OBJECTIVES: To estimate the demand for monthly services from a voluntary Colombian health insurer.

METHODS: An econometric model that allowed to estimate the frequency of use was built. It worked based on historical information and its variations in accordance to the type of coverage for each specific health plan, the risk from each individual included age, sex, and the presence or lack their off of chronic illnesses. Based on this model, it is possible to predict the number of activities according to the distribution of the population on a global scale with the use of an additional model that showcased demographic changes. The data was obtained as expected activities and it allowed to estimate the total spending based on fixed rates.

RESULTS: From a 4’905,582-health consumption records database, which was demanded by 222,183 affiliates from a total population of 275,619, it was estimated that in average an affiliate was likely to demand 1.69 services in 2018. From the total number of demanded services, clinical laboratory activities represented a 49.94%. The total and specific frequency changed based on the risk group the patient is part of. The highest is reserved for multichronic patients with diabetes, cardiovascular conditions and chronic renal disease undergoing dialysis, on the other hand, healthy young adults between 27 and 34-year olds are on the other side of the spectrum. They have the lowest frequency with a 0.02- Lastly, it is established that the insurance policy with the highest coverage represents a higher demand for services with a 73.76% of the total demand. The frequencies themselves can be discriminated to a level of specified activities, as well.

CONCLUSIONS: The estimated demand, through the established frequencies, allows the creation of a budget projection for a voluntary health insurer, and therefore the respective supply established in the quantity and type of services demanded.