[Quality of health service in the Colombian subsidized regime: a structural equation study based on the Donabedian...

Health systems are complex, making it difficult to measure their quality. The importance of evaluating quality in the subsidized regime lies in the fact that it serves a socioeconomically vulnerable population requiring priority attention. This study assessed the quality of services in the Colombian subsidized regime using the Donabedian model, analyzing users' perceptions.

An analytical cross-sectional study was conducted between September and November 2023. A validated questionnaire based on Moliner`s GLOVAL scale, validated by Nguyen et al., was administered to a convenience sample of 314 users. Data were subjected to confirmatory factor analysis and reliability testing, and the model was tested using structural equation modeling with GSCA Pro-1.2.1.0.

Perceived quality was determined by Donabedian's three dimensions. Facilities showed a positive effect on quality (β=0.209), while staff professionalism (β=0.501) and non-economic costs (β=0.297) evidenced the greatest weight. Outcomes, measured through emotional value (β=0.779) and satisfaction (β=0.796), confirmed a strong association with quality.

The study confirms the applicability of the Donabedian model in the Colombian subsidized regime, evidencing that staff professionalism is the factor with the greatest impact on perceived quality. The findings highlight the importance of strengthening care processes and the human dimension of care to improve patient satisfaction and emotional value, providing relevant input for designing continuous quality improvement policies in the Colombian health system.