It is now week two of my study abroad trip, and today was full of lectures, hospital visits, and museum tours! We started our day at Medifé, a company that owns a private insurance company, hospital and foundation, and Obras Sociales for executives. We met with Dr. Flora Ledesma, Medifé’s health innovation manager, who explained the complicated and intertwined system between the company’s private and union insurance. Medifé is the parent company, but it is also the name of the private insurance company. It services 300,000 people, and there are multiple ways to get this coverage. You can be a Direct Affiliate, where you pay the full fee for a plan. You can also be a part of a union, but have the 9% from it sent to Medifé rather than getting Obras Sociales. Finally, you may have it through a mandatory contract between unions and Medifé. There are different plans you can get through this insurance, and one thing I found interesting is that 4,000 out of the 300,000 customers are high necessity patients, but they make up 30% of insurance funds. Medifé, the umbrella company, also owns ASE Nacional, the Obras Sociales group for executives. ASE is its own union insurance, but it has access to Medifé hospitals. If there are no contracted hospitals in a certain area of Argentina, they also might contract to another hospital system like Swiss Medical.
After we finished our discussion at Medifé, we visited ICBA, the Cardiovascular Institute of Buenos Aires, a private hospital. We discussed hospital management and nursing at this hospital. I found the organization of this hospital very interesting, as there are multiple sub sectors for management. The first groups are divided vertically, by service. For example, some categories include surgery, electrophysiology, and imaging. The next sub group is divided by condition. For example, conditions include coronary, cardiomyopathy, rhythm, vascular, and transplant. Within each intersection, we have different clinics that host specific issues. For example, the arrhythmias clinic deals with AF, Syncope, Devices, and VT. Having all of these levels of management allows for distribution of power. It gives everyone the chance to manage a team, which the hospital believes really benefits their workers. This hospital’s main goals are also patient and disease centered care, patient experience, development, and impact.
We heard from Pablo Morales and Monica Weis, who both have an MSN degree in management and are Chief’s of Nursing at ICBA. They explained that nurses at this hospital go through a High Impact Process program that uses established milestones to train and develop nurses. They also have a communication model that highlights trust, listening, and empathy. 66% of nurses have their BSN, while 34% are LPN’s. One thing I find interesting about nursing in Argentina is that they do not have advanced practice nursing, but have recently made an additional program that allows you to become a specialized nurse in a specific area. When asked if they believed they would have APRN’s, they said they would love to make that push, but there is still a long way to go due to the legal framework of the country.
Finally, we ended our day at the MALBA, the Latin American Museum of Buenos Aires. The artwork there was extremely beautiful and fascinating. The first floor highlighted famous paintings from Latin America, including art by Frida Kahlo, Antonio Berni, and Jorge de la Vega. One thing I love about Latin American art is its vibrant colors. The second floor contained an Afro-Brazilian exhibit that began with deep reflection pieces about the country’s history with slavery and ended with demonstrations about growing and life. I loved getting to explore the art of Latin America and take a little while to reflect on the rich history of this region.
Today was an extremely long but impactful day. As everyday goes by, I am reminded that we are getting closer to leaving, but reflecting on all the amazing things we have done so far. See you tomorrow, for our final hospital and university visit!
