Publicación:
Challenges in Accessing Healthcare Services

Vista sencilla de ítem
authorProfile.id.code201725847
dc.contributor.advisorBardey, David
dc.contributor.advisorBecerra Camargo, Oscar Reinaldo
dc.contributor.authorRosero Rodríguez, Anghella Brigeth
dc.contributor.juryRiascos Villegas, Álvaro José
dc.contributor.juryBáscolo, Ernesto
dc.contributor.juryBuitrago, Giancarlo
dc.contributor.researchgroupFacultad de Economía::Grupo de Estudios Sobre desarrollo Económico
dc.date.accessioned2024-08-05T16:57:54Z
dc.date.available2024-08-05T16:57:54Z
dc.date.issued2024-07-24
dc.description.abstractThis 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.eng
dc.description.degreelevelDoctorado
dc.description.sponsorshipMinisterio de Ciencia, Tecnología e Innovación
dc.format.extent120 páginas
dc.format.mimetypeapplication/pdf
dc.identifier.doi10.57784/1992/74991
dc.identifier.instnameinstname:Universidad de los Andes
dc.identifier.reponamereponame:Repositorio Institucional Séneca
dc.identifier.repourlrepourl:https://repositorio.uniandes.edu.co/
dc.identifier.urihttps://hdl.handle.net/1992/74991
dc.language.isoeng
dc.publisherUniversidad de los Andes
dc.publisher.facultyFacultad de Economía
dc.publisher.programDoctorado en Economía
dc.relation.referencesWorld Health Organization. (2023). Universal health coverage (UHC). https://www.who.int/news-room/fact-sheets/detail/universal-healthcoverage-(uhc)
dc.relation.referencesEvans, D. B., Hsu, J., & Boerma, T. (2013). Universal health coverage and universal access. Bulletin of the World Health Organization, 91(8), 10–11.https://doi.org/10.2471/BLT.13.125450
dc.relation.referencesTanahashi, T. (1978). Health service coverage and its evaluation. Bulletin of the World Health Organization, 56(2), 295–303.
dc.relation.referencesLiu, C.,Watts, B., & Litaker, D. (2006). Access to and utilization of healthcare: The provider’s role. Expert Review of Pharmacoeconomics and Outcomes
dc.relation.referencesResearch, 6(6), 653–660. https://doi.org/10.1586/14737167.6.6.653
dc.relation.referencesWorld Health Organization. (2014). Final report of the WHO Consultative Group on Equity and Universal Health Coverage Making fair choices on the path to
dc.relation.referencesuniversal health coverage (tech. rep.).
dc.relation.referencesHirasuna, D. (2007). Universal Health Coverage: An Economist’ s Perspective (tech. rep.).
dc.relation.referencesUnited States Agency for International Development. (2017). Access To Universal Health Coverage Through High-Performing Health Care (tech. rep.).
dc.relation.referencesAgency of Healthcare Research and Quality. (2021). 2021 National Healthcare Quality and Disparities Report: Mississippi State Dashboard (tech. rep. No. 21(22)-0054-EF).
dc.relation.referencesVargas, I., Vzquez, M. L., Mogollán-Pérez, A. S., & Unger, J. P. (2010). Barriers of access to care in a managed competition model: Lessons from
dc.relation.referencesColombia. BMC Health Services Research, 10. https://doi.org/10.1186/1472-6963-10-297
dc.relation.referencesAnsari, Z., Laditka, J. N. and Laditka, S. B. (2006). Access to health care and hospitalization for ambulatory care sensitive conditions. Medical Care Research and Review 63: 719–741, doi:10.1177/1077558706293637.
dc.relation.referencesBaicker, K., Taubman, S. L., Allen, H. L., Bernstein, M., Gruber, J. H., Newhouse, J. P., Schneider, E. C., Wright, B. J., Zaslavsky, A. M. and Finkelstein, A. N. (2013).
dc.relation.referencesThe Oregon Experiment — Effects of Medicaid on Clinical Outcomes. New England Journal of Medicine 368: 1713–1722, doi:10.1056/nejmsa1212321.
dc.relation.referencesBanerjee, A., Finkelstein, A., Hanna, R., Olken, B. A., Ornaghi, A. and Sumarto, S. (2021). The challenges of universal health insurance in developing countries: Experimental evidence from indonesia’s national health insurance. American Economic Review 111: 3035–3063, doi:10.1257/aer.20200523.
dc.relation.referencesBardey, D. and Castaño, R. (2007). La regulación de tarifas en el sector de la salud en Colombia. Revista de Economía Institucional 9: 347–357.
dc.relation.referencesBáscolo, E., Houghton, N. and Del Riego, A. (2018). Lógicas de transformación de los sistemas de salud en América Latina y resultados en acceso y cobertura de salud. Revista Panamericana de Salud Pública 42, doi:10.26633/RPSP.2018.126.
dc.relation.referencesBernal, R., Eslava, M., Meléndez, M. and Pinzón, A. (2017). Switching from Payroll Taxes to Corporate Income Taxes : Firms ’ Employment and Wages after the Colombian 2012 Tax Reform.
dc.relation.referencesButler, S. M. (2016). The Future of the Affordable Care Act: Reassessment and Revision. JAMA 316: 495–497, doi:10.1001/JAMA.2016.9881.
dc.relation.referencesCalderón Alberto Agudelo, C., Botero, J. C., Bolaños, J. O. and Martínez, R. R. (2011). Sistema de salud en Colombia: 20 años de logros y problemas. Ciˆencia & Saúde Coletiva 16: 2817–2828.
dc.relation.referencesCamacho, A. and Ortiz, M. (2017). Is Money-Saving Preventive Care a Fairy Tale? Not for Early Childhood.
dc.relation.referencesComisión de Regulación en Salud (2010). Acuerdo 011 de 2010 Comisión de Regulación en Salud.
dc.relation.referencesCongreso de la República de Colombia (2011). Ley 1438 de 2011.
dc.relation.referencesConsejo nacional de seguridad social en salud (1996). Decreto 2423.
