Conflicto de valores en el sistema de salud de Colombia: entre la economía de mercado y la normativa constitucional, 2007--2009.
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| Title: | Conflicto de valores en el sistema de salud de Colombia: entre la economía de mercado y la normativa constitucional, 2007--2009. |
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| Alternate Title: | Conflicting values in Colombia's health system: balancing the market economy and constitutional legislation, 2007--2009. |
| Authors: | Molina, Gloria1, Ramírez, Andrés2 |
| Source: | Pan American Journal of Public Health / Revista Panamericana de Salud Pública. Apr2013, Vol. 33 Issue 4, p287-293. 7p. |
| Subjects: | MEDICAL care, SOCIAL security, DECISION making, DIGNITY, ETHICS, FOCUS groups, INTERVIEWING, SOCIAL values, THEORY-practice relationship |
| Geographic Terms: | COLOMBIA |
| Abstract (English): | Objective. To present the conflicting moral issues that arise in clinical and administrative decision-making processes in Colombia's General Health Social Security System (SGSSS). Methods. A study was conducted between 2007 and 2009 in six Colombian cities (Barranquilla, Bogotá, Bucaramanga, Leticia, Medellín, and Pasto) using a theory-based qualitative methodology. A total of 179 in-depth interviews were held with physicians, nursing personnel, and administrators with broad experience in the health sector, as well as 10 focus groups representing users and leaders of community organizations involved in health. The interviews, which followed a predetermined script and used semistructured questions, gathered personal and professional information from the respondents. Results. The health care decision-making process in Colombia is seen from two different moral perspectives: the rentier, or profit-making, motive, characterized by a neoliberal view of the market economy (the practical perspective), and the constitutional axiology of social democracy (the regulatory perspective). It was found that the utilitarian and individualistic motive predominates, in which individual and business profits are promoted over the collective interest, and this trend favors practices that undermine the rights of people and the community. Conclusions. Predominance of a morality that views the Colombian SGSSS in terms of the market model generates conditions that go against the principles and values that are supposed to guide the health system as guarantor of the right to health and human dignity. Health decisions should take into account not only technical and scientific criteria but also the principles and values involved, and consideration should be given to safeguarding them [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | Objetivo. Presentar los aspectos morales en conflicto en los procesos de toma de decisiones clínico-administrativas dentro del Sistema General de Seguridad Social en Salud (SGSSS) de Colombia. Métodos. La investigación se llevó a cabo entre 2007 y 2009 en seis ciudades colombianas (Barranquilla, Bogotá, Bucaramanga, Leticia, Medellín y Pasto), según una metodología cualitativa basada en la teoría fundamentada. Se realizaron 179 entrevistas en profundidad a médicos, personal de enfermería y administradores con amplia experiencia en el sector de la salud, y 10 grupos focales con usuarios y líderes de organizaciones comunitarias vinculadas a la salud. Las entrevistas, con preguntas semiestructuradas y según una guía elaborada pre-viamente, recababan información personal y profesional. Resultados. En el proceso de toma de decisiones en la atención en salud en Colombia se identificaron elementos de dos morales enfrentadas: la rentista, caracterizada por la axiología neoliberal de la economía de mercado (práctica) y otra fundamentada en la axiología constitucional (normativa) del Estado social de derecho. Predomina el enfoque utilitarista e individualista y se promueve el lucro individual y empresarial por encima del interés colectivo; esto favorece prácticas que contravienen los derechos de las personas y la comunidad. Conclusiones. El predominio de la moral que responde al modelo de mercado en el SGSSS colombiano genera condiciones adversas a los principios y valores que deben orientar el sistema de salud como garante del derecho a la salud y la dignidad humana. Para la toma de decisiones en salud es necesario tener en cuenta, además de los elementos técnicos y científicos, los principios y valores que están enfrentados y reflexionar sobre ellos para su legitimación [ABSTRACT FROM AUTHOR] |
| Copyright of Pan American Journal of Public Health / Revista Panamericana de Salud Pública is the property of Pan American Health Organization and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | MedicLatina |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: lth DbLabel: MedicLatina An: 88918441 AccessLevel: 6 PubType: Periodical PubTypeId: serialPeriodical PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Conflicto de valores en el sistema de salud de Colombia: entre la economía de mercado y la normativa constitucional, 2007--2009. – Name: TitleAlt Label: Alternate Title Group: TiAlt Data: Conflicting values in Colombia's health system: balancing the market economy and constitutional legislation, 2007--2009. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Molina%2C+Gloria%22">Molina, Gloria</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Ramírez%2C+Andrés%22">Ramírez, Andrés</searchLink><relatesTo>2</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Pan+American+Journal+of+Public+Health+%2F+Revista+Panamericana+de+Salud+Pública%22">Pan American Journal of Public Health / Revista Panamericana de Salud Pública</searchLink>. Apr2013, Vol. 33 Issue 4, p287-293. 