IDEAS home Printed from https://ideas.repec.org/a/bdr/ensayo/y2023i106p1-92.html
   My bibliography  Save this article

Aspectos financieros y fiscales del sistema de salud en Colombia

Author

Listed:
  • Ligia Alba Melo-Becerra
  • Luis E. Arango
  • Oscar Iván Ávila-Montealegre
  • Jhorland Ayala-García
  • Leonardo Bonilla-Mejía
  • Jesús Alonso Botero-García
  • Carolina Crispin-Fory
  • Manuela Cardona
  • Daniela Gallo
  • Clark Granger
  • Karelys Guzmán-Finol
  • Ana María Iregui-Bohórquez
  • Juan J. Ospina-Tejeiro
  • Diana Estefanía Pinilla-Alarcón
  • Christian Posso
  • María Teresa Ramírez-Giraldo
  • Jorge Enrique Ramos-Forero
  • Mario A. Ramos-Veloza
  • Diego Alexander Restrepo-Tobón
  • Jairo Humberto Restrepo-Zea
  • Giselle Tatiana Silva-Samudio
  • Diego Vásquez-Escobar

Abstract

El artículo realiza una descripción de los aspectos institucionales, mecanismos y fuentes de financiación del sistema de salud en Colombia. Utilizando modelos de equilibrio general, el estudio evalúa los efectos de diversos riesgos que enfrenta el sistema de salud, en las finanzas del sector, el déficit fiscal y algunas variables macroeconómicas. Estos riesgos incluyen el impacto del cambio demográfico, caracterizado por el envejecimiento de la población, los cambios en los patrones de morbilidad, especialmente relacionados con el aumento de enfermedades crónicas no transmisibles y la adopción de nuevas tecnologías médicas. Además, explora el impacto de la informalidad y del crecimiento económico, en la necesidad de recursos fiscales para el sector. El estudio encuentra que el país podría experimentar un incremento significativo en el gasto público necesario para financiar el sistema de salud, equivalente a 1,9% del PIB para el año 2030. El articulo también presenta estimaciones de medidas de eficiencia y de economías de escala para las empresas promotoras de salud y de las Instituciones Prestadoras de Servicios de Salud, resaltando la importancia de la eficiencia en el uso de los recursos del sistema para mitigar las presiones sobre el gasto público. **** ABSTRACT: The article provides an overview of institutional aspects, mechanisms, and funding sources in the Colombia's healthcare system. Through the use of general equilibrium models, the study assesses the impacts of various risks faced by the healthcare system, considering their effects on sector finances, fiscal deficit, and macroeconomic variables. These risks encompass the implications of demographic changes, characterized by population aging, shifts in morbidity patterns—especially linked to the rise of non-communicable diseases—and the adoption of new medical technologies. Additionally, the study explores the effects of informality and economic growth on the fiscal resource needs within the sector. It concludes that the country could undergo a significant increase in necessary public spending to finance the healthcare system in Colombia, amounting to 1.9% of GDP by 2030. The article also presents estimates of efficiency measures and economies of scale for healthcare promotion companies and Institutions Providing Health Services, underscoring the significance of resource efficiency within the system to alleviate pressures on public spending.

Suggested Citation

  • Ligia Alba Melo-Becerra & Luis E. Arango & Oscar Iván Ávila-Montealegre & Jhorland Ayala-García & Leonardo Bonilla-Mejía & Jesús Alonso Botero-García & Carolina Crispin-Fory & Manuela Cardona & Daniel, 2023. "Aspectos financieros y fiscales del sistema de salud en Colombia," Revista ESPE - Ensayos sobre Política Económica, Banco de la Republica de Colombia, issue 106, pages 1-92, October.
    • Handle: RePEc:bdr:ensayo:y:2023:i:106:p:1-92
    as

