Proposal of a Knowledge Management Model for Complex Systems: Case of the Supervision and Control Subsystem of the Colombian Health System.

BACKGROUND: Considering regulatory, supervision, and control health policy, an innovative knowledge management model is proposed for the Colombian health system, which is recognized as a complex system. METHODS: A model is constructed through a comparative analysis of various theoretical and conceptual frameworks, and an original methodology is proposed based on an analysis of the macroprocesses of the Supervision and Control System (SSC) of the Colombian General Social Security System in Health (SGSSS). After formulating hypotheses and conceptual references, information errors are determined within the different macroprocesses of the SGSSS, including those of governance and the SSC. RESULTS: The risks of generating duplicate, wrong, hidden, or non-existent information arise when the associated regulations need more specificity to be applied in all cases, thus leading to the risk of different interpretations by some actors. In this way, it is possible to hinder the generation of unified information, as there is no clarity as to who is responsible for the generation or creation of certain data. CONCLUSIONS: The proposed model is characterized by its flexibility and adaptability, integrating several processes that can be executed simultaneously or cyclically (depending on the system's needs) and allowing for the generation and feedback of knowledge at different stages, with some processes simultaneously executed to complement each other.

Revisión de los conceptos de territorio, población y salud en el contexto colombiano / Review of the concepts of territory, population and health in the Colombian context

Como parte del proyecto de investigación Aplicabilidad de las redes integradas de servicios de salud se revisan los conceptos de territorio, población y salud, como asectos para tener en cuenta en la planeación de los servicios de salud. El territorio se constituye en una unidad dinámica y homogénea en relación con la población que lo habita, y como fruto de las interacciones entre los habitantes y su entorno físico, económico y social se desarrolla una cultura y se logran diversos grados de bienestar. La población, entendida como un conglomerado organizado de seres humanos, conceptualiza la salud y manifiesta sus necesidades y expectativas relacionadas según la cultura imperante en un territorio.Esta puede expresarse desde no estar enfermo hasta considerar a la salud exigible, como un derecho relacionado con las condiciones de vida digna. Las instituciones formales o informales en cada territorio también son expresión de la cultura de dicha población y de la capacidad del Estado para organizarlas en busca del logro de las mejores condiciones de bienestar de sus habitantes. En Colombia se reconocen las diferencias regionales como elementos para considerar en los planes de desarrollo y se pueden conformar unidades territoriales diferentes a las divisiones político-administrativas tradicionales. En el caso del sector salud en el país, la organización del sistema de manera independiente de los territorios logra una mejoría en el aseguramiento de salud; pero, a su vez, origina dificultades en materia de salud pública y de acceso en algunos servicios críticos como la salud perinatal.

As part of the Applicability of the Integrated Health Services Networks research Project, the concepts of territory, population and health are reviewed, as elements to be considered in the planning of health services. Territory is constituted in a dynamic and homogeneous unit in relation to the population that inhabits it and, as a result of interactions between people and their physical, economic and social environment, a culture is developed and different degrees of wellness are achieved. Population, understood as an organized cluster of human beings, conceptualizes health and expresses their needs and related expectations according the prevailing culture in a territory. This can be expressed from not being sick to considering it enforceable as a right related to decent living conditions. Formal and informal institutions in each region are also an expression of the culture of said population and the state’s ability to organize them in search of the highest standards of welfare for its inhabitants. In Colombia, regional differences are recognized as elements to be considered in the development plans and different territorial units from the traditional political-administrative divisions can be formed. In the case of the country’s health sector, the organization of the system independently from the territories achieves an improvement in health insurance; however, at the same time it causes difficulties in public health and access to some critical services such as perinatal health.