Estado da arte da pesquisa em acesso aos servidos de saúde na Colombia, 2000-2013: revisáo sistemática crítica
01 Dec 2014-Vol. 13, Iss: 27, pp 12-26
TL;DR: This paper present a revision sistematica de trabajos de investigacion en el tema delacceso a servicios de salud en Colombia en el periodo 2000-2013.
Abstract: Este estudio presenta una revision sistematica de los trabajos de investigacion en el tema delacceso a servicios de salud en Colombia en el periodo 2000-2013. Las bases de datos empleadaspara la busqueda fueron Ebsco, Jstor, Proquest, ISI Web of Science, scielo y Cochrane. Losresultados mostraron que la mayoria de los estudios se efectuaron entre 2006 y 2011, la mayorparte de los cuales analizaron areas urbanas. Una tercera parte consistio en una investigacionsobre datos nacionales, en donde las tematicas estuvieron centradas en equidad en la utilizacionde servicios, algunos grupos de poblacion vulnerables, acceso a algunos servicios especificos,asi como en las implicaciones de la Ley 100 de 1993 en el acceso. Los resultados sugirieronque es necesario que Colombia mejore las fuentes de informacion, que los marcos teoricossean adaptados al contexto y que se realicen estudios que aborden de manera integral todos loseslabones que involucran el acceso.
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01 Jan 2007
TL;DR: For instance, a recent study by the Secretaria de Salud de Medellin (SDS) as discussed by the authors found that 68.7% of the femenines in Colombia have been treated with tamizaje citologico for cervical cancer.
Abstract: Fundamento: en paises en desarrollo no se han logrado
suficientes avances en reduccion de la carga de la enfermedad
por cancer cervical, por lo que es importante mejorar la cobertura,
condiciones de acceso y efectividad de los programas de
tamizaje El objetivo de este trabajo es analizar el acceso real
de mujeres usuarias del tamizaje citologico ofrecido por la
Secretaria de Salud de Medellin (Colombia)
Metodos: se analizaron 1519 registros de mujeres, provenientes
de un estudio transversal realizado en un area urbana
de Medellin (Colombia) Se realizo un analisis descriptivo y se
estimo un modelo de regresion logistica para explicar la practica
de citologia reciente (aquella realizada hace maximo 36
meses, previos a la aplicacion de la encuesta)
Resultados: El 68,7% de las mujeres se habian practicado
una citologia recientemente, el 17,2% tenia citologias previas
pero no recientes, y el 14,2% era la primera vez que acudia
al servicio La probabilidad de haberse realizado una
citologia reciente es mayor para mujeres con mas edad, antecedente
familiar de cancer cervical, antecedente personal de
infecciones de transmision sexual, mujeres con algun grado de
educacion y las que se encuentran en union estable o estan (o
estuvieron) casadas
Conclusiones: hay indicios de que la demanda por la citologia
esta concentrada, con una buena frecuencia para un
numero limitado de mujeres, mientras otras no la practican o
dejan de hacerlo
23 citations
01 Jan 2008
TL;DR: In this paper, the authors analyzed the access to health services for the population belonging to the contributive and subsidized regimes in the Colombian Caribbean region and constructed models of discreet selection to gain insight about the determinants for the use of health services because of both preventive and curative reasons.
Abstract: This document analyzes the access to health services for the population belonging to the contributive and subsidized regimes in the Colombian Caribbean region. Models of discreet selection are constructed - simple logit and Heckman probit - to gain insight about the determinants for the use of health services because of both preventive and curative reasons. Among the main results were that while the difference in the probability of access for the affiliated is very important in the case of use of the services because of prevention, this difference does not exist in the case of hospitalization. This suggests severity of the disease reduces the access difference to health services of the non affiliated with respect to those belonging to any regime of affiliation.
12 citations
TL;DR: HCD is a useful for design-based prevention in the field of cervical cancer and the integration of this approach with public health research would allow the generation of evidence during to the formulation of policies and programs as well as optimize existing interventions and facilitate the scalability and financing of what actually works.
Abstract: This article presents the design process of innovative prototypes for cervical cancer prevention in primary care centers located in low-income settings in Cali, Colombia, using the Human-Centered Design (HCD). The project was developed in collaboration with a public healthcare network comprised of 38 urban and rural centers with women between the ages of 25 and 65 years, healthcare providers of the cancer program, healthcare administrators and the general manager of said network. Our HCD process involved five stages: research, need synthesis, ideation and co-design process, prototyping and in-context usability testing. In practice, some of the stages are overlapped and iterated throughout the design process. We conducted observations, open-ended interviews and conversations, multi-stakeholder workshops, focus groups, systematic text condensation analyses and tests in real contexts. As a result, we designed four prototypes: (1) 'Encanto': An educational manicure service, (2) 'No le des la espalda a la citologia': A media-based strategy, (3) An educational wireless queuing device in the waiting room, and (4) Citobot: A cervical cancer early detection device, system, and method. The tests carried out with each prototype showed their value, limitations and possibilities in terms of subsequent development and validation through public health research or clinical research. We recognize that a longer-term evaluation is required in order to determine whether the prototypes will be used regularly, integrated into cervical cancer screening services and effectively improve access to cytology as a screening test. We conclude that HCD is a useful for design-based prevention in the field of cervical cancer. The integration of this approach with public health research would allow the generation of evidence during to the formulation of policies and programs as well as optimize existing interventions and, ultimately, facilitate the scalability and financing of what actually works.
