<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112016000600415</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2016.05.008</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Encuesta de acceso a servicios de salud para hogares colombianos]]></article-title>
<article-title xml:lang="en"><![CDATA[Health services access survey for Colombian households]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arrivillaga]]></surname>
<given-names><![CDATA[Marcela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aristizabal]]></surname>
<given-names><![CDATA[Juan Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[Mauricio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Estrada]]></surname>
<given-names><![CDATA[Victoria Eugenia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Pontificia Universidad Javeriana Facultad de Ciencias de la Salud Departamento de Salud Pública y Epidemiología]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<volume>30</volume>
<numero>6</numero>
<fpage>415</fpage>
<lpage>420</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112016000600415&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112016000600415&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112016000600415&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo: Diseñar y validar una encuesta de acceso a servicios de salud dirigida a hogares en Colombia para aportar una herramienta metodológica de país que permita ir acumulando evidencia sobre las condiciones de acceso real que tiene la población colombiana.  Método: Se realizó un estudio de validación con personas expertas y prueba piloto aplicada en el municipio de Jamundí, en el departamento del Valle del Cauca, Colombia. Se realizó un muestreo probabilístico, polietápico, estratificado y por conglomerados. La muestra final fue de 215 hogares.  Resultados: La encuesta quedó conformada por 63 preguntas distribuidas en cinco módulos: perfil sociodemográfico del jefe/a del hogar o adulto/a informante, perfil socioeconómico del hogar, acceso a servicios preventivos, acceso a servicios curativos y de rehabilitación, y gasto de bolsillo en acceso. En términos descriptivos, la promoción de servicios preventivos solo alcanzó valores del 44%; el uso de estos servicios siempre fue mayor, en especial en los grupos del primer año de vida y hasta los 10 años. Para los servicios de urgencias y hospitalización, la percepción de atención de la necesidad estuvo entre el 82% y el 85%. No obstante, hubo percepción de mala y muy mala calidad de la atención hasta en un 36%. Por su parte, la oportunidad de la atención de consulta médica general y con especialista presentó demoras.  Discusión: La encuesta diseñada es válida, relevante y representativa del constructo acceso a servicios de salud en Colombia. En términos empíricos, la prueba piloto mostró debilidades institucionales en un municipio del país, indicando además que la cobertura en salud no significa acceso real y efectivo a los servicios.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective: The aim of this study was to design and validate a health services access survey for households in Colombia to provide a methodological tool that allows the country to accumulate evidence of real-life access conditions experienced by the Colombian population.  Methods: A validation study with experts and a pilot study were performed. It was conducted in the municipality of Jamundi, located in the department of Valle del Cauca, Colombia. Probabilistic, multistage and stratified cluster sampling was carried out. The final sample was 215 households.  Results: The survey was composed of 63 questions divided into five modules: socio-demographic profile of the head of the household or adult informant, household socioeconomic profile, access to preventive services, access to curative and rehabilitative services and household out of pocket expenditure. In descriptive terms, the promotion of preventive services only reached 44%; the use of these services was always highest among children younger than one year old and up to the age of ten. The perceived need for emergency medical care and hospitalisation was between 82% and 85%, but 36% perceived the quality of care to be low or very low. Delays were experienced in medical visits with GPs and specialists.  Discussion: The designed survey is valid, relevant and representative of access to health services in Colombia. Empirically, the pilot showed institutional weaknesses in a municipality of the country, indicating that health coverage does not in practice mean real and effective access to health services.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Accesibilidad a servicios de salud]]></kwd>
<kwd lng="es"><![CDATA[Servicios preventivos de salud]]></kwd>
<kwd lng="es"><![CDATA[Prestación de atención en salud]]></kwd>
<kwd lng="es"><![CDATA[Colombia]]></kwd>
<kwd lng="en"><![CDATA[Health services accessibility]]></kwd>
<kwd lng="en"><![CDATA[Preventive health services]]></kwd>
<kwd lng="en"><![CDATA[Delivery of health care]]></kwd>
<kwd lng="en"><![CDATA[Colombia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Uribe]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
</person-group>
<source><![CDATA[Las contiendas por las reformas de la salud en Colombia, 1990-2011: Nacimiento y "declive" de un modelo de mercado para la salud]]></source>
<year>2011</year>
<publisher-loc><![CDATA[España ]]></publisher-loc>
<publisher-name><![CDATA[EAE Editorial Academia Española]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Visión comprensiva y crítica de los modelos conceptuales sobre acceso a servicios de salud, 1970-2013]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Arrivillaga]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Borrero]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<source><![CDATA[Cad Saúde Pública]]></source>
<year>2016</year>
<volume>32</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>e00111415</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="">
<source><![CDATA[Encuesta Nacional de Salud de España]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="">
<source><![CDATA[The National Health and Nutrition Examination Survey]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gutiérrez]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Rivera-Dommarco]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Shamah-Levy]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<source><![CDATA[Encuesta Nacional de Salud y Nutrición 2012. Resultados Nacionales]]></source>
<year>2012</year>
<publisher-loc><![CDATA[Cuernavaca, México ]]></publisher-loc>
