Modelo de supervisión basado en el riesgo para instituciones prestadoras de servicios de salud como herramienta para la protección de los derechos en salud en Perú
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AuthorsBenites Zapata, Vicente A.
Saravia-Chong, Héctor A
Aquije-Díaz, Allen J
KeywordsGestión de riesgos
Centros de salud
Derecho a la salud
Servicios de salud
Right to health
MetadataShow full item record
Other TitlesA risk-based monitoring model for health care service institutions as a tool to protect health rights in Peru
Citation[A risk-based monitoring model for health care service institutions as a tool to protect health rights in Peru]., 33 (3):401-410 Rev Peru Med Exp Salud Publica
PublisherInstituto Nacional de Salud (INS)
JournalRevista peruana de medicina experimental y salud publica
AbstractObjectives. To describe the monitoring model of the Health Care Service Institutions (HCSI) of the National Health Authority (NHA) and assess the factors associated with risk-adjusted normative compliance (%RANC) within the Peruvian Health System (PHS). Materials and Methods. We carried out a case study of the experience of the NHA in the development and implementation of a monitoring program based on the ISO 31000-2009. With HCSI as the units of analysis, we calculated the %RANC (a scorein continuous scale ranging from 0 to 100) for comprehensive monitoring (CM) and for specific evaluations made from 2013 to 2015. A higher score in the %RANC means lower operational risk. Also, slope coefficients (β) and their 95% confidence intervals (95% CI) were estimated using generalized linear models to estimate the association between %RANC as outcome, and health subsector, region, level of care and year, as explanatory variables. Results. The NHA made 1444 evaluations. For CM, only the Social Security Administration had higher %RANC than private centers (β=7.7%; 95% CI 3.5 to 11.9). The HCSI of the coastal region (β=-5.2, 95% CI -9.4 to -1.0), andean region (β=-12.5; 95% CI -16.7 to -8.3) and jungle region (β=-12.6, 95% CI% -17.7 to -7.6) had lower %RANC than those located in Lima Metropolitan area. %RANC was higher in 2015 than 2013 (β=10.8; 95% CI 6.4 to 15.3). Conclusions. The %RANC differs by health subsector, region and year of supervision. For CM, the HCSI in the Social Security Administration and in the Lima Metropolitan area had better scores, and scores improved over time. The implementation of actions aimed at improving %RANC in order to foster the full exercise of health rights in the PHS is suggested.
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Factores asociados a la no utilización de los servicios formales de prestación en salud en la población peruana: análisis de la Encuesta Nacional de Hogares (ENAHO) 2015Benites Zapata, Vicente A.; Lozada-Urbano, Michelle; Diego Urrunaga-Pastor; Márquez-Bobadilla, Edith; Moncada-Mapelli, Enrique; Mezones Holguín, Edward (Instituto Nacional de Salud (INS), 2017-09)The aim of the study was to estimate the prevalence of non-use of health services (NUHS) and its associated factors using the National Household Survey (ENAHO 2015). The participants were defined as NUHS if they have presented any symptoms, discomfort, illness, relapse of chronic illness or accident during the last month and did not go to the health services. 35036 participants were analyzed; the prevalence of NUHS was 53,9%. NUHS was higher in the coastal region (adjusted Prevalence Ratio [aPR]=1.24;95%CI:1.17-1.31), highlands (aPR=1.38;95%CI:1.31-1.46) and jungle (aPR=1.25,95%CI:1.18-1.33) compared to Lima. Likewise, there were a higher prevalence of NUHS in participants without health insurance (aPR=1.59;95%CI:1.52-1.66) and those affiliated to Ministry of Health insurance (aPR=1.16;95%CI:1.11-1.22) compared to those affiliated to Social Security. More than half of the participants suffered from NUHS, which was associated with geographical and health system conditions. It is required evidenced-informed public policies to improve this situation.
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