Table 5 Examples of quotations regarding "barriers related to the network of healthcare providers"
From: Barriers of access to care in a managed competition model: lessons from Colombia
Category | Quotations |
|---|---|
Changes in behavior of the public healthcare providers | "The difference is that ten years ago we simply gave the patient what he needed, without asking where are you from, what [insurance] do you have or don't have, we'd just treated them and the State paid. Now we have to ask what he has, what's wrong, and who will pay or who to charge." (manager, public secondary care provider - rural subsidized network). |
Distance to specialized care services | "Sometimes they just don't go, because on the one hand there's the bus ticket, which costs $6.000 [2.5€] roundtrip (...) and if they don't have it, they have to put up with the disease, because what can you do just with herbs?" (user, subsidized regime-rural area) |
"Many patents never get care because of that [geographic distance]. I have hypertensive patients who I've referred to internists and they've never gone (...) It's one zone in particular, and we're very far away" (health professional primary healthcare provider - urban contributory network) | |
Causes: deficit in service supply | "Sometimes the high technology hospital does not have a contract with certain institutions [insurance companies of the subsidized regime], and one finds oneself with the problem of having to send a patient somewhere, but not knowing where, you see? So the patient ends up staying in the emergency room because we can't find a place to send him." (manager, subsidized secondary care provider - rural subsidized network) |
"Bogotá is a very, very big city, with a gigantic deficit of beds. I think we're the only country in the world that calmly closes its two biggest [public] hospitals due to financial problems (...) (...) they should intervene and resolve the problem, but not close it (...)" (manager, public primary care provider - urban subsidized network) | |
Waiting time | "The waiting time is not good. I mean, I think that patients that make appointments that are relatively high priority are not getting them" (health professional, public secondary care provider - urban contributory network |
In-person and restricted appointment requirements | "There are patients that sometimes get up at the crack of dawn, stand in line, aren't able to get an appointment, get tired of it, and a year passes, then two, and they don't get their specific antigen, even though they could be developing a serious illness" (health professional, private secondary care provider - urban subsidized network) |