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publication November 15, 2019

External assessment of quality of care in the health sector in Colombia


The World Bank and International Finance Corporation (IFC) have jointly carried out a systematic assessment of the quality of health care in Colombia. The analysis covers both public and private service provision. It assesses the state of quality of care, as well as related strategies, policies, regulations and capacity to improve quality of care as a condition for the financial sustainability of the health sector. The report presents findings of this assessment as well as recommendations.

Colombia has virtually reached universal health coverage and has also made important progress in promoting a quality agenda across its health care system. Yet, concerns persist that quality of care does not meet the level of public and private investments in the sector or expectations of the population.

To conduct an assessment, the World Bank Group combined its system-wide healthcare quality diagnostic tool that looks at the overall system (regulation, strategy, design etc.) with the IFC’s IQ-Healthcare  tool that assesses quality of care at facility level to create a holistic assessment of quality gaps.  The assessment is based on quantitative analytics, key informant interviews, over 30 visits of public and private healthcare facilities, a review of key policy documents and a survey of health insurance companies.

The government of Colombia endorsed the key recommendations coming out of the report. These include actions to be taken by government, health insurance companies, local health authorities and healthcare providers to:

  • Develop and implement an integrated care model focused on primary health care to support the management of individuals with chronic conditions;
  • Improve accountability and contracting mechanisms to incentivize for quality;
  • Strengthen capacity for continuous quality improvement in the health sector through training, collaboratives, quality campaigns, and communities of practice;
  • Improve the rigor and use of information on quality to stimulate patient choice and benchmarking of healthcare providers;
  • Strengthen policies and regulations for quality: higher certification standards, accreditation for low-complexity hospitals, core curriculum for future healthcare professionals, reform of continuous education, strategies to improve quality in rural geographies including telemedicine.

The implementation of these recommendations will require the engagement of all stakeholders in the sector including health insurance companies, healthcare providers, department level authorities, universities, and patients and communities.

Implementation will be achieved through a variety of policy and regulatory changes currently under consideration, as well as initiatives for improving capacity and on incentives for behavior and cultural change.


Full report (English and Spanish)

Executive Summary (English and Spanish)