[Colombian Health spending 1993-2003: its composition and trends].

OBJECTIVE

Analysing the magnitude, composition, evolution and trends in Colombian national spending on health, forming a proposal and making an important contribution towards knowledge re the reality of social health security.

METHODOLOGY

The results obtained respond to an ongoing effort to systematise and standardise the adopted methodology and update calculations and estimates for the eleven-year period during which Law 100/1993 was being reformed. Analysing the above led to identifying changes in the flow of resources and establishing objective comparisons according to current/available international standards. The project began in the Colombian Planning Department (lasting 5 years) and was then passed to the Ministry of Social Protection's Health Reform Support Programme where new institutional scope has been applied during the last four years.

RESULTS

Perhaps the work's most important contribution consists of producing annual estimates of total public and private spending on health as a time-series, for a relatively significant period.

DISCUSSION

The results confirm fulfilment of the reform's suppositions in terms of the significant amount of resources channelled to the sector, the important substitution of financing private spending for spending on health insurance, greater dynamism and the importance of public funds in financing total spending and the managing of an important segment of such resources by some of the new agents created by the reform. This contrasts with the little importance paid to spending on promotion and prevention and on public health and basic attention programmes.