BTN News: Colombia’s healthcare system is experiencing a surge in public dissatisfaction, as evidenced by a sharp rise in legal actions and formal complaints in 2024. According to a recent report by the think tank Asà Vamos en Salud, the first four months of 2024 have seen a dramatic increase in the number of tutelas (legal claims demanding healthcare rights) and Petitions, Complaints, Claims, and Suggestions (PQRS). These trends highlight the growing challenges and inefficiencies within the system, sparking concern about the sustainability of healthcare services and the potential erosion of public trust.
The report reveals that 84,445 tutelas were filed in the first four months of 2024, marking a staggering 42.2% increase compared to the same period in 2023, when 59,371 tutelas were submitted. Meanwhile, PQRS complaints rose by 11%, reaching 505,991 cases. The increase in these figures suggests not only a deterioration in service delivery but also an escalating level of frustration among patients and their families.
Former Health Minister Augusto Galán Sarmiento, who currently leads Asà Vamos en Salud, attributes this uptick to ongoing issues in scheduling appointments, timely delivery of medications, and the execution of medical procedures. He emphasizes that these problems stem from deeper financial constraints that have been plaguing the healthcare system since last year, leading to further structural deterioration.
Supporting this view, the Colombian Association of Comprehensive Medical Insurance Entities (Acemi), which represents major contributory health insurance providers (EPS), concurs with the findings. Their analysis of the Ministry of Health’s recent report shows a consistent rise in both tutelas and PQRS, with cases jumping from 156,000 in 2022 to 198,000 in 2023—a 26.5% increase. This trend mirrors pre-pandemic levels of healthcare complaints, with 55% of the grievances originating from those under the contributory regime and the remainder from the subsidized regime.
The surge in complaints and legal claims is seen as a direct consequence of the financial and operational struggles within the healthcare system. Acemi has expressed urgent concern, calling for immediate measures to address the growing crisis. Their warning echoes across social media, emphasizing the need for swift action to prevent further deterioration.
A deeper dive into the data provided by Asà Vamos en Salud underscores the severity of the situation. The report highlights a 49.7% increase in tutelas related to unmet medical procedures, a 77.5% spike in claims for undelivered medications, and a 70.2% rise in complaints about delayed appointment scheduling. These figures point to significant delays in critical healthcare services, which could have dire consequences for patients.
According to the observatory, these delays are not merely a temporary glitch but rather indicative of a systemic problem. Prolonged wait times for appointments, a shortage of essential medications, and long queues for critical procedures have become alarmingly common. If left unaddressed, these issues could lead to a complete collapse in public confidence in the healthcare system, widening the gap in access to essential health services.
The Ministry of Health’s 2022 report outlines the primary reasons patients resort to legal actions to enforce their rights. These include the postponement of authorized medical procedures (26%), delays in scheduling appointments with specialists (24%), requests for services not covered by the Capitation Payment Unit (UPC) or MIPRES (13%), slow delivery of authorized medications (12%), and delays in providing services, medications, and technologies prescribed by MIPRES (5%).
The worsening scenario is further highlighted by the Superintendencia Nacional de Salud’s most recent data. In May 2024 alone, 146,002 PQRS complaints were registered, reflecting a 15.51% increase from the same month in 2023. This upward trend is most pronounced among EPS providers that have been under government intervention since last year, raising serious concerns about the efficacy of these interventions.
One particularly troubling example is the Nueva EPS, which has seen a staggering 169% increase in complaints—from 7,262 in May 2023 to 19,546 in May 2024—following its government intervention in April 2024. Julio Alberto Rincón, the intervention agent for Nueva EPS, acknowledges the challenges and notes that efforts are underway to revamp the service delivery model. However, he cautions that these changes will take time to yield tangible results.
Similarly, Sanitas, another major EPS provider that was intervened in April 2024, reported a 51% increase in complaints, rising from 11,877 in May 2023 to 18,050 in May 2024. The Servicio Occidental de Salud (S.O.S.) also saw a 15% increase in complaints during the same period.
In response, government-appointed agents have embarked on a nationwide tour, meeting with healthcare leaders, secretaries of health, and representatives of both public and private service networks. Their goal is to implement measures that will address the root causes of these complaints and ensure timely, comprehensive, and high-quality healthcare services for all.
The situation remains dire, with many unresolved complaints still pending, particularly in regions like Cali, where 13% of the nation’s PQRS cases originate. The Superintendencia Nacional de Salud has pledged to monitor these efforts closely and ensure that the necessary corrective actions are taken to restore confidence in the system.
In conclusion, the sharp increase in legal claims and complaints reflects a healthcare system under significant strain. Without urgent intervention and a comprehensive strategy to address these issues, the crisis could deepen, leading to further public dissatisfaction and potential long-term damage to the nation’s healthcare infrastructure. The coming months will be critical in determining whether the system can adapt and improve or whether it will continue to deteriorate, leaving millions of Colombians struggling to access the care they need.