dc.relation.referencesConsejo Nacional de Seguridad Social en Salud (2008). Acuerdo 403.
dc.relation.referencesDahuabe, A. and Marinho, M. L. (2022). Aprendizajes para avanzar hacia sistemas de salud universales, integrales, sostenibles y resilientes memoria de los seminarios realizados en junio y agosto de 2022. Tech. rep.
dc.relation.referencesDepartamento Nacional de Planeación (2016). Colombia-Evaluación de resultados e impacto de la unificación del POS, evaluación de resultados de la actualización del POS y evaluación de los procesos implementados en el marco de la unificación y actualización del POS. Tech. rep.
dc.relation.referencesFeyisa, D. and Feyisa, D. (2022). Toward Universal Health Coverage: The Role of Health Insurance System. Health Insurance doi:10.5772/INTECHOPEN.106431.
dc.relation.referencesFinkelstein, A. (2007). The aggregate effects of health insurance: Evidence from the introduction of medicare. Quarterly Journal of Economics 122: 1–37, doi:10.1162/qjec.122.1.1.
dc.relation.referencesFinkelstein, A., Hendren, N. and Luttmer, E. F. (2019). The value of medicaid: Interpreting results from the oregon health insurance experiment. Journal of Political Economy 127: 2836–2874, doi:10.1086/702238.
dc.relation.referencesFinkelstein, A., Taubman, S., Wright, B., Bernstein, M., Gruber, J., Newhouse, J. P., Allen, H., Baicker, K. and Group, O. H. S. (2012). The Oregon health insurance experiment: Evidence from the first year. The Quartely Journal of Economics 127: 1057–1106, doi:10.1093/qje/qjs020.Advance.
dc.relation.referencesGhorbani, A. and Ghorbani, A. (2021). Demand for Health and Healthcare. Healthcare Access doi:10.5772/INTECHOPEN.98915.
dc.relation.referencesGuerrero, R., Gallego, A. I., Becerril-Montekio, V. and Vásquez, J. (2011). Sistema de salud de Colombia. Salud Pública de México 53: 144–155.
dc.relation.referencesGustafsson-Wright, E., Pop lawska, G., Tanovíc, Z. and Gaag, J. van der (2018). The impact of subsidized private health insurance and health facility upgrades on healthcare utilization and spending in rural Nigeria. International Journal of Health Economics and Management 18: 221–276, doi:10.1007/s10754-017-9231-y.
dc.relation.referencesGutierrez, C. M. and Pettit, B. (2020). Employment and Health among Recently Incarcerated Men before and after the Affordable Care Act (2009-2017). American Journal of Public Health 110: S123–S129, doi:10.2105/AJPH.2019.305419.
dc.relation.referencesHaislmaier, E. F. and Slagle, A. (2021). Obamacare Has Doubled the Cost of Individual Health Insurance.
dc.relation.referencesHospital Universitario San Ignacio (2023). Preguntas frecuentes servicio Unidad de Urgencias - HUSI.
dc.relation.referencesJiang, H. J., Russo, C. A. and Barrett, M. L. (2006). Nationwide Frequency and Costs of Potentially Preventable Hospitalizations, 2006: Statistical Brief #72.
dc.relation.referencesJiang, L., Ye, L., Dai, M., Zhou, J. and Li, Q. (2020). Use Andersen’s behavior model to explain non-urgent visits in emergency department: A single center study in southwest China. International Emergency Nursing 52: 100845, doi:10.1016/j.ienj.2020.100845.
dc.relation.referencesKolstad, J. T. and Kowalski, A. E. (2012). The impact of health care reform on hospital and preventive care: Evidence from Massachusetts. Journal of Public Economics 96:909–929, doi:10.1016/j.jpubeco.2012.07.003.
dc.relation.referencesLopera-Medina, M. M. (2017). Utilización de servicios de salud por enfermedades catastróficas o de alto costo en Antioquia. Revista Gerencia y Políticas de Salud 16: 120–137, doi:10.11144/JAVERIANA.RGPS16-32.USSE.
dc.relation.referencesMahmoudi, E., Kamdar, N., Furgal, A., Sen, A., Zazove, P. and Bynum, J. (2020). Potentially Preventable Hospitalizations Among Older Adults: 2010-2014. Annals of family medicine 18: 511–519, doi:10.1370/afm.2605.
dc.relation.referencesManchikanti, L., Helm, S., Benyamin, R. M. and Hirsch, J. A. (2017). A critical analysis of obamacare: Affordable care or insurance for many and coverage for few? Pain Physician 20: 111–138, doi:10.36076/ppj.2017.138.
dc.relation.referencesMiller, G., Pinto, D. and Vera-Hernández, M. (2013). Risk protection, service use, and health outcomes under Colombia’s health insurance program for the poor. American Economic Journal: Applied Economics 5: 61–91, doi:10.1257/app.5.4.61.
dc.relation.referencesMilne, B. J., Parker, K., McLay, J., Von Randow, M., Lay-Yee, R., Hider, P., Cumming, J. and Davis, P. (2015). Primary Health Care Access and Ambulatory Sensitive Hospitalizations in New Zealand. Journal of Ambulatory Care Management 38: 178–187, doi:10.1097/JAC.0000000000000057.
dc.relation.referencesMinisterio de de Salud y Protección Social (2023). Boletín del Aseguramiento en Salud.
dc.relation.referencesMinisterio de Protección Social (2006). Decreto 1011 de 2006.
dc.relation.referencesMinisterio de salud de Colombia (2000). Resolución No. 3374 de 27 de Diciembre de 2000.
dc.relation.referencesMinisterio de salud y protección social (1994). Resolución número 5261.
dc.relation.referencesMinisterio de salud y protección social (2001). Resolución 1896.
dc.relation.referencesMinisterio de salud y protección social (2009). Resolución 3974.
dc.relation.referencesMinisterio de Salud y Protección Social (2010). Unidad de Pago por Capitación del régimen subsidiado.
