Gasto por procedimiento en la especialidad de cardiología intervencionista en pacientes con enfermedad coronaria del Seguro Social, Seccional Valle del Cauca. Noviembre 2003-diciembre 2004

Abstract

Introduction: Coronary illness affects a high proportion of affiliated with the Seguro Social (ISS) Departamento (=State) Valle del Cauca. This paper describes the costs in the specialty of interventionist cardiology of the Health Promoter Enterprise (EPS) because of this illness among November 2003-December 2004. The costs are larger than the budget of the ISS for this illness. This unbalance inside security social system contemporary in Colombia, that is a contributive regime, affects to the ISS because a high number of affiliated are adults of 45 years. The compensated population of the ISS Valle del Cauca is 423,440 people of which 43% is older 45 years, segment of age that concentrates the risk of coronary illness. Metodology: It is a descriptive study. It analyses the distribution of compensated population by age and sex; besides the payment of ISS Valle del Cauca to the Health Institutions (IPS) in the interventionist cardiology specialty. The information was taken of the register made by the IPS to the Social Secure Institute and crossed with the Individual Registers of Procedures in Health (RIPS) to identify the patients with coronary illness and to rate them in accordance with the International Illness Codes (CIE 10) likewise the book about activities, Processing and Interventions of the Obligatory Health Program (MAPIPOS). Universe: 1,349 processing. The population was 1,103 affiliated patients with the  Seguro Social with coronary illness diagnoses. Analysis and results: The compensated population of ISS represents 9.3% of Valle del Cauca population (4’532,378 inhabitants in the Departamento and 423,400 compensated). Of them 43% are 45 years old or more and are in risk for suffering coronary illness and need medical intervention. The ISS Valle del Cauca paid out to IPS with interventionist cardiology services the total of $5’320,786.046 more of five thousand millions pesos for 1,349 procedures realized to 1103 patients of coronary illness. This money represents 39% of the total budget to general contracting for that period. Conclusions: The Social Secure Valle del Cauca paid 2/5 parts of its budget in health services in procedures of interventionist cardiology during November 2003 to December 2004. The proportion of costs in this kind of intervention is high relating the great compensated population oldest of 45 years (43%) registered in ISS. There is an unbalance in the compensated population in ISS Valle del Cauca because after this age there is a higher concentration of the risk to suffer coronary illness and to need medical intervention. This situation is a threat to the financial stability of ISS Valle del Cauca section.