7p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22MEDICAL+care%22">MEDICAL care</searchLink><br /><searchLink fieldCode="DE" term="%22SOCIAL+security%22">SOCIAL security</searchLink><br /><searchLink fieldCode="DE" term="%22DECISION+making%22">DECISION making</searchLink><br /><searchLink fieldCode="DE" term="%22DIGNITY%22">DIGNITY</searchLink><br /><searchLink fieldCode="DE" term="%22ETHICS%22">ETHICS</searchLink><br /><searchLink fieldCode="DE" term="%22FOCUS+groups%22">FOCUS groups</searchLink><br /><searchLink fieldCode="DE" term="%22INTERVIEWING%22">INTERVIEWING</searchLink><br /><searchLink fieldCode="DE" term="%22SOCIAL+values%22">SOCIAL values</searchLink><br /><searchLink fieldCode="DE" term="%22THEORY-practice+relationship%22">THEORY-practice relationship</searchLink> – Name: SubjectGeographic Label: Geographic Terms Group: Su Data: <searchLink fieldCode="DE" term="%22COLOMBIA%22">COLOMBIA</searchLink> – Name: Abstract Label: Abstract (English) Group: Ab Data: Objective. To present the conflicting moral issues that arise in clinical and administrative decision-making processes in Colombia's General Health Social Security System (SGSSS). Methods. A study was conducted between 2007 and 2009 in six Colombian cities (Barranquilla, Bogotá, Bucaramanga, Leticia, Medellín, and Pasto) using a theory-based qualitative methodology. A total of 179 in-depth interviews were held with physicians, nursing personnel, and administrators with broad experience in the health sector, as well as 10 focus groups representing users and leaders of community organizations involved in health. The interviews, which followed a predetermined script and used semistructured questions, gathered personal and professional information from the respondents. Results. The health care decision-making process in Colombia is seen from two different moral perspectives: the rentier, or profit-making, motive, characterized by a neoliberal view of the market economy (the practical perspective), and the constitutional axiology of social democracy (the regulatory perspective). It was found that the utilitarian and individualistic motive predominates, in which individual and business profits are promoted over the collective interest, and this trend favors practices that undermine the rights of people and the community. Conclusions. Predominance of a morality that views the Colombian SGSSS in terms of the market model generates conditions that go against the principles and values that are supposed to guide the health system as guarantor of the right to health and human dignity. Health decisions should take into account not only technical and scientific criteria but also the principles and values involved, and consideration should be given to safeguarding them [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Abstract (Spanish) Group: Ab Data: Objetivo. Presentar los aspectos morales en conflicto en los procesos de toma de decisiones clínico-administrativas dentro del Sistema General de Seguridad Social en Salud (SGSSS) de Colombia. Métodos. La investigación se llevó a cabo entre 2007 y 2009 en seis ciudades colombianas (Barranquilla, Bogotá, Bucaramanga, Leticia, Medellín y Pasto), según una metodología cualitativa basada en la teoría fundamentada. Se realizaron 179 entrevistas en profundidad a médicos, personal de enfermería y administradores con amplia experiencia en el sector de la salud, y 10 grupos focales con usuarios y líderes de organizaciones comunitarias vinculadas a la salud. Las entrevistas, con preguntas semiestructuradas y según una guía elaborada pre-viamente, recababan información personal y profesional. Resultados. En el proceso de toma de decisiones en la atención en salud en Colombia se identificaron elementos de dos morales enfrentadas: la rentista, caracterizada por la axiología neoliberal de la economía de mercado (práctica) y otra fundamentada en la axiología constitucional (normativa) del Estado social de derecho. Predomina el enfoque utilitarista e individualista y se promueve el lucro individual y empresarial por encima del interés colectivo; esto favorece prácticas que contravienen los derechos de las personas y la comunidad. Conclusiones. El predominio de la moral que responde al modelo de mercado en el SGSSS colombiano genera condiciones adversas a los principios y valores que deben orientar el sistema de salud como garante del derecho a la salud y la dignidad humana. Para la toma de decisiones en salud es necesario tener en cuenta, además de los elementos técnicos y científicos, los principios y valores que están enfrentados y reflexionar sobre ellos para su legitimación [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Pan American Journal of Public Health / Revista Panamericana de Salud Pública is the property of Pan American Health Organization and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1590/S1020-49892013000400008 Languages: – Code: spa Text: Spanish PhysicalDescription: Pagination: PageCount: 7 StartPage: 287 Subjects: – SubjectFull: MEDICAL care Type: general – SubjectFull: SOCIAL security Type: general – SubjectFull: DECISION making Type: general – SubjectFull: DIGNITY Type: general – SubjectFull: ETHICS Type: general – SubjectFull: FOCUS groups Type: general – SubjectFull: INTERVIEWING Type: general – SubjectFull: SOCIAL values Type: general – SubjectFull: THEORY-practice relationship Type: general – SubjectFull: COLOMBIA Type: general Titles: – TitleFull: Conflicto de valores en el sistema de salud de Colombia: entre la economía de mercado y la normativa constitucional, 2007--2009. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Molina, Gloria – PersonEntity: Name: NameFull: Ramírez, Andrés IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: Apr2013 Type: published Y: 2013 Identifiers: – Type: issn-print Value: 10204989 Numbering: – Type: volume Value: 33 – Type: issue Value: 4 Titles: – TitleFull: Pan American Journal of Public Health / Revista Panamericana de Salud Pública Type: main |
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