dc.relation.referencesMinisterio de Salud y Protección Social (2013). Resolución Número 1441 De 2013. Por la cual se definen los procedimientos y condiciones que deben cumplir los Prestadores de Servicios de Salud para habilitar los servicios y se dictan otras disposiciones.
dc.relation.referencesMontero Pérez, F. J. (2020). Medicina de observación: Más allá de la primera decisión en urgencias.
dc.relation.referencesMontero Ruiz, E. (2016). Shared care (comanagement). Revista Clínica Española (English Edition) 216: 27–33, doi:10.1016/J.RCENG.2015.09.002.
dc.relation.referencesNaoum, P., Athanasakis, K., Skroumpelos, A. and Kyriopoulos, J. (2020). Idiopathic Pulmonary Fibrosis: Utilization of Health Services and Out-Of-Pocket Health Expenditures in Greece. Value in health regional issues 22, doi:10.1016/j.vhri.2020.04.002.
dc.relation.referencesNeelsen, S. and O’Donnell, O. (2017). Progressive universalism? The impact of targeted coverage on health care access and expenditures in Peru. Health economics 26: e179–e203, doi:10.1002/hec.3492.
dc.relation.referencesObservatorio Nacional de Salud (2015). Informe técnico Carga de enfermedad por enfermedades crónicas no transmisibles y discapacidad en Colombia. Tech. rep.
dc.relation.referencesOchoa-Rodríguez, Y., Rodríguez-Labañino, Y. and Estévez-Matos, Y. (2022). Hospitalizaciones inadecuadas prevenibles en la atención primaria de salud: desafío actual como problema social. Revista Médica Electrónica 44.
dc.relation.referencesOrganización Panamericana de la Salud (OPS) (2023). Cobertura Universal de Salud.
dc.relation.referencesPines, J. M., Hilton, J. A., Weber, E. J., Alkemade, A. J., Al Shabanah, H., Anderson, P. D., Bernhard, M., Bertini, A., Gries, A., Ferrandiz, S., Kumar, V. A., Harjola, V.-P., Hogan, B., Madsen, B., Mason, S., ¨ Ohlén, G., Rainer, T., Rathlev, N., Revue, E., Richardson, D., Sattarian, M. and Schull, M. J. (2011). International Perspectives on Emergency Department Crowding. Academic Emergency Medicine 18: 1358–1370, doi:10.1111/j.1553-2712.2011.01235.x.
dc.relation.referencesRedondo-Sendino, , Guallar-Castillón, P., Banegas, J. R. and Rodríguez-Artalejo, F.(2006). Gender differences in the utilization of health-care services among the older adult population of Spain. BMC Public Health 6: 1–9, doi:10.1186/1471-2458-6-155/TABLES/3.
dc.relation.referencesRiascos, J., A. J. and Camelo, S. A., S. A. (2015). Una estimación del costo y cambios en el bienestar de los colombianos con el nuevo Plan de Beneficios en Salud. Revista de Economía del Rosario 17: 229–314, doi:10.12804/rev.econ.rosario.17.02.2014.04.
dc.relation.referencesRodríguez-Páez, F. G., Jiménez-Barbosa, W. G., Palencia-Sánchez, F., Rodríguez-Páez, F. G., Jiménez-Barbosa, W. G. and Palencia-Sánchez, F. (2018). Uso de los servicios de urgencias en Bogotá, Colombia: Un análisis desde el Triaje. Universidad y Salud 20: 215–226, doi:10.22267/RUS.182003.124.
dc.relation.referencesRosenbaum, S. (2011). The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice. Public Health Reports 126: 130, doi:10.1177/003335491112600118.
dc.relation.referencesRoy, K. and Chaudhuri, A. (2012). Gender differences in healthcare utilization in late life. The Palgrave Handbook of Gender and Healthcare, Second Edition : 256–272doi:10.1057/9781137295408{\ }16/COVER.
dc.relation.referencesSchafermeyer, K. W. (2000). Health economics I: Basic Economic Principles. Journal of Managed Care Phamacy 6, doi:10.4135/9781473920514.n9.
dc.relation.referencesSecretaría Distrital de Salud de Bogotá (2016). Manual de usuario Validador RIPS SDS. Tech. rep., Alcaldía Mayor de Bogota DC, Bogota.
dc.relation.referencesSkinner, J. and Chandra, A. (2016). The Past and Future of the Affordable Care Act. JAMA 316: 497–499, doi:10.1001/JAMA.2016.10158.
dc.relation.referencesSommers, B., Blendon, R., Epstein, A. and Orav, E. (2016). Changes in utilization and health among low-income adults after medicaid expansion or expanded private insurance. JAMA Internal Medicine 176: 1501–1509, doi:10.1001/jamainternmed.2016.4419.
dc.relation.referencesTarazi, C. (2015). The Effect of Insurance Coverage on Healthcare Expenditures. Atlantic Economic Journal 43: 303–304, doi:10.1007/s11293-015-9461-7.
dc.relation.referencesVargas, I., Vzquez, M. L., Mogollán-Pérez, A. S. and Unger, J. P. (2010). Barriers of access to care in a managed competition model: Lessons from Colombia. BMC Health Services Research 10, doi:10.1186/1472-6963-10-297.
dc.relation.referencesWherry, L. and Miller, S. (2017). Early Coverage, Access, Utilization, and Health Effects of the Affordable Care Act Medicaid Expansions: A Quasi-Experimental Study. Ann Intern Med 176: 139–148, doi:10.7326/M15-2234.Early.
dc.relation.referencesWorld Health Organization (2014). Final report of the WHO Consultative Group on Equity and Universal Health Coverage Making fair choices on the path to universal health coverage. Tech. rep.
dc.relation.referencesWu, N., Yu, Y. F., Chuang, C. C.,Wang, R., Benjamin, N. N. and Coultas, D. B. (2015). Healthcare resource utilization among patients diagnosed with idiopathic pulmonary fibrosis in the United States. Journal of Medical Economics 18: 249–257, doi:10.3111/13696998.2014.991789.
