Analysis of user variations in prepaid medicine entities in Colombia - Case study
DOI:
https://doi.org/10.15649/2346030X.774Keywords:
healthcare, services delay, turnover, simulación, private healtchcare.Abstract
Healthcare services in countries like Colombia has many problems related to the service. A system financed with public resources has many delays in financial transactions associated with payment to health providers. The non-attention of users, the appointment allocation times and other delays in this essential service makes many of the patients search for better forms of care, which allow them health at home and other amenities in terms of service access. Prepaid medicine enters this space and is essential to improve the coverage of the health
system. However, the performance of these systems is compromised with the high turnover of users, the lending changes of entities and the nonconformity generated by reprogramming attention events. In this article, a simulation model is presented, which allows evaluating improvement alternatives in these entities and subsequently proposes policies that generate better customer perception and stability in the rotation of users of prepaid medicine. It is evident that there is a high turnover of auditors that attend customer requests, therefore, it is suggested to improve their stability so that requests are dealt with in a timely manner by the same auditor, generating process traceability. Consequently, the perception of service quality and customer retention improve significantly
References
B. Tehranineshat, M. Rakhshan, C. Torabizadeh y M. Fararouei, “Compassionate Care in Healthcare Systems: A Systematic Review,” J. Natl. Med. Assoc., vol. 111, no. 5, pp. 546–554, 2019, doi: 10.1016/j.jnma.2019.04.002.
F. Mohammed-Albejaidi, “Healthcare System in Saudi Arabia: An Analysis of Structure, Total Quality Management and Future Challenges,” 2010. [En Linea]. Disponible en: http://www.cdsi.gov.sa/census31/index.php.
C. Wendt, “Mapping European healthcare systems: A comparative analysis of financing, service provision and access to healthcare,” J. Eur. Soc. Policy, vol. 19, no. 5, pp. 432–445, 2009, doi: 10.1177/0958928709344247.
M. Top, M. Konca y B. Sapaz, “Technical efficiency of healthcare systems in African countries: An application based on data envelopment analysis,” Heal. Policy Technol., vol. 9, no. 1, pp. 62–68, 2020, doi: 10.1016/j.hlpt.2019.11.010.
A.E. Volandes y M.K. Paasche-Orlow, “Health literacy, health inequality and a just healthcare system,” Am. J. Bioeth., vol. 7, no. 11, pp. 5–10, 2007, doi: 10.1080/15265160701638520.
S. Abolghasem, M. Toloo y S. Amézquita, “A dataset of healthcare systems for cross-efficiency evaluation in the presence of flexible measure,” Data Br., vol. 25, 2019, doi: 10.1016/j.dib.2019.104239.
C. Wendt, L. Frisina y H. Rothgang, “Healthcare system types: A conceptual framework for comparison,” Soc. Policy Adm., vol. 43, no. 1, pp. 70–90, 2009, doi: 10.1111/j.1467-9515.2008.00647.x.
M. M. Reynolds, “Health Care Public Sector Share and the U.S. Life Expectancy Lag: A Country-level Longitudinal Study,” Int. J. Heal. Serv., vol. 48, no. 2, pp. 328–348, 2018, doi: 10.1177/0020731417753673.
I. Garcia-Subirats et al., “Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil,” Soc. Sci. Med., vol. 106, pp. 204–213, 2014, doi: 10.1016/j.socscimed.2014.01.054.
N. Reibling, M. Ariaans y C. Wendt, “Worlds of Healthcare: A Healthcare System Typology of OECD Countries,” Health Policy, vol. 123, no. 7. pp. 611–620, 2019, doi: 10.1016/j.healthpol.2019.05.001.
G. Werker, A. Sauré, J. French y S. Shechter, “The use of discrete-event simulation modelling to improve radiation therapy planning processes,” Radiother. Oncol., vol. 92, no. 1, pp. 76–82, Jul. 2009, doi: 10.1016/j.radonc.2009.03.012.
P. Sharma, “Discrete-event simulation,” Int. J. Sci. Technol. Res., vol. 4, no. 04, pp. 136–140, 2015.
J. J. Caro, J. Möller y D. Getsios, “Discrete Event Simulation : The Preferred Technique for Health Economic Evaluations ?,” Value Heal., vol. 13, no. 8, pp. 1056–1060, 2010, doi: 10.1111/j.1524-4733.2010.00775.x.
A. Giraldo-Osorio y C. Vélez-Álvarez, “La Atención Primaria de Salud: desafíos para su implementación en América Latina,” Aten. Primaria, vol. 45, no. 7, pp. 384–392, 2013, doi: 10.1016/j.aprim.2012.12.016.
