Estrategias de mejora del proceso de dispensación de medicamentos del plan de beneficios del régimen subsidiado en salud
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Fecha
2022
Autores
Maldonado Mateus, Marta Celina
Lizcano Maldonado, María Camila
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Ediciones Universidad Simón Bolívar
Facultad de Administración y Negocios
Facultad de Administración y Negocios
Resumen
Los reclamos por fallas de diversa índole en la dispensación de medicamentos han sido una de las principales causas de queja de los usuarios del Sistema General de Seguridad Social en Salud (SGSSS). La falta de oportunidad, la no entrega o entrega parcial de los medicamentos, las trabas administrativas por deficiencias en el sistema de información de los prestadores y demoras en autorizaciones son algunas de las causas más frecuentes que obligan al usuario a desistir de su tratamiento o a interponer alguna acción de tutela, interponer quejas o reclamos para lograr el cumplimiento de su derecho adquirido como usuario del sistema. Estas dificultades no son ajenas a los habitantes de Pamplona afiliados al Régimen Subsidiado en Salud, como se evidenció con esta investigación basada en los informes disponibles en la dirección territorial de salud en los años 2017 a 2021.
Al aplicar la metodología de triangulación de las diferentes normas que han reformado al SGSSS y de análisis de las políticas públicas, relacionadas con el acceso a los tratamientos farmacológicos, se logra una exploración de carácter bibliográfico que permite identificar
4 variables para el análisis.
En esta investigación se pretende determinar las necesidades y oportunidades de mejora en el proceso de dispensación de medicamentos, no solamente por las EAPB sino por los demás actores del sistema, entre ellos el Ministerio de Salud, que reglamenta las normas que son de su cumplimiento pero que a la fecha aún no implementa, ocasionando en gran medida que las entidades de inspección, vigilancia y control no cuenten con insumos producto de un monitoreo para realizar sus labores de seguimiento y control de la entrega de los medicamentos incluidos en el plan de servicios y tecnologías en salud por parte de las EAPB a sus usuarios.
A partir de las experiencias condensadas en los informes y de la revisión de la normativa vigente aplicable información que fue procesada a través de revisión documental y mecanismos de triangulación de información teniendo en cuenta las variables definidas para el análisis, se realizan propuestas para mejora en el proceso de dispensación de medicamentos, dirigidas a los actores del sistema en el municipio de Pamplona proponiendo una ruta articulada entre los actores del sistema complementada con un escenario producto de la voluntad política territorial, para fortalecer el ejercicio de sus funciones de seguimiento, vigilancia y control, y como insumo para gestionar el riesgo en salud de su población.
Complaints due to failures of various kinds in the dispensing of medicines have been one of the main causes of complaints from users of the General Social Security Health System (SGSSS). Lack of timeliness, non-delivery or partial delivery of medicines, administrative obstacles due to deficiencies in the information system of the providers and delays in authorizations are some of the most frequent causes that force the user to desist from treatment or to file a tutela action, file complaints or claims to achieve compliance with their acquired right as a user of the system. These difficulties are not alien to the inhabitants of Pamplona affiliated to the Subsidized Health Regime, as evidenced by this research based on the reports available in the territorial health directorate in the years 2017 to 2021. By applying the methodology of triangulation of the different norms that have reformed the SGSSS and analysis of public policies, related to access to pharmacological treatments, an exploration of bibliographic character is achieved that allows identifying 4 variables for the analysis. The purpose of this research is to determine the needs and opportunities for improvement in the process of dispensing medicines, not only by the EAPBs but also by the other actors in the system, including the Ministry of Health, which regulates the standards that must be complied with but which to date have not yet been implemented, causing to a large extent that the inspection, surveillance and control entities do not have the inputs resulting from monitoring to carry out their work of follow-up and control of the delivery of medicines included in the health services and technologies plan by the EAPBs to their users. Based on the experiences condensed in the reports and the review of the applicable regulations in force, information that was processed through documentary review and information triangulation mechanisms, taking into account the variables defined for the analysis, proposals are made to improve the process of dispensing medicines, aimed at the actors of the system in the municipality of Pamplona, proposing an articulated route among the actors of the system complemented with a scenario resulting from the territorial political will, to strengthen the exercise of their monitoring, surveillance and control functions, and as an input to manage the health risk of the population.
Complaints due to failures of various kinds in the dispensing of medicines have been one of the main causes of complaints from users of the General Social Security Health System (SGSSS). Lack of timeliness, non-delivery or partial delivery of medicines, administrative obstacles due to deficiencies in the information system of the providers and delays in authorizations are some of the most frequent causes that force the user to desist from treatment or to file a tutela action, file complaints or claims to achieve compliance with their acquired right as a user of the system. These difficulties are not alien to the inhabitants of Pamplona affiliated to the Subsidized Health Regime, as evidenced by this research based on the reports available in the territorial health directorate in the years 2017 to 2021. By applying the methodology of triangulation of the different norms that have reformed the SGSSS and analysis of public policies, related to access to pharmacological treatments, an exploration of bibliographic character is achieved that allows identifying 4 variables for the analysis. The purpose of this research is to determine the needs and opportunities for improvement in the process of dispensing medicines, not only by the EAPBs but also by the other actors in the system, including the Ministry of Health, which regulates the standards that must be complied with but which to date have not yet been implemented, causing to a large extent that the inspection, surveillance and control entities do not have the inputs resulting from monitoring to carry out their work of follow-up and control of the delivery of medicines included in the health services and technologies plan by the EAPBs to their users. Based on the experiences condensed in the reports and the review of the applicable regulations in force, information that was processed through documentary review and information triangulation mechanisms, taking into account the variables defined for the analysis, proposals are made to improve the process of dispensing medicines, aimed at the actors of the system in the municipality of Pamplona, proposing an articulated route among the actors of the system complemented with a scenario resulting from the territorial political will, to strengthen the exercise of their monitoring, surveillance and control functions, and as an input to manage the health risk of the population.
Descripción
Palabras clave
Dispensación, Sistema, Acceso, Medicamentos, Prescripción, Dispensing, System, Access, Drugs, Prescription