dc.relation.referencesAgency of Healthcare Research and Quality (2021). 2021 National Healthcare Quality and Disparities Report: Mississippi State Dashboard. Tech. Rep. 21(22)-0054-EF.
dc.relation.referencesAsociación Colombiana de Hospitales y Clínicas (2023). Liquidaciones de EPS: un efecto dominó sobre clínicas, hospitales, pacientes y el sistema mismo, por el que nadie responde. Revista Hospitalaria del sector salud.
dc.relation.referencesAtwood, A. and Lo Sasso, A. T. (2016). The effect of narrow provider networks on health care use. Journal of Health Economics 50: 86–98, doi:10.1016/J.JHEALECO.2016.09.007.
dc.relation.referencesBalakrishnan, R. and Soderstrom, N. S. (2000). The Cost of System Congestion: Evidence from the Healthcare Sector. Journal of Management Accounting Research 97.
dc.relation.referencesBanerjee, R., Ziegenfuss, J. Y. and Shah, N. D. (2010). Impact of discontinuity in health insurance on resource utilization. BMC Health Services Research 10, doi:10.1186/1472-6963-10-195.
dc.relation.referencesBesancenot, D., Lamiraud, K. and Vranceanu, R. (2023). A model for dual health care market with congestion differentiation. Journal of Economics & Management Strategy 32: 400–423, doi:10.1111/JEMS.12505.
dc.relation.referencesBesancenot, D., Sirven, N. and ranceanu, R. (2021). A Model of Hospital Congestion with Imperfect Referral System. Revue d’Economie Politique 131: 951–970, doi:10.3917/redp.316.0131.
dc.relation.referencesBesancenot, D., Sirven, N. and Vranceanu, R. (2018). A Model of Hospital Congestion in Developing Countries. SSRN Electronic Journal doi:10.2139/ssrn.3178188.
dc.relation.referencesCalderón Alberto Agudelo, C., Botero, J. C., Bolaños, J. O. and Martínez, R. R. (2011). Sistema de salud en Colombia: 20 años de logros y problemas. Ciˆencia &Saúde Coletiva 16: 2817–2828.
dc.relation.referencesChartock, B. L. (2022). Quality Disclosure, Demand, and Congestion: Evidence from Physician Ratings.
dc.relation.referencesDunn, A., Gottlieb, J. D., Shapiro, A. H., Sonnenstuhl, D. J. and Tebaldi, P. (2024). A Denial a Day Keeps the Doctor Away. The Quarterly Journal of Economics :5–24doi:10.1093/qje/qjad035.
dc.relation.referencesDuran, D. and Jimenez, J. S. (2015). Saludcoop: lo que fue y lo que está por venir.
dc.relation.referencesEscobar, G., Iglesias, E. B., Matajira, C. and Rodríguez, J. (2016). Sistema de Evaluación y Calificación de Actores 2016: Ranking de Satisfacción EPS 2016. Tech. rep.
dc.relation.referencesGarthwaite, C., Gross, T. and Notowidigdo, M. J. (2018). Hospitals as insurers of last resort. American Economic Journal: Applied Economics 10: 1–39, doi:10.1257/app.20150581.
dc.relation.referencesLee, Y. H. and Choi, Y. H. (2020). Optimal cost adjustment for a selfish routing healthcare network. Health Care Management Science 23: 585–604, doi:10.1007/S10729-020-09512-6.
dc.relation.referencesLi, X., Liu, H., Tang, Q. and Zhu, J. (2020). Liquidation risk in insurance under contemporary regulatory frameworks. Insurance: Mathematics and Economics 93:36–49, doi:10.1016/j.insmatheco.2020.04.005.
dc.relation.referencesLin, H., Xu, M. and Xie, C. (2023). Location and Capacity Planning for Preventive Healthcare Facilities With Congestion Effects. Journal of Industrial and Management Optimization 19: 3044–3059, doi:10.3934/jimo.2022076.
dc.relation.referencesLiu, C., Watts, B. and Litaker, D. (2006). Access to and utilization of healthcare: the provider’s role. Expert review of pharmacoeconomics & outcomes research 6: 653–660,doi:10.1586/14737167.6.6.653.
dc.relation.referencesMarcari, W. G. and Selby, J. (2015). The impact of health insurance on health Co-Op Liquidations on Providers. Health care & life sciences doi:10.1146/annurev.publhealth.28.021406.144042.
dc.relation.referencesMatranga, D. and Sapienza, F. (2015). Congestion analysis to evaluate the efficiency and appropriateness of hospitals in Sicily. Health Policy 119: 324–332, doi:10.1016/J.HEALTHPOL.2014.12.012.
dc.relation.referencesMinisterio de de Salud y Protección Social (????). Aseguramiento al sistema general de salud.
dc.relation.referencesMinisterio de de Salud y Protección Social (2016). Resolución 4622 de 2016.
dc.relation.referencesMinisterio de Salud (2002). Decreto 2309 de 2002.
dc.relation.referencesMinisterio de salud de Colombia (2000). Resolución No. 3374 de 27 de Diciembre de 2000.
dc.relation.referencesMullens, C. L., Hernandez, J. A., Murthy, J., Hendren, S., Zahnd, W. E., Ibrahim, A. M. and Scott, J. W. (2023). Understanding the impacts of rural hospital closures: A scoping review. Journal of Rural Health : 227–237doi:10.1111/jrh.12801.
dc.relation.referencesOrganización Mundial de la Salud (OMS) (2020). Servicios sanitarios de calidad.
dc.relation.referencesOsei Afriyie, D., Masiye, F., Tediosi, F. and Fink, G. (2023). Purchasing for highquality care using National Health Insurance: evidence from Zambia. Health Policy and Planning 38: 681–688, doi:10.1093/heapol/czad022.
dc.relation.referencesPardo-Garcia, C. and Sempere-Monerris, J. J. (2018). Mixed provision of health care services with double coverage. Journal of Economics/ Zeitschrift fur Nationalokonomie 123: 49–70, doi:10.1007/s00712-017-0550-8.
dc.relation.referencesPresidencia de la República de Colombia (2006). Decreto 1011 de 2006.
