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1.
Cad. Saúde Pública (Online) ; 34(1): e00194916, 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-889862

ABSTRACT

Resumo: A pesquisa analisou o processo de expansão das Organizações Sociais da Saúde (OSS) no Brasil durante o período de 2009-2014. Para tanto, dimensionou as dez maiores OSS segundo recursos financeiros captados, explorou suas qualificações como entidades sem fins lucrativos, tomando em conta as evidências empíricas que apontam para sua expansão e consolidação no processo de gestão e prestação de serviços de saúde via estratégias próprias de organizações privadas lucrativas. O estudo é descritivo e exploratório, e foi realizado com base em fontes documentais de domínio público. No plano das relações com o Estado, as OSS têm se beneficiado das brechas e facilidades concedidas pela lei e apresentado uma notável expansão. Evidenciou-se um movimento recente das OSS pela busca concomitante da condição de entidades filantrópicas, assegurando múltiplas oportunidades de captação de recursos e de benefícios fiscais; a possibilidade de aplicação de excedentes financeiros no mercado de capitais; e a remuneração de seus corpos diretivos. Há uma concentração em serviços hospitalares com maior densidade tecnológica; nítida predominância de cláusulas respeitantes ao incremento de repasses financeiros em detrimento de outras cláusulas regulatórias; existência de modalidades especiais de contratos com serviços-meios absolutamente estratégicos para o funcionamento geral do Sistema Único de Saúde. Portanto, neste estudo as OSS se configuram como um dos componentes do Complexo Econômico Industrial da Saúde, nas vertentes da gestão, da prestação e da regulação de serviços, em um cenário de intensiva mercantilização da saúde e de transferência de fundo público para o setor privado.


Abstract: The study analyzed the expansion of Social Healthcare Organizations (OSS in Portuguese) in Brazil from 2009 to 2014. The ten largest OSS were measured according to their budget funding and their qualifications as non-profit organizations were explored, considering evidence of their expansion and consolidation in the management and provision of health services via strategies proper to for-profit private enterprises. The study is descriptive and exploratory and was based on public-domain documents. In their relations with government, the OSS have benefited from legal loopholes and incentives and have expanded accordingly. There has been a recent trend for these organizations to simultaneously apply for status as charitable organizations, thereby ensuring multiple opportunities for fundraising and additional tax incentives, permission to invest financial surpluses in the capital market, and remunerate their boards of directors. These organizations tend to concentrate in technology-dense hospital services, with clauses concerning increasing financial transfers to the detriment of other regulatory clauses, and special contract modalities for enabling services that are absolutely strategic for the overall functioning of the Brazilian Unified National Health System. Thus, in this study, the OSS are one component of the Health Economic and Industrial Complex, acting in management, provision, and regulation of services in a scenario of intensive commodification of health and the transfer of public funds to the private sector.


Resumen: La investigación analizó el proceso de expansión de las Organizaciones Sociales de Salud (OSS) en Brasil, durante el período de 2009-2014. Para ello, se dimensionaron las diez mayores OSS, según los recursos financieros captados, exploró sus características, como entidades sin ánimo de lucro, tomando en consideración las evidencias empíricas que apuntan a su expansión y consolidación en el proceso de gestión y prestación de servicios de salud, vía estrategias propias de organizaciones privadas con ánimo de lucro. El estudio es descriptivo y exploratorio, y fue realizado en base a fuentes documentales de dominio público. En el plano de las relaciones con el Estado, las OSS se han beneficiado de las brechas y facilidades concedidas por la ley y presentado una notable expansión. Se evidenció un movimiento reciente de esas organizaciones por la búsqueda concomitante de su condición como entidades filantrópicas, asegurando múltiples oportunidades de captación de recursos y de beneficios fiscales; la posibilidad de inversión de excedentes financieros en el mercado de capitales; y la remuneración de sus cuerpos directivos. Existe una concentración en servicios hospitalarios con una mayor densidad tecnológica; nítida predominancia de cláusulas, respecto al incremento de transferencias financieras, en detrimento de otras cláusulas regulatorias; existencia de modalidades especiales de contratos con servicios-medios absolutamente estratégicos para el funcionamiento general del Sistema Único de Salud. Por tanto, en este estudio las OSS se configuran como uno de los componentes del Complejo Económico Industrial de la Salud, en las vertientes de la gestión, de la prestación y de la regulación de servicios, en un escenario de intensiva mercantilización de la salud y de transferencia de fondos públicos hacia el sector privado.


