Francisco J. Yepes

MD, MSc, Dr. PH
Pontifical Xavierian Universit... · Facultad de Ciencias Económicas y Administrativas

Publications

  • [Show abstract] [Hide abstract]
    ABSTRACT: Describing the extent and forms of use of pay for performance (P4P) in Colombian healthcare. This was a descriptive study based on interviews and surveys of health insurance agency managers in Bogotá, Colombia. The authors relied on transaction cost theory to interpret the results. P4P was found to be used by contribution scheme insurers in an outpatient setting, basically in promotion and prevention; P4P is not being used in a hospital setting. Subsidized scheme insurers do not use P4P. Similarly, P4P is not being used in the case of so called associated users. P4P use in Colombia is limited. Colombian practice only partially validates the transaction costs theory approach to governance model attributes, one of which is incentive intensity.
    Revista de salud publica (Bogota, Colombia) 10/2011; 13(5):727-36.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the ability of transaction costs theory to explain incentives in the health care chain. We performed a case study of CPS, a health insurance company in Bogota (Colombia), which preferred not to publish its name. CPS moves in the environment of high transaction costs and uses the hybrid form of governance at the outpatient level. Incentive intensity, administrative control and the contract all agree with the theory. At the hospital level, the market is used, despite greater uncertainty. Because of the discrete form (1.0) of the incentives and the absence of administrative control, it is difficult for CPS to relate payment to hospital performance. Transaction costs theory explains the configuration of incentives. Another contribution made by this theory to the literature is the criterion to differentiate between the market and the hybrid. We propose that the market uses discrete-type (1.0) incentives, while the hybrid uses continuous, commission-like incentives.
    Gaceta Sanitaria 09/2011; 25(6):450-3. · 1.12 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To evaluate the ability of transaction costs theory to explain incentives in the health care chain.
    Gaceta Sanitaria 01/2011; · 1.12 Impact Factor
  • Source
    Francisco José Yepes Luján
    Revista Gerencia y Políticas de Salud. 06/2010; 9(18):118-123.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Systematic Review (Narrative Synthesis). More than 100 publications in the period 2000 and 2008 were reviewed permitting the identification of positive and negative results of the Colombian Health Reform started by Law 100 of 1993
    1st edited by Centro Internacional de Investigaciones para el Desaarrollo, 03/2010; Mayol ediciones., ISBN: 978-958-8307-86-2
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper analyzes the main advances in health coverage and health services demand in Colombia using the 1997 and 2003 living standards surveys. The study showed an increase in health coverage associated with expansion of the subsidized care system, although a large proportion of the population is still not entitled to health care. The type of entitlement also directly affects the demand for services. There was an increase in preventive medical consultations in 2003 and a decrease in the use medical care for acute illness, due mainly to lack of money. Access to medicines increased from 1997 to 2003, as reflected by a decrease in out-of-pocket expenditure on medicines.
    Cadernos de Saúde Pública 02/2008; 24(1):122-30. · 0.83 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper analyzes the main advances in health coverage and health services demand in Colombia using the 1997 and 2003 living stan- dards surveys. The study showed an increase in health coverage associated with expansion of the subsidized care system, although a large proportion of the population is still not entitled to health care. The type of entitlement also di- rectly affects the demand for services. There was an increase in preventive medical consultations in 2003 and a decrease in the use medical care for acute illness, due mainly to lack of money. Access to medicines increased from 1997 to 2003, as reflected by a decrease in out-of-pocket ex- penditure on medicines.
    Cadernos De Saude Publica - CAD SAUDE PUBLICA. 01/2008; 24(1).
  • Source
    Manuel Ram�rez, Francisco Yepes, Claudio Karl
    [Show abstract] [Hide abstract]
    ABSTRACT: La introducci�n del nuevo sistema de seguridad social en 1993 trajo cambios en las relaciones existentes entre las instituciones colombianas. En el sector salud, el nuevo sistema conllev� a la creaci�n de agentes intermediarios, quienes han desarrollado un papel de importancia en la determinaci�n de los flujos econ�micos del sector y sus participantes. Hasta el momento, pocas investigaciones han establecido estas interacciones, lo que motiv� a este estudio. En este documento se propone una primera aproximaci�n a la construcci�n de estas relaciones en una s�ntesis de la econom�a colombiana, esto es, una matriz de contabilidad social.
    UNIVERSIDAD DEL ROSARIO - FACULTAD DE ECONOM�A, BORRADORES DE INVESTIGACI�N. 01/2006;
