Propuesta de mejoramiento de la gestión del servicio de atención materno perinatal del Hospital Universitario Erasmo Meoz de San José de Cúcuta como alternativa para mitigar el impacto del fenómeno migratorio venezolano en el sistema de salud
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2021
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Ediciones Universidad Simón Bolívar
Facultad de Administración y Negocios
Facultad de Administración y Negocios
Resumen
Antecedentes:
De acuerdo a cifras de Migración Colombia, hasta agosto de 2021 en el país había 1.842.390 migrantes, de los cuales 164.229 residían en Norte de Santander y 98.680 en la ciudad de Cúcuta, siendo esta la tercera ciudad con mayor cantidad de población migrante.
El Banco Mundial (2018) asegura que en Colombia “La atención a la población migrante de Venezuela ha generado una presión sobre las ya precarias finanzas de varios de los hospitales públicos, particularmente en aquellas ciudades con mayor flujo migratorio.
Por su parte, el Banco de la República (2020) hace un análisis del coste fiscal que origina la atención de migrantes venezolanos, ante ello afirma que “los servicios prestados por la red pública alcanzaron COP 557.423 millones durante el período 2017-2019” (p.36). Los departamentos que más han gastado son, Bogotá, Norte de Santander y la Guajira. A su vez, el hospital que mayor facturación elabora por atenciones de salud a migrantes desde Venezuela, es el Erasmo Meoz de Norte de Santander. Lo cual es un desafío para la política pública en General. En cuanto al tema que atañe el presente trabajo, durante el periodo 2017-2019, de 5.458.330 atenciones a 749.449 migrantes, aproximadamente el 21,5% fue a madres gestantes.
Objetivos:
Desarrollar una propuesta para la gestión del servicio de atención materno perinatal del Hospital Universitario Erasmo Meoz de San José de Cúcuta como alternativa para mitigar el impacto del fenómeno migratorio venezolano.
Determinar las características (problemas, necesidades y oportunidades derivados a la demanda por la atención) de la población migrante atendida en el servicio materno perinatal.
Caracterizar la oferta de los servicios de salud, necesidades y oportunidades del Servicio materno perinatal del Hospital Universitario Erasmo Meoz de San José de Cúcuta.
Plantear una propuesta que contribuyan al fortalecimiento de la gestión del servicio de atención en el área materno perinatal en el Hospital Universitario Erasmo Meoz de San José de Cúcuta.
Materiales y Métodos: El enfoque es deductivo, paradigma cuantitativo, el nivel descriptivo y el diseño de campo es no experimental.
Resultados: Se realiza el análisis descriptivo de la población migrante atendida en la ESE Hospital Universitario Erasmo Meoz en donde en proporción los nacimientos de migrantes pasaron de representar el 5,21% en 2016 a 83,08% en 2020. Se identifica que para el año 2016, se puede observar que este padecimiento lo sufrían principalmente las maternas colombianas 96,6% comparado con la baja afección en este mismo año a las maternas venezolanas 3,4%. Para el año 2018, se evidencia que las maternas venezolanas que padecieron eventos de Morbilidad Materna Extrema supera a las de nacionalidad colombiana 51% y 49% respectivamente.
Se realiza la descripción e identificación de las necesidades y oportunidades de los servicios de la ESE HUEM los cuales comprenden: Las Urgencias Gineco-Obstétricas, atención del Parto, ginecobstetricia Internación (Hospitalización), Cuidado Básico e Intermedio Neonatal.
Una vez revisado y analizado los datos estadísticos de las atenciones realizadas, así como la caracterización del servicio materno perinatal se realiza la siguiente propuesta como Alternativa Para Mitigar el Impacto del Fenómeno Migratorio Venezolano sobre el Sistema de Salud:1. Gestión y articulación de los diferentes niveles de atención materno perinatal de la ciudad. 2. Gestión integral de la atención en articulación con los diferentes actores locales nacionales e instituciones internacionales y ONG 3. Presentación de proyectos para la ampliación de la capacidad instalada del Hospital. 4.Ruta de Atención del Servicio Materno Perinatal
Conclusiones:
Incremento de la demanda del servicio materno perinatal por la población migrante venezolana.
La Capacidad instalada del servicio para la atención de maternas en la ESE Hospital Universitario Erasmo Meoz, demuestra ser insuficiente para la atención de maternas locales y migrantes.
Mejora de la gestión del servicio a partir de la implementación de una ruta para proporcionar una atención eficaz, eficiente y de calidad para las maternas que demandan este servicio.
ABSTRACT Background: According to figures from Migration Colombia, as of August 2021 there were 1,842,390 migrants in the country, of which 164,229 resided in Norte de Santander and 98,680 in the city of Cúcuta, being this the third city with the largest number of migrant population. The World Bank (2018) assures that in Colombia "The attention to the migrant population of Venezuela has generated a pressure on the already precarious finances of several of the public hospitals, particularly in those cities with greater migratory flow. For its part, the Banco de la República (2020) analyzes the fiscal cost of caring for Venezuelan migrants, stating that "the services provided by the public network reached COP 557.423 million during the period 2017-2019" (p.36). The departments that have spent the most are Bogotá, Norte de Santander and La Guajira. In turn, the hospital with the highest turnover for health care for migrants from Venezuela, is Erasmo Meoz from Norte de Santander. For its part, the Banco de la República (2020) makes an analysis of the fiscal cost that originates the attention of Venezuelan migrants, before saying that "the services provided by the public network reached COP 557.423 million during the period 2017-2019" (p.36). The departments that have spent most are, Bogotá, Norte de Santander and la Guajira. In turn, the hospital that produces the highest turnover for health care to migrants from Venezuela, is the Erasmo Meoz of Norte de Santander. Which is a challenge for public policy in general. In terms of the subject of this work, during the period 2017-2019, of 5,458,330 attentions to 749,449 migrants, approximately 21.5% were to pregnant mothers. Objectives: To develop a proposal for the management of the maternal perinatal care service of the Erasmo Meoz University Hospital of San José de Cúcuta as an alternative to mitigate the impact of the Venezuelan migratory phenomenon. To determine the characteristics (problems, needs and opportunities arising from the demand for care) of the migrant population in the perinatal maternal service. To characterize the supply of health services, needs and opportunities of the maternal perinatal service of the Erasmo Meoz University Hospital of San José de Cúcuta. To propose a proposal that contributes to the strengthening of the management of the maternal perinatal care service at the Erasmo Meoz University Hospital of San José de Cúcuta. Materials and Methods: The approach is deductive, quantitative paradigm, descriptive level and the field design is non-experimental. Results: A descriptive analysis of the migrant population attended at the ESE Hospital Universitario Erasmo Meoz was performed, where the proportion of migrant births increased from 5.21% in 2016 to 83.08% in 2020. It is identified that for the year 2016, it can be observed that this condition was mainly suffered by Colombian mothers 96.6% compared to the low affection in this same year to Venezuelan mothers 3.4%. For the year 2018, it is evident that Venezuelan mothers who suffered from Extreme Maternal Morbidity events exceeded those of Colombian nationality 51% and 49% respectively. The description and identification of the needs and opportunities of the services of the ESE HUEM is carried out, which include: Gynecological-Obstetric Emergencies, Childbirth care, gynecobstetrics Internment (Hospitalization), Basic and Intermediate Neonatal Care. After reviewing and analyzing the statistical data on the care provided, as well as the characterization of the maternal-perinatal service, the following proposal is made as an alternative to mitigate the impact of the Venezuelan migration phenomenon on the health system:1. Management and articulation of the different levels of maternal and perinatal care in the city. 2.Comprehensive management of care in coordination with the different local national actors and international institutions and NGOs 3. Presentation of projects for the expansion of the Hospital's installed capacity. 4.Route of Attention of the Maternal Perinatal Service. Conclusions: Increased demand for maternal and perinatal services by the Venezuelan migrant population. The installed capacity of the maternal care service at the ESE Erasmo Meoz University Hospital is insufficient for the care of local and migrant mothers. Improvement of the management of the service through the implementation of a route to provide effective, efficient and quality care to mothers who demand this service.
