LOS RECOBROS EN EL SISTEMA DE SALUD EN COLOMBIA: CASI UNA ENFERMEDAD

This paper presents a description of the data that the Fidufosyfa Consortium reports as recoveries on oncological pathologies from May 2011 to February 16, 2012. The analysis includes a description of the diagnostic variables, region, type of recovery, age, the recovery amount, and glossed and approved amount. Oncology was chosen because this pathology might be the one that the operation Boards Technical-Scientific Peer - hereafter referred to as JTCP- use to start working with and because such pathology embraces the illnesses that are considered as a growing problem in the public health system in Colombia. The frequency determines that the services on oncological pathologies are not quite recovered but their high costs confirm that they do increase the public expense on health. The JTCP, in its role of technical advisory committee in the National Health Superintendency, will issue, as it does today the Scientific Technical Committee of the EPS – hereafter referred to as CTC- technical and scientific concepts regarding the provision or non-provision of health services which are excluded from the Compulsory Health Plan. The revised data that analyze, within a temporary scenario, the performance of CTC, confirm that the amount of recoveries on the provision of excluded technologies is high, especially oncology-related ones, and that the process to authorize services is delayed. This suggests the possibility of creating a procedure that guarantees these services in a shorter period of time and through ordinary different procedures so that writ of protection is avoided.