Francisco J. Yepes

Public Health

MD, MSc, Dr. PH
13.87

Publications

  • Iouri Gorbanev · Sandra Agudelo-Londoño · Francisco J. Yepes

    No preview · Article · Sep 2015
  • Iouri Gorbanev · Ariel Cortés · Sandra Agudelo · Francisco J. Yepes
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    ABSTRACT: O objetivo foi explorar os determinantes para a não implementação dos Grupos de Diagnósticos Homogêneos (GDH) em hospitais colombianos. Realizou-se um estudo de caso qualitativo para analisar as percepções dos diretores de seis hospitais com e sem GDH em Bogotá. A teoria de difusão da inovação foi o fundamento teórico da entrevista aplicada. Os diretores tiveram percepções similares em relação aos determinates. Ainda que os GDH tenham sido percebidos como positivos, foram encontrados obstáculos para sua implementação, tanto em nível organizacional quanto em nível institucional. Concluiu-se que sem uma política pública a probabilidade de programar GDHs na Colômbia, no futuro, é pequena.
    No preview · Article · Sep 2015 · Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública
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    Yuri Gorbaneff · Ariel Cortes · Sergio Torres · Francisco J. Yepes
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    ABSTRACT: The paper examines the ability of the transaction cost theory to explain the incentives in the health chain. A case study was conducted on CPS, a health insurer in Bogota. CPS moves in the environment of high transaction costs, and uses the hybrid form of governance at outpatient level, which is according to the theory. At hospital level, despite high uncertainty, the market is used as a form of governance, which makes it difficult to relate payments to hospital performance. The paper concludes that the transaction costs theory partially explains the configuration of incentives.
    Preview · Article · Sep 2013 · Estudios Gerenciales
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    Francisco J Yepes

    Full-text · Article · Jun 2013 · Revista Gerencia y Politicas de Salud
  • Yuri Gorbaneff · Ariel Cortes · Sergio Torres · Francisco Yepes
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    ABSTRACT: Objective To evaluate the ability of transaction costs theory to explain incentives in the health care chain.
    No preview · Article · Nov 2011 · Gaceta Sanitaria
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    Iouri Gorbanev · Ariel Cortes · Sergio Torres · Francisco Yepes
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    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.
    Preview · Article · Oct 2011 · Revista de salud publica (Bogota, Colombia)
  • Yuri Gorbaneff · Ariel Cortes · Sergio Torres · Francisco Yepes
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    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.
    No preview · Article · Sep 2011 · Gaceta Sanitaria
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    Francisco J. Yepes
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    ABSTRACT: Since health reform began in Colombia, deliveries assisted by qualified personnel in hospitals have risen to 90.7 per cent and 93.5 per cent of expectant mothers are cared for through prenatal monitoring. Mandatory insurance coverage and health spending have both increased. Nevertheless, advances in the reduction of maternal mortality obtained prior to the reforms (1995) have ceased and deteriorated. Official figures for 2007, not corrected for underreporting,1 show a maternal mortality ratio of 75.6 deaths per 100,000 live births. This figure does not reflect the marked disparities among regions and population groups where maternal mortality ratios reach close to 200 deaths per 100,000 live births. In 2004, the Ministry of Social Protection responsible for health in Colombia established an “Action Plan” which has had very poor results. The plan is extremely inadequate because of the very limited coverage of regional entities by insuring agencies.
    Full-text · Technical Report · Oct 2010
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    Francisco José Yepes Luján

    Full-text · Article · Jun 2010 · Revista Gerencia y Politicas de Salud
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    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
    Full-text · Book · Mar 2010
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    Full-text · Article · Jan 2010
  • Eliana Martnez-Herrera · Ruben Dario Gmez-Arias Sr · Francisco Jos Yepes-Lujan Sr
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    ABSTRACT: The Colombian Network for Research on Policy and Health Systems (CNRPHS) is a project which involves academicians and policymakers in five regions around the country. Its work aims to close the gaps that exist among researchers, policy makers and civil society organizations, developing capabilities for the strengthening and support of essential public health functions and for the achievement of the Millennium Development Goals. CNRPHS promotes the idea of Social Knowledge Management (SKM) in Public Health and encourages analysis among health stakeholders on a local, regional and national level. The SKM model contributes to equitable social development as it recognizes the impact that science and technology have on economic growth and sustainable human development, in future scenarios where the well-being of people is ever more dependent on the production, distribution and equitable utilization of knowledge. CNRPHS bases its activities on cooperative, interdisciplinary and inter-institutional work which intend to enhance the use of informed evidences by decision makers providing communication tools that allow them to interact with investigators. Communication is a decisive element that can positively influence the criteria for decision-making. The paper "Systematization of experiences in the development of policies for public health research´s CNRPHS" was produced by the Pan American Health Organization /World Health Organization with support provided by the United States Agency for International Development's (USAID) Office of Regional Sustainable Development which belongs itself to the Office for Latin America and The Caribbean. It is currently available online at www.lachealthsys.org. This paper shows the link between public health and health outcomes throughout the production, distribution, valuation, appropriation and application of knowledge, carried out by different social agents. The intentions of these one is to improve the understanding and solution of priority problems in each region, especially the reduction of poverty and inequity, through the use of knowledge translation.
    No preview · Conference Paper · Apr 2009
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    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.
    Full-text · Article · Feb 2008 · Cadernos de Saúde Pública
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    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.
    Full-text · Article · Jan 2008 · Cadernos de Saúde Pública
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    Manuel Ram�rez · Francisco Yepes · Claudio Karl
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    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.
    Full-text · Article · Jan 2006
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    Manuel Ramirez · Andrés Zambrano · Francisco José Yepes · Jóse Guerra
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    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.
    Full-text · Article · Aug 2005
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    Francisco José Yepes L. · Roberto Gutiérrez P.

    Full-text · Article · Jan 2004
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    Barbara McPake · Francisco Jose Yepes · Sally Lake · Luz Helena Sanchez
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    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.
    Full-text · Article · Jul 2003 · Health Policy and Planning
  • Francisco Yepes

    No preview · Chapter · Jan 2000
  • Yepes Luján Francisco José · Sánchez Gómez Luz Helena

    No preview · Article · Jan 2000 · Revista Panamericana de Salud Pública

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