Barreras de acceso administrativo a los servicios de salud en población Colombiana, 2013

Hernández, Jorge Martín Rodríguez; Rubiano, Diana Patricia Rodríguez; Barona, Juan Carlos Corrales

doi:10.1590/1413-81232015206.12122014

Cited by 33 publications

(39 citation statements)

References 14 publications

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“…Interviews with health managers and health professionals indicate that although the diagnosis of Chagas disease is covered by the health benefits plan, to carry out these tests, health insurance companies must previously authorize the service, which generates dissatisfaction to users by the queues, time consumption, distances to the authorization sites, denials, and systematic delays by health insurers. These results are in agreement with those reported by Hernández et al [ 33 ], who characterized the main administrative barriers faced by the Colombian population when they attempt to gain access to health services. They found the barriers derived from the authorizations, lack of opportunity for specialized medical appointments, surgical procedures, and drug delivery.…”

Section: Discussionsupporting

confidence: 93%

Barriers to Diagnosis Access for Chagas Disease in Colombia

Olivera

Villamil

Gahona

et al. 2018

Journal of Parasitology Research

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Chagas disease is the leading cause of nonischemic cardiomyopathy in Latin America. Timely access to diagnosis and trypanocidal treatment and preventive tools for millions of infected people continues to be a challenge. The purpose of this study was to identify potential barriers for the diagnosis of Chagas disease in Colombia from the perspective of healthcare providers. Using a simultaneous mixed-methods study design, we analyzed trends in access to screening and diagnosis for Chagas disease in Colombia and assessed the national barriers to access. The main barriers to access at the national level included a limited governmental public health infrastructure for the diagnosis of Chagas disease and limited physician awareness and knowledge of the disease. Data indicate that 1.5% of total expected cases based on national prevalence estimates were reported. Few public health laboratories have the capacity to perform complementary tests for the diagnosis of Chagas disease and almost 6 months elapse between the requests of the tests and the confirmation of the disease. This study shows that infected people must overcome a number of barriers to achieve diagnosis. Reducing barriers to early diagnosis of Chagas disease is an important goal in the fight against the disease.

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Section: Discussionsupporting

confidence: 93%

Barriers to Diagnosis Access for Chagas Disease in Colombia

Olivera

Villamil

Gahona

et al. 2018

Journal of Parasitology Research

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“…Disparities in cancer survival related to the health system can be attributed to barriers and delays in obtaining diagnostic care, associated with more advanced stages at diagnosis. In Colombia, practically all medical procedures require authorization from the insurer, which in many cases lead to substantial diagnostic and treatment delays and - consequently - to more advanced stages in diagnosis and poorer outcomes 38 , 39 . Therefore, many people turn to the out-of-pocket payment of some services to avoid delays, but people with low financial resources have no other avenues for access to timely diagnosis and treatment and are subject to the administrative procedures of their insurers.…”

Section: Discussionmentioning

confidence: 99%

“…Las disparidades en la supervivencia por cáncer relacionadas con el sistema de salud pueden ser atribuidas a barreras y retrasos para obtener la atención para el diagnóstico, lo cual se asocia con estadios más avanzados al momento del diagnóstico. En Colombia, prácticamente todos los procedimientos médicos requieren autorización del asegurador, lo que en muchos casos lleva a retrasos considerables en la confirmación diagnóstica y en el tratamiento y, consecuentemente, a estadios diagnósticos más avanzados y peores resultados finales 38 , 39 . Por esta razón, muchas personas recurren al pago de bolsillo de algunos servicios para evitar retrasos, pero las personas con bajos recursos financieros no tienen otras vías para acceder a diagnóstico y tratamiento oportunos y están sujetos a los procedimientos administrativos de sus aseguradoras.…”

Section: Discussionunclassified

Health inequities and cancer survival in Manizales, Colombia: a population-based study

Arias-Ortiz

Vries

2018

Colomb Med

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Objective: To analyze differences in survival of breast, cervical, lung, prostate and stomach cancer by health insurance regime (HIR) and socioeconomic position (SEP) in an intermediate city in a middle-income country.Methods: All patients with breast, cervix uteri, lung, prostate and stomach cancer diagnosed between 2003 and 2007 and characterized by the Manizales population-based Cancer Registry (MCR) were included and followed up to a maximum of 5 years for identifying deaths. Survival probabilities estimated by HIR were defined according to the type of affiliation at the date of diagnosis, and by socioeconomic stratification of residence (SS) as indicator of SEP, stratifying for other prognostic factors using Kaplan-Meier methods. Cox proportional hazard models were fitted for multivariate analysis.Results: A total of 1,384 cases and 700 deaths were analyzed. Five-year observed survival was 71.0% (95% IC: 66.1-75.3) for breast, 51.4% (95% IC: 44.6-57.9) for cervix, 15.4% (95% IC: 10.7-20.8) for lung, 71.1% (95% IC: 65.3-76.1) for prostate and 23.8% (95% IC: 19.3-28.6) for stomach. Statistically significant differences in survival by HIR were observed for breast, lung, prostate, and stomach - with poorer survival for the subsidized and uninsured patients. Differences by SS were observed for lung and prostate. Differences in survival by HIR were independent of SS, and viceversa. Conclusions: Important inequities in cancer survival exist related to HIR and SEP. Possible explanations include underlying comorbidities, late stage at diagnosis, or barriers to timely and effective treatment.

