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The purpose of this work is to determine the implementation of the health care model with a differential approach to the population with disabilities in an IPS of Monteria in 2021. To reveal a municipal panorama of the application of these models by the Health Provider Institutions. , as established by current regulations, for the health care of special populations. First, the population with disabilities treated at the IPS was characterized sociodemographic ally. For this characterization, a survey was applied that includes a set of questions about general aspects of the environment, social support, attitudes of others, use and need for personal assistance and use and need for assistive devices. On the other hand, the standards established in the regulations in force in Colombia (accessibility, treatment, satisfaction, infrastructure) that regulate the implementation of a health model with a differential approach and its respective compliance were analyzed. The analysis of results showed dissatisfaction of users for feeling that their care was not adjusted to the characteristics and needs of their condition. In addition, it revealed that the IPS does not implement a model with a differential approach for the provision of services. Finally, improvement strategies were proposed, based on the SWOT analysis that was carried out based on the research in the IPS, for which an improvement plan was established focused on correcting each of the identified weaknesses and that will serve as the basis for Health Provider Institutions in the municipality of Monteria. Keywords: 8 • Differential Approach: it is a set of actions that are aimed at population groups that deserve it; and contribute to reducing social exclusion g

Objetivo. Describir el comportamiento financiero de las enfermedades de alto costo en una Empresa Promotora de Salud del departamento de Sucre durante la vigencia fiscal 2017. Materiales y métodos. Estudio de tipo descriptivo, retrospectivo con enfoque cuantitativo, la población y muestra estuvo conformada por 1956 atenciones de EAC reportadas en los Registros Individuales de Prestación de Servicios (RIPS) en una Empresa Promotora de Salud (EPS) de Colombia durante la vigencia 2017. Se utilizó como técnica de recolección de datos el análisis documental, a través de una guía de revisión tipo matriz, cuyos resultados fueron representados en gráficas y tablas. Resultados. La entidad presento un valor total de $4.624.112.819 de costos asociados a EAC, lo cual representó el 6% del valor del costo presupuestal definitivo de la vigencia fiscal, y un 5% del valor de su ejecución del valor del costo contable. El nivel de siniestralidad de la EPS, en el 2017 es de 103%. Se realizaron 1905 atenciones en 508 pacientes, lo que corresponde al 3% del total de atenciones y al 7% de los pacientes atendidos por la EPS durante el año de interés. Cada paciente de alto costo recibió en promedio 3,8 atenciones durante el año. La edad promedio de los usuarios fue de 51 años, el 46,8% mujeres y el 53,5% hombres. Las EAC más prevalentes corresponden a VIH, enfermedad cardio vascular, Insuficiencia renal, Cáncer entre otras. Conclusiones. las EAC, representan una severa carga en la prestación del servicio integral de atención en salud. Las exigencias de inversión en las atenciones demandan de la institución el acceso de avances médicos con algunas especificaciones técnicas, procedimientos costosos y continuos en la recuperación o mantenimiento del estado de salud de este tipo de pacientes.

Some risks may arise in the billing process, among which we find glosses, which have a financial impact on the IPS that provide the service, reflected in economic losses. Objective. Determine the main causes of glosses and their financial impact in a Health Service Provider Entity located in the Municipality of Puerto Libertador. Methodology. Descriptive, quantitative, retrospective study. The population and sample consisted of 50 invoices with glosses presented during the year 2020. The data was obtained through the Genoma Plus software, where the concepts and reasons for glosses were taken into account. Results. The main cause of glosses identified is the failure to meet goals with 34%, followed by returns due to billing failures (22%). During the study period, the values glossed by each EPS to the institution were analyzed, evidencing that Coosalud represents the highest glossed value with 38.1%, then Nueva EPS with 25.9%. Conclusions. The different causes of glosses generate a negative financial impact, because it directly affects the operation and sustainability of the Health Institution.

Objective. Determine the legal management of the guardianship action in a Health Promotion Company of Montería during the period from June to December 2020. Methodology. Descriptive, retrospective study with a quantitative approach. The population and sample consisted of 50 protection actions filed during the period from June to December 2022, before a company that promotes health services (EPS). Results: the main cause of the guardianships established corresponds to the request for appointments by specialists (44%); 74% corresponds to requests that are in the Basic Health Plan; mostly from users affiliated with the subsidized regime (88%), who had a comprehensive ruling (94%) Conclusions: officials do not have the necessary tools and resources to promptly and diligently respond to the protection actions filed; are limited only to sending the request via email and in some way.

