Estudio analítico del estado del arte de la gestión del riesgo financiero en la salud en Colombia.
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Fecha
2025
Autores
Orellano Guzmán, Valentina Paola
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Ediciones Universidad Simón Bolívar
Facultad de Administración y Negocios
Facultad de Administración y Negocios
Resumen
El presente trabajo aborda la gestión del riesgo financiero en el sector salud en Colombia,
enfocándose en su evolución normativa, metodológica y científica en los últimos 15 años. Parte de
un contexto regulatorio en el cual, desde el año 2001 con el Decreto 1537, se exige a las entidades
públicas implementar políticas para administrar riesgos. Posteriormente, la Ley 1122 de 2007 y el
Plan Nacional de Salud Pública 2007-2010 fortalecen el enfoque preventivo. En 2011, la gestión del
riesgo se alinea con estándares internacionales mediante la adopción de la norma ISO 31000. Todo
esto confluye en el fortalecimiento del Sistema General de Seguridad Social en Salud, especialmente
ante situaciones críticas como la crisis financiera hospitalaria, que llevó a que un 26% de los
hospitales públicos estuvieran en riesgo en 2016, cifra que venía de un alarmante 40-45% en años
anteriores.
Desde un enfoque técnico, se entiende el riesgo como la posibilidad de que un evento negativo afecte
a una población o entidad, influido por factores internos (vulnerabilidad) y externos (amenazas). La
gestión del riesgo busca disminuir la incertidumbre sobre estos eventos a través de estrategias
preventivas, de mitigación y de respuesta, con especial atención en la salud pública y en la
sostenibilidad financiera del sistema. En este contexto, las Instituciones Prestadoras de Salud (IPS)
enfrentan riesgos derivados de la cartera, la presión tecnológica y demográfica, y la expansión del
Plan Obligatorio de Salud (POS), lo que genera altos niveles de endeudamiento y pone en peligro su
sostenibilidad financiera.
This paper addresses financial risk management in the Colombian healthcare sector, focusing on its regulatory, methodological, and scientific evolution over the past 15 years. It is based on a regulatory context in which, since 2001 with Decree 1537, public entities have been required to implement risk management policies. Subsequently, Law 1122 of 2007 and the 2007-2010 National Public Health Plan strengthened the preventive approach. In 2011, risk management was aligned with international standards through the adoption of ISO 31000. All of this contributes to strengthening the General Social Security System in Health, especially in critical situations such as the hospital financial crisis, which led to 26% of public hospitals being at risk in 2016, a figure that had risen from an alarming 40% to 45% in previous years. From a technical perspective, risk is understood as the possibility of a negative event affecting a population or entity, influenced by internal factors (vulnerability) and external factors (threats). Risk management seeks to reduce uncertainty surrounding these events through preventive, mitigation, and response strategies, with special attention to public health and the financial sustainability of the system. In this context, Health Care Providers (IPS) face risks derived from portfolio losses, technological and demographic pressure, and the expansion of the Mandatory Health Plan (POS), which generates high levels of debt and jeopardizes their financial sustainability
This paper addresses financial risk management in the Colombian healthcare sector, focusing on its regulatory, methodological, and scientific evolution over the past 15 years. It is based on a regulatory context in which, since 2001 with Decree 1537, public entities have been required to implement risk management policies. Subsequently, Law 1122 of 2007 and the 2007-2010 National Public Health Plan strengthened the preventive approach. In 2011, risk management was aligned with international standards through the adoption of ISO 31000. All of this contributes to strengthening the General Social Security System in Health, especially in critical situations such as the hospital financial crisis, which led to 26% of public hospitals being at risk in 2016, a figure that had risen from an alarming 40% to 45% in previous years. From a technical perspective, risk is understood as the possibility of a negative event affecting a population or entity, influenced by internal factors (vulnerability) and external factors (threats). Risk management seeks to reduce uncertainty surrounding these events through preventive, mitigation, and response strategies, with special attention to public health and the financial sustainability of the system. In this context, Health Care Providers (IPS) face risks derived from portfolio losses, technological and demographic pressure, and the expansion of the Mandatory Health Plan (POS), which generates high levels of debt and jeopardizes their financial sustainability
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Palabras clave
Sector salud, Sistema General de Seguridad Social en Salud (SGSSS), Instituciones Prestadoras de Salud (IPS), Sostenibilidad financiera, Evaluación de riesgo
