Comparación de la estructura y los resultados globales de 5 Sistemas de Salud. Aportes para el acceso efectivo a servicios de calidad en Colombia

Abstract

La cobertura universal en salud es una de las metas de los Objetivos de Desarrollo Sostenible relacionado a la salud y el bienestar. Ha sido un componente clave en las políticas de los países para robustecer el desempeño de los sistemas de salud y elaborar nuevas políticas de intervención diseñadas para dar un acceso efectivo y de calidad. Los países se han centrado en reducir la fragmentación de la financiación y la organización de los sistemas de salud, donde influyen otros aspectos como la voluntad política, organización y preparación de las autoridades para lograr una atención en salud efectiva. En este trabajo se realiza la comparación de la estructura y el desempeño del sistema de salud colombiano con cuatro países, dos latinoamericanos y dos europeos para así identificar las diferencias potenciales que puedan contribuir a un acceso a servicios de salud de calidad y un acercamiento a la cobertura universal en salud.

Universal health coverage is a major target in Sustainable Development Goals related to health and well-being. It has been a key component in countries' policies face to strengthen health systems performance and develop new intervention policies designed to provide effective and quality access for citizens. Countries have focused on reducing fractioning of finances and health systems organization, where several aspects, such as political will, authority’s coordination and preparation to achieve effective health care, influence in a very important way. This work aims to compare different healthcare systems in four countries face to Colombian one: two Latin American and two European cases, in terms of structure and performance in order to identify considerable differences that may contribute to reach quality health services and a closer approaching to the universal health coverage. Five final recommendations were given: improve real access to health services, financing country's formality for greater development and social welfare, investment focused on primary healthcare as a gateway to healthcare services, fight against corruption to achieve better resource management and health budgets and preventing them from being drained through misusage, and finally, payment mechanisms, face to contracting forms towards a prospective global payment based on a demand payment, and not individualized as it is seen today. In recent years, Colombia has improved an achievement in terms of high levels of coverage, and an important increase in life expectancy; but it still faces important challenges in the health system such as improving quality, having a real access and reducing regional gaps that generate inequality in Health.