Examinando por Autor "Guerrero Carvajal, Ramiro"

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A century of trends in adult human height
(eLife Sciences Publications Ltd, 2016-07-26) Guerrero Carvajal, Ramiro
Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5-22.7) and 16.5 cm (13.3- 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8- 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries. © NCD Risk Factor Collaboration.
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.
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.
Control of hypertension with medication: a comparative analysis of national surveys in 20 countries
(World Health Organization, 2014-01-01) Murraye, Christopher JL.
High blood pressure, also known as hypertension, is a major contributor to the global disease burden and was responsible for 7% of all disability-adjusted life years in 2010.1 Moreover, the number of people with uncontrolled hypertension has increased to around 1 billion worldwide in the past three decades.2 As a result, the effective control of hypertension has become a priority for global health policy and, with growing interest in the prevention and control of noncommunicable diseases (NCDs),3 it is vital that health-care systems deliver appropriate interventions for tackling high blood pressure.
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.
La doble descentralización en el sector salud: evaluación y alternativas de política pública
(Fedesarrollo, 2014-06-30) Guerrero Carvajal, Ramiro
Este estudio del Centro de Estudios en Protección Social y Economía de la Salud (PROESA) de la Universidad Icesi describe los problemas, las tensiones y los vacíos que esta doble descentralización genera en el Sistema de Seguridad Social en Salud colombiano.
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.
Inequalities in non-communicable diseases and effective responses
(The Lancet Publishing Group, 2013-02-16) Guerrero Carvajal, Ramiro
In most countries, people who have a low socioeconomic status and those who live in poor or marginalised communities have a higher risk of dying from non-communicable diseases (NCDs) than do more advantaged groups and communities. Smoking rates, blood pressure, and several other NCD risk factors are often higher in groups with low socioeconomic status than in those with high socioeconomic status; the social gradient also depends on the country's stage of economic development, cultural factors, and social and health policies. Social inequalities in risk factors account for more than half of inequalities in major NCDs, especially for cardiovascular diseases and lung cancer. People in low-income countries and those with low socioeconomic status also have worse access to health care for timely diagnosis and treatment of NCDs than do those in high-income countries or those with higher socioeconomic status.
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.
Overcoming social segregation in health care in Latin America
(The Lancet Publishing Group, 2015-03-28) Guerrero Carvajal, Ramiro
Latin America continues to segregate different social groups into separate health-system segments, including two separate public sector blocks: a well resourced social security for salaried workers and their families and a Ministry of Health serving poor and vulnerable people with low standards of quality and needing a frequently impoverishing payment at point of service. This segregation shows Latin America's longstanding economic and social inequality, cemented by an economic framework that predicted that economic growth would lead to rapid formalisation of the economy. Today, the institutional setup that organises the social segregation in health care is perceived, despite improved life expectancy and other advances, as a barrier to fulfilling the right to health, embodied in the legislation of many Latin American countries.
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.
Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants
(Elsevier, 2016-04-09) Guerrero Carvajal, Ramiro
Background One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. Methods We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue.