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Revista de Salud Pública

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GOMEZ, Luis Alejandro; TOVAR, Hilda Constanza  and  AGUDELO C, Carlos A.. Use of health services and epidemiological profiles as parameters for adjusting the Compulsory Health Plan in Colombia. Rev. salud pública [online]. 2003, vol.5, n.3, pp.246-262. ISSN 0124-0064.

OBJECTIVE: To evaluate the use of health services and the epidemiological profiles as parameters for adjusting the contents of the Compulsory Health Plan-POS. METHODS: An evaluative study of the contents of the Compulsory Health Plan-POS was performed regarding the use of health services and the regional epidemiological profiles, within the framework of the current problems of the General System of Health Social Security. The 1994 Survey on Equity of the Fiscal Expenditure, the 1997 National Survey on Quality of Life, and the 2000 National Household Survey estimated the use of services. The epidemiological profiles were obtained from the 2000 mortality data of the National Administrative Statistics Department-DANE. RESULTS: Affiliation to the health system has only reached 56 % of the total population. However, health expenditure has increased constantly between 1993 and 2000, from 7,2 % to nearly 10 % of the GNP. Greater use of health services was found among the elderly population, and people with greater levels of spending. Women, particularly those residing in urban areas and on the higher quintile of spending, are the people who most use the health services. The people who use health services the least are men in urban areas in the lower quintile of spending. CONCLUSIONS: Organizing the Compulsory Health Plan with a modular structure makes it possible to adjust it according to the parameters of the use of health services and epidemiological profiles, in such a way that it contributes to the opportunity and pertinence of services, as well as to increase the affiliation to the system.

Keywords : Healthcare system; health service; epidemiology; insurance.

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