Exploratory analysis of the impact of quality management practices in a provider network services mother child health care in a middle-income economy

摘要

Health systems in some Latin American experience, at present, important aimed at raising the efficiency, effectiveness and efficiency of its operation reforms. The health sector in Colombia is developing a transformation agenda that will allow increasing the accessibility, quality and efficiency by providers of public and private health services, to achieve meet the demand of the insured and uninsured population and increase quality in care, so that they succeed in improving health indicators. In this sense, the main goal is to ensure access, optimize the use of resources and improve the quality of services provided to the population (Social M. d. 2005). This article aims to present how the level of implementation of quality practices in a network of provision of maternal childcare, has an impact on health outcomes and user satisfaction. The exploratory study focused on the analysis of the implementation of quality models in the process of maternal and childcare network under consideration of the tax regime. For its development the SIPOC methodology that allowed us to characterize the network under study, the Delphi method for carrying out semi-structured interviews to a group of experts, interviews were based on the integration of structure, process and results applied, attributes health networks according to PAHO (Pan American Health Organization), quality models (ISO standards and accreditation) and the guidelines of the National Policy. As a result, the network under study is at a medium level of articulation, indicating that processes are planned and developed in only part of the actors who make it up, the level of implementation of quality practices indicates that 20 lines studied mostly do not have a systemic development, break points in the network service provider, lack of internalization of schemes of measurement and analysis of data, strategic alignment, emerging knowledge management and basic schemes are identified for Continuous improvement. In addition, the service delivery network, lacks information systems containing all the key data of the users, a cornerstone for ensuring the traceability of medical records, maintain operational control of the network, and enable the Ministry of Health found progress in establishing programs within their management plans and the impact on the results on health indicators and user satisfaction.