dc.relation.referencesPresidencia de la República de Colombia (2015). Decreto 2519 de 2015.
dc.relation.referencesStolper, K. C., Boonen, L. H., Schut, F. T. and Varkevisser, M. (2019). Managed competition in the Netherlands: Do insurers have incentives to steer on quality? Health Policy 123: 293–299, doi:10.1016/j.healthpol.2018.08.018.
dc.relation.referencesVargas, I., Vzquez, M. L., Mogollán-Pérez, A. S. and Unger, J. P. (2010). Barriers of access to care in a managed competition model: Lessons from Colombia. BMC Health Services Research 10, doi:10.1186/1472-6963-10-297.
dc.relation.referencesVera-hernández, M., Rodríguez-lesmes, P., Vera-hernández, M., Buitrago, G., Rodríguez, P. A. and Serna, N. (2023). The Role of Hospital Networks in Individual Mortality.
dc.relation.referencesViceministerio de Protección Social (????). Liquidación de Caprecom y Saludcoop EPS.
dc.relation.referencesVidyarthi, N. and Kuzgunkaya, O. (2015). The impact of directed choice on the design of preventive healthcare facility network under congestion. Health Care Management Science 18: 459–474, doi:10.1007/s10729-014-9274-2.
dc.relation.referencesYu, H., Wang, P., Zheng, H., Luo, J. and Liu, J. (2020). Impacts of congestion on healthcare outcomes: an empirical observation in China. Journal of Management Analytics 7: 344–366, doi:10.1080/23270012.2020.1731720.
dc.relation.referencesZhang, Y., Berman, O. and Verter, V. (2009). Incorporating congestion in preventive healthcare facility network design. European Journal of Operational Research 198:922–935, doi:10.1016/j.ejor.2008.10.037.
dc.relation.referencesAdauy, H., Angulo, P., Sepúlveda, J., Sanhueza, A., Becerra, D., Morales, V., Barreras, J., Adauy, M. H., Angulo, L. P., María, A., Sanhueza, X. A., Becerra, I. D., Morales, J. V. and Hirmas, M. (2013). Barreras y facilitadores de acceso a la atención de salud: una revisión sistemática cualitativa. Rev Panam Salud Publica 33: 2013.
dc.relation.referencesAlbanese, E., Liu, Z., Acosta, D., Guerra, M., Huang, Y., Jacob, K. S., Jimenez-Velazquez, I. Z., Llibre Rodriguez, J. J., Salas, A., Sosa, A. L., Uwakwe, R., Williams,J. D., Borges, G., Klibanski, M. G., Mccrone, P., Ferri, C. P. and Prince, M. J. (2011). Equity in the delivery of community healthcare to older people: findings from 10/66 Dementia Research Group cross-sectional surveys in Latin America, China, India and Nigeria. BMC Health Services Research 11: 1–11, doi:10.1186/1472-6963-11-153.
dc.relation.referencesArrieta-Gómez, A. I. (2018). Realizing the fundamental right to health through litigation: The Colombian case. Health and Human Rights 20: 133–145.
dc.relation.referencesBardey, D. (2013). Competencia en el sector de la salud: énfasis en el caso colombiano. Coyuntura Económica y Social: Investigación Económica y Social XLIII: 2014–5.
dc.relation.referencesBardey, D. (2017). El sistema de salud colombiano: ¿bueno o malo?
dc.relation.referencesBardey, D. (2023). La Reforma a la Salud. Tech. Rep. 48.
dc.relation.referencesBardey, D. and Riascos, A. J. (2022). Nota Macro No . 45 Reforma a la salud : los pros y los contra.
dc.relation.referencesBhalotra, S. and Fernández, M. (2021). The Right to Health and the Health Effects of Denials. Centro de Estudios sobre Desarrollo Económico (CEDE) : 1–49.
dc.relation.referencesCampos-Miño, S., Sasbón, J. S. and Dessauer, B. von (2012). [Pediatric intensive care in Latin America]. Medicina intensiva 36: 3–10, doi:10.1016/J.MEDIN.2011.07.004.
dc.relation.referencesCañón, O., Rathe, M. and Giedion, U. (2014). Estudio de caso del Plan de Servicios de Salud PDSS de la República Dominicana. Tech. rep., Banco Interamericano de Desarrollo.
dc.relation.referencesCarvajal-Barona, R., Tovar-Cuevas, L. M., Aristizábal-Grisales, J. C. and Varela- Arévalo, M. T. (2017). Barreras asociadas a la adherencia al tratamiento de tuberculosis en Cali y Buenaventura, Colombia, 2012. Revista Gerencia y Politicas de Salud 16: 68–84, doi:10.11144/Javeriana.rgps16-32.baat.
dc.relation.referencesCastro, B., Ing, L., Park, Y., Abrams, J. and Ryan, M. (2018). Addressing noncommunicable disease in dominican republic: Barriers to hypertension and diabetes care. Annals of Global Health 84: 625–629, doi:10.29024/aogh.2370.
dc.relation.referencesChapman, H. J., Veras-Estévez, B. A., Pomeranz, J. L., Pérez-Then, E. N., Marcelino, B. and Lauzardo, M. (2017). The Role of Powerlessness Among Health Care Workers in Tuberculosis Infection Control. Qualitative Health Research 27: 2116–2127, doi: 10.1177/1049732317731317.
dc.relation.referencesCongreso de la República de Colombia (1993). Ley 100 de 1993.
dc.relation.referencesCongreso de la República de Colombia (2011). Ley 1438. doi:10.2307/j.ctvswx8sw.11.
dc.relation.referencesCongreso de la República de Colombia (2015). Ley estatutaria 1751.
dc.relation.referencesCongreso Nacional de la República (2001). Ley 87 de 2001.
dc.relation.referencesCongreso Nacional de la República Dominicana (2007). Ley 188.
dc.relation.referencesConsejo Nacional de Seguridad Social (2002). Reglamento sobre el seguro familiar de salud y el plan básico de salud. Tech. rep., Consejo Nacional de Seguridad Social.
