Síntesis Teórica y Desarrollo de Modelo teórico - operacional para la Gestión de Riesgos Presupuestal en Nosocomios Públicos Latinoamericanos

Budget risk management represents one of the most significant structural challenges for public hospitals in Latin America, resulting from the convergence of macroeconomic instability, political volatility, complex epidemiological transitions, and persistent resource constraints. In this context, this study aims to develop an integrated theoretical-conceptual framework for hospital budget risk management, specifically adapted to the institutional and operational characteristics of Latin American public health systems. The study is based on a theoretical-conceptual review of 60 academic and technical sources, analyzed through narrative synthesis and thematic analysis, collected between July and August 2025. Of the total documents reviewed, 56.7% were published between 2020 and 2025, while 86.7% are directly related to the Latin American context, with a predominance of studies from Brazil, Peru, Chile, and Ecuador. As a result, the study proposes a contextualized operational definition of hospital budget risk management and identifies five interrelated constituent dimensions: anticipatory budget planning, control of budget deviations, response to financial contingencies, strategic resource prioritization, and strengthening of technical capacities. Each dimension is operationalized through specific components, resulting in an integrated theoretical-operational model comprising fifty indicators aimed at supporting managerial decision-making and enhancing financial sustainability.