Breast cancer is one of the most diagnosed diseases in the world, it can occur in both men and women, but it is much more frequently diagnosed in women. Significant support for breast cancer awareness and funding for research have helped advance the diagnosis and treatment of breast cancer. Survival rates for breast cancer have increased, and the number of deaths associated with this disease continues to decline, largely due to factors such as earlier detection, a new personalized approach to treatment, and a better understanding of the illness. In order to promote a culture of prevention and early detection of breast diseases, risk factors and healthy lifestyles that allow providing timely diagnostic actions and adequate treatment of the disease, pleasant spaces are designed, called "Pink Clinics “In the investigation, the Pink Clinic of an IPS in the city is shown as a strategy for the early detection of cancer Objective: To determine the social impact of the pink clinics during the year 2020 in the population of women between 40 and 69 years of age in a IPS of Monteria. Type of research and study setting: The research was non-experimental, descriptive, cross-sectional with a quantitative approach. Because it starts from a question where the topic to be investigated is delimited, allowing to determine the social impact of the pink clinics, as well as designing an instrument that allows it to be measured, identifying characteristics associated with adherence to the program guidelines in the beneficiary population. The study was conducted in a Primary IPS, located in the city of Monteria. Results: the participation of 322 users between 40 and 69 years’ old who attended the pink office, where we determined the compliance indicators, is shown. Taking into account the annual goal was 42.1%, in addition, the procedures and activities of the care route of those attending the program are explained. It was evidenced that 100% of the women attended consider attending the office to be of great importance, likewise, that in the same percentage this space has positively 13 influenced their habits and lifestyles. An improvement plan was designed in the provision of the service in accordance with the instruments applied Keywords: Breast cancer, strategy, social impact and primary care.

Objective Design the base model of organizational development for the creation of the orthopedic service in the ESE San Nicolás de Planeta Rica. Methodology. Descriptive, projective, mixed approach study, information was taken from primary and secondary sources, the informants were the beneficiary population represented by family units (470), health service providers (15), the contents of the normative filings and experiences of an entity specialized in traumas and fractures. Results. Legally based on numeral 3 of article 173 of Law 100 of 1993, article 56 of Law 715 of 2001, articles 2 of Decree-Law 4107 of 2011, articles 7, 8 and 14 of Decree 1011 of 2006 and its Chapters I and II, Article 118 of Decree-Law 019 of 2012 and Resolution 1441 of 2013; it is structured in five steps from filing to obtaining the active code; the offer corresponds to procedures of medium and low complexity, of which they are minor (41.2%) and non-surgical (41.2%). The mixed intramural modality with hospital outpatient services was defined, the "patient-centered" service structure with two subunits, this involves a hierarchical-vertical structure and horizontal coordination; it can generate social, health, growth and institutional prestige impacts. Conclusions. The designed model describes a functional unit of public law, of partial hospitalization, with institutional and extra-institutional services, the offer of services will correspond to low and medium complexity in orthopedics and traumatology, as well as minor, non-invasive procedures; patients with minor trauma being subjects of attention.

La presente propuesta de intervención se inserta en los ámbitos de la Responsabilidad Social Empresarial en Instituciones de salud, específicamente en la Empresa Social del Estado Hospital San Francisco de Ciénaga de Oro en el departamento de Córdoba; empresa en la cual la responsabilidad social empresarial es un mecanismo desconocido en cuanto a su aplicación, por tanto la mayor parte de las personas que laboran en las mismas no tienen el conocimiento adecuado, lo que puede traer como consecuencia problemas en la gestión del personal, problemas financieros o de sostenibilidad, desconocimiento del valor de la protección ambiental, asi es como se presenta la problemática referida a riesgos de contaminación ambiental por el manejo de residuos hospitalarios, inexistencia de contribución con el desarrollo local y que hayan salarios bajos que redundan en condiciones de precariedad económica de las familias de los empleados. El objetivo de esta propuesta es implementar un modelo de Responsabilidad Social Empresarial, presentando estrategias y metas de acuerdo a las necesidades de mejora identificadas en el Hospital y de acuerdo a las perspectivas de los actores implicados, en este caso, la gerente, los administrativos, profesionales de la salud, los técnicos y los auxiliares en aspectos como la gestión del conocimiento, la calidad de vida laboral, la intervención participativa, el liderazgo, gestión de prevención de riesgos en salud y gestión de acciones preventivas y correctivas entre otras estrategias.