    Download full text from publisher

    File URL: https://repositorio.banrep.gov.co/bitstream/handle/20.500.12134/10699/Espe106.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Per Krusell & Lee E. Ohanian & JosÈ-Victor RÌos-Rull & Giovanni L. Violante, 2000. "Capital-Skill Complementarity and Inequality: A Macroeconomic Analysis," Econometrica, Econometric Society, vol. 68(5), pages 1029-1054, September.
    2. Ligia Alba Melo-Becerra & Jorge Enrique Ramos-Forero, 2017. "El gasto público en Colombia: Algunos aspectos sobre su tamaño, evolución y estructura," Borradores de Economia 1003, Banco de la Republica de Colombia.
    3. R. C. Geary, 1950. "A Note on "A Constant-Utility Index of the Cost of Living"," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 18(1), pages 65-66.
    4. Rafael La Porta & Andrei Shleifer, 2014. "Informality and Development," Journal of Economic Perspectives, American Economic Association, vol. 28(3), pages 109-126, Summer.
    5. Pablo Daniel Monterubbianesi, 2014. "El rol de la salud en el proceso de crecimiento económico: una revisión de la literatura," Revista Cuadernos de Economia, Universidad Nacional de Colombia, FCE, CID, June.
    6. Ramiro Guerrero & Sergio I. Prada & Dov Chernichovsky, 2014. "La doble descentralización en el sector salud: evaluación y alternativas de política pública," Cuadernos de Fedesarrollo 12019, Fedesarrollo.
    7. Robert J. Barro, 1998. "Determinants of Economic Growth: A Cross-Country Empirical Study," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262522543, April.
    8. David Bardey & Giancarlo Buitrago, 2016. "Integración vertical en el sector colombiano de la salud," Revista Desarrollo y Sociedad, Universidad de los Andes,Facultad de Economía, CEDE, vol. 77, August.
    9. Jairo Humberto Restrepo & John Fernando Lopera & Sandra Milena Rodríguez, 2007. "La integración vertical en el sistema de salud colombiano," Revista de Economía Institucional, Universidad Externado de Colombia - Facultad de Economía, vol. 9(17), pages 279-308, July-Dece.
    10. Glover, Andrew, 2019. "Aggregate effects of minimum wage regulation at the zero lower bound," Journal of Monetary Economics, Elsevier, vol. 107(C), pages 114-128.
    11. Kumbhakar, Subal C & Ghosh, Soumendra & McGuckin, J Thomas, 1991. "A Generalized Production Frontier Approach for Estimating Determinants of Inefficiency in U.S. Dairy Farms," Journal of Business & Economic Statistics, American Statistical Association, vol. 9(3), pages 279-286, July.
    12. Amy Finkelstein & Matthew Gentzkow & Heidi Williams, 2016. "Sources of Geographic Variation in Health Care: Evidence From PatientMigration," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 131(4), pages 1681-1726.
    13. Subhash Ray, 1999. "Measuring Scale Efficiency from a Translog Production Function," Journal of Productivity Analysis, Springer, vol. 11(2), pages 183-194, April.
    14. Carolina Crispin-Fory & Ligia Alba Melo-Becerra & Diego Alexander Restrepo-Tobón & Diego Vásquez-Escobar, 2023. "Eficiencia y solidez financiera de las Instituciones prestadoras de Servicio de Salud (IPS) en Colombia," Borradores de Economia 1248, Banco de la Republica de Colombia.
    15. Romina Cavatassi & Mario González-flores & Paul Winters & Jorge Andrade-Piedra & Patricio Espinosa & Graham Thiele, 2011. "Linking Smallholders to the New Agricultural Economy: The Case of the in Ecuador," Journal of Development Studies, Taylor & Francis Journals, vol. 47(10), pages 1545-1573.
    16. Ligia Alba Melo B. & Jorge Enrique Ramos F,, 2010. "Algunos aspectos fiscales y financieros del sistema de salud en Colombia," Borradores de Economia 7620, Banco de la Republica.
    17. Lluch, Constantino & Williams, R, 1975. "Cross Country Demand and Savings Patterns: An Application of the Extended Linear Expenditure System," The Review of Economics and Statistics, MIT Press, vol. 57(3), pages 320-328, August.
    18. Battese, G E & Coelli, T J, 1995. "A Model for Technical Inefficiency Effects in a Stochastic Frontier Production Function for Panel Data," Empirical Economics, Springer, vol. 20(2), pages 325-332.
    19. Luis E. Arango & Jesús Alonso Botero-García & Daniela Gallo & Ligia Alba Melo-Becerra, 2023. "Efectos fiscales y macroeconómicos de diferentes riesgos del sistema de salud," Borradores de Economia 1258, Banco de la Republica de Colombia.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Karelys Guzmán-Finol & Jhorland Ayala-García, 2024. "Cartera hospitalaria y diferencias regionales en la prestación de los servicios de salud en Colombia," Documentos de trabajo sobre Economía Regional y Urbana 328, Banco de la Republica de Colombia.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ligia Alba Melo-Becerra & Diego Vásquez-Escobar & María Isabel Alarcón-Obando & Giselle Tatiana Silva-Samudio, 2024. "Empresas Promotoras de Salud en Colombia: Gestión del riesgo en salud, eficiencia técnica y solidez financiera," Borradores de Economia 1272, Banco de la Republica de Colombia.
