, New Hampshire, EE. UU.
b Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
c Department of Psychiatry, Geisel School of Medicine at Dartmouth, New Hampshire, EE. UU.
d Departamento de Psiquiatría y Salud Mental, Pontificia Universidad Javeriana, Bogotá, Colombia
e Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, EE. UU.
f Hospital Universitario San Ignacio, Bogotá, Colombia
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y hay relativamente poca investigaci&#243;n sobre CVRS en pa&#237;ses de bajos y medianos ingresos<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">4&#8211;6</span></a>&#46; En pa&#237;ses de bajos y medianos ingresos&#44; variables demogr&#225;ficas y socioecon&#243;micas tambi&#233;n se asocian con CVRS&#46; La CVRS tiende a ser peor en personas con enfermedades cr&#243;nicas&#44; discapacidad&#44; o mayor &#237;ndice de masa corporal &#40;IMC&#41;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">7&#8211;9</span></a>&#46; Tener un empleo<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">9&#44;10</span></a>&#44; mayores ingresos<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">7&#8211;9</span></a> y mayor nivel educativo<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">7&#8211;10</span></a> est&#225;n asociados con una mejor CVRS&#44; mientras que ser mujer<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">7</span></a> o ser de mayor edad se asocian con una peor CVRS<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">7&#8211;9&#44;11</span></a>&#46; Adicionalmente&#44; aunque los sistemas de salud difieren entre pa&#237;ses de bajos y medianos ingresos<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">12</span></a>&#44; investigaci&#243;n preliminar sugiere que estar vinculado al sistema de salud se asocia con mejor CVRS<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">8&#44;10</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Colombia ha hecho esfuerzos por mejorar la salud de sus habitantes a trav&#233;s de cambios en el sistema de salud&#44; pero pocos estudios han evaluado diferencias en la CVRS basada en el tipo de afiliaci&#243;n al sistema de salud&#46; Colombia emiti&#243; la Ley 100 en 1993<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">13</span></a>&#44; con el objetivo de proveer un cubrimiento de salud para todos sus ciudadanos&#46; Para el a&#241;o 2013&#44; 96&#37; de la poblaci&#243;n estaba cubierta por el sistema de salud&#44; la mayor&#237;a a trav&#233;s o del r&#233;gimen contributivo o del subsidiado<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">14&#44;15</span></a>&#46; M&#225;s de la mitad de la poblaci&#243;n colombiana est&#225; afiliada por el r&#233;gimen subsidiado&#44; el cual asegura a la poblaci&#243;n desempleada&#44; pobre&#44; o con trabajos informales<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">14</span></a>&#46; En contraste&#44; el sistema contributivo provee aseguramiento en salud a personas con empleos formales y&#47;o con capacidad de pago&#46; El sistema contributivo se financia a trav&#233;s del empleado y del empleador a trav&#233;s de contribuciones tomadas del salario de la persona&#44; mientras que el aseguramiento en el r&#233;gimen subsidiado est&#225; financiado en mayor proporci&#243;n por impuestos generales<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">14</span></a>&#46; Sin importar el tipo de r&#233;gimen al cual se est&#233; afiliado&#44; todos los colombianos tienen derecho al mismo paquete de servicios en salud<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a>&#46; Esta estructura de financiamiento sirve una funci&#243;n redistributiva y supera las barreras econ&#243;micas para la obtenci&#243;n de servicios sanitarios&#46; En comparaci&#243;n con el sistema de salud existente previo a la implementaci&#243;n de la Ley 100&#44; el sistema actual ha mejorado la utilizaci&#243;n de los servicios en salud&#44; incluyendo servicios ambulatorios&#44; hospitalarios y consumo de medicamentos&#44; aunque aquellos en el r&#233;gimen contributivo a&#250;n tienen mayor acceso sobre aquellos pertenecientes al r&#233;gimen subsidiado<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">17&#44;18</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Estudios recientes han evaluado la CVRS en Colombia&#44; obteniendo resultados similares sobre la asociaci&#243;n entre sexo femenino<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">19&#8211;21</span></a>&#44; mayor edad<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">19&#44;20</span></a> y la presencia de enfermedad cr&#243;nica<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">22</span></a> con menor CVRS&#46; Aunque Colombia est&#225; luchando actualmente con una marcada desigualdad econ&#243;mica<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">23</span></a>&#44; el ingreso se ha visto relacionado de manera inconsistente con la CVRS en la poblaci&#243;n colombiana<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">21</span></a>&#46; Tal desigualdad econ&#243;mica tambi&#233;n puede ser un mediador para el desarrollo de una educaci&#243;n desigual&#44; y un menor nivel educativo ha sido asociado con menor CVRS entre los colombianos<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">24</span></a>&#46; A nuestro conocimiento&#44; el &#250;nico estudio en Colombia que evaluaba la relaci&#243;n entre tipo de afiliaci&#243;n al sistema de salud y CVRS encontr&#243; que para adultos viviendo en Barranquilla&#44; aquellos afiliados al r&#233;gimen subsidiado reportaron salud pobre o aceptable m&#225;s frecuentemente que aquellos afiliados al r&#233;gimen contributivo<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Existen otras variables que impactan la CVRS en pa&#237;ses de bajos y medianos ingresos<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">25&#8211;27</span></a>&#46; La alfabetizaci&#243;n en salud&#44; definida como el conjunto de habilidades &#171;necesarias para obtener acceso a&#44; entender y usar informaci&#243;n de tal manera que promueva y mantenga una adecuada salud&#187;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">28</span></a> ha sido asociada con peores desenlaces en salud&#44; tales como hospitalizaci&#243;n&#44; menor utilizaci&#243;n de servicios preventivos&#44; y mayor uso de servicios de