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Proesa - General

URI permanente para esta colecciónhttp://hdl.handle.net/10906/81381

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Examinando Proesa - General por Autor "Guerrero Carvajal, Ramiro"

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    Capital requirements of health insurers under different risk-adjusted capitation payments
    (Centro de Estudios en Protección Social y Economia de la Salud - PROESA, 2017-02-01) Guerrero Carvajal, Ramiro
    Defining optimal capital requirements for health insurers is a matter of interest for policy-makers. They determine the insolvency probability of health insurers and the minimum number of enrolees in order to keep insolvency under control. In this paper we develop a methodology for estimating the expected loss per health insurer after considering their specific risk profile and the capitation formula with which they are paid. We assume the expected loss follows a normal distribution within risk pools consisting of a unique combination of long-term disease, age, gender, and location, and then define the minimum capital requirement as the 1st quantile of the loss distribution. An application is made for insurers in the statutory health care system of Colombia.
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    Case Study: HIV/AIDS in the Context of the Colombian Health Care Reform
    (Centro de Estudios en Protección Social y Economia de la Salud - PROESA, 2012-07-01) Castro, Héctor
    Starting in the early nineties, Colombia, the third most populous country in Latin America, implemented a profound reform of its health system. A universal social health insurance system was created. The new system collects funds centrally, and allows for multiple competing plans that receive risk adjusted capitated payments and are responsible for delivering a basic and legally mandated basket of services. This case reviews how the HIV/AIDS epidemic has been managed in the context of this reform. The inclusion of Antiretroviral (ARV) in the mandated basic basket proved a powerful mechanism for ensuring access to care. Results are less clear, and to some extent disappointing, for prevention activities.
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    Diseño y reforma del Plan Obligatorio de Salud en Colombia.
    (Centro de Estudios en Protección Social y Economia de la Salud - PROESA, 2012-05-01) Guerrero Carvajal, Ramiro
    The way a benefits package is implemented in a health system is as important as its content. This article focuses on the way a package is designed and implemented, rather than on its medical content. It starts by defining the packages and presenting the different ways of designing them, and the implications of the latter on equity and access. Some international experiences are presented and commented, with special emphasis on recent reforms in Chile and México. The concepts and cases presented in the paper are then discussed in the Colombian context in order to identify relevant lessons and insights for the current process of reforming and updating the Colombian benefits package.
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    Escenarios posibles para el Sistema General de Seguridad Social en Salud (SGSSS)
    (Centro de Estudios en Protección Social y Economia de la Salud - PROESA, 2014-12-01) Guerrero Carvajal, Ramiro; Prada Ríos, Sergio Iván
    This document presents three alternative health systems models (totally public, totally privatized, or combined). These are presented as scenarios toward which the Colombian health system could evolve in the future. The presentation of these different perspectives aims to inform the public debate about the difficulties present in the current healthcare system and what direction could its design take in the future. Among the elements of each scenario, we mention the funding mechanisms, service delivery models, monitoring, regulation, and the benefits that covered by the system, among others.
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    Medición de gasto de bolsillo en salud usando la Encuesta Nacional de Calidad de Vida de Colombia
    (Centro de Estudios en Protección Social y Economia de la Salud - PROESA, 2016-03-01) Guerrero Carvajal, Ramiro
    In this paper three different methodologies for calculating out-of-pocket health expenditure are suggested based on the items included in the Living Standard Measurement Study. The results show that out-of-pocket health expenditure decreases in the 2008-2014 period regardless of the approach used, suggesting a continuous improvement on the financial protection goal of the Colombian health system.
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    La sinfonía incompleta: La reforma al Sistema de Salud de Colombia
    (Centro de Estudios en Protección Social y Economia de la Salud - PROESA, 2012-09-01) Chernichovsky, Dov
    Este documento hace un análisis crítico de la reforma al Sistema de Salud que emprendió Colombia con la entrada en vigor de la Ley 100 de 1993. El documento expone por qué, a pesar un diseño creíble y visionario de modelo, la implementación de la reforma sigue incompleta. El documento propone una serie de cambios que puedan hacer de las instituciones existentes un Sistema de Salud más eficiente y más equitativo que el actual. Las recomendaciones incluyen la integración inteligente de los recursos, la reconsideración del modelo de competencia regulada en áreas marginales y cambios en los entes responsables por la promoción de la salud y la atención preventiva.