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Antioquia destina $285 mil millones al rescate hospitalario: una apuesta crítica por la sostenibilidad del sistema de salud
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En un momento decisivo para el sistema de salud en Antioquia, la Asamblea Departamental aprobó una adición presupuestal histórica de $577 mil millones, de los cuales más de la mitad serán destinados a enfrentar la profunda crisis que aqueja a más de 50 centros asistenciales. Esta medida busca no solo estabilizar la red pública hospitalaria, sino también garantizar el acceso a servicios básicos para población no asegurada, mejorar la calidad de la atención y dignificar al talento humano en salud.
Una medida estructural ante una emergencia crónica
La crisis de los hospitales públicos en Antioquia no es reciente. Durante años, las instituciones han reportado problemas financieros crecientes, servicios de urgencias sobrepasados y dificultades operativas relacionadas con pagos atrasados, carteras morosas y débil articulación con aseguradoras. Ante este panorama, la adición presupuestal por $577 mil millones aprobada por la Asamblea Departamental representa una intervención sin precedentes, orientada principalmente al rescate financiero y funcional del sistema.
Según el documento oficial de la Asamblea de Antioquia, el 75% de los nuevos recursos asignados al sector salud, es decir, aproximadamente $285 mil millones, se invertirá en cinco frentes fundamentales:
- Atención a personas no aseguradas: un problema estructural que incrementa la presión sobre hospitales públicos.
- Saneamiento financiero hospitalario: para saldar deudas con proveedores y garantizar continuidad en la atención.
- Fortalecimiento de la red de servicios: con énfasis en hospitales de primer y segundo nivel, rurales y urbanos.
- Abastecimiento de medicamentos controlados: especialmente psicotrópicos y de alto costo, donde se han presentado escasez crónica.
- Mejoramiento de condiciones laborales del personal médico y asistencial: un punto crítico para frenar la migración de talento humano.
La Gobernación de Antioquia ha resaltado que esta inversión es urgente para garantizar la continuidad del servicio en territorios donde “la red pública está aguantando con lo mínimo”.
Un diagnóstico severo: más de 50 hospitales en riesgo operativo
Datos oficiales indican que más de 50 hospitales públicos del departamento se encuentran en condición financiera crítica o en riesgo de cierre técnico. Según el Observatorio de Salud de la Secretaría Seccional de Salud de Antioquia (OSSSA), los pasivos acumulados superan los $420 mil millones, mientras que la cartera por cobrar a las EPS representa el 65% del total de ingresos reportados por estas instituciones en 2024.
Además, los servicios de urgencias en municipios como Bello, Turbo, Apartadó, Itagüí y Caucasia han reportado una ocupación superior al 150%, obligando a desviar pacientes a centros de mayor complejidad que también enfrentan saturación.
En este contexto, la inversión no solo es necesaria, sino crítica para evitar el colapso progresivo del sistema. Como lo señaló la Defensoría del Pueblo en su Informe al Congreso de la República, Antioquia concentra uno de los mayores volúmenes de quejas por acceso a servicios hospitalarios en el país, especialmente en zonas periféricas y rurales.
¿A dónde irán los recursos? Detalle de la inversión
La distribución del paquete presupuestal aprobado está centrada en una estrategia de impacto a corto y mediano plazo:
Adicionalmente, el 25% restante del total de la adición presupuestal ($144.250 millones) será destinado a políticas sociales complementarias que inciden directamente en la salud pública:
- Programas de nutrición infantil en zonas priorizadas.
- Intervenciones de salud visual en instituciones educativas públicas.
- Atención integral a la primera infancia.
- Fortalecimiento del programa Jóvenes Pa’ Lante, enfocado en prevención de violencia, salud mental y proyectos de vida.
Implicaciones para la red pública: entre la expectativa y la ejecución
La medida ha sido bien recibida por gremios médicos, alcaldes y directores de hospitales, quienes han reiterado la necesidad de que estos recursos sean ejecutados con celeridad, transparencia y control. No obstante, organismos de control como la Contraloría General de la República han advertido en informes previos sobre baja ejecución presupuestal en el sector salud de los departamentos, incluso cuando hay disponibilidad de recursos.
Según reportes, la situación en algunos hospitales ha llegado a tal punto que los gerentes han tenido que acudir a créditos o reducir servicios para mantener operaciones mínimas.
Así mismo, la capacidad institucional para administrar estos fondos será clave. La Gobernación ha señalado que se establecerán mesas técnicas de seguimiento con la Secretaría de Salud, alcaldías municipales y gerencias hospitalarias.
Un modelo replicable para otras regiones en crisis
La experiencia antioqueña podría convertirse en una referencia nacional en la medida en que logre traducir esta inyección presupuestal en mejoras tangibles. Departamentos como Chocó, La Guajira, Cauca y Magdalena también presentan síntomas severos de insostenibilidad hospitalaria y han solicitado al Gobierno Nacional medidas similares.
El Ministerio de Salud y Protección Social ha reconocido, en el marco de las mesas técnicas de la reforma a la salud, que la red pública hospitalaria requiere una estrategia nacional de salvamento. En declaraciones recientes, el viceministro Jaime Urrego enfatizó que “las gobernaciones deben asumir un rol proactivo en la protección de sus hospitales, y Antioquia ha dado un paso significativo en esa dirección”.
¿oxígeno financiero o solución estructural?
La adición presupuestal aprobada por la Asamblea de Antioquia es, sin duda, una respuesta contundente a la crisis hospitalaria. Sin embargo, su impacto dependerá del rigor con que se ejecuten los recursos, del seguimiento técnico y del fortalecimiento institucional de la red pública.
La atención a población no asegurada y la dignificación del personal de salud son apuestas sociales de alto valor, pero el saneamiento financiero no será sostenible si no se acompaña de mejores prácticas de gestión, control de gasto y mayor coordinación con las EPS.
Lo que está en juego no es solo la viabilidad financiera de los hospitales, sino la confianza de la ciudadanía en un sistema que debe garantizar el derecho a la salud con calidad, equidad y oportunidad.
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