  • Source
    Manuel Ramirez, Andrés Zambrano, Francisco José Yepes, Jóse Guerra
    [Show abstract] [Hide abstract]
    ABSTRACT: En este documento se esbozan los principales avances en cuanto a cobertura en salud, demanda de servicios médicos, y percepción del estado de salud en Colombia por medio de la Encuesta de Calidad de Vida de 1997 y 2003. Se encuentra un aumento en la cobertura en salud en la población donde el régimen subsidiado fue el que presentó mayor incremento en cobertura. Aún así existe una gran proporción que no cuenta con aseguramiento. También se evidencia un aumento en la consulta por prevención en 2003 y una disminución de las consultas por falta de dinero. En general el tipo de afiliación la demanda de servicios y el estado de salud autorreportado difieren regiones, formalidad del trabajo y quintiles de ingreso.
    08/2005;
  • Source
    Francisco José Yepes L., Roberto Gutiérrez P.
    Revista Facultad Nacional de Salud Pública. 01/2004; 22(1):147-158.
  • Source
    Barbara McPake, Francisco Jose Yepes, Sally Lake, Luz Helena Sanchez
    [Show abstract] [Hide abstract]
    ABSTRACT: Many countries are experimenting with public hospital reform - both increasing the managerial autonomy with which hospitals conduct their affairs, and separating 'purchaser' and 'provider' sides of the health system, thus increasing the degree of market pressure brought to bear on hospitals. Evidence suggesting that such reform will improve hospital performance is weak. From a theoretical perspective, it is not clear why public hospitals should be expected to behave like firms and seek to maximize profits as this model requires. Empirically, there is very slight evidence that such reforms may improve efficiency, and reason to be concerned about their equity implications. In Colombia, an ambitious reform programme includes among its measures the attempt to universalize a segmented health system, the creation of a purchaser-provider split and the transformation of public hospitals into 'autonomous state entities'. By design, the Colombian reform programme avoids the forces that produce equity losses in other developing countries. This paper reports the results of a study that has tried to track hospital performance in other dimensions in the post-reform period in Bogotá. Trends in hospital inputs, production and productivity, quality and patient satisfaction are presented, and qualitative data based on interviews with hospital workers are analyzed. The evidence we have been able to collect is capable of providing only a partial response to the study question. There is some evidence of increased activity and productivity and sustained quality despite declining staffing levels. Qualitative data suggest that hospital workers have noticed considerable changes, which include greater responsiveness to patients but also a heavier administrative burden. It is difficult to attribute specific causality to all of the changes measured and this reflects the inherent difficulty of judging the effects of large-scale reform programmes as well as weaknesses and gaps in the data available.
    Health Policy and Planning 07/2003; 18(2):182-94. · 3.06 Impact Factor
  • Yepes Luján Francisco José, Sánchez Gómez Luz Helena
    Revista Panamericana de Salud Pública 01/2000; · 0.85 Impact Factor
  • F J Yepes, L Durán-Arenas
    [Show abstract] [Hide abstract]
    ABSTRACT: Health management has become a fashion and it is now common to talk about strategic or service management, or of total quality management applied to health systems. However, all these elements of business management are being translated to health systems without a previous analysis on the implicit health model and the rationality of the prevalent production functions, which can lead to a higher level of efficiency but with an inadequate use of resources. This paper suggests the importance of integrating the advances in management and health sciences and proposes what are considered to be the conceptual basis for the design of a management tool geared to conduct local health systems with effectiveness, efficiency, quality and equity.
    Salud publica de Mexico 01/1994; 36(2):190-9. · 0.94 Impact Factor
  • L Velez, H Zuluaga, F J Yepes
    Educación médica y salud 02/1974; 8(3):279-88.
  • F Yepes
    Educación médica y salud 02/1973; 7(3):305-15.
  • F J Yepes
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper discusses the comparative analysis of health systems, its relative low level of development, its great importance for training health sector leaders and some of the difficulties and limitations for implementing it transnationally. The appropriate understanding of the sociohistorical conditions and the economic and political context are of germane importance for comparative analyses. Moreover, analysis of the financial aspects of health systems, as well as that of the physical or technological infrastructure, of the human resources, or the organizational structure and also of the health levels bring about particular difficulties which need adequate methodological developments.
    Salud publica de Mexico 33(4):392-5. · 0.94 Impact Factor

23 Following View all

35 Followers View all