Evolution of the Concept of Risk Management in the General Social Security Health System: A Narrative Review (2002-2022)

Abstract

Introduction:

The Health Risk Management-HRM approach adopted by Colombia is aimed at enhancing the health status of its populace. Nonetheless, prior to 2015, there were no explicit guidelines or protocols for its execution, resulting in the absence of a framework for the actors of the Healthcare System to provide services using the methodologies and techniques of the HRM.

Methods:

To assess the advancement of the Health Risk Management concept, a Narrative Review was conducted, utilizing the data available in MEDLINE and the repositories of the Colombian Ministry of Health and Social Protection, the National Institute of Health, the Bank of the Republic, the Colombian Association of Medicine Insurance Companies-ACEMI, and the National Health Superintendency.
Results:

MEDLINE uncovered a total of 4019 articles, of which 44% focused on HRM as Clinical Management, 15% on managing physical risks in healthcare workers, pharmacovigilance, and managing Chronic Non-Communicable Disease. The remaining 41% attributed it to the safety of individuals with mental illnesses. When exploring Colombian repositories, the HRM had a more systemic scope, involving insurers, healthcare providers, and territorial entities.

Conclusion:

The Ten-Year Public Health Plan 2012-2021 was the initial document to introduce the concept of HRM. The strategic framework (the health policy and care model) was established in 2016 when the Colombian Ministry of Health and Social Protection mandated the implementation of regulatory guidelines for systemic health risk management, 23 years after the enactment of Law 100.