Barreras de acceso del sistema de salud colombiano en zonas rurales: percepciones de usuarios del régimen subsidiado

Bran-Piedrahita, Lemy; Arias, Alejandro Valencia; Palacios-Moya, Lucia; Molina, Sergio Gómez; Acevedo-Correa, Yesenia; Arciniegas, Claudia Milena Arias

doi:10.17151/hpsal.2020.25.2.6

Cited by 16 publications

(8 citation statements)

References 22 publications

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“…Colombia has a mixed public-private healthcare system organized into two arms: one contributory and another subsidized ( Arrivillaga, 2021 ). Health insurance coverage for Colombians is almost universal (95%), ( Arrivillaga, 2021 ) and all people insured in the health system theoretically have access to comprehensive HIV treatment, although in practice there are several economic, geographic, and administrative to effective access, in particular for the poorest and people living in rural areas ( Bran Piedrahita et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Qualitative assessment of the impacts of the COVID-19 pandemic on migration, access to healthcare, and social wellbeing among Venezuelan migrants and refugees in Colombia

Stevenson

Guillén²,

Bevilacqua

et al. 2023

Journal of Migration and Health

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Section: Introductionmentioning

confidence: 99%

Qualitative assessment of the impacts of the COVID-19 pandemic on migration, access to healthcare, and social wellbeing among Venezuelan migrants and refugees in Colombia

Stevenson

Guillén²,

Bevilacqua

et al. 2023

Journal of Migration and Health

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“…(23) relaciona desde aspectos administrativos, financieros y geográficos, sobre todo en poblaciones que habitan en contextos de vulnerabilidad. Estas afectaciones inciden en el proceso terapéutico a tal punto que las mujeres pueden desistir de los tratamientos (24) . Los múltiples requerimientos burocráticos para la atención de las mujeres complican el acceso y afecta el itinerario dentro del sistema sanitario.…”

Section: Discussionunclassified

“…al. (24) en el estudio de barreras de acceso al sistema de salud colombiano. El proceso migratorio per se genera cambios en los itinerarios al encontrar inequidades en la atención sanitaria, tal como lo describe Machado (26) , ya sea por falta de apoyo en la navegación por el sistema, costo elevado de las atenciones, discriminación desde los actores en salud y las expectativas de las mujeres sobre la calidad del tratamiento.…”

Section: Discussionunclassified

Itinerarios terapéuticos de mujeres migrantes con hipertensión arterial: miradas desde el proceso salud-enfermedad-atención

Sotelo Daza,

Ramos Valencia

2023

Enf Global

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Introduction: Arterial hypertension (AH) is a global risk factor for morbidity and mortality and the main cause of premature death, largely affecting women. The purpose of the study was to understand how migrant women (MW) with AH configure their therapeutic itineraries (TI) in the search for health care in Colombia, from the health-disease-care process. Methods: Qualitative study with a grounded theory approach. 16 interviews and two focus groups were conducted with MW with AH in Popayán Colombia. Intentional theoretical sampling was carried out until reaching theoretical saturation and the abstraction of emerging categories through open, axial and selective coding. Results: Open coding generated 1,135 codes. The main emerging category was that TI in AH care are determined by social, cultural, political, and economic dynamics. As related subcategories emerged: the risks of getting sick from AH configure TI; heterogeneity of formal and informal therapeutic resources arises to attend to the disease; there are determinants of access to the health system; and mobilization of various practices for monitoring and control of the disease. Conclusion: Women in a situation of migration with AH configure TI to achieve health care not only from the state health system, but from various elements of the social, cultural, political and economic order. To this extent, AH goes beyond morbid nominations exclusive to biomedicine and the doctor-patient relationship, to address and transcend towards a condition that requires resolving contingencies of the context. Introducción: La hipertensión arterial (HTA) es un factor de riesgo de morbilidad y mortalidad a nivel global y la principal causa de muerte prematura, afecta en buena parte a mujeres. El propósito del estudio fue comprender cómo las mujeres migrantes (MM) con HTA configuran sus itinerarios terapéuticos (IT) en la búsqueda de atención sanitaria en Colombia, desde el proceso salud-enfermedad-atención. Métodos: Estudio cualitativo con enfoque de teoría fundamentada. Se realizaron 16 entrevistas y 2 grupos focales a MM con HTA en Popayán Colombia. Se realizó muestreo teórico intencionado hasta alcanzar la saturación teórica y la abstracción de categorías emergentes a través de codificación abierta, axial y selectiva. Resultados: La codificación abierta generó 1.135 códigos. La categoría principal emergente fue que los IT en la atención de la HTA están determinados por dinámicas sociales, culturales, políticas y económicas. Como subcategorías relacionadas emergieron: riesgos de enfermar por HTA configuran IT; surge heterogeneidad de recursos terapéuticos formales e informales para atender la enfermedad; existen determinantes de acceso al sistema sanitario; y movilización de diversas prácticas para el seguimiento y control del padecimiento. Conclusión: Las mujeres en situación de migración con HTA configuran IT para lograr la atención en salud no solo desde el sistema sanitario estatal, sino a partir de diversos elementos del orden social, cultural, político y económico. En esta medida, la HTA supera nominaciones mórbidas exclusivas de la biomedicina y de la relación médico-paciente, para abocarse y trascender hacia un padecimiento que exige resolver contingencias del contexto.

