Logo_Icesi

Maestría en Gerencia de Organizaciones de Salud

URI permanente para esta colecciónhttps://hdl.handle.net/10906/130310

Examinar

Examinando Maestría en Gerencia de Organizaciones de Salud por Autor "Rojas Sierra, Juliana Inés"

Seleccione resultados tecleando las primeras letras
Mostrando 1 - 1 de 1
  • Miniatura
    Ítem
    Propuesta de un modelo de atención de alta complejidad en regiones desatendidas: ¿cómo cerrar la brecha en salud especializada? Caso cáncer de mama
    (Universidad Icesi, 2025-06-01) Rojas Sierra, Juliana Inés; Soto Rojas, Victoria Eugenia
    Data from the BID (Inter-American Development Bank) shows a gap in the public health network in Latin America close to USD 100,000 million, mainly in: maintaining operational installed capacity, the need to expand coverage, improve access, and make services more complex. This reality presents governments and investors with budget problems and a lack of tools to plan health investments (Astorga, 2018). The WHO (World Health Organization) has defined Universal Health Coverage (UHC) as “the desired outcome of the health system's functioning that is achieved when anyone who needs to access health services (promotion, prevention, treatment, rehabilitation, and palliative care) can do so, without incurring financial difficulties.” This is in line with the sustainable development goals of “achieving universal health coverage, particularly protection against financial risks, access to quality essential health services, and access to safe, effective, affordable, and quality medicines and vaccines for all” (United Nations, 2015). In a region of southwestern Colombia, there are no IPS (Health Service Providers) that offer care for complex health conditions. Patients must travel long distances on poorly maintained roads to be treated in cities that provide high-complexity care. This constitutes a significant social, economic, and emotional impact for patients and their families, as they must migrate, at least temporarily, to cities without a support network; they must make significant economic efforts for sustenance and stop working simultaneously, as well as distance themselves from their families, and in cases of having dependents, they must leave them in someone else's care. Likewise, if the disease requires urgent attention, prolonged transfer times translate into a greater risk of mortality and complications derived from not receiving timely care. Residents do not have universal health coverage, and the region has a deficit of investment in health infrastructure and adequate plans for this purpose. This work describes the gap in high-complexity services and proposes a sustainable model, adapted to local realities based on a particular pathology: breast cancer. A model initially applicable to breast cancer is proposed, which could be extended to other prevalent oncological pathologies. With phased growth, the aim is to close the gap in access to high-complexity care in the long term. The analysis of the demographic characteristics of the region of interest highlights the lack of infrastructure for health care for conditions requiring high-complexity medicine and particularly oncological services. In addition to insufficient infrastructure, deficiencies are identified in the assisted and administrative routes to access oncological services, aggravated by factors such as geographic dispersion, rural poverty, and poor road connectivity. All these factors, synergistically, create difficulties that make timely care for these types of diseases impossible. The collected data shows gaps in the provision of oncology services in all municipalities of interest; from diagnosis phases to palliative care or rehabilitation; as well as inequities in health access. Oncological pathology is prioritized due to the burden it represents in mortality, quality-adjusted life years, and disability-adjusted life years (QALYs and DALYs). Cancer is the second leading cause of death in the world, causing about 10 million deaths annually in 2022. Of these, 70% occurred in middle and low-income countries like Colombia. (Union for International Cancer Control UICC, 2023). Oncological disease constitutes a health priority for the government with the intention of reducing gaps in cancer care. For this reason, the registration of information for people with cancer began through Resolution 0247 of 2014, oncological disease was included in high-cost accounts (High Cost Account, 2024), and the Decennial Plan for Cancer Control was defined as part of the Decennial Public Health Plan 2022 - 2031 (SISPRO, 2023). This demonstrates that for the national government, it is a priority to promote the fight for cancer care. However, there are still areas of Colombia without the infrastructure or organization of networked health services to care for oncological patients. For this reason, a care model is proposed that allows services to be provided to treat cancer in territories characterized by low supply. This model is designed based on the estimated gap, in line with the BID's description of master investment plans; addressing one facet of the problem of inequitable access to care for cancer patients, the concentration of such services in large cities, and therefore the consequences of untimely and discontinuous access to specialized care for these types of diseases.