dc.relation.referencesConsejo Nacional de Seguridad Social en Salud (2004). Acuerdo 260 de 2004.
dc.relation.referencesDepartamento Nacional de Planeación (2017). Evaluación de procesos y resultados de la implementación del Modelo Integral de Atención en Salud (MIAS) en el Guainía. Tech. rep.
dc.relation.referencesFernández, M. and Bhalotra, S. (2021). The right to health and the CRC.
dc.relation.referencesFoster, J., Burgos, R., Tejada, C., Cáceres, R., Altamonte, A. T., Perez, L. J., Noboa, F. R., Urbaez, M. F., Heath, A., Hilliard, R. C., Chiang, F. and Hall, P. (2010). A community-based participatory research approach to explore community perceptions of the quality of maternal-newborn health services in the Dominican Republic. Midwifery 26: 504–511, doi:10.1016/j.midw.2010.06.001.
dc.relation.referencesFranco-Giraldo, (2012). La última reforma del sistema general de seguridad social en salud Colombiano. Revista de salud pública 14: 865–877.
dc.relation.referencesGarib, Z., Vargas, A. L., Trumbo, S. P., Anthony, K., Diaz-Ortega, J. L., Bravo-Alcántara, P., Leal, I., Danovaro-Holliday, M. C. and Velandia-González, M. (2016). Missed Opportunities for Vaccination in the Dominican Republic: Results of an Operational Investigation. BioMed Research International 2016, doi:10.1155/2016/4721836.
dc.relation.referencesGiedion, U., Díaz, B. Y., Alfonso, E. A. and Savedoff, W. D. (2009). Impacto del seguro de salud subsidiado sobre el estado de salud, y sobre el acceso y uso de los servicios sanitarios. In Amanda L. Glassman, María-Luisa Escobar, Antonio Giuffrida and úrsula Giedion (eds), Salud al alcance de todos: Una década de expansión del seguro médico en Colombia. New York: Banco Interamericano de Desarrollo, chap. 3, 51–76.
dc.relation.referencesGómez-Camelo, D. (2005). Análisis comparado de los sistemas de salud de la región Andina y el Caribe. Revista de Salud Pública 7: 305–316, doi:10.1590/s0124-00642005000300006.
dc.relation.referencesHandy, L. K., Maroudi, S., Powell, M., Nfila, B., Moser, C., Japa, I., Monyatsi, N., Tzortzi, E., Kouzeli, I., Luberti, A., Theodoridou, M., Offit, P., Steenhoff, A., Shea, J. A. and Feemster, K. A. (2017). The impact of access to immunization information on vaccine acceptance in three countries. PLoS ONE 12, doi:10.1371/journal.pone.0180759.
dc.relation.referencesHernández, J. M. R., Rubiano, D. P. R. and Barona, J. C. C. (2015). Barreras de acceso administrativo a los servicios de salud en población Colombiana, 2013. Ciencia e Saude Coletiva 20, doi:10.1590/1413-81232015206.12122014.
dc.relation.referencesHoughton, N., Báscolo, E., Fitzgerald, J. and Coitiño, A. (2023). Using mixed methods for understanding and addressing barriers to health services: recommendations and lessons learned. Rev Panam Salud Publica 47, doi:https://doi.org/10.26633/RPSP.2023.117.
dc.relation.referencesHoyos-Vertel, L. M. and De Rodríguez, L. M. (2019). Barriers to antenatal women with severe maternal morbidity in Antioquia, Colombia. Revista de Salud Publica 21: 17–21, doi:10.15446/rsap.v21n1.69642.
dc.relation.referencesIván, D. and Cuesta, L. (2022). Diseño de un modelo de gestión integral y calidad para ortalecer en equipos territoriales de salud pública y otros grupos del sistema de salud capacidades y desempeño de las funciones esenciales en salud pública Presentación de resultados Equipo de traba. Tech. rep.
dc.relation.referencesKeys, H. M., Noland, G. S., De Rochars, M. B., Blount, S. and Gonzales, M. (2019a). Prevalence of malaria and lymphatic filariasis in bateyes of the Dominican Republic. Infectious Diseases of Poverty 8, doi:10.1186/s40249-019-0547-3.
dc.relation.referencesKeys, H. M., Noland, G. S., De Rochars, M. B., Taylor, T. H., Blount, S. and Gonzales, M. (2019b). Perceived discrimination in bateyes of the Dominican Republic: results from the Everyday Discrimination Scale and implications for public health programs. BMC Public Health 19: 1–13, doi:10.1186/s12889-019-7773-2.
dc.relation.referencesLiebermann, E. J., VanDevanter, N., Shirazian, T., Frías Gúzman, N., Niles, M., Healton, C. and Ompad, D. (2020). Barriers to Cervical Cancer Screening and Treatment in the Dominican Republic: Perspectives of Focus Group Participants in the Santo Domingo Area. Journal of Transcultural Nursing 31: 121–127, doi: 10.1177/1043659619846247.
dc.relation.referencesLockwood, A., Dandekar, A., Arias, M., Ovalles, M. and Bentley, S. (2019). Factors associated with pediatric emergency room utilization in an urban community hospital in Santiago, Dominican Republic. Annals of Global Health 85: 1–6, doi:10.5334/aogh.2327.
dc.relation.referencesLópez Mallama, O. M. (2021). Política de calidad en salud: requisitos de habilitación y su efecto en la situación financiera de una IPS en Cali, 2018. Revista Sapientía 10: 65–74, doi:10.54278/sapientia.v10i19.64.
dc.relation.referencesMadhi, S. A., Rivera, L. M., Sáez-Llorens, X., Menéndez, C., Carrim-Ganey, N., Cotton, M. F., Katzman, D., Luttig, M. M., Candelario, R., Baker, S. and Roychoudhury, M.(2018). Factors influencing access of pregnant women and their infants to their local healthcare system: A prospective, multi-centre, observational study. BMC Pregnancy and Childbirth 18, doi:10.1186/s12884-017-1655-3.
