Acceso a la atención en salud en Colombia

Objective Contribute to knowledge on access to services in Colombia
after the reform of the health system, presenting the main results and
gaps in research.
Methods We conducted a systematic review of the literature, through the
exhaustive search and analysis of original articles published between 1994 and 2006.
2009. We included 27 quantitative and qualitative researches that met the following criteria
the selection criteria. The analysis was framed in the theoretical models of Aday
and Andersen and Gold, which differentiate between potential and realised access and consider
the characteristics of the population, providers, and insurers that influence
the use.
Results Explanatory analyses of the use of health services at
of determinants are scarce and partial (limited to a few years).
geographical areas, pathologies or specific groups). Few studies deepen
in contextual factors - policies and characteristics of suppliers and insurers - and
or in the perspective of the actors on the factors influencing the
access. The studies do not seem to indicate an increase in access made - except for
in the subsidised scheme - and, on the other hand, point to the existence of important
barriers related to population factors (insurance, income and education)
and characteristics of the services (geographical accessibility, organisational, etc.).
and quality).
Conclusions The review shows important limitations in the analysis of the
in Colombia that indicate the need to reorient the evaluation towards the
and incorporate context variables and the perspective of the actors.
to better understand the impact of reform on the use of services.