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“…Even though in 2020 the health care coverage was 98%, only 50–70% of the population could effectively access health care services [ 1 ]. Variables such as socioeconomic and educational level, the place of residence, the geographic location of the health care institutions, and some administrative barriers can explain the gap [ 2 , 3 ]. The health care system is a mix of public and private for-profit insurers and health care providers.…”

Section: Introductionmentioning

confidence: 99%

Experience of a TelEmergency program in Colombia South America: descriptive observational study between 2019 and 2021

et al. 2023

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Introduction Colombia has 50,912,429 inhabitants, but only 50–70% of the population can effectively access health care services. The emergency room (ER) is a main contributor to the in-hospital care system since up to half of the admissions come through it. Telemedicine has become a tool to facilitate effective access to health care services, improve the timeliness of care, reduce diagnostic variability, and reduce costs associated with health. The aim of this study is to describe the experience of a Distance Emergency Care Program through Telemedicine (TelEmergency) to improve specialist access for patients at the Emergency Room (ER) in low- and medium-level care hospitals in Colombia. Methods An observational descriptive study of a cohort including 1,544 patients during the program’s first two years was conducted. Descriptive statistics were used to analyze the available data. The data are presented with summarized statistics of sociodemographic, clinical, and patient-care variables. Results The study included a total of 1,544 patients, and the majority were adults between 60 and 79 years of age (n = 491, 32%). More than half were men (n = 832, 54%), and 68% (n = 1,057) belonged to the contributory health care regime. The service was requested from 346 municipalities, 70% (n = 1,076) from intermediate and rural settings. The most common diagnoses were related to COVID-19 (n = 356, 22%), respiratory diseases (n = 217, 14%), and cardiovascular diseases (n = 162, 10%). We observed 44% (n = 681) of local admissions either under observation (n = 53, 3%) or hospitalization (n = 380, 24%), limiting the need for hospital transfers. Program operation data revealed that 50% (n = 799) of requests were answered within two hours by the medical staff. The initial diagnosis was modified in 7% (n = 119) of the patients after being evaluated by specialists at the TelEmergency program. Conclusions This study shows the operational data collected during the first two years after the implementation of the TelEmergency program in Colombia, the first of its kind in the country. Its implementation offered specialized timely management of patients at the ER in low- and medium-level care hospitals, where there is no availability of specialized doctors.

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Barreras de acceso del sistema de salud colombiano en zonas rurales: percepciones de usuarios del régimen subsidiado

Cited by 16 publications

References 22 publications

Qualitative assessment of the impacts of the COVID-19 pandemic on migration, access to healthcare, and social wellbeing among Venezuelan migrants and refugees in Colombia

Qualitative assessment of the impacts of the COVID-19 pandemic on migration, access to healthcare, and social wellbeing among Venezuelan migrants and refugees in Colombia

Itinerarios terapéuticos de mujeres migrantes con hipertensión arterial: miradas desde el proceso salud-enfermedad-atención

Experience of a TelEmergency program in Colombia South America: descriptive observational study between 2019 and 2021

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