ABSTRACT
Objetivo: analizar las características de las acciones de tutela en salud interpuestas por usuarios de los servicios de salud de la ciudad de Leticia, localizada en la Amazonia colombiana. Metodología: se llevó a cabo un estudio descriptivo de corte transversal, mediante una muestra representativa y aleatoria de tutelas interpuestas por los usuarios de los servicios de salud desde 2004 hasta 2008. Resultados: en el período estudiado hubo crecimiento progresivo del número de tutelas; 72 por ciento fueron interpuestas por afiliados al régimen contributivo; la EPS con mayor número de demandas fue Saludcoop. Los servicios más tutelados son los siguientes: solicitud de tiquetes para desplazarse a Bogotá en busca de alguna atención médica, solicitud de consulta con especialistas, exámenes de diagnóstico, medicamentos y cirugías, la mayor parte de ellos incluidos en el Plan Obligatorio de Salud. Los derechos más demandados mediante la tutela son a la salud, a la seguridad social y a la vida. Conclusión: la acción de tutela se ha convertido en prerrequisito para poder acceder al derecho a la salud, dadas las múltiples barreras a que se enfrentan los usuarios.
Objective: To analyze the characteristics of the tutelage actions lodged by users of the health system in the municipality of Leticia, Amazon River region, Colombia. Methodology: A descriptive cross-section study was carried out, by means of a randomized, stratified, representative sample of tutelage actions lodged in that city, from 2004 to 2008. Results: During the analyzed period, there was a progressive growth in the number of tutelage actions lodged; 72 percent of them were lodged by people affiliated to the contributive regimen of the Colombian health system. Saludcoop was the institution that faced more tutelage actions. The services requested with such actions were as follows: air tickets for traveling to Bogotá in search of health services, attention by specialists, diagnostic procedures, medications, and surgical interventions. In general, those services, other than the air tickets, should have been provided under the Colombian compulsory health plan. The most frequently requested rights were to health, to social security and to life. Conclusion: Tutelage action has become a prerequisite to access to health services in Colombia due to the many barriers that users must face.
Subject(s)
Humans , Jurisprudence , Right to Health , Human Rights/legislation & jurisprudence , Social Security/legislation & jurisprudenceABSTRACT
Objetivo: describir las características del proceso de contratación de servicios de salud entre las entidades administradoras de planes de beneficio - EAPB (Entidades Promotoras de Salud (EPS) y entes territoriales) con los Institutos Promotores de Salud (IPS) públicas y privadas en la ciudad de Medellín, entre los años 2007 y 2008. Metodología: se realizó un estudio descriptivo exploratorio; se analizó una muestra de minutas de contratos firmados entre EAPB e IPS, y se realizaron entrevistas en profundidad para identificar los aspectos relevantes del proceso de negociación y de las relaciones entre contratantes y contratistas. Hallazgos relevantes: las minutas de los contratos son muy diversas, se observa un desbalance en las obligaciones de las partes y hay constantes tensiones interinstitucionales relacionadas con la posición dominante de las EAPB.
Objective: to describe the characteristics of the health service contracting out process betweenAdministrator Entities of Benefit Plans health Promoting Entities and Territorial Entities- with public and private Health Service Providers of Medellin city, between 2007 and 2008. Methodology:a descriptive, exploratory methodological approach was used to analyze a sample of the contracts minutes and a qualitative approach to identify the relevant aspects of the negotiation process and the relationship between contractors and contracting parties in the development ofthe contracts. Main finding: the contract is a source of ongoing inter-institutional stress during the negotiation, development, and ending phases affected by the exercise of the underwriter´s dominant position of the health insurers opposed to the purpose of willing agreement guaranteeing effective access to health service.
Objetivo: descrever as características do processo de contratação de serviços de saúde entre as entidades administradoras de planos de benefício EAPB (Entidades Promotoras de Saude(EPS) e entidades territoriais) com as organizações prestadoras (IPS) públicas e privadas na cidade de Medellín, entre os anos 2007 e 2008. Metodologia: realizou-se um estudo descritivo e exploratório; analisou-se um mostra de minutas de contratos assinados entre as entidadesadministradoras (EAPB) e as organizações prestadoras (IPS), e realizaram-se entrevistas aprofundidade para identificar os aspectos relevantes do processo de negociação e das relaçõesentre contratantes e contratados. Descobrimentos relevantes: as minutas dos contratos são muito diversas, observa-se um desequilíbrio nas obrigações das partes e há contastes tensões interinstitucionais relacionadas com a posição dominante das entidades administradoras (EAPB).