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  • PublicaciónAcceso abierto
    Factores que influyen en la gestión de glosas y devoluciones de una institución prestadora de servicios de salud en Montería, 2021
    (2022-08-25) Cogollo Arteaga, Luís Carlos; Gonzalez Rojas, Donis Patricia; Mendoza Zuluaga, María Alejandra; Espitia Cabralez, Enalbis Esther
    The health institution in research presents financial deficits as a consequence of the glosses and returns generated after providing health care services, which is why the objective of this research was to determine the factors that influence the returns and glosses for the provision of services in the period of time between January and September 2021, in order to present strategies to improve the collection of overdue payments. The methodology implemented in this research was a cross-sectional descriptive study, taking the research period and analysis of glosses and returns the time between January and September 2021, consolidated in a database for analysis where it could be evidenced 4,812 glossed invoices and 3,075 invoices under the concept of return, equivalent to a total of 7,887 invoices with inconsistencies that represent economic losses and delays in collecting money for the institution and increasing the costs of non-quality in the administrative and assistance fields. After carrying out the analysis of the information, it was possible to identify shortcomings in the billing processes, documentary audit and concurrent audit. Taking into account the concepts of glosses, it was possible to identify that the ICU Intensive Care Units generate the highest percentage of inconsistency in the billing generated by the IPS, in addition to the most representative factors in terms of the glosses of the billing for the provision of services of the IPS, 2,790 corresponds to the performance of procedures without prior authorization from the EPS. Based on these findings, improvement actions were generated in order to minimize shortcomings and thus contribute to improving the flow of resources and the collection of overdue payments by the IPS
  • PublicaciónAcceso abierto
    Percepción de los usuarios sobre la calidad de los servicios de salud en instituciones hospitalarias 2015-2019
    (2022-04-21) Arrieta Córdoba, René Alberto; Herrera Gutiérrez, Concepción
    This documentary research made it possible to characterize the health services offered in hospital institutions in the field of quality during the period from 2015 to 2019. This review illustrated the existence of services identified as primary and secondary with their respective subclassifications. In the second instance, as a state of the art, in Colombia the presence of a series of works is observed, under the discursive modality of research articles that account for the concern that higher education institutions have, through the Faculties of Health Sciences for strengthening the quality of health services offered, a process that is coupled, in some cases, with the perception of users, that is, their opinion is key to the implementation of improvement plans that allow mitigating all those shortcomings that they perceive when they go to a hospital institution to request a health service. For this, the methodology of this study is located within the scope of the documentary review of primary and secondary sources and the respective analysis of their results to obtain conclusions and recommendations related to the subject in question. The results of the study show that, to a certain degree of acceptance with the quality of the services received, the perception that users have regarding the quality of the services they obtain in hospital institutions is related to efficiency and satisfaction in care. received in the different dependencies. Appreciation that managers and workers must take into account for the implementation of continuous improvement plans; because the information obtained from these investigations constitutes inputs that will benefit health institutions, direct providers and will decisively contribute to the satisfaction and effective solution of the needs and expectations of users.
  • PublicaciónAcceso abierto
    La función del pago global prospectivo y su papel en la contratación de servicio de salud
    (2021-09-27) Ariz Galarcio, Isaac Antonio; Amador Ahumada, Concepción Elena
    Prospective Global Payment is a payment and contracting model in force in Colombia and highly applicable for the optimal functioning of the Health System, which is why it is widely used by Health Promotion Companies and Health Service Provider Institutions at the time to establish contractual agreements for the provision of health services to the Colombian population. Based on this, the present monograph aims to analyze the function of prospective global payment and its role in the contracting of health services based on the experience of the IPS MediSinú of the city of Monteria, Córdoba. During the development of this work, different concepts of the contracting modality object of study are presented here, that is, the Prospective Global Payment, these definitions allow to build a concept on it and to know the way in which it affects the contractual relationships. Health and Health Service Provider Institutions, in the same way, clarity is made about the subclasses of Prospective Global Payment models, and what each of them implies, thus having per episode per specialty, among others. There is also a series of allusions about the advantages and disadvantages of this hiring model and the way in which they should be assumed in a managerial way. Knowledge of these factors broadens the vision of a contracting model that is gaining strength in the country.