Accesibilidad en salud desde la gestión pública: revisión bibliográfica

Introduction: Barriers to accessing healthcare services continue to affect their effectiveness, particularly among vulnerable populations. Timely identification of these barriers is crucial for the development of equitable public policies. Objective: To systematize recent scientific evidence on barriers to healthcare access linked to public management during the 2020–2024 period. Methods: A systematic review was conducted following the PRISMA 2020 protocol. The main databases consulted were Scopus, Web of Science, EBSCO, ProQuest, and SciELO. Empirical studies with quantitative, qualitative, or mixed-method designs published between 2020 and 2024 that addressed healthcare access barriers from a public management perspective were included. Articles without empirical data, narrative reviews, and editorials were excluded. Results: A total of 31 studies were included: 14 quantitative (45.2 %), 12 qualitative (38.7 %), and 5 mixed-method (16.1 %). The most frequently reported barriers were geographic (n=13), administrative (n=12), and economic (n=11). Cultural barriers (such as stigma, language, discrimination, and cultural belonging) and physical barriers (such as shortages of human resources, technological equipment, and essential medicines) were also reported. The largest study included 102,928 participants; however, the average sample size across all studies was 6,481. Peru and the United States were the countries with the highest number of included studies. Conclusions: Structural barriers to healthcare access persisted, particularly in vulnerable contexts. Public management exhibited fragmented and insufficient responses. Overcoming these limitations would have required integrated approaches focused on equity, strategic planning, and financial sustainability of health systems.