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Selección adversa en el régimen contributivo de salud: el caso de la EPS de Susalud

Author

Listed:
  • Johanna Vásquez Velásquez
  • Karoll Gómez Portilla

Abstract

Resumen: El mercado de seguro de salud presenta fallas derivadas de la existencia de información asimétrica. En el caso particular de selección adversa, los individuos tienen mayor información para predecir mejor que el asegurador su estado de salud futuro de modo que se autoseleccionan en el plan que mejor se ajuste a su probabilidad esperada de uso de servicios, generándose una mala distribución del riesgo. De acuerdo a lo anterior, esta investigación centra su análisis en identificar la existencia de selección adversa asociada a la compra del seguro de salud en el régimen contributivo colombiano y se analiza si dicho fenómeno es impulsado por la calidad de los servicios ofrecidos por las empresas aseguradoras. Para esto, se construyó el panorama general del régimen contributivo de salud y la posible selección adversa existente en él a través de la lectura y análisis de 2 encuestas nacionales sobre calidad de los servicios de salud y la caracterización del 80% de la población afiliada. También se realizó un análisis de caso, la EPS de Susalud, donde por métodos cualitativos y cuantitativos se construyeron indicadores de medidas estructurales de calidad y la valoración que hacen los usuarios de la calidad del seguro comprado a Susalud. Los resultados parecen indicar que las senales de calidad enviadas por la EPS de Susalud están siendo captadas, en buena medida, por los usuarios potenciales de selección adversa, por lo tanto, hacen una elección racional ya que utilizan la mayor parte de la información disponible para formar su evaluación de calidad al afiliarse a la EPS

Suggested Citation

  • Johanna Vásquez Velásquez & Karoll Gómez Portilla, 2004. "Selección adversa en el régimen contributivo de salud: el caso de la EPS de Susalud," Borradores del CIE 3489, Universidad de Antioquia, CIE.
    • Handle: RePEc:col:000099:003489
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    References listed on IDEAS

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    More about this item

    Keywords

    economía de la información; selección adversa; seguro de salud;
    All these keywords.

    JEL classification:

    • D8 - Microeconomics - - Information, Knowledge, and Uncertainty
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies

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