11 citations
30 May 2019
TL;DR: In this paper, a review of the Radiodiagnosis and Radiotherapy technology program is presented, where the degree projects presented from 2012 to 2016 are classified, making an analysis and interpretation of the central contributions of student research.
Abstract: DOI: https://doi.org/10.31948/rev.criterios/26.1-art6
This review article allows us to know the ongoing research process, whose general objective is to establish research trends in the Radiodiagnosis and Radiotherapy Technology program. Its purpose is to properly direct the research, enabling its practice in specific knowledge, so that the research spirit is disseminated in the student. Through the development of the specific objectives, the degree projects presented from 2012 to 2016 will be classified, making an analysis and interpretation of the central contributions of student research. For this, a descriptive methodology with a hermeneutical approach is used, which facilitates the collection of information through a document review sheet and thus determine the thematic orientation developed in each investigation, according to the thematic axes and areas of knowledge treated within the program, and obtain as a result, the consolidation of research trends. In this way, the area and the thematic axis to which most of the student degree works can be determined. It is also conceived as a result, the determination of a new thematic axis.
9 citations
09 Dec 2015
TL;DR: In this article, the authors present a case analysis to identify differences in access to curative services among people affiliated to the contributive and subsidized system, demonstrating infringement of the fundamental right to health care.
Abstract: This study presents a case analysis to identify differences in access to curative services among people affiliated to the contributive and subsidized system. At the population level, around a tenth of the population feels the need and demand a healing service, 97.8 % being treated. Descriptive, cross-sectional investigation; fundamentals variables were operationalized taking into account the need serviced. Cases were considered, those presenting a health problem in the last month, consulted a formal service and were treated. The results show differences between the regimes of access and satisfaction; for example, in relation to the medicines they claimed 87.8 % of contributive and subsidized 55.9 %, statistically significant differences. Administrative and financial barriers were found; and characteristics of the services that affect access to care and quality in both regimes, demonstrating infringement of the fundamental right to health care.
8 citations
References
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TL;DR: The Behavioral Model of Health Services Use was initially developed over 25 years ago and is reviewed and assessed for continued relevance.
Abstract: The Behavioral Model of Health Services Use was initially developed over 25 years ago. In the interim it has been subject to considerable application, reprobation, and alteration. I review its development and assess its continued relevance.
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TL;DR: Results provide strong support for the view that differentiation does exist among the five areas and that the measures do relate to the phenomena with which they are identified.
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TL;DR: This paper explains the comprehensiveness and dynamic nature of this conceptualisation of access to care and identifies relevant determinants that can have an impact on access from a multilevel perspective where factors related to health systems, institutions, organisations and providers are considered with factors at the individual, household, community, and population levels.
Abstract: Access is central to the performance of health care systems around the world. However, access to health care remains a complex notion as exemplified in the variety of interpretations of the concept across authors. The aim of this paper is to suggest a conceptualisation of access to health care describing broad dimensions and determinants that integrate demand and supply-side-factors and enabling the operationalisation of access to health care all along the process of obtaining care and benefiting from the services. A synthesis of the published literature on the conceptualisation of access has been performed. The most cited frameworks served as a basis to develop a revised conceptual framework. Here, we view access as the opportunity to identify healthcare needs, to seek healthcare services, to reach, to obtain or use health care services, and to actually have a need for services fulfilled. We conceptualise five dimensions of accessibility: 1) Approachability; 2) Acceptability; 3) Availability and accommodation; 4) Affordability; 5) Appropriateness. In this framework, five corresponding abilities of populations interact with the dimensions of accessibility to generate access. Five corollary dimensions of abilities include: 1) Ability to perceive; 2) Ability to seek; 3) Ability to reach; 4) Ability to pay; and 5) Ability to engage. This paper explains the comprehensiveness and dynamic nature of this conceptualisation of access to care and identifies relevant determinants that can have an impact on access from a multilevel perspective where factors related to health systems, institutions, organisations and providers are considered with factors at the individual, household, community, and population levels.
1,560 citations
Journal Article•
215 citations
TL;DR: It is concluded that managed care in Colombia has created complex bureaucracies that delay and limit care through cost-containment mechanisms, which has resulted in harmful consequences for people's lives.
153 citations