(You may be interested: Specialists launch alert for new closures in pediatric services in Medellín).
Since 2020, the National Union of Pediatricians of Colombia (Sicolped) has been registering the sustained closure of pediatric, gynecological-obstetric and pediatric intensive care units. The problem is that in these services, which are of a second level of complexity, in most cases the pathology that generates hospitalization is resolved with few inputs, which leaves low profitability for the clinics and their investors.
In the last three years alone, the figures indicate that 22 specialized units have been closed, with Antioquia being the most affected, with 9 closures in Medellín, one closure in Bello, one in Caldas, and another in Itaguí. In Bogotá there have been two closures and in Cali another two.
The Alma Mater Hospital, northeast of Medellín, also ceased pediatric care during the last week. From the IPS they explained to this newspaper that it is a temporary closure while the possibility of providing highly complex services to children is evaluated. However, they indicated that at the moment they do not have an estimated date on which the restart of operations can take place.
The Colombian Society of Pediatrics (SCP) had already ruled on the subject a few days ago, requesting an immediate meeting with the Minister of Health, to find solutions to the problem and urging that the provision of services for minors in the country not be governed Just for economic reasons.
“In recent years, this problem has been worsening in a worrying way, justified by the fact that these beds do not generate sufficient economic profitability. It is imperative to emphasize that this purely financial approach ignores the incalculable value of the health and well-being of our nation’s children and adolescents.
The government is already aware of the problem. The Minister of Health, Guillermo Alfonso Jaramillo, who is a pediatrician, assured that, in fact, as a doctor he himself had already suffered from this problem of closing pediatric units in a clinic where he worked a few years ago. This, due to lack of profitability.
“This has been a constant for many years. When I was Secretary of Health of Bogotá I had to have many encounters, even unsatisfactory ones, with clinics and hospitals. And at the same time with some vertical integrations of the EPS, because it turns out that there are services that are not profitable, unfortunately”, assured the official.
According to Jaramillo, the problem is that the Ministry does not have the capacity to order private clinics to open services that do not work for them economically speaking, therefore, as a solution, the head of the health portfolio suggests that it is necessary to strengthen the capacity of public hospitals .
“When a pediatric ward or a pediatric intensive care unit in a private entity closes, unfortunately we do not have a way to force that for-profit company to maintain a service that does not make them profitable. What is happening? We have to strengthen public hospitals, we have to finance them with everyone’s resources. And that’s what we’re going to do. We are going to support hospitals that are interested in improving the quality of care for our children and open those wards,” Jaramillo said.
The minister pointed out that they have already started with actions in this regard, ordering the opening of a new pediatric unit at the Buenaventura hospital. “I ordered the manager of the Buenaventura hospital to open a Pediatric Care Unit for me and we are going to support him to open it. That is what we are going to do from the Ministry of Health”, highlighted the official.
“The low cost of drugs, tests and procedures makes it unprofitable. In children there is not as much volume of procedures as in adults, proportionally, because they do not require as many cardiovascular interventions as adults, and cancer is less frequent in children”, points out Lancheros.
The doctor also emphasizes that the drop in births in Colombia has not been a factor that has decreased demand, but what has happened is that patients who previously attended specialized pediatric services have now moved to other clinical areas. According to the pediatrician, what this is causing is that children “end up overcrowded” in Emergency Units, or in spaces that are not designed for proper treatment.
But women are also affected by this problem, since they can be faced with scenarios of obstetric violence in childbirth care by not being attended in a specialized area prepared for it.
For her part, Clemencia Mayorga, former president of the Colombian Society of Bogotá Regional Pediatrics and Sicolped, points out that what is required is that the Government offer a subsidy to the supply of pediatric services in Colombia.
“We are asking the national government, specifically the Ministry of Health, to solve this issue in two ways: the first is that hospitals, public and private, require a supply subsidy to make these services sustainable for them. We need economic resources that guarantee that clinics and hospitals can continue to offer their pediatric service. And second, we are asking for an administrative act, via decree, to regulate those conditions of authorization of what a closure of a pediatric unit should be like, so that the population is not exposed to a closure of services from one moment to another ”, assures the pediatrician.
Mayorga is concerned that the country has two respiratory infection peaks, the first between March and June and the second between mid-September and November. The problem is that with the increase in the closures of pediatric units, those who would end up being affected in the end are the children, who would not have adequate spaces for their care.
“Our concern is how we are going to deal with this second peak of acute respiratory infection with emergency services that cannot locate patients for hospitalization and that, therefore, are going to be in serious conditions, putting the health of children at risk” , says Mayorga.
The problem is that the closures continue to grow, and meanwhile, added to the deficit, the loss of pediatric beds worsens the situation for babies, children and women who require care that, although it is of the highest quality, economically leaves very little profit.
