Factores geográficos, económicos y administrativos que afectan la accesibilidad a la atención en salud de mediana complejidad en el departamento de Córdoba - 2021

Abstract

By the year 2021, the department of Córdoba will have a population of 1,844,076 inhabitants distributed in 30 municipalities, 49% living in rural and dispersed areas and 51% in urban areas. 49.7% are men and the rest are women. It is the second poorest department in Colombia and has a health services network of more than 1,000 institutions at all levels of complexity. These aspects directly or indirectly affect the access to medium complexity health services, since out of the 30 municipalities only seven offer this type of services, the rest must refer their patients to institutions that are more than two hours away by car, with access roads in regular conditions, subject to the regulation opportunity of the EPS, availability of beds of the receiving entity, among others. Objective: To describe the geographical, economic and administrative characteristics that affect access to medium complexity health services, from the basic level of care in the department of Córdoba during the year 2021. Methodology: A mixed retrospective descriptive retrospective study was carried out. The target population were public institutions of low and medium complexity of the department. A non-probabilistic sample was taken from EPS, ESE and nursing homes, as well as from patients' relatives for interviews. The information collection instruments are a data collection form for geographic and economic data, available resources and production of services where distances and time for geographic access and availability of ambulance type vehicle from one institution to another were recorded. Likewise, the number of referrals generated from the low complexity classified by services and type of services. To collect information from patients' relatives, a questionnaire was prepared with 10 questions aimed at obtaining information on indirect costs for transportation, lodging and meals. Administrative accessibility was evaluated on the basis of the fractionation of contracting and the estimated average regulation time. Results: were consolidated in contingency tables with absolute and relative values, using descriptive statistics for qualitative and quantitative variables. This 13 information was represented in maps, figures and graphs to identify the variables analyzed. Positive aspects were identified and those that need to be improved by departmental and health authorities in order to contribute to reduce the risks of complications and indirect expenses that patients must pay when they are referred outside their municipality. The results will be published in a scientific journal in the form of a scientific article.