Examinando por Autor "Buitrago, Giancarlo"

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    Challenges in Accessing Healthcare Services
    (Universidad de los Andes, 2024-07-24) Rosero Rodríguez, Anghella Brigeth; Bardey, David; Becerra Camargo, Oscar Reinaldo; Riascos Villegas, Álvaro José; Báscolo, Ernesto; Buitrago, Giancarlo; Facultad de Economía::Grupo de Estudios Sobre desarrollo Económico
    This thesis examines challenges in accessing healthcare services, focusing on the relationship between coverage and access. By leveraging unique healthcare interventions, this research explores the effects of expanding coverage on service utilization and examines the impact of insurance company closures on access to care. Additionally, the thesis provides an analysis of the diverse barriers that hinder individuals from accessing healthcare services. Chapter 1 leverages a reform that increased the range of available health services for approximately fifty percent of the population. Using a difference-in-differences approach, this chapter analyzes the effects of offering a more comprehensive range of health services on insured individuals’ utilization of health services and public expenditure per patient. The findings indicate that expanding the health plan to include more services increased health service utilization among eligible individuals compared to non-eligible individuals. However, there were no significant differences in public expenditure per patient between the two groups, likely due to the fee negotiation process. Chapter 2 examines the closure of one of Colombia’s largest insurers in 2015, which resulted in the random reassignment of policyholders to other insurers. Consequently, the receiving insurers experienced a sudden and unexpected influx of new affiliates, leading to varying levels of congestion. Using a difference-in-differences empirical strategy, this chapter investigates the impact of insurers’ congestion and quality on healthcare service utilization. The findings suggest that individuals transferred to more congested insurers experienced decreased healthcare utilization compared to those transferred to less congested insurers. Conversely, individuals transferred to higher-quality insurers exhibited increased healthcare utilization relative to those transferred to lower-quality insurers. Moreover, high-quality insurers were able to mitigate the adverse effects of congestion. Chapter 3 provides a comparative analysis of access barriers to health services in Colombia and the Dominican Republic. Using a mixed-methods methodology, the study reveals that in Colombia, the most frequently cited barriers relate to organizational accessibility and difficulties in contacting health services. In contrast, barriers in the Dominican Republic primarily center on availability and financial affordability.
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    Proyecto CoVIDA
    (Universidad de los Andes, Escuela de Gobierno Alberto Lleras Camargo, Facultad de Economía, CEDE, 2021) Laajaj, Rachid; Sarmiento-Barbieri, Ignacio; De Los Rios, Camilo; Aristizabal, Danilo; Behrentz, Eduardo; Bernal, Raquel; Buitrago, Giancarlo; Cucunuba, Zulma; de la Hoz, Fernando; Gaviria, Alejandro; Hernández, Luis Jorge; León, Leonardo; Moyano, Diane; Osorio, Elkin; Ramírez Varela, Andrea; Restrepo, Silvia; Rodriguez, Rodrigo; Schady, Norbert; Vives, Martha; Webb, Duncan
    En esta nota resumimos parte de los resultados obtenidos en CoVIDA, un proyecto multidisciplinario liderado por la Universidad de Los Andes, en conjunto con la Secretaría de Salud de Bogotá y la Universidad Nacional. Este programa centinela realizó aproximadamente 60,000 pruebas de Reacción en Cadena de la Polimerasa (PCR por sus siglas en inglés) en Bogotá que permiten detectar material genético del coronavirus en una muestra. CoVIDA se enfocó en testear mayoritariamente individuos asintomáticos y que por sus ocupaciones tienen mayor riesgo de contagio. Combinando estos datos con registros de todos los casos reportados a la Secretaría de Salud de Bogotá, caracterizamos la propagación y dinámica de la pandemia COVID-19 desde junio de 2020 hasta principios de marzo de 2021.
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    SARS-CoV-2 spread, detection, And dynamics in a megacity in Latin America
    (Universidad de los Andes, Facultad de Economía, CEDE, 2021) Laajaj, Rachid; De Los Rios, Camilo; Sarmiento-Barbieri, Ignacio; Aristizabal, Danilo; Behrentz, Eduardo; Bernal, Raquel; Buitrago, Giancarlo; Cucunubá, Zulma; de la Hoz, Fernando; Gaviria, Alejandro; Hernández, Luis Jorge; León, Leonardo; Moyano, Diane; Osorio, Elkin; Ramírez Varela, Andrea; Restrepo, Silvia; Rodríguez, Rodrigo; Schady, Norbert; Vives, Martha; Webb, Duncan
    In many developing countries, the COVID-19 pandemic has spread much faster and wider than the number of detected cases implies. By combining data from 59,770 RT-PCR tests on mostly asymptomatic individuals with administrative data on all detected cases, we capture the spread and dynamics of the COVID-19 pandemic in Bogotá from June 2020 to early March 2021. Our data provide unusually broad and detailed information on mostly asymptomatic adults in Bogotá, allowing to describe various features of the pandemic that appear to be specific to a developing country context. We find that, by the end of March 2021, slightly more than half of the population in Bogotá has been infected, despite only a small fraction of this population being detected. In July 2020, after four months of generalized quarantine that mitigated the pandemic without curving it, the initial buildup of immunity contributed to the end of the first wave. We also show that the share of the population infected by February 2021 varies widely by occupation, socio-economic stratum, and location. This, in turn, has affected the dynamics of the spread: while the first wave of infections was driven by the lowest economic strata and highly-exposed occupations, the second peak affected the population more evenly. A better understanding of the spread and dynamics of the pandemic across different groups provides valuable guidance for eficient targeting of health policy measures and restrictions.
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    PublicaciónAcceso abierto
    Understanding how socioeconomic inequalities drive inequalities in SARS-CoV-2 infections
    (Universidad de los Andes, Facultad de Economía, CEDE, 2021) Laajaj, Rachid; Webb, Duncan; Aristizabal, Danilo; Behrentz, Eduardo; Bernal, Raquel; Buitrago, Giancarlo; Cucunubá, Zulma; de la Hoz, Fernando; Gaviria, Alejandro; Hernández, Luis Jorge; De Los Rios, Camilo; Ramírez Varela, Andrea; Restrepo, Silvia; Schady, Norbert; Vives, Martha
    Across the world, the SARS-CoV-2 (COVID-19) pandemic has disproportionately affected economically disadvantaged groups. This differential impact has numerous possible explanations, each with significantly different policy implications. We examine, for the first time in a low- or middle-income country, which mechanisms best explain the disproportionate impact of the virus on the poor. Combining an epidemiological model with rich data from Bogotá, Colombia, we show that total infections and inequalities in infections are largely driven by inequalities in the inability to work remotely and in within-home secondary attack rates. Inequalities in isolation behavior are less important but non-negligible, while access to testing and contract-tracing plays practically no role. Interventions that mitigate transmission are often more effective when targeted on socioeconomically disadvantaged groups.