C.D.V. De-Goyet, J.P. Sarmiento y F. Grünewald, Health response to the earthquake in Haiti to the earthquake in Haiti: January 2010, no. January. Washington, 2011.
M.E. Daza-Rodríguez, M.I. Daza-Porto y A.B. Pérez-Orozco, “Servicio al cliente: una estrategia gerencial para incrementar la competitividad organizacional en empresas de Valledupar (Colombia),” Aibi Rev. Investig. Adm. e Ing., vol. 5, no. 1, pp. 20–26, 2017, doi: 10.15649/2346030x.425.
S. Brailsford, “A comparison of discrete event simulation and system dynamics for modelling health care systems,” pp. 1–17, 2001, Accessed: Jun. 19, 2012. [Online]. Available: http://eprints.soton.ac.uk/35689/1/glasgow_paper.pdf.
L.B. Rawlings, “A new approach to social assistance: Latin America’s experience with conditional cash transfer programmes,” Int. Soc. Secur. Rev., vol. 58, no. 2–3, pp. 133–161, 2005, doi: 10.1111/j.1468-246X.2005.00220.x.
C. Valencia, “Medicina prepagada: ¿Qué es y para qué sirve?,” SaludSa, 2018. https://blog.saludsa.com/medicina-prepagada-definicion (accessed Jun. 23, 2017).
I. Bernal-González, N.A. Pedraza-Melo y M.L. Sánchez-Limón, “El clima organizacional y su relación con la calidad de los servicios públicos de salud: diseño de un modelo teórico,” Estud. Gerenciales, vol. 31, no. 134, pp. 8–19, 2015, doi: 10.1016/j.estger.2014.08.003.
A.Y. López-Cárdenas, Y.C. Velandia-Paredes y M.S. González Verjel, “Propuesta para aumentar la competitividad de los productores de Uchuva de Norte de Santander mediante la diversificación de su oferta exportable,” Aibi Rev. Investig. Adm. e Ing., vol. 6, pp. 41–51, 2018, doi: 10.15649/2346030x.484.
E.V. Gutierrez-Gutierrez y C.J. Vidal, “A Home Health Care Districting Problem in a Rapid-Growing City,” Ing. y Univ., vol. 19, no. 1, p. 87, 2015, doi: 10.11144/javeriana.iyu19-1.ahhc.
J.M. Lafleur y M.V. Romero, “Combining transnational and intersectional approaches to immigrants’ social protection: The case of Andean families’ access to health,” Comp. Migr. Stud., vol. 6, no. 1, 2018, doi: 10.1186/s40878-018-0073-7.
Finanzas personales, “¿Para qué prepagada?,” Finanzas personales, 2007. https://www.finanzaspersonales.co/gaste-eficientemente/salud/articulo/para-que-prepagada/36057 (accessed Jul. 23, 2019).
O. Onwujekwe y B. Uzochukwu, “Socio-economic and geographic differentials in costs and payment strategies for primary healthcare services in Southeast Nigeria,” Health Policy (New. York)., vol. 71, no. 3, pp. 383–397, 2005, doi: 10.1016/j.healthpol.2004.06.006.
V. Giménez, W. Prieto, D. Prior y E. Tortosa-Ausina, “Evaluation of efficiency in Colombian hospitals: An analysis for the post-reform period,” Socioecon. Plann. Sci., vol. 65, pp. 20–35, 2019, doi: 10.1016/j.seps.2018.02.002.
R. Guerrero, A.I. Gallego, V. Becerril-Montekio y J. Vásquez, “Sistema de salud de Colombia,” Salud Publica Mex., vol. 53, no. SUPPL. 2, 2011.
A.L. Hernández-Abreo, B.D. Abreo-Pinzón y L.F. Bohorquez- Chacón, “Programa responsabilidad social empresarial: Empresa Global Service & Business S.A.S,” Aibi Rev. Investig. Adm. e Ing., pp. 2–12, 2018, doi: 10.15649/2346030x.479.
S.L. Uribe, I. Guarín, S. Gómez y L. Vergel, “Prevención de los peligros y promoción de entornos saludables en el teletrabajo desde la perspectiva de la salud pública,” Aibi Rev. Investig. Adm. e Ing., pp. 44–52, 2020, doi: 10.15649/2346030x.802.
O. Larrañaga, “Eficiencia y equidad en el sistema de salud chileno,” Ser. Financ. del Desarro. CEPAL, vol. 49, p. 45, 1997.
A. Nevárez, P.C. Constantino y F. García, “Comparación de la eficiencia técnica de los sistemas de salud en países pertenecientes a la OMS,” Econ. Soc. y Territ., vol. VI, no. 24, pp. 1071–1090, 2007.