urgencia<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">29</span></a>&#46; Adem&#225;s&#44; una mejor CVRS se asocia con una mayor alfabetizaci&#243;n en salud entre pacientes con enfermedades cr&#243;nicas<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">27</span></a>&#44; mientras que peor CVRS se asocia con menor alfabetizaci&#243;n en salud para muestras de pacientes saludables<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">25&#44;26</span></a>&#44; aunque algunas investigaciones sugieren que este efecto puede ser influenciado por el nivel educativo<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">30</span></a>&#46; La alfabetizaci&#243;n en salud est&#225; influenciada por el nivel educativo y el estatus socioecon&#243;mico&#44; pero la alfabetizaci&#243;n en salud tambi&#233;n se ha visto como un factor mediador en la relaci&#243;n entre estatus socioecon&#243;mico y desenlaces en salud y en calidad de vida<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">31</span></a>&#46; Existen pocos estudios que hayan evaluado la alfabetizaci&#243;n en salud&#44; afiliaci&#243;n al sistema de salud y CVRS&#44; pero hallazgos obtenidos en Ghana muestran c&#243;mo el cubrimiento en salud est&#225; asociado de manera positiva con CVRS&#44; solamente para aquellos con una alta alfabetizaci&#243;n en salud<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a>&#46; En nuestro conocimiento&#44; no existen estudios que hayan evaluado el impacto de la alfabetizaci&#243;n en salud en CVRS en Colombia&#44; o que hayan evaluado si la alfabetizaci&#243;n en salud difiere seg&#250;n el tipo de afiliaci&#243;n el sistema de aseguramiento en salud&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">El objetivo de este estudio es evaluar los efectos de la alfabetizaci&#243;n en salud y la calidad de vida relacionada con salud en Colombia&#46; Este estudio evalu&#243; CVRS y alfabetizaci&#243;n en salud en pacientes adultos que visitaran uno de seis centros de atenci&#243;n primaria en Colombia&#46; Relaciones entre CVRS&#44; variables demogr&#225;ficas y alfabetizaci&#243;n en salud fueron examinadas de manera general y por subgrupos&#44; seg&#250;n tipo de afiliaci&#243;n al sistema de salud&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Procedimiento</span><p id="par0030" class="elsevierStylePara elsevierViewall">Este estudio hace parte del trabajo inicial para un proyecto sobre &#171;Escalonamiento de intervenciones cient&#237;ficas en salud mental en Latinoam&#233;rica&#187; &#40;proyecto DIADA&#58; Detecci&#243;n y atenci&#243;n integrada de la depresi&#243;n y uso de alcohol en atenci&#243;n primaria&#41;&#46; El proyecto DIADA est&#225; desarrollando y evaluando un sistema para implementar servicios de salud mental en el contexto de la atenci&#243;n primaria en Am&#233;rica Latina&#46; Todos los procedimientos del estudio fueron aprobados por los comit&#233;s de &#233;tica de la Pontificia Universidad Javeriana y por el <span class="elsevierStyleItalic">Dartmouth College</span>&#46; Los participantes suministraron consentimiento informado y posteriormente completaron una encuesta programada en REDCap que fue autoadministrada en una tableta en las salas de espera de los centros de atenci&#243;n primaria donde estos fueron reclutados<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">32</span></a>&#46; El uso de la aplicaci&#243;n REDCap permiti&#243; que los evaluadores recolectaran los datos de manera confidencial y sin conexi&#243;n a internet en &#225;reas con pobre acceso a la red&#44; pero los datos fueron subidos a la plataforma diariamente&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Participantes</span><p id="par0035" class="elsevierStylePara elsevierViewall">Los participantes fueron 1&#46;580 pacientes adultos &#40;&#8805; 18 a&#241;os&#41;&#44; reclutados en las salas de espera de los seis centros de atenci&#243;n primaria en Colombia para una encuesta sobre salud y usa de tecnolog&#237;a &#40;ver el estudio de Su&#225;rez-Obando et al&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">33</span></a> para m&#225;s detalles&#41;&#46; Para reclutar a una muestra m&#225;s representativa&#44; centros de atenci&#243;n en salud p&#250;blicos y privados fueron utilizados como centros de reclutamiento&#44; y estos centros estaban ubicados en zonas urbanas&#44; suburbanas y rurales&#46;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel"><span class="elsevierStyleItalic">&#8226;</span></span><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Centro de atenci&#243;n 1</span> es un centro de atenci&#243;n privado ambulatorio ubicado en la capital del pa&#237;s&#44; la ciudad de Bogot&#225; &#40;poblaci&#243;n aproximada de nueve millones&#41;&#46; Este centro suministra atenci&#243;n primaria enfocada en el paciente dentro de un contexto de medicina familiar para pacientes de predominio urbano&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel"><span class="elsevierStyleItalic">&#8226;</span></span><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Centro de atenci&#243;n 2</span> es un centro de salud p&#250;blico en una ciudad peque&#241;a &#40;poblaci&#243;n aproximada de 11&#46;000&#41;&#44; que ofrece servicios ambulatorios &#40;por ejemplo&#44; urgencias&#44; transporte con ambulancia&#44; servicio domiciliario&#41; para 14&#46;000 personas aproximadamente&#44; 47&#37; de las cuales viven en &#225;reas rurales&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel"><span class="elsevierStyleItalic">&#8226;</span></span><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Centro de atenci&#243;n 3</span> es un centro de salud p&#250;blico con servicios para poblaci&#243;n urbana&#44; suburbana y rural en una ciudad de mediano tama&#241;o &#40;poblaci&#243;n aproximada de 110&#46;000&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel"><span class="elsevierStyleItalic">&#8226;</span></span><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Centro de atenci&#243;n 4</span> es un hospital p&#250;blico que ofrece servicios psiqui&#225;tricos especializados para la poblaci&#243;n de un centro urbano peque&#241;o &#40;poblaci&#243;n aproximada de 17&#46;000&#41; y &#225;reas rurales aleda&#241;as&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel"><span class="elsevierStyleItalic">&#8226;</span></span><p id="par0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Centro de atenci&#243;n 