Asociaciones público-privadas para servicio de salud: ¿la solución al sistema de salud peruano?

Abstract

RESUMENLa participación del inversor privado en la prestación de servicios de salud públicos, en la figura denominada "asociación público-privada" (APP) data del siglo pasado, tanto en América Latina como en Europa, en el Perú se publicó en el 2008 la normativa para APP en infraestructura, mantenimiento y prestación de servicios en general, pero es a finales del 2013 cuando se inicia a implementar APP para servicios de salud. En Colombia se dieron cuenta de que esta modalidad les resulta muy costosa; en Chile no regularon desde el inicio y hoy es difícil regular al privado; Costa Rica nunca entregó todo el poder de decisión al privado, siempre mantuvo la responsabilidad de brindar el servicio de salud a su población y mantiene la salud como un derecho. En el Perú, en esta etapa de implementación de APP para servicios de salud, no se tiene en cuenta las recomendaciones de otras experiencias como: la transparencia, participación de todos los involucrados, desarrollo de legislación específica, entre otros. ABSTRACTPrivate investor participation in the provision of public health care services (called "public-private partnership" or PPP) dates from the last century, both in Latin America and Europe. In Peru, legislation for PPPs was published in 2008 in terms of infrastructure, maintenance and service provisions in general; but it was at the end of 2013 when PPP began to be implemented for health services. In Colombia, it was realized that this model was very costly. In Chile, the private sector was not regulated from the beginning and today it is difficult to regulate. Costa Rica never gave full decisional power to private sector; the responsibility for providing health services to its population and maintaining health as a right has always been maintained. In Peru, at this stage of PPPs implementation for health services, other experiences are not taken into account such as: transparency, participation of all stakeholders, development of specific legislation, among others.

Quality Evaluation of Health Services Using the Kano Model in Two Hospitals in Peru

“…Moreover, focused on the third objective regarding the use of the above classification to improve hospital management and health care quality, the lack of resources in Peruvian hospitals (as in many Latin American countries) constitutes a great challenge that requires not only a significant budget increase but also demand an effective management of resources. On top of that, there is an insufficient number of health professionals, and many of them are inadequate trained in urban and rural areas in Peru [ 59 ]. Finally, besides legislation for PPPs was published in 2008 regarding infrastructure, maintenance, and service provisions; it was only until 2013 when PPP began to be implemented for health services [ 59 ].…”

“…On top of that, there is an insufficient number of health professionals, and many of them are inadequate trained in urban and rural areas in Peru [ 59 ]. Finally, besides legislation for PPPs was published in 2008 regarding infrastructure, maintenance, and service provisions; it was only until 2013 when PPP began to be implemented for health services [ 59 ]. Therefore, the implementation of PPPs in the Peruvian health sector represents an opportunity to promote and guarantee the quality of health services, mainly among users excluded from the system [ 59 , 60 ].…”

What does COVID-19 tell us about the Peruvian health system?

“…The World Bank Group has played an influential role in driving forward the PPP agenda in the health sector (and beyond), with other institutions like the Inter-American Development Bank (IADB) following the same path. Health PPPs have been on the Peruvian agenda since 2008, after the creation of the Health Ministry's Investment Committee, and a new law allowing EsSalud the right to enter into long-term contracts, including PPP contracts, without obtaining prior federal approval (Zevallos, Salas and Robles 2014). In 2015 the IADB approved a loan to strengthen the capacity of the country to implement PPPs in the health sector.…”

La especialidad médica de gestión en salud en la Universidad Nacional Mayor de San Marcos: 30 años formando gestores para el sector salud

“…Estos especialistas han publicado investigaciones sobre temas relacionados a la reforma del sector salud en Perú, el presupuesto por resultados, asociaciones público-privadas hasta temas de inversión en salud (18)(19)(20)(21) . La optimización de los procesos de planeamiento, organización, dirección, control; así como, la calidad en salud en las instituciones, constituyen elementos clave para la mejora del desempeño de nuestro sistema de salud.…”