<publisher-name><![CDATA[Instituto Nacional de Salud Pública]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Access to healthcare among working aged Hispanic adults in the United States]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Durden]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Hummer]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<source><![CDATA[Soc Sci Q]]></source>
<year>2006</year>
<volume>87</volume>
<page-range>1319-43</page-range></nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[An evaluation of access to health care services along the rural-urban continuum in Canada]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sibley]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Weiner]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[BMC Health Services Research]]></source>
<year>2011</year>
<volume>11</volume>
<page-range>20</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Equity in maternal health in South Africa: analysis of health service access and health status in a national household survey]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wabiri]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Chersich]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Zuma]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<source><![CDATA[Plos One]]></source>
<year>2013</year>
<volume>8</volume>
<page-range>e73864</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Equidad en el acceso a servicios de salud en Antioquia, Colombia]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mejía]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Tamayo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Salud Pública]]></source>
<year>2007</year>
<volume>9</volume>
<page-range>26-38</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Measuring equity in access to health care]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Waters]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<source><![CDATA[Soc Sci Med]]></source>
<year>2000</year>
<volume>51</volume>
<page-range>599-612</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Determinantes del uso de los servicios de salud materna en el Litoral Pacífico Colombiano]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aguado]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Girón]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Osorio]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Latinoamericana Ciencias Soc Niñez y Juv]]></source>
<year>2007</year>
<volume>5</volume>
<page-range>1-36</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Acceso a los servicios preventivos en los regímenes contributivo y subsidiado de salud en un barrio estrato dos de la ciudad de Cali]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Zapata]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Aristizábal]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Gerenc Polit Salud]]></source>
<year>2011</year>
<volume>10</volume>
<page-range>153-75</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[A survey of access to medical services in nursing and residential homes in England]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Glendinning]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Jacobs]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Alborz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Br J Gen Pract]]></source>
<year>2002</year>
<volume>52</volume>
<page-range>545-8</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Access to specialty care and medical services in community health centers]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cook]]></surname>
<given-names><![CDATA[NL]]></given-names>
</name>
<name>
<surname><![CDATA[Hicks]]></surname>
<given-names><![CDATA[LS]]></given-names>
</name>
<name>
<surname><![CDATA[Malley]]></surname>
<given-names><![CDATA[AJO]]></given-names>
</name>
</person-group>
<source><![CDATA[Heal Aff]]></source>
<year>2007</year>
<volume>26</volume>
<page-range>1459-68</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Listening to rural Hispanic immigrants in the Midwest: a community-based participatory assessment of major barriers to health care access and use]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cristancho]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Garces]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<source><![CDATA[Qual Health Res]]></source>
<year>2008</year>
<volume>18</volume>
<page-range>633-46</page-range></nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Factores que inciden en el acceso de la población desplazada a las instituciones prestadoras de servicios de salud en Colombia]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mogollón]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Vázquez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Cad Saúde Pública]]></source>
<year>2008</year>
<volume>24</volume>
<page-range>745-54</page-range></nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Luces y sombras de la reforma de la salud en Colombia: Ley 100 de 1993]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yepes]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Gerenc Polit Salud]]></source>
<year>2010</year>
<volume>9</volume>
<page-range>118-23</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="">
<collab>Ministerio de Salud y Protección Social</collab>
<source><![CDATA[Estadísticas Prestación de Servicios: Cuadro de Indicadores de Prestación Acceso]]></source>
<year></year>
<publisher-loc><![CDATA[Bogotá (COL) ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Assessing content validity and content equivalence using structural equation modeling]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ding]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Hershberger]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Structural Equation Modeling: A Multidisciplinary Journal]]></source>
<year>2002</year>
<volume>9</volume>
<page-range>283-97</page-range></nlm-citation>
</ref>
<ref id="B20">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Objectifying content validity: conducting a content validity study in social work research]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[McGartland]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Berg]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Tebb]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Social Work Research]]></source>
<year>2003</year>
<volume>27</volume>
<page-range>94-104</page-range></nlm-citation>
</ref>
<ref id="B21">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Validez de contenido y juicio de expertos: una aproximación a su utilización]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Escobar]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Cuervo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Avances en Medición]]></source>
<year>2008</year>
<volume>6</volume>
<page-range>27-36</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