dc.relation.referencesMathon, D., Apparicio, P. and Lachapelle, U. (2018). Cross-border spatial accessibility of health care in the North-East Department of Haiti. International Journal of Health Geographics 17: 1–15, doi:10.1186/S12942-018-0156-6/TABLES/4.
dc.relation.referencesMelo-Becerra, L. A., Arango-Thomas, L. E., ávila-Montealegre, , Ayala-García, J., Bonilla-Mejía, L., Botero-García, J. A., Cardona-Badillo, M., Crispin-Fory, C., Gallo-Montaño, D. d. P., Granger-Castaño, C. J., Guzmán-Finol, K., Iregui-Bohórquez, A. M., Ospina-Tejeiro, J. J., Pinilla-Alarcón, D., Posso-Súarez, C., Ramírez-Giraldo, M. T., Ramos-Forero, J. E., Ramos-Veloza, M., Restrepo-Tobón, D. A., Restrepo-Zea,J. H., Silva-Samudio, G. T. and Vásquez-Escobar, D. M. (2023). Aspectos financieros y fiscales del sistema de salud en Colombia. Ensayos Sobre Politica Economica 2023: 6–73, doi:10.32468/espe106.
dc.relation.referencesMiller, G., Pinto, D. and Vera-Hernández, M. (2013). Risk protection, service use, and health outcomes under Colombia’s health insurance program for the poor. American Economic Journal: Applied Economics 5: 61–91, doi:10.1257/app.5.4.61.
dc.relation.referencesMinisterio de de Salud y Protección Social (2019). Encuesta de evaluación de los servicios de las EPS - Informe de resultados 2019. Tech. rep.
dc.relation.referencesMinisterio de de Salud y Protección Social (2020). Encuesta de evaluación de los servicios de las EPS - Informe de resultados 2020. Tech. rep.
dc.relation.referencesMinisterio de de Salud y Protección Social (2021). Encuesta de evaluación de los servicios de las EPS - Informe de resultados 2021. Tech. rep.
dc.relation.referencesMinisterio de de Salud y Protección Social (2023). Cifras de afiliación en salud. Ministerio de salud de Colombia and Universidad Nacional de Colombia (2012). Identifiación y afiliación de beneficiarios- SISBEN. Tech. rep.
dc.relation.referencesMinisterio de Salud Pública y Protección Social (2013). Resolución 5521 de 2013.
dc.relation.referencesMinisterio de Salud y Protección Social (2010). Unidad de Pago por Capitación del régimen subsidiado.
dc.relation.referencesMinisterio de Salud y Protección Social (2016). Sistema Obligatorio de Garantía de Calidad en Salud (SOGCS). Tech. rep.
dc.relation.referencesMinisterio de Salud y Protección Social (2021). Cuotas moderadoras y copagos (Acuerdo 260 de 2004 CNSSS).
dc.relation.referencesMontgomery, M. C., Alholm, Z., Almonte, A., Sykes, K. J., Rudolph, G., Cusick, B., Castello, L., Sowemimo-Coker, G., Tang, I., Haberlack, S. and Chan, P. A. (2020). A cross-sectional evaluation of HIV testing practices among women in the rural Dominican Republic. BMC Women’s Health 20, doi:10.1186/s12905-020-0891-2.
dc.relation.referencesNewhouse, J. P. (1996). Reimbursing Health Plans and Health Providers: Efficiency in Production Versus Selection. Journal of Economic Literature XXXIV: 1236–1263.
dc.relation.referencesOrganización Panamericana de la Salud (2021). Tablero de los indicadores básicos.
dc.relation.referencesPatiño, J. F. (2013). El sistema de salud de Colombia: crisis sin precedentes. Revista Colombiana de Cirugía 28: 259–261.
dc.relation.referencesProcuraduría General de la Nación (2008). El derecho a la salud en perspectiva de derechos humanos y el sistema de inspeccion, vigilancia y control del estado colombiano en materia de quejas en salud.
dc.relation.referencesRathe, M. and Moliné, A. (2011). Sistema de salud de República Dominicana. Salud Publica de Mexico 53: 255–264, doi:10.1590/S0036-36342011000800020.
dc.relation.referencesRestrepo-Zea, J. H., Silva-Maya, C., Andrade-Rivas, F. and Vh-Dover, R. (2014). Acceso a servicios de salud: Análisis de barreras y estrategias en el caso de Medellín, Colombia. Revista Gerencia y Politicas de Salud 13: 236–259, doi:10.11144/Javeriana.rgyps13-27.assa.
dc.relation.referencesRiascos Villegas, J. (2013). Mecanismos de compensación complementarios al ajuste de riesgo prospectivo en el SGSSS en Colombia y la Cuenta de Alto Costo. Desarrollo y Sociedad : 165–191doi:10.13043/DYS.71.5.
dc.relation.referencesRitterbusch, A. E., Correa Salazar, C. and Correa, A. (2018). Stigma-related Access barriers and violence against trans women in the Colombian healthcare system. Global Public Health 13: 1831–1845, doi:10.1080/17441692.2018.1455887.
dc.relation.referencesRodríguez Garavito, C. (2012). La judicialización de la salud: síntomas, diagnóstico y prescripciones. In Bernal, and Gutíerrez, C. (eds), La salud en Colombia. Universidad de los Andes, chap. 12, 507–560, doi:10.7440/j.ctt1b3t87j.16.
dc.relation.referencesRodríguez Hernández, J. M., Rodríguez Rubiano, D. P. and Corrales Barona, J. C. (2015). Barreras de acceso administrativo a los servicios de salud en población Colombiana, 2013. Ciencia e Saude Coletiva 20: 1947–1958, doi:10.1590/1413-81232015206.12122014.
dc.relation.referencesRosa, A. de la, Mordan, J., Barinas, I., Toribio, M., Mancebo, D., Rodríguez, A. and Pacheco-Herrero, M. (2021). Acceptability and adoption of clinical practice guidelines and treatment protocols on preeclampsia/ eclampsia in the Dominican Republic. Revista Panamericana de Salud Publica/Pan American Journal of Public Health 45:1–6, doi:10.26633/RPSP.2021.15.