The present intervention proposal aims at reducing failures and errors in customer / user service, which is why it seeks to present the importance of improving inducción and reinduction processes to help employees make the best use of their capacities and develop their potential, to carry out an objective evaluation of the competencies and degree of information management required for the position. The objective of this proposal is to implement a reinduction program for customer service personnel at the EPS Salud Total Montería - Córdoba following the logical framework methodology to increase their fidelity, achieve quality in the provision of services and thus continue with the stability of the company having as a pillar strategies focused on quality, management of human talent and customer / user satisfaction in order to meet and assist customers / users in their requirements, fluid dialogue, a quick response and effective to their requests, analyze the current structure of the positions related to customer service in the company, review and standardize the customer service and care process, analyze the diagnosis of initial conditions of the hired personnel, identify the issues required for the development of the inducción and reinduction program. The proposal made seeks to strengthen capacities in health personnel regarding the quality of customer / user service by improving the inducción and reinduction process.

Objetivo. Determinar la relación entre calidad y costos de los servicios de salud en el área de hospitalización de una Empresa Social del Estado durante el periodo comprendido entre diciembre de 2021 y febrero de 2022 en Montería Córdoba. Metodología. La investigación se desarrolló bajo la metodología mixta porque se tomaron variables numéricas como son la calidad y los costos y causas de glosas, descriptiva y transversal con preponderancia cualitativa. Resultados. Luego del análisis del Informe de Glosas generado por la Empresa Social del Estado radicada en Montería y del Informe de Auditoria Gubernamental realizado por la Contraloría General del Departamento de Córdoba, en la vigencia 2019-2020, se obtuvo como resultado que, ambos informes coinciden en establecer que los motivos más frecuentes para la generación de glosas están asociados a las tarifas. Es así que, el informe de glosas del período comprendido entre el 01 de diciembre de 2021 y el 28 de febrero de 2022 indica que esta glosa tiene un impacto negativo de $768.272.358, lo que representa el 34% de valor de las glosas. Por su parte, el informe de Auditoria Gubernamental para la vigencia 2019-2020 desarrollado por la Contraloría General del Departamento de Córdoba indica que este motivo tuvo un impacto negativo de $58.735.384. Las glosas afectan en forma negativa el valor de la factura que se genera por la prestación del servicio de salud, lo cual atentará contra la viabilidad económica de la entidad. Conclusiones. La calidad en la prestación de servicios de salud en el área de hospitalización de una Empresa Social del Estado genera credibilidad en los posibles usuarios, hecho que contribuirá a la estabilidad financiera de la entidad. La No calidad en la prestación de servicios ocasiona incumplimientos, los cuales generan afectación parcial o total de la factura, y atentan contra la estabilidad económica de la institución.

The objective of this study was to determine the level of Burnout Syndromeinthecare staff of the ESE CAMU Pueblo Nuevo, during the post-pandemic period, 2022.Methodology. Descriptive, cross-sectional study, with a quantitative approach, theMaslach Burnout Inventory (MBI) questionnaire was used; the sampleconsistedof6 general practitioners, 1 professional nurse and 12 nursing assistants. Results.Burnout syndrome had a high level for the aspect of emotional exhaustionin42.11%, in depersonalization 36.84% and a low level for personal fulfillment in15.79%; while at the medium level the emotional exhaustion dimensionpresented21.05%, depersonalization and personal fulfillment, equal percentages of 26.32%.In the emotional exhaustion and depersonalization aspects, a positiveanddirectcorrelation was found (0.7245), while for emotional exhaustionanddepersonalization with respect to personal fulfillment, a weak inversenegativecorrelation was found. Conclusion. Burnout syndrome with different levelswasfound in all the subjects of the sample, 57.89% have a low level; 31.58%presenteda medium level and 5.26% a high level, which indicates that these symptomscanaffect work performance, decision making, treatment of patients, amongotherphysical, social or emotional aspects.

The purpose of this study is to recognize, through a review of the literature, decision making as a significant strategy for managing conflicts in health promoting institutions. Information management accounts for a series of factors that explain why decision-making can contribute to mitigating conflicts and managing them in any organization, in this case in health promoting institutions. As theoretical support, the contributions of Lazzati, Amaya, Sanabria, among others, whose arguments about the factors and elements or functional ingredients in decisionmaking as an input for conflict management, were reviewed. Methodologically, the study is located in the documentary review of primary and secondary sources and the respective analysis of their discourse to obtain conclusions and recommendations associated with the subject. In this way, the results of the study allow the design of an information collection strategy, in the form of a survey that, when applied, would allow establishing the relationship between decision-making and conflict management within a health promoting institution.