5</span> es un centro de salud p&#250;blico localizado en un centro urbano peque&#241;o &#40;poblaci&#243;n aproximada de 11&#46;000&#41;&#46; Este centro de atenci&#243;n provee atenci&#243;n primaria y ambulatoria&#44; servicio de urgencias&#44; y capacidad para estancias cortas de hospitalizaci&#243;n para los habitantes de la zona y &#225;reas rurales aleda&#241;as&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel"><span class="elsevierStyleItalic">&#8226;</span></span><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Centro de atenci&#243;n 6</span> es un centro de atenci&#243;n p&#250;blico en una ciudad peque&#241;a &#40;poblaci&#243;n aproximada de 47&#46;000&#41;&#46; Este centro atiende pacientes de la ciudad y &#225;reas rurales aleda&#241;as&#46;</p></li></ul></p><p id="par0070" class="elsevierStylePara elsevierViewall">Solo aquellas personas &#40;n <span class="elsevierStyleItalic">&#61;</span> 1&#46;481&#44; 93&#44;7&#37;&#41; que proporcionaron datos completos y que reportaron tipo de afiliaci&#243;n al sistema de salud&#44; ya sea bajo el r&#233;gimen contributivo &#40;n<span class="elsevierStyleMonospace">&#61;</span>615&#41; o al subsidiado &#40;n &#61; 866&#41; fueron incluidos en el presente an&#225;lisis&#46; Un total de 95 participantes reportaron otros tipos de aseguramiento en salud&#44; un participante no report&#243; estatus socioecon&#243;mico y tres participantes no completaron las mediciones para CVRS o para alfabetizaci&#243;n en salud&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Mediciones</span><p id="par0075" class="elsevierStylePara elsevierViewall">La encuesta incluy&#243; &#237;tems para evaluar variables sociodemogr&#225;ficas &#40;por ejemplo&#44; edad&#44; sexo&#44; educaci&#243;n&#44; estrato socioecon&#243;mico&#44; tipo de afiliaci&#243;n al sistema de salud&#41;&#44; uso de tecnolog&#237;a &#40;no reportado&#59; ver el estudio de Su&#225;rez-Obando et al&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">33</span></a>&#41;&#44; CVRS&#44; y alfabetizaci&#243;n en salud&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">CVRS</span><p id="par0080" class="elsevierStylePara elsevierViewall">Los participantes completaron el cuestionario EQ-5D-3L<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a>&#44; una herramienta para evaluar la CVRS validada en Sudam&#233;rica&#44; pero no espec&#237;ficamente en Colombia&#46; Los participantes calificaron su estado de salud actual a trav&#233;s de cinco dominios&#58; movilidad&#44; autocuidado&#44; actividades diarias&#44; dolor&#44; ansiedad y depresi&#243;n&#46; Para cada dominio&#44; los participantes pod&#237;an reportar sin problemas&#44; problemas leves&#44; problemas moderados&#44; problemas graves o problemas extremos&#47;imposibilidad&#46; La calificaci&#243;n a trav&#233;s de los dominios fue combinada en perfiles de cinco d&#237;gitos&#44; los cuales reflejaban el estado de salud del individuo&#46; Para el an&#225;lisis&#44; a estos perfiles les fueron asignados puntajes generales basados en cargas para preferencias regionales para los perfiles de estado de salud derivados de puntajes de escala visual an&#225;loga recolectados en Argentina<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">35</span></a>&#46; Las calificaciones para el reporte de problemas dentro de cada dominio fueron dicotomizadas como sin problemas&#44; o como algunos problemas &#40;por ejemplo&#44; calificaciones de problemas moderados o severos fueron combinados&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Alfabetizaci&#243;n en salud</span><p id="par0085" class="elsevierStylePara elsevierViewall">La alfabetizaci&#243;n en salud fue evaluada con una herramienta de tres &#237;tems validada en idioma espa&#241;ol&#44; pero no espec&#237;ficamente para la poblaci&#243;n colombiana<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">36</span></a>&#46; Los participantes respondieron a tres preguntas usando una escala Likert de cinco puntos&#58; 1&#41; &#171;&#191;Qu&#233; tan seguro&#40;a&#41; se siente al llenar formas usted solo&#40;a&#41;&#63;&#187;&#59; 2&#41; &#171;&#191;Qu&#233; tan seguido tiene problemas aprendiendo sobre su condici&#243;n m&#233;dica porque es dif&#237;cil entender informaci&#243;n escrita&#63;&#187;&#59; 3&#41; &#171;&#191;Qu&#233; tan seguido tiene usted un familiar&#44; un amigo&#44; un empleado del hospital o la cl&#237;nica u otra persona que le ayude a leer materiales del hospital o la cl&#237;nica&#63;&#187; La pregunta sobre seguridad al momento de llenar formas ten&#237;a como opciones de respuesta 1 &#61; Completamente seguro hasta 5 &#61; Para nada seguro&#46; Las dos preguntas adicionales iban desde 1 &#61; Nunca hasta 5 &#61; Siempre&#46; Las respuestas fueron sumadas para calcular un puntaje entre 3-15 con puntajes mayores indicando menor alfabetizaci&#243;n en salud&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lisis</span><p id="par0090" class="elsevierStylePara elsevierViewall">Caracter&#237;sticas demogr&#225;ficas&#44; alfabetizaci&#243;n en salud y CVRS fueron comparadas para las personas con afiliaci&#243;n al r&#233;gimen contributivo o subsidiado utilizando pruebas <span class="elsevierStyleItalic">t</span> para datos de intervalo y pruebas &#967;<span class="elsevierStyleSup">2</span> para datos categ&#243;ricos&#46; Adicionalmente&#44; para evaluar diferencias en alfabetizaci&#243;n en salud despu&#233;s de tener en cuenta nivel educativo y socioecon&#243;mico&#44; se realiz&#243; un an&#225;lisis de covarianza &#40;ANCOVA&#41;&#44; comparando alfabetizaci&#243;n en salud entre aquellos con afiliaci&#243;n al r&#233;gimen subsidiado y contributivo con nivel educativo y estrato socioecon&#243;mico como covariables&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Un modelo de regresi&#243;n jer&#225;rquico fue desarrollado para evaluar la contribuci&#243;n relativa de variables demogr&#225;ficas y alfabetizaci&#243;n en salud con CVRS para la muestra general&#46; En el primer paso&#44; sexo&#44; edad&#44; etnia &#40;codificado como mestizo comparado con otra raza&#47;etnicidad&#41;&#44; estado civil &#40;codificado como participantes casados&#47;cohabitando o no&#41;&#44; situaci&#243;n laboral &#40;codificado como tiempo completo&#44; tiempo parcial&#44; independiente relativo a sin empleo&#41;&#44; nivel educativo &#40;codificado como participantes que hayan completado