Atención prenatal en las gestantes afiliadas al régimen contributivo y vinculadas en Bogotá, 2005 / Prenatal health care to pregnant women belonging to the taxpayer health care system and to women belonging to the subsidized health care system in Bogota, in 2005

RESUMEN

Introducción: En 2005 se encontraron diferencias en las tasas de mortalidad materna en Bogotá, según la condición de las usuarias en el sistema. Fue ostensiblemente mayor en el régimen subsidiado y, en términos generales, mayor a la observada en ciudades como Medellín y Cali. Objetivo: Describir, comparar y establecer diferencias en la integralidad y oportunidad de los servicios de salud que recibieron las gestantes antes del parto, afiliadas al régimen contributivo y las atendidas como vinculadas en Bogotá, en 2005. Método: Estudio descriptivo de corte transversal. Las categorías utilizadas para la descripción y comparación de los servicios fueron integralidad y oportunidad (inicio de consultas antes del parto). Resultados: Hubo mayor integralidad en la atención de las gestantes afiliadas al régimen contributivo (21,5) que en las vinculadas (4,8). El 100% de las gestantes afiliadas al régimen contributivo (partos de octubre, noviembre y diciembre) empezó consultas prenatales en el primer trimestre y sólo el 50,1%, el 46,2% y el 38%, de las vinculadas, respectivamente, en cada uno de estos meses; en las consultas en el puerperio inmediato de los dos grupos (partos de octubre y noviembre) hubo diferencias significativas. Conclusiones: Existieron diferencias significativas entre los dos grupos evaluados, en integralidad y oportunidad de las atenciones de salud recibidas por las gestantes antes del parto. Palabras clave embarazo, atención prenatal, prevención primaria.

ABSTRACT

Background: Differences were found in 2005 in the maternal mortality rates depending on the status of the users of the System in Bogota. The maternal mortality rate was higher for those inthe subsidized regime, and in general it was greater for Bogota than the rate of other cities such as Medellin and Cali. This is not an isolated case, and is possibly connected with the operation of the Colombian Social Health Care System (SGSSS) and other socioeconomic conditions which influence the health care results. Aim: To describe, compare and establish differences in the integrality and opportunity of health care services received by pregnant women before labor, for those in the contributory system and for those in the subsidized system in Bogota in 2005. Design: A cross-sectional study was conducted, based on the information of the database used by MPS to establish the sufficiency of UPC in 2005 and for women belonging to the subsidized system, as well as the RIPS for the same year. The categories used to describe and compare the services were integrality and opportunity (beginning of the consultations before labor). Results: There was greater integrality in the service rendered to pregnant women belonging to the contributory system (21.5) than the one rendered to those of the subsidized system (4.8). 100% of the pregnant women of the contributory system (labors of October, November and December) started prenatal consultations in the first quarter whereas only 50.1%, 6.2% and 38% of the women in the subsidized system did in each one of these months. Significant differences were found during the immediate puerperium in the consultations for the two groups (labors of October and November). Conclusions: There were significant differences between the two groups assessed regarding the integrality and opportunity of the health careservice received by pregnant women before labor. Keywords Pregnancy, prenatal care, preventive care.