What should be publicly funded in the Colombian health system? A mixed methods study of citizens’ perceptions
Background In recent years, citizens have become more interested and willing to influence health policy decision-making, and governments worldwide are more prone to citizen engagement in such processes. Prioritising which health technologies should be publicly funded is one decision that requires pr...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/1/e085866.full |
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| author | Juan Carlos Velasquez Claudia Marcela Vélez Diana Patricia Díaz-Hernández Pamela Velázquez-Salazar Gilma Hernández-Herrera Daniel Felipe Patiño-Lugo Olga Francisca Salazar-Blanco Leydi Camila Rodríguez-Corredor Viviana María Vélez-Marín Anny Julieth Jaramillo-García |
| author_facet | Juan Carlos Velasquez Claudia Marcela Vélez Diana Patricia Díaz-Hernández Pamela Velázquez-Salazar Gilma Hernández-Herrera Daniel Felipe Patiño-Lugo Olga Francisca Salazar-Blanco Leydi Camila Rodríguez-Corredor Viviana María Vélez-Marín Anny Julieth Jaramillo-García |
| author_sort | Juan Carlos Velasquez |
| collection | DOAJ |
| description | Background In recent years, citizens have become more interested and willing to influence health policy decision-making, and governments worldwide are more prone to citizen engagement in such processes. Prioritising which health technologies should be publicly funded is one decision that requires prudence and consideration of the values and expectations of the people who will be affected by it.Objective To identify and understand the citizens’ perceptions about which health technologies should be publicly funded in Colombia.Design Sequential exploratory mixed methods study; the first was a qualitative embedded case study, and the second was a Q methodology study.Participants 46 citizens were interviewed, and 30 citizens ordered a Q-sample of 45 statements.Analysis Interviews were content analysed. We performed a content analysis of the interviews, and, for the quantitative strand, we performed a principal component analysis and varimax rotation to identify view patterns. We also estimated the z-scores of each statement and the load to each factor. We jointly interpreted both sets of findings.Results We identified two general approaches citizens used to consider public funding of healthcare technologies. One approach endorsed full coverage of all health technologies required by every Colombian. In the second approach, public funding is conditional on the characteristics of the person who needs the technology, their disease/condition, the kind of technology required and the expectation of efficient health system performance. When integrating the results of the Q methodology, we found five patterns of points of view about the public funding of health technologies.Conclusion Colombian citizens consider and balance a range of different factors when making decisions about which health technologies are publicly funded. Citizens not only use technical criteria to decide but also provide the perspective and values of those affected by the decision. |
| format | Article |
| id | doaj-art-eb9b305ab6d04fc6acca0d3e467904ba |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-eb9b305ab6d04fc6acca0d3e467904ba2025-01-21T08:15:09ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-085866What should be publicly funded in the Colombian health system? A mixed methods study of citizens’ perceptionsJuan Carlos Velasquez0Claudia Marcela Vélez1Diana Patricia Díaz-Hernández2Pamela Velázquez-Salazar3Gilma Hernández-Herrera4Daniel Felipe Patiño-Lugo5Olga Francisca Salazar-Blanco6Leydi Camila Rodríguez-Corredor7Viviana María Vélez-Marín8Anny Julieth Jaramillo-García9Facultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, ColombiaFacultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, ColombiaFacultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, ColombiaFacultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, ColombiaFacultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, ColombiaFacultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, ColombiaFacultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, ColombiaFacultad Nacional de Salud Pública, Universidad de Antioquia, Medellin, Antioquia, ColombiaFacultad de Medicina, Universidad de Antioquia, Medellin, Antioquia, ColombiaFacultad Nacional de Salud Pública, Universidad de Antioquia, Medellin, Antioquia, ColombiaBackground In recent years, citizens have become more interested and willing to influence health policy decision-making, and governments worldwide are more prone to citizen engagement in such processes. Prioritising which health technologies should be publicly funded is one decision that requires prudence and consideration of the values and expectations of the people who will be affected by it.Objective To identify and understand the citizens’ perceptions about which health technologies should be publicly funded in Colombia.Design Sequential exploratory mixed methods study; the first was a qualitative embedded case study, and the second was a Q methodology study.Participants 46 citizens were interviewed, and 30 citizens ordered a Q-sample of 45 statements.Analysis Interviews were content analysed. We performed a content analysis of the interviews, and, for the quantitative strand, we performed a principal component analysis and varimax rotation to identify view patterns. We also estimated the z-scores of each statement and the load to each factor. We jointly interpreted both sets of findings.Results We identified two general approaches citizens used to consider public funding of healthcare technologies. One approach endorsed full coverage of all health technologies required by every Colombian. In the second approach, public funding is conditional on the characteristics of the person who needs the technology, their disease/condition, the kind of technology required and the expectation of efficient health system performance. When integrating the results of the Q methodology, we found five patterns of points of view about the public funding of health technologies.Conclusion Colombian citizens consider and balance a range of different factors when making decisions about which health technologies are publicly funded. Citizens not only use technical criteria to decide but also provide the perspective and values of those affected by the decision.https://bmjopen.bmj.com/content/15/1/e085866.full |
| spellingShingle | Juan Carlos Velasquez Claudia Marcela Vélez Diana Patricia Díaz-Hernández Pamela Velázquez-Salazar Gilma Hernández-Herrera Daniel Felipe Patiño-Lugo Olga Francisca Salazar-Blanco Leydi Camila Rodríguez-Corredor Viviana María Vélez-Marín Anny Julieth Jaramillo-García What should be publicly funded in the Colombian health system? A mixed methods study of citizens’ perceptions BMJ Open |
| title | What should be publicly funded in the Colombian health system? A mixed methods study of citizens’ perceptions |
| title_full | What should be publicly funded in the Colombian health system? A mixed methods study of citizens’ perceptions |
| title_fullStr | What should be publicly funded in the Colombian health system? A mixed methods study of citizens’ perceptions |
| title_full_unstemmed | What should be publicly funded in the Colombian health system? A mixed methods study of citizens’ perceptions |
| title_short | What should be publicly funded in the Colombian health system? A mixed methods study of citizens’ perceptions |
| title_sort | what should be publicly funded in the colombian health system a mixed methods study of citizens perceptions |
| url | https://bmjopen.bmj.com/content/15/1/e085866.full |
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