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This paper is intended to determine the worth of unpaid health care in Uruguay and to characterize the caregivers (either paid or unpaid) who serve ill people. These objectives are accomplished mainly through the quantitative analysis of the data gathered by the first National Survey of Unpaid Health Care (2013) in Uruguay. This survey enables to become aware and set the worth of the unpaid health care times (replacement cost method) and to characterize the unpaid caregivers. This paper shows how the unpaid health care provided by homes accounts for a third of whole health care aggregate in the Gross Domestic Product. Women are the main caregivers, thus assuming the costs of losing their autonomy and seeing reduced the opportunities to enjoy their rights. [ABSTRACT FROM AUTHOR]

This article aims to disclose the response capacity of the Health Information Systems (HIS) in Colombia to support an inspection, surveillance and control model (ISC) driven towards the monitoring of the risks undermining the access, use and quality of the health services. This paper is based on a descriptive cross-sectional study under a risk management approach including a review of the regulations framework dealing with the threats to the effective enjoyment of the right to health (EERH) and the characteristics of the information reported by the actors in the system, which is required to carry out the said monitoring. The data supporting the monitoring to the health care processes and its impact on the population health are not enough to appropriately oversee the risks involved. Advantage should be taken from the changes currently taking place in the health system in order to rethink how the system performance is taken as monitored object. [ABSTRACT FROM AUTHOR]

Cuban National System faces an important challenge, which is to consolidate the improvement programs of their institutions; consequently, there are considered key objectives like: fostering creativity and innovation; promoting continuous training; and ensuring the efficiency seeking, the application of best practices and permanent processes evaluation. These objectives are commonly assumed when organizations adopted managerial approaches based on quality, efficiency, effectiveness and service to clients. Hence, this paper shows the results of experiences in business process management, being conceived as a work setting of improvement in health institutions. To seek such goal, it is conducted a bibliography study of 70 methodological procedures, resulting in a new approach that is applied to five hospitals in a Cuban province in order to prove its efficacy for performance improvement, which is illustrated by progress being obtained in service and processes functioning with consequent extension to other hospital of the province. [ABSTRACT FROM AUTHOR]

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]

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]

This article approaches the issue of philosophical perspectives of social justice and its relationship with some of the implications for health systems in Latin America and the world. Three philosophical perspectives of social justice from the radical liberal approach, egalitarian and redistributive liberal, and Marxist egalitarianism or reviewed. Society, their conceptions of health and public health approach. From the theoretical support these approaches, the relationship State are identified. Based on these concepts identify some implications for health systems in each of its representative aspects. The paper concludes with some reflections about the need to discuss the fundamental right to health as a fundamental element of universal health systems and assume a perspective as input for the design and analysis of health systems from the right to health. [ABSTRACT FROM AUTHOR]

This paper studies the public policies and components of the healthcare system affecting Colombian women with HIV/AIDS. Although there is national interest in controlling the HIV/ AIDS epidemic, current policies are not linked to specific lines of action and do not include a coherent gender approach that can guarantee comprehensive healthcare. HIV/AIDS policies are formulated within the frame of current economic policies and health reform implemented as part of Law 100 of 1993. These policies must be supported by economic plans that make it possible for the most vulnerable population to overcome the conditions of social inequity and by a healthcare system which guarantees complete access to appropriate healthcare. [ABSTRACT FROM AUTHOR]