al menos el bachillerato comparado a menor educaci&#243;n&#41;&#44; bajo estrato socioecon&#243;mico &#40;codificado como rural&#44; estrato 1&#44; estrato 2 comparado a otros estratos socioecon&#243;micos&#41;&#44; y tipo de afiliaci&#243;n al sistema de salud fueron designados como predictores de CVRS&#46; En el paso 2&#44; alfabetizaci&#243;n en salud fue adicionada para evaluar su impacto en CVRS&#46; Para determinar los contribuidores espec&#237;ficos a CVRS por tipo de afiliaci&#243;n al sistema&#44; modelos de regresi&#243;n jer&#225;rquicos fueron desarrollas de manera separada por subgrupos de r&#233;gimen contributivo y r&#233;gimen subsidiado&#46; Estos modelos incluyeron sexo&#44; edad&#44; etnia&#44; estado civil&#44; situaci&#243;n laboral&#44; nivel educativo&#44; y bajo nivel socioecon&#243;mico en el paso 1 y despu&#233;s adicionando alfabetizaci&#243;n en salud en el paso 2&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><p id="par0100" class="elsevierStylePara elsevierViewall">La mediana de edad entre los participantes fue de 45 a&#241;os &#40;IQR &#61; 30&#44;61&#41; y 53&#44;1&#37; &#40;n &#61; 786&#41; fueron mujeres &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; M&#225;s de la mitad de la muestra se identific&#243; como mestizo &#40;ascendencia mixta europea y amerindia<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">37</span></a>&#59; 58&#44;3&#37;&#44; n &#61; 863&#41;&#44; mientras que 20&#44;6&#37; se identificaron como blancos &#40;n &#61; 305&#41; y 21&#44;1&#37; se identific&#243; como otro grupo racial&#47;&#233;tnico &#40;n &#61; 313&#59; por ejemplo&#44; ind&#237;gena&#44; negro&#47;afrocolombiano&#41;&#46; M&#225;s de la mitad de la muestra &#40;58&#44;5&#37;&#41; ten&#237;an afiliaci&#243;n al r&#233;gimen subsidiado&#44; mientras que 41&#44;5&#37; pertenec&#237;an al r&#233;gimen contributivo&#46; Los participantes con afiliaci&#243;n al r&#233;gimen subsidiado se diferenciaron de aquellos del r&#233;gimen contributivo por sitios de reclutamiento&#44; sexo&#44; estado laboral&#44; estrato socioecon&#243;mico&#44; nivel educativo y etnicidad &#40;todos p &#60; 0&#44;04&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#44; pero no por estado civil &#40;p &#61; 0&#44;27&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">La mediana para CVRS &#40;punteada 0&#44;0-1&#44;0&#41; para la muestra fue de 0&#44;84 &#40;IQR &#61; 0&#44;70&#44; 1&#44;0&#41;&#44; y CVRS no difiri&#243; entre aquellos afiliados al r&#233;gimen contributivo en relaci&#243;n con los afiliados al r&#233;gimen subsidiado &#40;p &#61; 0&#44;76&#41;&#46; En la muestra general&#44; 18&#37; reportaron algunos o extremos problemas con su movilidad&#44; 4&#44;2&#37; reportaron algunos o extremos problemas con el autocuidado&#44; 14&#44;8&#37; reportaron algunos o extremos problemas con las actividades diarias&#44; 41&#44;3&#37; reportaron algunos o extremos problemas con dolor y 22&#44;8&#37; reportaron algunos o extremos problemas con ansiedad&#47;depresi&#243;n&#46; Ninguna de las categor&#237;as para CVRS difiri&#243; entre aquellos vinculados al r&#233;gimen subsidiado&#44; en comparaci&#243;n con el contributivo &#40;todos p &#62; 0&#44;10&#41;&#46; Una prueba <span class="elsevierStyleItalic">t</span> revel&#243; que los participantes vinculados con el r&#233;gimen subsidiado ten&#237;an menor alfabetizaci&#243;n en salud &#40;p &#60; 0&#44;001&#41;&#44; aunque esta diferencia no sigui&#243; siendo significativa &#40;p &#61; 0&#44;38&#41; despu&#233;s de que nivel educativo &#40;p &#60; 0&#44;001&#41; y estrato socioecon&#243;mico fueron adicionados como covariables&#46;</p><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Calidad de vida&#44; factores demogr&#225;ficos y alfabetizaci&#243;n en salud</span><p id="par0110" class="elsevierStylePara elsevierViewall">Para la muestra general&#44; el modelo de regresi&#243;n lineal jer&#225;rquico revel&#243; varias asociaciones significativas con CVRS en el paso 1 &#40;<span class="elsevierStyleItalic">F</span> &#91;8&#44; 1&#46;472&#93; &#61; 12&#44;08&#44; p &#60; 0&#44;001&#44; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span> &#61; 0&#44;06&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; Espec&#237;ficamente&#44; menor edad y etnia&#47;raza mestiza se vieron asociados con mayor CVRS&#46; Al adicionar alfabetizaci&#243;n en salud en el paso 2&#44; mejor&#243; de manera significativa el modelo &#40;<span class="elsevierStyleItalic">F</span> &#91;1&#44; 1&#46;471&#93; &#61; 15&#44;54&#44; p &#60; 0&#44;001&#44; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span> &#61; 0&#44;07&#41;&#44; pero no cambi&#243; ninguna de las asociaciones significativas encontradas en el paso 1&#46; Una mayor alfabetizaci&#243;n en salud se asoci&#243; de manera significativa con una mejor CVRS &#40;p &#60; 0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Calidad de vida&#44; factores sociodemogr&#225;ficos&#44; y alfabetizaci&#243;n en salud por tipo de afiliaci&#243;n al sistema de salud</span><p id="par0115" class="elsevierStylePara elsevierViewall">Para aquellos con afiliaci&#243;n al r&#233;gimen contributivo&#44; el paso 1 del modelo de regresi&#243;n lineal jer&#225;rquico arroj&#243; un modelo significativo &#40;<span class="elsevierStyleItalic">F</span> &#91;7&#44; 607&#93; &#61; 2&#44;13&#44; p &#61; 0&#44;04&#44; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span> &#61; 0&#44;02&#59; <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41; y asociaciones significativas con CVRS&#46; Identificarse como mestizo comparado con otro tipo de etnia se asoci&#243; con una mayor CVRS&#46; Al adicionar alfabetizaci&#243;n en salud en el paso 2 no mejor&#243; de manera significativa el modelo &#40;<span class="elsevierStyleItalic">F</span> &#91;1&#44; 606&#93; &#61; 2&#44;98&#44; p &#61; 0&#44;109&#44; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span> &#61; 0&#44;03&#41;&#44; aunque el modelo general sigui&#243; siendo significativo &#40;p &#61; 0&#44;02&#41;&#46; La alfabetizaci&#243;n en salud no se asoci&#243; de manera significativa con CVRS para aquellos afiliados al r&#233;gimen contributivo &#40;p &#61; 0&#44;09&#41;&#44; y el ser mestizo se mantuvo significativamente asociado con una mayor CVRS &#40;p &#61; 0&#44;01&#41;&#46; Para participantes vinculados con el r&#233;gimen subsidiado&#44; el modelo de regresi&#243;n