Publicación:

Diseño del plan de cobertura del programa de promoción y prevención del hospital san Antonio e.s.e. del municipio de Natagaima del departamento del Tolima

Resumen

The General System of Social Security in Health (SGSSS), as a framework for the presentation of the service, must guarantee to the insured population in the different Entities Administrators of Benefit Plans (EAPB), health care through the Institutions Providers of Health Services (IPS), governed by contractual processes being responsible for the services offered and duly authorized. The provision of public health services must be projected within these contractual processes, aimed at the comprehensive provision of services, promoting health maintenance and disease prevention as established by health regulations in Colombia. The execution of these programs and services are the responsibility of the state, the EAPB, the IPS and in general of the population, depending directly on the supply and demand of these in the contractual period. For this reason, the San Antonio Hospital of the municipality of Natagaima, must design a coverage plan for the promotion and prevention program, oriented to the projection of the different education and care programs according to the budget offered, through the Unit of Payment by Capitation (UPC), focused on the population that is the object of said services in the municipality, thus reducing the financial and operational risk that can be generated by non-compliance with defined coverage at the time of programmatic contracting by the EAPB. The coverage plans are an important tool for the different institutions since it allows to project the execution figures and costs of the promotion and prevention activities, allowing the financial projection of the IPS, the realization of a permanent monitoring of the executions allows to reduce the possibilities of losing economic income due to the breach of contractually established activities between the IPS and the EAPB, activities that favor the population affiliated with the different EAPB regimes that are present in the municipality of Natagaima, users who have the right to access to the health services included in the Obligatory Health Plan (POS).