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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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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.