Search

Insurers (hmos) argue that there is no incentive to invest in prevention activities because members can easily move to another insurance company. At the same time freedom to choose hmos is a key accountability mechanism of the Colombian Health System because citizens can leave low-quality insurers and enroll in high-quality insurers. This paper quantifies the size of the rate of transfers between hmos in the country to shed light on this debate. This study used publicly available information on affiliation histories to the health system for the last 14 years (2001-2014) for a random sample of adults between 40 and 50 in five different capital cities. The rate of enrollee transfers within a continuous enrollment period between HMO was estimated. Results showed that 56% of enrollees had four or more enrollment periods; within the same enrollment period at least 54% of enrollees did not transfer between HMO; in a year less than 6% decided to transfer; there was a weak correlation between transfers and HMO service quality indicators. Results showed that the transfer rate is low but that the drop-out rate is high. People do not transfer but leaves the systems frequently, which suggest that this behavior is explained by labor market fluctuations. The transfer between HMO is not frequent and this suggests that as accountability mechanism is not working and thus needs to be redesigned. [ABSTRACT FROM AUTHOR]

Traffic accidents, due to the serious consequences they have on people, and the high economic costs associated with them, are considered a worldwide social and public health problem. This paper assesses economic loss due to motorcycle accidents between 2012 and 2013 in a level 3 hospital. This is a quantitative-explanatory study, where an aggregate loss model is applied. An input of 2,518 patients is used which represents 9.08% of the Medellín's accidents reported. The 72.18% of all emergency events came from motorcycle accidents. Sunday was the day with highest accidents number with a 122 average patients. Average losses per day amount to COP 36,373 million. The operational VaR --maximum loss per day at 95% confidence-- is COP 112,400 million, and represents the probable maximum loss per day. The numbers and variables allow developing mobility policies and increased controls on days and vulnerable places with the highest traffic accidents number. [ABSTRACT FROM AUTHOR]

Objective: This paper proposed a conceptual framework to overcome the limitations the disciplinary approaches face when analysing the processes of implementation of health policies on the territory. Method and framework: With this purpose, it established links between the contributions from three fields: the studies on the performance on health care, the theoretical contributions provided by geography, and the research on public policies and implementation. Results: As a result of this approach, it is possible to capture phenomena and processes that, from each of the particular disciplinary perspectives, are opaque for the analysis: on one side, conceiving health attention as a point within a whole that compromises different notions of territory; on the other hand, recognise that at the moment of the implementation on the territory there is a process of recreation of the institutions, where they appear on scene and negotiate different regulation logics. [ABSTRACT FROM AUTHOR]