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OECD Reviews of Health Systems: Colombia 2016

image of OECD Reviews of Health Systems: Colombia 2016

Colombia’s record in extending health insurance and health services to its population is impressive. In 1990, around 1 in 6 of the population had health insurance. Now, nearly 97% do, with greatest expansion occurring amongst poorer households. Likewise, in 1993 out-of-pocket spending made up 52% of total national expenditure on health. By 2006, this had fallen to less than 15%. Although Colombia has high rates of income inequality (with a Gini coefficient of 53.5 in 2012, compared to the OECD average of 32.2), access to health care services is much more equal. In urban populations, for example, 1.8% of children aged less than two years of age are recorded as having received no routine vaccinations, compared to 1.0% of rural children.  Colombia nevertheless faces important challenges to maintain and improve the performance of its health system. This report looks at Colombia’s health care system in detail and offers recommendations on what Colombia can do to ensure accessibility, quality, efficiency and sustainability.

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Assessment and recommendations

Colombia has a well-designed health system, with broadly effective policies and institutions that other countries could learn from and that deserves to be better known internationally. Colombia has achieved financial protection against excessive health care costs for almost all citizens, as well as an equal basket of services for those in and out of formal employment. Insurance coverage has risen rapidly from 23.5% of the population in 1993 to 96.6% in 2014, with individual’s out-of-pocket spending on health care falling from 52% in 1993 to 14.4% of total national spend on health in 2013, one of the lowest figures in the region. Per capita allocation of funds for health care is equal for those in contributory and publicly-subsidised insurance schemes. Annual consumption of health care for those enrolled in contributory schemes, however, appears less equal at USD PPP 834 per year (2013), compared to USD PPP 449 for those enrolled in publicly-subsidised insurance (although the former figure includes transaction costs). Population health parameters are improving rapidly: life expectancy is now 72.1 years for men and 78.5 years for women (2013), around four years less than OECD averages, and infant mortality has fallen from 40 deaths per 1 000 live births (1970) to 12.8 in 2013 (OECD average 4.1).

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