lineal jer&#225;rquico fue significativo en el paso 1 &#40;<span class="elsevierStyleItalic">F</span> &#91;7&#44; 858&#93; &#61; 14&#44;83&#44; p &#60; 0&#44;001&#44; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span> &#61;&#44;11&#59; <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; Asociaciones significativas con una mayor CVRS en el paso 1 incluyeron menor edad&#44; ser mestizo comparado con otras etnias y estar empleado&#46; Al adicionar alfabetizaci&#243;n en salud en el paso 2 mejor&#243; de manera significativa el modelo &#40;<span class="elsevierStyleItalic">F</span> &#91;1&#44; 857&#93; &#61; 9&#44;41&#44; p &#60; 0&#44;01&#44; <span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span> &#61; 0&#44;12&#41; y la alfabetizaci&#243;n en salud se asoci&#243; de manera significativa con CVRS &#40;p &#60; 0&#44;01&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discusi&#243;n</span><p id="par0120" class="elsevierStylePara elsevierViewall">Una peor alfabetizaci&#243;n en salud se vio asociado con una peor CVRS para la muestra general&#44; lo que extiende otros resultados obtenidos en pa&#237;ses de bajos y medianos ingresos &#40;por ejemplo&#44; China&#44; Ghana y Uruguay<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">26&#44;27&#44;30</span></a>&#41; a Colombia&#46; Adem&#225;s&#44; una mayor alfabetizaci&#243;n en salud impact&#243; de manera significativa la CVRS despu&#233;s de tener en cuenta variables sociodemogr&#225;ficas&#46; Al examinar asociaciones de manera individual para subgrupos por tipo de afiliaci&#243;n al sistema de salud&#44; una peor alfabetizaci&#243;n en salud se asoci&#243; de manera significativa con una peor CVRS solo entre aquellos afiliados al r&#233;gimen subsidiado&#46; La alfabetizaci&#243;n en salud fue menor en el grupo de afiliados al r&#233;gimen subsidiado&#44; pero esta diferencia no fue significativa despu&#233;s de ajustar por nivel educativo y estrato socioecon&#243;mico&#44; sugiriendo que estas variables influyen en las diferencias para alfabetizaci&#243;n en salud&#46; Los resultados de este estudio sugieren que reducir barreras al acceso de informaci&#243;n sobre salud puede ser beneficioso para mejorar la CVRS de pacientes que acuden a centros de atenci&#243;n primaria en Colombia&#46; Estos datos tambi&#233;n sugieren que la investigaci&#243;n futura podr&#237;a beneficiarse al examinar si aquellas personas vinculadas con el r&#233;gimen subsidiado se benefician m&#225;s que aquellas vinculadas con el contributivo de intervenciones que est&#233;n enfocadas en habilidades asociadas con el acceso y el uso de informaci&#243;n en salud &#40;por ejemplo&#44; aprender sobre condiciones m&#233;dicas&#44; leer material hospitalario&#44; llenar formas&#41;&#46; En pa&#237;ses de altos ingresos&#44; modificaciones como presentar solo informaci&#243;n esencial sobre salud&#44; puede mejorar los desenlaces en salud para individuos con baja alfabetizaci&#243;n en salud<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">38</span></a>&#46; Adem&#225;s&#44; hallazgos preliminares sugieren que intervenciones en alfabetizaci&#243;n en salud pueden resultar en mejor&#237;a de la CVRS entre individuos con enfermedad cr&#243;nica<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">39</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Consistente con estudios previos&#44; una mayor edad se vio asociada con menor CVRS&#44; tanto de manera general como en el grupo de pacientes afiliados al r&#233;gimen subsidiado<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">19&#44;20&#44;40</span></a>&#46; Adem&#225;s&#44; individuos identificados como mestizos&#44; el grupo &#233;tnico predominante en Colombia&#44; reportaron una mayor CVRS comparado con otros grupos &#233;tnicos&#46; A nuestro conocimiento&#44; no existen estudios adicionales que reporten sobre diferencias en CVRS por grupo &#233;tnico en Colombia&#46; Sin embargo&#44; a diferencia de investigaciones previas&#44; la CVRS en esta muestra no difiri&#243; por sexo o tipo de afiliaci&#243;n al sistema de salud&#46; Los hallazgos del presente estudio podr&#237;an haber diferido de estudios previos&#44; dado que la muestra fue tomada de centros de atenci&#243;n primaria y no de la poblaci&#243;n general&#44; por lo que incluy&#243; solamente personas buscando una atenci&#243;n sanitaria&#46; Esta muestra tambi&#233;n incluy&#243; m&#225;s mujeres y utiliz&#243; una medici&#243;n de tipo continuo para CVRS&#44; en vez de una medici&#243;n de tipo categ&#243;rica<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">19&#44;20</span></a>&#44; lo que tambi&#233;n puede haber influenciado los resultados&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Las limitaciones del presente estudio podr&#237;an ser abordadas por nuevas investigaciones&#46; Primero&#44; este estudio us&#243; una medici&#243;n autorreportada de alfabetizaci&#243;n en salud que fue validada en idioma espa&#241;ol&#44; pero no en la poblaci&#243;n colombiana&#44; lo que puede limitar su utilidad&#44; teniendo en cuenta diferencias regionales potenciales en cuanto a cultura o dialecto&#46; De manera similar&#44; aunque la herramienta EQ-5D-3L ha sido usada para medir CVRS en Colombia<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">20</span></a>&#44; no hay disponibles puntos de referencia para determinar el &#237;ndice de puntuaci&#243;n&#44; por lo que valores regionales &#40;de Argentina&#41; fueron utilizados&#46; La investigaci&#243;n futura podr&#237;a validar estas medidas con una muestra colombiana&#46; La muestra del presente estudio fue reclutada de centros de atenci&#243;n primaria que atienden situaciones de baja complejidad usualmente&#44; aunque la condici&#243;n cl&#237;nica espec&#237;fica de los pacientes no fue conocida&#46; Los resultados de esta poblaci&#243;n puede que no sean generalizables para la poblaci&#243;n general del pa&#237;s&#46; Aunque los puntajes de CVRS en esta muestra fueron similares a aquellos encontrados en la poblaci&#243;n general&#44; nuevos estudios podr&#237;an reclutar una muestra m&#225;s representativa<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">20</span></a>&#46; Finalmente&#44; los subgrupos seg&#250;n afiliaci&#243;n al sistema de salud difirieron en la mayor&#237;a de variables sociodemogr&#225;ficas&#46; Muchos de estos fueron incluidos en los modelos de