The Colombian health insurance system and its effect on access to health care

ABSTRACT: In 1993, the Colombian government sought to reform its health care system under the guidance of international financial institutions (the World Bank and International Monetary Fund). These institutions maintain that individual private health insurance systems are more appropriate than prev...

Full description

Autores:
Álvarez Castaño, Luz Stella
Swartzman, Dan
Salmon, Warren
Tipo de recurso:
Article of investigation
Fecha de publicación:
2011
Institución:
Universidad de Antioquia
Repositorio:
Repositorio UdeA
Idioma:
eng
OAI Identifier:
oai:bibliotecadigital.udea.edu.co:10495/23468
Acceso en línea:
http://hdl.handle.net/10495/23468
Palabra clave:
Sistemas de Salud
Health Systems
Prestación de Atención de Salud
Delivery of Health Care
Accesibilidad a los Servicios de Salud
Health Services Accessibility
Rights
openAccess
License
http://creativecommons.org/licenses/by-nc/2.5/co/
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network_acronym_str UDEA2
network_name_str Repositorio UdeA
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dc.title.spa.fl_str_mv The Colombian health insurance system and its effect on access to health care
title The Colombian health insurance system and its effect on access to health care
spellingShingle The Colombian health insurance system and its effect on access to health care
Sistemas de Salud
Health Systems
Prestación de Atención de Salud
Delivery of Health Care
Accesibilidad a los Servicios de Salud
Health Services Accessibility
title_short The Colombian health insurance system and its effect on access to health care
title_full The Colombian health insurance system and its effect on access to health care
title_fullStr The Colombian health insurance system and its effect on access to health care
title_full_unstemmed The Colombian health insurance system and its effect on access to health care
title_sort The Colombian health insurance system and its effect on access to health care
dc.creator.fl_str_mv Álvarez Castaño, Luz Stella
Swartzman, Dan
Salmon, Warren
dc.contributor.author.none.fl_str_mv Álvarez Castaño, Luz Stella
Swartzman, Dan
Salmon, Warren
dc.subject.decs.none.fl_str_mv Sistemas de Salud
Health Systems
Prestación de Atención de Salud
Delivery of Health Care
Accesibilidad a los Servicios de Salud
Health Services Accessibility
topic Sistemas de Salud
Health Systems
Prestación de Atención de Salud
Delivery of Health Care
Accesibilidad a los Servicios de Salud
Health Services Accessibility
description ABSTRACT: In 1993, the Colombian government sought to reform its health care system under the guidance of international financial institutions (the World Bank and International Monetary Fund). These institutions maintain that individual private health insurance systems are more appropriate than previously established national public health structures for overcoming inequities in health care in developing countries. The reforms carried out following international financial institution guidelines are known as “neoliberal reforms.” This qualitative study explores consumer health choices and associated factors, based on interviews with citizens living in Medellín, Colombia, in 2005–2006. The results show that most study participants belonging to low-income and middle-income strata, even with medical expense subsidies, faced significant barriers to accessing health care. Only upper-income participants reported a selection of different options without barriers, such as complementary and alternative medicines, along with private Western biomedicine. This study is unique in that the informal health system is linked to overall neoliberal policy change.
publishDate 2011
dc.date.issued.none.fl_str_mv 2011
dc.date.accessioned.none.fl_str_mv 2021-10-26T18:05:05Z
dc.date.available.none.fl_str_mv 2021-10-26T18:05:05Z
dc.type.spa.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.citation.spa.fl_str_mv Alvarez LS, Salmon JW, Swartzman D. The Colombian health insurance system and its effect on access to health care. Int J Health Serv. 2011;41(2):355-70. doi: 10.2190/HS.41.2.i. PMID: 21563628.
dc.identifier.issn.none.fl_str_mv 0020-7314
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/10495/23468
dc.identifier.doi.none.fl_str_mv 10.2190/HS.41.2.i
dc.identifier.eissn.none.fl_str_mv 1541-4469
identifier_str_mv Alvarez LS, Salmon JW, Swartzman D. The Colombian health insurance system and its effect on access to health care. Int J Health Serv. 2011;41(2):355-70. doi: 10.2190/HS.41.2.i. PMID: 21563628.
0020-7314
10.2190/HS.41.2.i
1541-4469
url http://hdl.handle.net/10495/23468
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.ispartofjournalabbrev.spa.fl_str_mv Int. J. Health Serv.
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dc.format.extent.spa.fl_str_mv 16
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dc.publisher.spa.fl_str_mv Sage Publications
dc.publisher.group.spa.fl_str_mv Determinantes Sociales y Económicos de la Situación de Salud y Nutrición
dc.publisher.place.spa.fl_str_mv Westport, Estados Unidos
institution Universidad de Antioquia
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spelling Álvarez Castaño, Luz StellaSwartzman, DanSalmon, Warren2021-10-26T18:05:05Z2021-10-26T18:05:05Z2011Alvarez LS, Salmon JW, Swartzman D. The Colombian health insurance system and its effect on access to health care. Int J Health Serv. 2011;41(2):355-70. doi: 10.2190/HS.41.2.i. PMID: 21563628.0020-7314http://hdl.handle.net/10495/2346810.2190/HS.41.2.i1541-4469ABSTRACT: In 1993, the Colombian government sought to reform its health care system under the guidance of international financial institutions (the World Bank and International Monetary Fund). These institutions maintain that individual private health insurance systems are more appropriate than previously established national public health structures for overcoming inequities in health care in developing countries. The reforms carried out following international financial institution guidelines are known as “neoliberal reforms.” This qualitative study explores consumer health choices and associated factors, based on interviews with citizens living in Medellín, Colombia, in 2005–2006. The results show that most study participants belonging to low-income and middle-income strata, even with medical expense subsidies, faced significant barriers to accessing health care. Only upper-income participants reported a selection of different options without barriers, such as complementary and alternative medicines, along with private Western biomedicine. This study is unique in that the informal health system is linked to overall neoliberal policy change.COL006560816application/pdfengSage PublicationsDeterminantes Sociales y Económicos de la Situación de Salud y NutriciónWestport, Estados Unidosinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_2df8fbb1https://purl.org/redcol/resource_type/ARTArtículo de investigaciónhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by-nc/2.5/co/http://purl.org/coar/access_right/c_abf2https://creativecommons.org/licenses/by-nc/4.0/The Colombian health insurance system and its effect on access to health careSistemas de SaludHealth SystemsPrestación de Atención de SaludDelivery of Health CareAccesibilidad a los Servicios de SaludHealth Services AccessibilityInt. J. Health Serv.International Journal of Health Services355370412LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://bibliotecadigital.udea.edu.co/bitstream/10495/23468/3/license.txt8a4605be74aa9ea9d79846c1fba20a33MD53ORIGINALAlvarezLuz_2011_ColombianHealth.pdfAlvarezLuz_2011_ColombianHealth.pdfArtículo de investigaciónapplication/pdf467070http://bibliotecadigital.udea.edu.co/bitstream/10495/23468/1/AlvarezLuz_2011_ColombianHealth.pdfe0e2cb7decc300306ca961ea4bfe7624MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8933http://bibliotecadigital.udea.edu.co/bitstream/10495/23468/2/license_rdfc0c92b0ffc8b7d22d9cf56754a416a76MD5210495/23468oai:bibliotecadigital.udea.edu.co:10495/234682021-10-26 13:05:05.727Repositorio Institucional Universidad de Antioquiaandres.perez@udea.edu.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