J.L.A. Lara y F.R. Gómez, “Determining factors of catastrophic health spending in Bogota, Colombia,” Int. J. Health Care Finance Econ., vol. 11, no. 2, pp. 83–100, 2011, doi: 10.1007/s10754-011-9089-3.
R. Pérez-Cuevas et al., “Understanding public perception of the need for major change in Latin American healthcare systems,” Health Policy Plan., vol. 32, no. 6, pp. 816–824, 2017, doi: 10.1093/heapol/czx020.
R.E. Gómez, “La vigilancia epidemiológica de las enfermedades zoonóticas en la coordinación de zoonosis del estado Táchira-Venezuela,” Aibi Rev. Investig. Adm. e Ing., pp. 24–34, 2013, doi: 10.15649/2346030x.536.
F.A. Dávila, J.S. Herrera, D.A. Yasnó, L.C. Forero y M.V. Alvarado, “Satisfacción en un servicio de urgencias según el sistema de aseguramiento en salud,” Rev. Calid. Asist., vol. 32, no. 2, pp. 89–96, 2017, doi: 10.1016/j.cali.2016.06.010.
Dirección de Planeación Institucional y Calidad, “GLOSARIO. Secretaría Distrital de Salud,” vol. 132, p. 74, 2017.
M.A. Ahmed y T.M. Alkhamis, “Simulation optimization for an emergency department healthcare unit in Kuwait,” Eur. J. Oper. Res., vol. 198, no. 3, pp. 936–942, 2009, doi: 10.1016/j.ejor.2008.10.025.
R.C. Basole, D.A. Bodner y W.B. Rouse, “Healthcare management through organizational simulation,” Decis. Support Syst., vol. 55, no. 2, pp. 552–563, 2013, doi: 10.1016/j.dss.2012.10.012.
K. Hoffer, “Comfort Theory and Practice: A Vision for Holistic Health Care and Research,” Nurs. Educ. Perspect., vol. 25, no. 2, p. 92, 2004, doi: 10.1097/00002800-200501000-00014.
A. Ortiz, F.O. Sveen, J.M. Sarriegi y J. Santos, “Use of modelling paradigms : an explanatory study of SD and ABM models,” in 26th International Conference of the System Dynamics Society, 2008, pp. 1–16.
J. Aracil y F. Gordillo, Dinamica de sistemas. Alianza Editorial Madrid, 1997.
Y.F. Ceballos, M. Uribe y G. Sánchez, “Modelo de Dinámica de Sistemas para la Predicción del Comportamiento del Mercado Porcícola,” Inf. tecnológica, vol. 24, no. 4, pp. 25–26, Jul. 2013, doi: 10.4067/S0718-07642013000400013.
Y. Barlas, “Formal aspects of model validity and validation in system dynamics.,” Syst. Dyn. Rev., vol. 12, no. 3, pp. 183–210, 1996, doi: 10.1002/(SICI)1099-1727(199623)12:3<183::AID-SDR103>3.0.CO;2-4.
D.A. Velez, F. Ceballos y G. Sanchez-Torres, “Simulation-Based Improvement Procedure for Small-Scale Shoe Manufacturing Companies,” J. Adv. Manuf. Syst., vol. 17, no. 01, pp. 23–33, 2018, doi: 10.1142/S0219686718500026.
C. Kieran, E. Mark, T. Jillian y T. Stanley, Simulation Modeling with SIMUL8, 4.1. Visual Thinking International, 2007.
S. Ramwadhdoebe, “A tutorial on discrete-event simulation for health policy design and decision making: optimizing pediatric ultrasound screening for hip dysplasia as an illustration.,” Health Policy, vol. 93, no. 2–3, pp. 143–50, Dec. 2009, doi: 10.1016/j.healthpol.2009.07.007.
D.C. Montgomery, “Diseño de Experimentos,” 2004.
R.A. Mustafa et al., “Decision making about healthcare-related tests and diagnostic test strategies. Paper 2: a review of methodological and practical challenges,” J. Clin. Epidemiol., vol. 92, pp. 18–28, 2017, doi: 10.1016/j.jclinepi.2017.09.003.
K.G. Tijdens y D. De-Vries, “Health Workforce Remuneration Comparing Wage Levels, Ranking and Dispersion of 16 Occupational Groups in 20 Countries,” SSRN Electron. J., 2013, doi: 10.2139/ssrn.2221586.
R. Constanza y A. Voinov, Landscape simulation modeling: a spatially explicit, dynamic approach. Springer Verlag, 2004.
J. Banks, "Handbook of Simulation: Principles, Methodology, Advances," Applications, and Practice, 2nd ed. New York: John Wiley & Sons, 1998.
L. Gulyás y G. Kampis, “Models, Representations and Comparisons in Computer Simulations,” Procedia Comput. Sci.
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