regresi&#243;n&#44; pero algunas variables &#40;por ejemplo&#44; centro de atenci&#243;n&#41; no fueron incluidas en los modelos&#44; dado que no estaban balanceadas en los subgrupos seg&#250;n afiliaci&#243;n&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; una mejor alfabetizaci&#243;n en salud se asoci&#243; de manera significativa con una mayor CVRS en una muestra grande de adultos colombianos reclutados en centros de atenci&#243;n primaria de salud en Colombia&#46; Aunque la CVRS no difiri&#243; para aquellos en el r&#233;gimen contributivo vs&#46; aquellos en el r&#233;gimen subsidiado&#44; una mejor alfabetizaci&#243;n en salud se vio asociada con una mejor CVRS para aquellos afiliados al r&#233;gimen subsidiado&#46; Son necesarias nuevas investigaciones para examinar si las intervenciones enfocadas en habilidades sobre alfabetizaci&#243;n en salud&#44; relacionadas con acceso y uso de informaci&#243;n sanitaria&#44; pueden mejorar la CVRS en la poblaci&#243;n colombiana&#44; particularmente en personas afiliadas al r&#233;gimen contributivo en salud&#46; Estos resultados sugieren que las intervenciones dirigidas a la navegaci&#243;n y al acceso a la informaci&#243;n en salud pueden ser importantes para mejorar la CVRS&#44; particularmente para aquellos en el r&#233;gimen subsidiado&#46; Pol&#237;ticas p&#250;blicas o educaci&#243;n comunitaria en salud que se enfoquen en presentar informaci&#243;n sobre salud de una manera m&#225;s comprensible pueden ayudar a atenuar las diferencias en CVRS asociada con alfabetizaci&#243;n en salud&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Financiaci&#243;n</span><p id="par0140" class="elsevierStylePara elsevierViewall">La investigaci&#243;n reportada en esta publicaci&#243;n fue financiada por el Instituto Nacional de Salud Mental &#40;NIMH&#41; de los Institutos Nacionales de Salud &#40;NIH&#41; con el n&#250;mero de la subvenci&#243;n de 1U19MH109988 &#40;investigadores principales m&#250;ltiples&#58; Lisa A&#46; Marsch&#44; PhD y Carlos G&#243;mez-Restrepo&#44; MD PhD&#41;&#46; El contenido es &#250;nicamente opini&#243;n de los autores y no representan los puntos de vista del NIH o del gobierno de los EE&#46; UU&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicto de intereses</span><p id="par0145" class="elsevierStylePara elsevierViewall">Los autores reportan que no tienen conflictos de inter&#233;s&#44; excepto la Dr&#46; Lisa A&#46; Marsch&#44; una de las investigadoras principales de este proyecto&#44; quien se encuentra afiliada con la compa&#241;&#237;a que desarroll&#243; la plataforma m&#243;vil de intervenci&#243;n utilizada en esta investigaci&#243;n&#46; Esta relaci&#243;n es manejada extensamente por la Dra&#46; Marsch y su instituci&#243;n acad&#233;mica&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contexto</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Colombia emiti&#243; la Ley 100 en 1993&#44; con el objetivo de proveer un cubrimiento de salud para toda la poblaci&#243;n&#44; y para el a&#241;o 2013&#44; m&#225;s del 96&#37; de la poblaci&#243;n colombiana ten&#237;a cubrimiento en salud&#46; No obstante&#44; es poca la evidencia sobre c&#243;mo la calidad de vida relacionada con la salud &#40;CVRS&#41; y la alfabetizaci&#243;n en salud se relacionan con la vinculaci&#243;n de las personas a los dos reg&#237;menes m&#225;s predominantes en el sistema de salud colombiano&#58; el r&#233;gimen subsidiado &#40;para personas con bajos ingresos&#41; y el r&#233;gimen contributivo &#40;para personas con mayores ingresos&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En esta investigaci&#243;n se analizaron datos de adultos que acudieron a seis centros de atenci&#243;n primaria en salud en Colombia&#44; con el fin de determinar la relaci&#243;n entre CVRS &#40;evaluada a trav&#233;s de componentes como problemas de movilidad&#44; autocuidado&#44; realizaci&#243;n de actividades usuales&#44; dolor&#47;malestar y ansiedad&#47;depresi&#243;n&#41;&#44; factores sociodemogr&#225;ficos&#44; tipo de afiliaci&#243;n al r&#233;gimen de salud y alfabetizaci&#243;n en salud&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Los resultados mostraron que las personas afiliadas al r&#233;gimen contributivo ten&#237;an mayor alfabetizaci&#243;n en salud que aquellas afiliadas al r&#233;gimen subsidiado&#44; lo cual se puede explicar por diferencias a nivel educativo y estatus socioecon&#243;mico&#46; Para CVRS no hubo diferencias en cuanto a tipo de r&#233;gimen en salud&#46; Aunque una menor alfabetizaci&#243;n en salud se vio relacionada con peor CVRS en la muestra general&#44; en an&#225;lisis de subgrupos solo se mantuvo esta tendencia en el grupo de personas con r&#233;gimen de salud subsidiado&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El enfoque en habilidades que determinan parte de la alfabetizaci&#243;n en salud&#44; como interpretaci&#243;n de informaci&#243;n m&#233;dica o llenar cuestionarios&#44; puede mejorar la CVRS&#44; particularmente en las personas afiliadas al r&#233;gimen subsidiado&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Contexto"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objetivos y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Context</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Colombia passed Law 100 in 1993 with the goal of providing universal health care coverage&#44; and by 2013&#44; over 96&#37; of the Colombian population had health insurance coverage&#46; However&#44; little is known about how health-related quality of life &#40;HRQoL&#41; and health literacy are related among those with the two most common types of health insurance coverage&#58; subsidised &#40;those with lower incomes&#41; and contributory &#40;those with higher incomes&#41; coverage&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Objectives and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">In the current exploratory investigation&#44; data from adults visiting six primary care clinics in Colombia were analysed to examine the relationship between HRQoL &#40;assessed as problems with mobility&#44; self-care&#44; completing usual activities&#44; pain&#47;discomfort&#44; and anxiety&#47;depression&#41;&#44; demographics&#44; the two health insurance types&#44; and health literacy&#46; Analyses also assessed whether&#44; within insurance types&#44; health literacy was related to HRQoL&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Results showed that those with contributory health insurance coverage had greater health literacy than those with subsidised coverage&#44; and this was accounted for by differences in education and socioeconomic status&#46; HRQoL did not differ by insurance type&#46; Although lower health literacy was related to worse HRQoL in the overall sample&#44; in subgroup analyses lower health literacy significantly related to worse HRQoL only among those with subsidised health insurance coverage&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Targeting skills which contribute to health literacy&#44; such as interpreting medical information or filling out forms&#44; may improve HRQoL&#44; particularly in those with subsidised insurance coverage&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Context"
