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Welcome to Worldwide Physical Therapy Practice: a focus on Primary Care Physical Therapy

This is a project created by and for the students in the School of Physical Therapy at the University of St. Augustine in St. Augustine Florida. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

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Delivery of Care

In Colombia, the physical therapist diversifies the practice in health services, education, recreation and sports, wellness and in the industry field through the development of research, administration, advisory, consulting and services. Colombian Physical therapists work in hospitals, clinics, private practice, universities and colleges, companies and industries, sports therapy and other services. The physical therapist participates in processes of social transformation through research and services. The main focus of the profession is in rehabilitation, disease prevention and health promotion.
Physical therapists work in the areas of orthopedics, cardio-pulmonary, cardiovascular, occupational health, neurology, public health, sports and physical activity, cosmetic procedures, administration, consulting, alternative therapies, music therapy, oncology, mental health, equine therapy, urogenital and podology.
In recent studies, it was determined that there is 1 physical therapist per 1000 habitants. Additionally, there is 0.31 physical therapists per 1 doctor in Colombia. Physical therapy recognizes the importance of the society and its interaction with health, it reveals the relationship between poverty, work conditions and disease as the key elements that affect the individual’s health. Therefore, the physical therapist can answer the population’s health needs in a global context from the education, research and patient care.

Type of Health System

In Colombia, there are 2 sectors of healthcare: public and private. The public sector is split in the payers and the subsidized ones. The private sector is growing more in the last years, it offers various insurance plans and provides the best care available.

Each Plan has a separate Compulsory Health Plan ("POS" - Plan Obligatorio de Salud) with different coverage for each plan: while the Contributory Plan covers nearly all illnesses and health problems, the Subsidized Plan leaves out a significant amount of illnesses and does not take into account regional differences.

Urban and rural residents experienced significant differences in access to health care, the largest cities Bogota, Medellin and Cali have the most coverage. At the rural level, the best services were delivered by the departments in the coffee growing areas. The non-Andean regions and marginal neighborhoods in medium and small-sized cities get poor quality care.

Colombia’s health care system isn’t perfect, but it’s beginning to attract a lot of outside attention. In a 2012 study of 190 Latin American clinics and hospitals conducted by América Economía magazine, 16 Colombian facilities ranked among the top 40. And medical tourism is becoming a hot industry here. Last year, 50,000 people visited Colombia to take advantage of lower costs on cardiovascular surgery, fertility treatments, dental work, cancer treatments, and cosmetic surgery, spending an estimated $216 million, up from $134 million the previous year.

Payment System

The System for the Selection of Beneficiaries for Social Programs (SISBEN), classifies the people according to their socio-economic level into 6 strata, being stratum 1 homeless people and extreme poverty and stratum 6 the highest level of affluence. According to the survey results, people will be placed in one of the Plans. Those placed in the Contributory Plan (strata three to six) must contribute monthly a certain amount from their salaries to finance the system, while the State covers the costs corresponding to those within the Subsidized Plan (strata one and two). Other organizations called Health Providing Entities (EPS) offer private healthcare, by selling health services packages to the public and contract such services with the healthcare-providing institution. These EPS offer the highest medical attention and priority service to the patient at a much higher cost.

The health care institutions avoid providing health care to poor people who cannot guarantee payment, which therefore leaves the "linked" out of the system (as they are attended to only if payment is given "up front"). Patients are turned into clients and health care centers lack budgets to buy medicines or pay for salaries, surgeries, etc. Furthermore, those affiliated to the Contributory Plan can go to any public or private IPS whereas those affiliated to the Subsidized Plan can only go to old public hospitals.