Abstract

Abstract

The National Superintendence of Health (Supersalud) is the entity in Colombia in charge of overseeing, among others, the Health Promoting Entities (EPS). Supersalud receives daily, through different communication channels, a series of Petitions-Complaints-Claims and Requests (PQRD) regarding the quality of service provided by the EPSs. This information is catalogued according to variables such as gender, age group, reason, pathology, among others, and is associated with a Municipal and Departmental code, thus enabling its georeferencing.

The PQRD are generally analysed without the information requests and are then identified as Petitions-Complaints-Claims (PQR). In this thesis, we analysed the 2017 information cut-off of the subset of the PQR associated with vital risk, in order to identify which are the main pathologies on which users express the greatest dissatisfaction related to the attention of the Health System, and which are the EPS of the contributory and subsidised regime on which these dissatisfactions fall.

This relationship between sufficiency and quality was evaluated through a qualitative indicator, constructed from the analysis of overlapping geographic layers (at the departmental level) and the use of geoprocessing tools for the execution of repetitive tasks necessary to compare the information from the provider network, the number of affiliates for each EPS and the agreements between EPSs and IPSs.

The results were organised in a geographic control board to facilitate the analysis and were compared with geographic reference information from DANE and Minsalud regarding public health in Colombia for periods of time close to the one analysed. Thus, it was possible to relate the resulting departments with the territories in which there is greater mortality associated with the pathologies analysed, and the EPSs that belong to category C of the indicator constructed were identified, which corresponds to the category with the highest level of criticality of quality and coverage, given that it assumes the following: The sufficiency of the high complexity network for the pathology analysed is low and is reflected in the poor perception of its affiliates. The vast majority of the EPSs identified at the end of January 2021 are under some special surveillance measure by Supersalud, and some of them have even been forcibly liquidated. In conclusion, it was identified that a greater territorial presence of Supersalud is required to receive the PQRDs of the most vulnerable population.

Key words: public health; Colombia; GIS; severe pathologies; evaluation.