República de Colombia

POPULATION : 46. 044.611 7.6% over 60 years

51.4 % females48.6 % males

PRIVATEPRE-PAID

CONTRIBUTIVEWorkersEmployees 12.5% salary 38.77%

SUBSIDIZE

Unable to pay for healthSubsidy by Goverment and

contributive 50.59%

COLOMBIAN HEALTH CARE SYSTEM

http://www.paho.orghttp://www.asivamosensalud.org

Before 1990 Health coverage 30.4%Law 100 / 1993 : Achive universal access to social security

DISEASE ESTIMATED NUMBER OF PATIENTS AFFECTED WITH THE DISEASE

PATIENTS IN NEED OF PALLIATIVE CARE

COPD 3.308.082 992.424

Congestive heart failure 206.564 61.969

Neurologic development disorders

597.629 179.288

Cerebrovascular 290.705 87.211

Dementia 191.368 57.410

Epilepsy 150.465 45.139

Peripheral neuropathy 124.170 37.251

Parkinson Disease 68.658 20.597

Craneoencephalic trauma sequelae

211.717 63.515

HIV/AIDS 217.681 65.304

Cancer 460.446 138.133

Chronic kidney disease 15.819 4.745

TOTAL 1.752.986

ESTIMATED OF PATIENTS IN NEED OF PALLIATIVE CARE

PREPOCOL Stud. Chest 2008; 133(2): 343-349. Rev Colomb Cardiol 2009; 16(6):249-255Rev Panam Salud Pública 2003;14(2):104-111.

http://www.unicef.org/spanish/infobycountry/colombia_statistics.html#76 . http://www.cancer.gov.co/documentos/Incidencia/Tabla%202.pdf.

PALLIATIVE CARE EDUCATION

• 3 Postgraduate Programs: – For Anesthesiologist, Family Practice, Oncologist,

Rehab ( 1 year)– For MD,Nurses, psycologist ( 3 years)

• 1Undergraduate Program:-For last year medical students as an obligatory course

PALLIATIVE CARE PROGRAMS

•

CALI

MEDELLIN

BOGOTA

BARRANQUILLA

BUCARAMANGA

VILLAVICENCIO

CARTAGENA

PEREIRA

PASTO

(9 de 32): 28%

Qualitative analysisStrong points:

1. Education

2. Medications

3. Cancer Law

Weak points: 1. No reliable data2. No economical studies3. No Palliative Care Plan4. Not enough people trained5. Not enough PC services

Main dilemmas & challenges

Dilemmas: 1. Is palliative care cost-efective in Colombian Health System

Challenges: 1.Economical studies2.Improve Education3.Access to services and availability of medication 4.Include Palliative care in standars of quality of care