Calderón Carlos Alberto Agudelo, Botero Jaime Cardona, Bolaños Jesús Ortega, Martínez Rocio Robledo
Facultad de Medicina, Instituto de Salud Pública, Universidad Nacional de Colombia, Bogotá, DE, Colombia.
Cien Saude Colet. 2011 Jun;16(6):2817-28. doi: 10.1590/s1413-81232011000600020.
An overview of some of the key processes and results of Colombia's National Health System is presented. A systematic review of the literature evaluating the quality of the evidence published in indexed journals and literature not published in journals was made. Health system financial resources have seen a sustained increase while spending on health has remained at around 8% of GNP. Coverage, measured by affiliation to contributory and subsidized regimes, is in the order of 92% of the total population. The Mandatory Health Plan, defining the benefits to which one has access, has been broadly maintained but has been hampered by mechanisms for making legal complaints, thereby leading to financial deficits. The health system has contributed towards improving the poorest sector's income, but inequalities persist due to the lack of universal coverage, differences in health plans and the system's expenditure according to the population's income. Advances made in the National Health System have been positive but universality has not been achieved and this has stagnated in matters regarding access to services and equality.
介绍了哥伦比亚国家卫生系统的一些关键流程和成果概况。对评估索引期刊上发表的证据质量以及未在期刊上发表的文献进行了系统的文献综述。卫生系统财政资源持续增加,而卫生支出一直维持在国民生产总值的8%左右。以参加缴费型和补贴型制度衡量的覆盖率约占总人口的92%。界定可享受福利的《强制性健康计划》总体上得以维持,但因法律投诉机制而受到阻碍,进而导致财政赤字。卫生系统有助于改善最贫困部门的收入,但由于缺乏全民覆盖、健康计划差异以及系统支出随人口收入的不同,不平等现象依然存在。国家卫生系统取得了积极进展,但尚未实现全民覆盖,在服务获取和平等问题上停滞不前。