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          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Objectives and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusion"
          ]
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col">Generaln &#61; 1&#46;481&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col">Contributivon &#61; 615 &#40;41&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col">Subsidiadon &#61; 866 &#40;58&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mdn &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mdn &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mdn &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Edad&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;30&#44; 61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;30&#44; 58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;31&#44; 63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alfabetizaci&#243;n en salud&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;6&#44; 9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;5&#44; 8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;7&#44; 11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">CVRS - &#237;ndice&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#44;84 &#40;&#44;70&#44; 1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#44;84 &#40;&#44;66&#44; 1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#44;84 &#40;&#44;72&#44; 1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Sitios de atenci&#243;n</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sitio 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">458 &#40;30&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">457 &#40;74&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sitio 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">260 &#40;17&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;3&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">240 &#40;27&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sitio 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">249 &#40;16&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52 &#40;8&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">197 &#40;22&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sitio 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">171 &#40;11&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">140 &#40;16&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sitio 5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">176 &#40;11&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">16 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">160 &#40;18&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sitio 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">167 &#40;11&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">39 &#40;6&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">128 &#40;14&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Femenino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">786 &#40;53&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">306 &#40;49&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">480 &#40;55&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">695 &#40;46&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">309 &#40;50&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">386 &#40;44&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Estado civil</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Soltero&#40;a&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">468 &#40;31&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">197 &#40;32&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">271 &#40;31&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Casado&#40;a&#41;&#47;cohabitando&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">762 &#40;51&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">327 &#40;52&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">435 &#40;50&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Separado&#40;a&#41;&#47;divorciado&#40;a&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">192 &#40;13&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;11&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">121 &#40;14&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Viudo&#40;a&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;4&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;3&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;4&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Situaci&#243;n laboral</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo completo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">263 &#40;17&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">219 &#40;35&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;5&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medio tiempo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">109 &#40;7&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;3&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;10&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Independiente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">330 &#40;22&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">122 &#40;19&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">208 &#40;24&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Amo&#40;a&#41; de casa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">337 &#40;22&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77 &#40;12&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">260 &#40;30&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estudiante&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">111 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">58 &#40;9&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">53 &#40;6&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Desempleado&#40;a&#41;&#47;retirado&#40;a&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">331 &#40;22&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">118 &#40;19&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">213 &#40;24&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Estrato socioecon&#243;mico</span>&#42;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#193;rea rural&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">237 &#40;16&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">9 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">228 &#40;26&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estrato 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">476 &#40;32&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;5&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">444 &#40;51&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estrato 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">344 &#40;23&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">171 &#40;27&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">173 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estrato 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">304 &#40;20&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">285 &#40;46&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estrato 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98 &#40;6&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96 &#40;15&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;0&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estrato 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estrato 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Nivel educativo</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Menos de educaci&#243;n primaria completada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">271 &#40;18&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;4&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">245 &#40;28&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Completada primaria&#44; pero no secundaria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">426 &#40;28&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89 &#40;14&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">337 &#40;38&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Completada secundaria no terciaria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">446 &#40;30&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">201 &#40;32&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">245 &#40;28&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Completada terciaria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">338 &#40;22&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">299 &#40;48&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;4&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2735867.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
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        ]
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      1 => array:8 [
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        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
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                  \t\t\t\t">Bajo estatus socioecon&#243;mico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">F&#58; R</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span> Cambio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">F</span> &#40;8&#44; 1&#46;472&#41; &#61; 12&#44;08&#42;&#42;&#42;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">B&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SE B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
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                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#44;70&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;00&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">-0&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#44;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;04&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Casado&#40;a&#41;&#47;cohabitando&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">-0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Educaci&#243;n secundaria completa&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#44;29&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Bajo estatus socioecon&#243;mico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alfabetizaci&#243;n en salud<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">F</span> &#40;7&#44; 607&#41; &#61; 2&#44;13&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Educaci&#243;n secundaria completa&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Bajo estatus socioecon&#243;mico&nbsp;\t\t\t\t\t\t\n
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                    0 => array:2 [
                      "titulo" => "Comparing the performance of the standard EQ-5D 3L with the new version EQ-5D 5L in patients with chronic hepatic diseases"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Scalone"
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                            2 => "S&#46; Fagiuoli"
                            3 => "A&#46; Gardini"
                            4 => "F&#46; Fusco"
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                        "tituloSerie" => "Qual Life Res&#46;"
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                          "etal" => false
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                      "doi" => "10.1002/jcop.22101"
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                        "paginaInicial" => "93"
                        "paginaFinal" => "103"
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Información del artículo
ISSN: 00347450
Idioma original: Español
DOI:10.1016/j.rcp.2020.11.018
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