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“…Acorde a lo anterior, es importante mencionar el contexto del Sistema General de Seguridad Social en Salud del país. Si bien se han dado cambios importantes en la legislación, todavía se presentan barreras de acceso a los servicios de salud en poblaciones especialmente vulnerables (24), lo cual ha sido demostrado en estudios cualitativos y cuantitativos sobre el tema (34,35), y en algunos específicos con relación a la atención odontológica en otros grupos sociales (36).…”

Section: Discussionunclassified

Estado de salud bucal y factores relacionados en mujeres en situación de prostitución en Medellín (Colombia) / Oral health status and its related factors in a group of women in situation of prostitution in Medellín (Colombia)

et al. 2018

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RESUMEN. Antecedentes: Se requiere analizar la situación de salud bucal en grupos vulnerables desde la perspectiva de los determinantes sociales para establecer estrategias de intervención efectivas. Objetivo: Describir el estado de salud bucal y factores relacionados en un grupo de mujeres en situación de prostitución en la ciudad de Medellín (Colombia). Métodos: Este fue un estudio descriptivo en una muestra por conveniencia de 53 mujeres que ejercen la prostitución. Se aplicó encuesta y examen clínico y se analizaron variables de autopercepción de salud bucal, índice COP-D (cariados, obturados y perdidos), índice de caries significativa (SiC), problemas de articulación temporomandibular (ATM) y estado protésico. Resultados: 88,2 % de las mujeres encuestadas reportaron un mal estado de salud bucal, 81 % se sentían insatisfechas con su estado bucal y 60 % reportó problemas bucales. La prevalencia de caries dental fue del 64 %, con un COP-D de 15,6 (±8,4), y un SiC de 25,5 (±3,6). Se presentaron diferencias en el estado de salud bucal en indicadores clínicos y subjetivos según factores sociodemográficos. Más de tres cuartas partes requerían cambia o realizar nuevas prótesis superiores o inferiores. En casi la mitad se hallaron ruidos articulares en la ATM según evaluación clínica. Conclusiones: El estado de salud bucal según los indicadores analizados es reflejo de las condiciones sociales en que se encuentran estas mujeres. Se encontraron diferencias en los indicadores de salud bucal de acuerdo con diferentes factores sociodemográficos, lo cual sugiere la influencia de los determinantes sociales en las desigualdades en salud bucal.ABSTRACT. Background: The analysis of the oral health situation in vulnerable groups from a perspective of social determinants is required to implement effective intervention strategies. Purpose: To describe the oral health status and its related factors in a group of women in situation of prostitution in Medellín (Colombia). Methods: A descriptive study was conducted with a convenience sample of 53 women. A survey and clinical examination was carried out. The study analyzed variables related to self-perceived oral health, DTMF Index, Significant Caries Index (SiC), temporomandibular joint problems (TMJ), and the status of fixed/removable prosthesis. Results: 88.2 % of the surveyed women reported their oral health status was poor, 81 % of them felt unsatisfied with their mouth, and 60 % reported oral problems. The prevalence of dental caries was 64 %, with a DTMF of 15.6 (± 8.4), and a SiC of 25.5 (± 3.6). There were differences in oral health status in clinical and subjective indicators according to sociodemographic factors. More than three-quarters required changing or making new upper and/or lower partial or fixed dentures. In almost half, articular noises were found in TMJ according to the clinical evaluation. Conclusions: The oral health status, from the basis of the indicators analyzed, reflects the social conditions found in these women. Differences in the oral health indicators were in accordance to sociodemographic factors. This situation suggests that there is an influence of social determinants on oral health inequalities.

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Barreras de acceso administrativo a los servicios de salud en población Colombiana, 2013

Cited by 33 publications

References 14 publications

Barriers to Diagnosis Access for Chagas Disease in Colombia

Barriers to Diagnosis Access for Chagas Disease in Colombia

Health inequities and cancer survival in Manizales, Colombia: a population-based study

Estado de salud bucal y factores relacionados en mujeres en situación de prostitución en Medellín (Colombia) / Oral health status and its related factors in a group of women in situation of prostitution in Medellín (Colombia)

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