ABSTRACT Background: According to figures from Migration Colombia, as of August 2021 there were 1,842,390 migrants in the country, of which 164,229 resided in Norte de Santander and 98,680 in the city of Cúcuta, being this the third city with the largest number of migrant population. The World Bank (2018) assures that in Colombia "The attention to the migrant population of Venezuela has generated a pressure on the already precarious finances of several of the public hospitals, particularly in those cities with greater migratory flow. For its part, the Banco de la República (2020) analyzes the fiscal cost of caring for Venezuelan migrants, stating that "the services provided by the public network reached COP 557.423 million during the period 2017-2019" (p.36). The departments that have spent the most are Bogotá, Norte de Santander and La Guajira. In turn, the hospital with the highest turnover for health care for migrants from Venezuela, is Erasmo Meoz from Norte de Santander. For its part, the Banco de la República (2020) makes an analysis of the fiscal cost that originates the attention of Venezuelan migrants, before saying that "the services provided by the public network reached COP 557.423 million during the period 2017-2019" (p.36). The departments that have spent most are, Bogotá, Norte de Santander and la Guajira. In turn, the hospital that produces the highest turnover for health care to migrants from Venezuela, is the Erasmo Meoz of Norte de Santander. Which is a challenge for public policy in general. In terms of the subject of this work, during the period 2017-2019, of 5,458,330 attentions to 749,449 migrants, approximately 21.5% were to pregnant mothers. Objectives: To develop a proposal for the management of the maternal perinatal care service of the Erasmo Meoz University Hospital of San José de Cúcuta as an alternative to mitigate the impact of the Venezuelan migratory phenomenon. To determine the characteristics (problems, needs and opportunities arising from the demand for care) of the migrant population in the perinatal maternal service. To characterize the supply of health services, needs and opportunities of the maternal perinatal service of the Erasmo Meoz University Hospital of San José de Cúcuta. To propose a proposal that contributes to the strengthening of the management of the maternal perinatal care service at the Erasmo Meoz University Hospital of San José de Cúcuta. Materials and Methods: The approach is deductive, quantitative paradigm, descriptive level and the field design is non-experimental. Results: A descriptive analysis of the migrant population attended at the ESE Hospital Universitario Erasmo Meoz was performed, where the proportion of migrant births increased from 5.21% in 2016 to 83.08% in 2020. It is identified that for the year 2016, it can be observed that this condition was mainly suffered by Colombian mothers 96.6% compared to the low affection in this same year to Venezuelan mothers 3.4%. For the year 2018, it is evident that Venezuelan mothers who suffered from Extreme Maternal Morbidity events exceeded those of Colombian nationality 51% and 49% respectively. The description and identification of the needs and opportunities of the services of the ESE HUEM is carried out, which include: Gynecological-Obstetric Emergencies, Childbirth care, gynecobstetrics Internment (Hospitalization), Basic and Intermediate Neonatal Care. After reviewing and analyzing the statistical data on the care provided, as well as the characterization of the maternal-perinatal service, the following proposal is made as an alternative to mitigate the impact of the Venezuelan migration phenomenon on the health system:1. Management and articulation of the different levels of maternal and perinatal care in the city. 2.Comprehensive management of care in coordination with the different local national actors and international institutions and NGOs 3. Presentation of projects for the expansion of the Hospital's installed capacity. 4.Route of Attention of the Maternal Perinatal Service. Conclusions: Increased demand for maternal and perinatal services by the Venezuelan migrant population. The installed capacity of the maternal care service at the ESE Erasmo Meoz University Hospital is insufficient for the care of local and migrant mothers. Improvement of the management of the service through the implementation of a route to provide effective, efficient and quality care to mothers who demand this service.
Descripción
Palabras clave
Migración, Madres Gestantes Venezolanas, Sistema de salud, Migration, Venezuelan Pregnant Mothers, Health system
