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March 2014 / Page 1
2012 Demographic Indicators Total Population 1,105,280
Area (km2) 99,633 Population density 10.5 hab/km2
Eligible population for Sumar 461,689
2012 Health Coverage
Population without health
insurance
57.9 %
2012 Infrastructure
Total Public Hospitals 52 # Private health facilities with hospital stay 77
# Primary Health Centers 90 Health providers hired by Sumar 142
PROVINCE OF CHACO
Plan Nacer has been implemented since 2005. Programa SUMAR was first implemented in
August 2012.
March 2014 / Page 2
2012 Morbidity and mortality
Maternal mortality rate 6.8
Infant mortality rate 13.3
Neonatal mortality rate 7.5
Postneonatal mortality rate 5.8
MINISTRY OF PUBLIC HEALTH OF THE PROVINCE OF CHACO
HEALTH ORGANIZATION OF THE PROVINCE The province is organized into 8 health regions and it has 165 health providers: Region I. UMDESOCH
Region II. Center Chaqueña Region III. Oriental Chaqueña Region IV. Southwest
Region V. Impenetrable Region VI. North Region VII. Center West Region VIII. Metropolitan
MINISTER
SUB-SECRETARIATES
• Health
• Management
Coordination and
Control
• Institutional
relationships
• Primary Health
Care
PROGRAMA SUMAR
March 2014 / Page 3
FINAL GOAL
March 2014 / Page 4
TO EMPOWER
HEALTH PROVIDERS
IMPLEMENTED STRATEGIES
March 2014 / Page 5
TO ENCOURAGE AND FACILITATE ACCESS OF
HEALTH PROVIDERS TO THE INFORMATION
TO BUILD AN EFFICIENT ADMINISTRATIVE CIRCUIT BY
ENCOURAGING HEALTH PROVIDERS’ SELF-MANAGEMENT
TO PROVIDE THE NECESSARY ADMINISTRATIVE TOOLS
TO TRANSPOSE PROVINCIAL GOALS TO ACHIEVE
PERFORMANCE SELF-ASSESSMENT
TO ACHIEVE INFORMATION FEEDBACK TO ENABLE
MONITORING THEIR PERFORMANCE FROM THE UGSP
Command Board
Tracers
Reports
Register Administration
Billing
Enrollment
Billing
Data Handling Systems
Decision Support Systems
Management Systems
March 2014 / Page 6
UTILIZED INFORMATION SYSTEMS
PRICING
March 2014 / Page 7
KEY ELEMENTS IN THE PRICING PROCESS
FINANCIAL
CONSISTENCY
TOOL
HEALTH
PRIORITIES (PRIORITIZED
SERVICES)
PREVALENCE
RATE
HEALTH SERVICE PLAN
March 2014 / Page 8
INFORMATION
ADM. CIRCUIT
TOOLS
GOALS
FEEDBACK
Health Service Plan (PSS) based on complexity. Correct
use of PSS.
Enrollment and Billing System
PSS Usage percentage between 60 and 70 %
Evaluation of performance and search for new
health care habits for the population
Admission Doctor’s
office Administration
Service
Report
ENROLLMENT EVOLUTION
March 2014 / Page 9
STRATEGIES on BASIC EFFECTIVE COVERAGE (BEC)
March 2014 / Page 10
Information: report on the status of beneficieries without BEC or about to expire
Circuit: Identify beneficiaries and report health services
Tools: I.T. System. List of beneficiaries
Goals: The health provider knows their goals by age group. Monthly.
Feedback: Monitoring – Evaluation – Planning actions to provide Coverage to
beneficiaries with BEC about to expire
BASIC EFFECTIVE COVERAGE 2013-2014
March 2014 / Page 11
TRACERS
March 2014 / Page 12
HEALTH PROVIDER
PRIORITIZATION
TARGET POPULATION
STRUCTURE
MANAGEMENT CAPACITY
TRACER IDENTIFICATION
Administrative Circuit
IT Systems Quarterly
Goals Monitoring and
Evaluation
CASES
HOW
WHAT
WHEN
NACER TRACER RESULTS
March 2014 / Page 13
20%
28% 28% 28%
20%
32%
36%
16%
32%
23% 26% 25%
17% 17% 19%
31%
28%
31% 30% 29% 30%
34%
31%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
2° C 3° C 1° C 2° C 3° C 1° C 2° C 3° C 1° C 2° C 3° C 1° C 2° C 3° C 1° C 2° C 3° C 1° C 2° C 3° C 1° C 2° C 3° C
2005 2006 2007 2008 2009 2010 2011 2012
Evolution of the Global Retribution per Plan Nacer Tracer Province of Chaco
2° Quarter 2005 to 3° Quarter 2012 – Retribution expressed as a percentage of the capita
Maximum Global Retribution: 40% of the capita
EVOLUTION OF SERVICE RECORDS
March 2014 / Page 15
BILLING I.T. SYSTEMS
1 • Infrastructure
2 • Equipment
3 • Supplies
4 • Hiring human resources
5 • Training
6 • Incentives for human resources
FUND ALLOCATION
3.59%
19.98%
0.37%
14.12%
11.45%
1.52% 0.52% 1.67%
0.00%
46.77%
Medicos
Otros
Edilicio
Eq Medico
Eq No Medico
Edilicio
Eq Medico
Eq No Medico
Capacitacion
Fdo Estimulo
March 2014 / Page 16
Doctors
Other
Building
Medical Equip
Non-medical Equip
Building
Medical Equip
Non-medical Equip
Training
Stimulus fund
INFANT MORTALITY IN THE PROVINCE OF CHACO
March 2014 / Page 17
ABORIGINAL HEALTH AGENTS FOM IMPENETRABLE
NUEVA POMPEYA MISSION
March 2014 / Page 18
ABORIGINAL HEALTH AGENTS FROM IMPENETRABLE
EL SAUZALITO
March 2014 / Page 19
March 2014 / Page 20