The case of enteral nutritional support tube in Colombia: Problems institutional coordination

Abstract

INTRODUCTION: this paper examines the case of prescription enteral nutritional support tube in Colombia, analyzed from the perspective of the Social Security System in Health, and explained as the result of a problem of institutional coordination. The role and incentives of different actors are identified and shown how the interaction of these discourages the use of enteral nutrition in cases where it is necessary, with corresponding clinical effect for the patient and increased cost for the system.

METHODS: analysis of the effects it may have in clinical practice the problem of institutional coordination of regulators in the country, analyze their origin and the incentives and interests of the various stakeholders, prior synthesis of the relevant literature review. The search was conducted in the following databases: PubMed, Medline, and Embase ScienceDirect.

CONCLUSIONS: the current situation of enteral nutritional support in Colombia is the result of a suboptimal equilibrium, resulting from a problem of institutional coordination that can only be solved when the agents to look beyond their local incentives, and nutritional support is a key component of hospital care and constitutes a means to the end: the health of the population served.