    2. Luis E. Arango & Jesús Alonso Botero-García & Daniela Gallo & Ligia Alba Melo-Becerra, 2023. "Efectos fiscales y macroeconómicos de diferentes riesgos del sistema de salud," Borradores de Economia 1258, Banco de la Republica de Colombia.
    3. Tom Kompas & Tuong Nhu Che & R. Quentin Grafton, 2004. "Technical efficiency effects of input controls: evidence from Australia's banana prawn fishery," Applied Economics, Taylor & Francis Journals, vol. 36(15), pages 1631-1641.
    4. Daniel Solís & Boris E. Bravo‐Ureta & Ricardo E. Quiroga, 2009. "Technical Efficiency among Peasant Farmers Participating in Natural Resource Management Programmes in Central America," Journal of Agricultural Economics, Wiley Blackwell, vol. 60(1), pages 202-219, February.
    5. António Afonso & Ana Patricia Montes & José M. Domínguez, 2024. "Measuring Tax Burden Efficiency in OECD Countries: An International Comparison," CESifo Working Paper Series 11333, CESifo.
    6. Victor Moutinho & Mara Madaleno, 2021. "Assessing Eco-Efficiency in Asian and African Countries Using Stochastic Frontier Analysis," Energies, MDPI, vol. 14(4), pages 1-17, February.
    7. Kox, Henk L.M. & Leeuwen, George van & Wiel, Henry van der, 2010. "Competitive, but too small - productivity and entry-exit determinants in European business services," MPRA Paper 24389, University Library of Munich, Germany.
    8. Dhehibi, Boubaker & Lachaal, Lassaad & Elloumi, Mohamed & Messaoud, Emna B., 2007. "Measurement and Sources of Technical Inefficiency in the Tunisian Citrus Growing Sector," 103rd Seminar, April 23-25, 2007, Barcelona, Spain 9391, European Association of Agricultural Economists.
    9. Noel Uri, 2003. "The Effect of Incentive Regulation in Telecommunications in the United States," Quality & Quantity: International Journal of Methodology, Springer, vol. 37(2), pages 169-191, May.
    10. Subal C. Kumbhakar & Christopher F. Parmeter & Valentin Zelenyuk, 2022. "Stochastic Frontier Analysis: Foundations and Advances I," Springer Books, in: Subhash C. Ray & Robert G. Chambers & Subal C. Kumbhakar (ed.), Handbook of Production Economics, chapter 8, pages 331-370, Springer.
    11. Roy, Manish & Mazumder, Ritwik, 2016. "Technical Efficiency of Fish Catch in Traditional Fishing: A Study in Southern Assam," Journal of Regional Development and Planning, Rajarshi Majumder, vol. 5(1), pages 55-68.
    12. Cristian BARRA & Roberto ZOTTI, 2019. "Bank Performance, Financial Stability And Market Concentration: Evidence From Cooperative And Non‐Cooperative Banks," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 90(1), pages 103-139, March.
    13. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.
    14. Edward Ebo ONUMAH & Bernhard BRÜMMER & Gabriele HÖRSTGEN-SCHWARK, 2010. "Productivity of the hired and family labour and determinants of technical inefficiency in Ghana's fish farms," Agricultural Economics, Czech Academy of Agricultural Sciences, vol. 56(2), pages 79-88.
    15. William Griffiths & Xiaohui Zhang & Xueyan Zhao, 2010. "A Stochastic Frontier Model for Discrete Ordinal Outcomes: A Health Production Function," Department of Economics - Working Papers Series 1092, The University of Melbourne.
    16. Coelli, Tim J. & Battese, George E., 1996. "Identification Of Factors Which Influence The Technical Inefficiency Of Indian Farmers," Australian Journal of Agricultural Economics, Australian Agricultural and Resource Economics Society, vol. 40(2), pages 1-26, August.
    17. Bhaumik, Sumon K. & Dimova, Ralitza, 2012. "Does Human Capital Endowment of FDI Recipient Countries Really Matter? Evidence from Cross-Country Firm Level Data," IZA Discussion Papers 6382, Institute of Labor Economics (IZA).
    18. Adamopoulou, Effrosyni & Manaresi, Francesco & Rachedi, Omar & Yurdagul, Emircan, 2021. "Minimum Wages and Insurance within the Firm," IZA Discussion Papers 14943, Institute of Labor Economics (IZA).
    19. Lavado, Rouselle F. & Barrios, Erniel B., 2010. "Spatial Stochastic Frontier Models," Discussion Papers DP 2010-08, Philippine Institute for Development Studies.
    20. Roberto Furesi & Fabio Madau & Pietro Pulina, 2013. "Technical efficiency in the sheep dairy industry: an application on the Sardinian (Italy) sector," Agricultural and Food Economics, Springer;Italian Society of Agricultural Economics (SIDEA), vol. 1(1), pages 1-11, December.

    More about this item

    Keywords

    Sistema de salud; financiamiento salud; déficit fiscal; enfermedades crónicas no transmisibles; medidas de eficiencia; disparidades regionales en salud; esquemas de financiamiento; Colombia; Healthcare system; health financing; fiscal deficit; non-communicable chronic diseases; efficiency measures; regional health disparities; financing schemes; Colombia;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bdr:ensayo:y:2023:i:106:p:1-92. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Clorith Angélica Bahos Olivera (email available below). General contact details of provider: https://edirc.repec.org/data/brcgvco.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.