dc.relation.referencesSánchez, A. (2005). El modelo Dominicano de prestación de servicios de salud, un apuesta de futuro. Tech. rep.
dc.relation.referencesSanchez, G., Laza, C., Estupiñan, C. and Estupiñan, L. (2014). Barreras de acceso a los servicios de salud: narrativas de mujeres con cáncer de mama enColombia. Revista Facultad Nacional de Salud Pública 32: 305–313.
dc.relation.referencesSantos Frías, E. (2020). Garantías del Derecho de la Seguridad Social en la República Dominicana vista desde la Constitución y las leyes No.87-01 y 13-20. Revista de la Facultad de Derecho de México 70: 247, doi:10.22201/fder.24488933e.2020.277-i.76266.
dc.relation.referencesSistema único de Beneficiarios (2005). Decreto No. 143-05. Superintendencia de Salud y Riesgos Laborales (2022). Propuesta SISALRIL es aprobada por el CNSS; aumenta per cápita en Régimen Subsidiado y Planes Especiales de Jubilados y Pensionados. Superintendencia de Salud y Riesgos Laborales (2023). Estadísticas - Afiliación.
dc.relation.referencesTanahashi, T. (1978). Health service coverage and its evaluation. Bulletin of the World Health Organization 56: 295–303.
dc.relation.referencesTaylor, B. S., Reyes, E., Levine, E. A., Khan, S. Z., Sergio Garduñ, L., Donastorg, Y., Hammer, S. M., Brudney, K. and Hirsch, J. S. (2014). Patterns of Geographic Mobility Predict Barriers to Engagement in HIV Care and Antiretroviral Treatment Adherence. AIDS PATIENT CARE and STDs 28: 284–295, doi:10.1089/apc.2014.0028.
dc.relation.referencesUribe, C., Amado, A., Rueda, A. M. and Mantilla, L. (2019). Barriers to access to palliative care services perceived by gastric cancer patients, their caregivers and physicians in Santander, Colombia. Ciencia e Saude Coletiva 24: 1597–1607, doi:10.1590/1413-81232018245.04432019.
dc.relation.referencesVargas, I., Unger, J. P., Mogollón-Pérez, A. S. and Vázquez, M. L. (2013). Effects of managed care mechanisms on access to healthcare: Results from a qualitative study in Colombia. International Journal of Health Planning and Management 28: 13–33, doi:10.1002/hpm.2129.
dc.relation.referencesWorld Health Organization (????). NHA Indicators.
dc.relation.referencesWorld Health Organization (2014). Final report of the WHO Consultative Group on Equity and Universal Health Coverage Making fair choices on the path to universal health coverage. Tech. rep.
dc.relation.referencesYamin, A. E., Parra-Vera, O., Abadia, C. E., Oviedo, D. G., Arrieta-Gómez, A. I., Procuraduría General de la Nación and Stahlhofer, M. M. (2009). The right to health and the CRC. PLoS Medicine 6: 0147–0150, doi:10.1371/journal.pmed.1000032.
dc.relation.referencesYee, C. A., Legler, A., Davies, M., Prentice, J. and Pizer, S. (2020). Priority access to health care: Evidence from an exogenous policy shock. Health Economics 29: 306–323, doi:10.1002/HEC.3982.
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 Internationalen
dc.rights.accessrightsinfo:eu-repo/semantics/embargoedAccess
dc.rights.coarhttp://purl.org/coar/access_right/c_f1cf
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/
dc.subject.keywordHealthcareeng
dc.subject.keywordHealth service utilizationeng
dc.subject.keywordUniversal health coverageeng
dc.subject.keywordPublic expenditure on healtheng
dc.subject.keywordCongestioneng
dc.subject.keywordQuality careeng
dc.subject.keywordHealth insuranceeng
dc.subject.keywordBarriers accesseng
dc.subject.themesEconomíaspa
dc.titleChallenges in Accessing Healthcare Serviceseng
dc.typeTrabajo de grado - Doctorado
dc.type.coarhttp://purl.org/coar/resource_type/c_db06
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.contentText
dc.type.driverinfo:eu-repo/semantics/doctoralThesis
dc.type.redcolhttps://purl.org/redcol/resource_type/TD
dc.type.versioninfo:eu-repo/semantics/acceptedVersion
dspace.entity.typePublication
person.identifier.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000592412
person.identifier.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000641839
person.identifier.gsidhttps://scholar.google.es/citations?user=sWIi9DQAAAAJ
person.identifier.gsidhttps://scholar.google.es/citations?user=LJ4qikAAAAJ
person.identifier.orcid0000-0002-0441-8610
person.identifier.orcid0000-0002-0365-9869
relation.isDirectorOfPublicationf620d93f-4db1-4bef-ba9c-62ac58bb7d12
relation.isDirectorOfPublicationc9449e94-d7ea-4eff-b5fc-4da621527478
relation.isDirectorOfPublication.latestForDiscoveryf620d93f-4db1-4bef-ba9c-62ac58bb7d12
relation.isReviewerOfPublication147596ca-5a85-40eb-bb61-ef97c571b5f9
relation.isReviewerOfPublication.latestForDiscovery147596ca-5a85-40eb-bb61-ef97c571b5f9
Archivos
Bloque original
Mostrando 1 - 2 de 2
Miniatura
Nombre:
Autorizacion_tesis_biblioteca_ob_db.pdf
Tamaño:
244.47 KB
Formato:
Adobe Portable Document Format
Descripción:
HIDE
Descargar
No hay miniatura disponible
Nombre:
Challenges in accessing healthcare services Thesis_publicable_disclaimer.pdf
Tamaño:
2.49 MB
Formato:
Adobe Portable Document Format
Descargar
Bloque de licencias
Mostrando 1 - 1 de 1
No hay miniatura disponible
Nombre:
license.txt
Tamaño:
2.48 KB
Formato:
Item-specific license agreed upon to submission
Descripción:
Descargar
Colecciones
Tesis/Trabajos de Grado