University hospitals in Colombia: regulatory framework, case analysis and teaching-service model from the perspec- tive of quality management

Abstract

Law 2333 of 2023 established demanding requirements for their certification, including mandatory accreditation. However, there is a gap between the regulatory framework and the operational reality of institutions. Objective: To conduct an integrative review that articulates the legal framework, quality processes and teaching-service model with the analysis of specific cases of Colombian university hospitals, characterizing their corporate type, complexity level, associated university, governance and integration strategies. Methodology: Systematic review of Colombian regulations (Law 2333, Decrees 1011, 2376, 903, Resolution 3100) and analysis of five cases selected through purposive sampling: IPS Universitaria (mixed corporation), Fundación Valle del Lili (foundation), Hospital Universitario Nacional (corporation), Clínica Universitaria Bolivariana (private) and Hospital Universitario del Valle (ESE). Documentary analysis and comparative matrices were used. Results: Significant heterogeneity was identified in legal forms, complexity levels and governance models. All cases comply with habilitation and most have initiated accreditation processes. The teaching-service model is materialized through formal agreements, joint committees and strategies such as progressive delegation and integration workshops.
Challenges persist in curricular articulation, financing and measurement of results. Discussion and conclusions: The success of the model depends on the capacity to adapt to institutional diversity and the strengthening of the teaching-service relationship as a strategic axis. It is necessary to harmonize quality standards, strengthen shared governance and develop specific indicators for university hospitals.