Colombia healthcare progressing but could do better

Colombia has significantly improved its health but should focus on improving efficiency and quality. New OECD report – almost every Colombian now has access to health care.

Colombia has significantly improved its health system over the past 20 years, leading to a rise in life expectancy and a fall in infant mortality. To maintain its ambition of universal, high-quality health care, Colombia should now focus on improving efficiency and strengthening financial sustainability, according to a new OECD report.

The OECD Review of Health Systems: Colombia says that almost every Colombian now has access to health care, with coverage nearly quadrupling from 23.5% of the population in 1993 to 96.6% in 2014.

Health insurance coverage increased most rapidly among the poorest 20% of the population (from 4% in 1993 to 89%) and in rural areas (from 6.6% in 1993 to 92.6%).

All Colombians have access to the same health care services and have good financial protection from excessive health care spending if they get sick. Out-of-pocket expenditure paid by patients is only 14% of total health spending. This is one of the lowest proportions in Latin America and is lower than the OECD average of 19%. Unmet health care needs and waiting times for medical appointments have been significantly reduced.

Health insurers in Colombia have not yet developed into effective and efficient purchasers of health care services, according to the report. Payments to doctors, clinics and hospitals should increasingly reward health care quality and good outcomes, rather than volumes of health service provided.

Despite important achievements in recent years, the Colombian health sector still faces important challenges. The focus now needs to be on improving quality, efficiency and sustainability. The report recommends that Colombia work towards developing a stronger performance and accountability management for health insurers. More demanding performance management is equally needed for clinics, hospitals and other health care providers.