Subject(s)
Humans , Organizations, Nonprofit/organization & administration , Health Services Administration/economics , Privatization/trends , Delivery of Health Care/organization & administration , Organizations, Nonprofit/economics , Organizations, Nonprofit/legislation & jurisprudence , Organizations, Nonprofit/trends , Health Services Administration/legislation & jurisprudence , Health Services Administration/trends , Brazil , Privatization/economics , Privatization/legislation & jurisprudence , Residence Characteristics , Delivery of Health Care/legislation & jurisprudence , Delivery of Health Care/trends , Health Policy
2.
Salud pública Méx ; 57(supl.2): s153-s162, 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-762079

ABSTRACT

Objetivo. Documentar la asociación entre factores de la oferta de servicios de atención de VIH sobre la mortalidad por sida en México en el periodo 2008-2013. Material y métodos. Se analizaron datos del sistema de administración, logística y vigilancia de antirretrovirales (SALVAR) y de una encuesta aplicada en unidades de atención. Se utilizaron modelos de regresión logit multivariados para estimar la asociación entre características de la oferta de servicios -en particular, de la gerencia de servicios y de la capacitación y experiencia de los prestadores- y la mortalidad por sida, distinguiendo entre mortalidad temprana y no temprana, y controlando por características clínicas de los pacientes. Resultados. Las características clínicas de los pacientes (CD4 inicial y carga viral) explican 44.4% de la variabilidad en la mortalidad temprana entre clínicas y 13.8% de la variabilidad de mortalidad no temprana. Las características de la oferta aumentan 16% del poder explicativo en el caso de la mortalidad temprana y 96% en el de la mortalidad no temprana. Conclusiones. Los aspectos de gerencia e implementación de los servicios de atención de VIH contribuyen significativamente a explicar la mortalidad por sida en México. Mejorar estos aspectos del programa nacional puede mejorar sus resultados.


Objective. To document the association between supply-side determinants and AIDS mortality in Mexico between 2008 and 2013. Materials and methods. We analyzed the SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. Results. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Conclusions. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.


Subject(s)
Humans , Male , Female , Adult , Health Services Administration/economics , Acquired Immunodeficiency Syndrome/mortality , Health Services/supply & distribution , Health Services Accessibility/economics , Algorithms , HIV Infections/drug therapy , Logistic Models , Acquired Immunodeficiency Syndrome/economics , Models, Economic , CD4 Lymphocyte Count , Continuity of Patient Care , Anti-HIV Agents/supply & distribution , Viral Load , Mortality, Premature , Ambulatory Care Facilities/economics , Mexico/epidemiology , National Health Programs/economics
3.
Rev. saúde pública ; 48(4): 622-631, 08/2014. tab, graf
Article in English | LILACS | ID: lil-721032

ABSTRACT

OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes. METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics. RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee’s permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table). The study determined that “facilitators” under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical) services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System. CONCLUSIONS The characteristics identified a regionalized system ...


OBJETIVO Analisar o sistema de governança regional em saúde quanto a estratégias e disputas de gestão. PROCEDIMENTOS METODOLÓGICOS Pesquisa qualitativa com gestores de saúde de 19 municípios que integram a região de saúde no estado da Bahia. Foram realizadas 17 entrevistas semiestruturadas com gestores/gerentes (estadual, regional e municipal), grupo focal, observações na Comissão Intergestores Regional e documentos institucionais, em 2012. Foram analisados os componentes político-institucional e organizacional e interpretados pela hermenêutica-dialética. RESULTADOS A comissão intergestores regional foi a principal estratégia da governança regional, sendo ferramenta fundamental para fortalecimento da governança por reunir diferentes sujeitos responsáveis pela tomada de decisão nos territórios sanitários e pela negociação da alocação de recursos e distribuição dos estabelecimentos de uso comum na região. A rotatividade de secretários de saúde, baixa autonomia nas decisões executivas, a qualificação técnica insuficiente para exercício da função e o atravessamento das políticas partidárias na tomada de decisão são fatores que obstruem a comissão intergestores regional às demandas sociais. Recursos financeiros insuficientes não viabilizam o cumprimento da programação pactuada integrada nem o aumento da oferta pública na rede e impunham ao gestor a compra de serviços no mercado privado por valores acima da Tabela do Sistema Único de Saúde. Foram relatados atravessadores contratados para agilizar o acesso aos serviços especializados (diagnóstico, terapêutico e/ou cirúrgico) em outros municípios mediante pagamento direto a médicos por procedimentos ...


Subject(s)
Humans , Delivery of Health Care/organization & administration , National Health Programs/organization & administration , Brazil , Health Policy , Health Services Administration/economics , Local Government , Public Health Practice , Regional Health Planning
5.
Córdoba; s.n; 2012. 44 p.
Thesis in Spanish | LILACS | ID: lil-713424

ABSTRACT

La Hipertensión arterial esencial (HTA) y la diabetes mellitus (DM) son factores de riesgo cardiovascular altamente prevalentes. El tratamiento farmacológico de la HTA pueden disminuir su morbimortalidad. El objetivo de esta tesis fue describir las recomendaciones sobre prescripción de medicamentos antihipertensivos a personas con HTA y a personas con HTA Y DM (HTA-DM) incluidas en guías de práctica clínica (GPC) de buena calidad y comparar éstas con el perfil de prescripción de una obra social en 2010. Se realizó una búsqueda sitemática de GPC, se preseleccionaron según indicadores básicos de calidad metodológica y se aplicó la metodología Appraisal of Guidelines Research and Evaluation for Europe (AGREE) para su evaluación y selección definitiva por calidad. Se realizó un estudio indicación-prescripción en personas con diagnostico de HTA e HTA-DM que adquirieron medicamentos antihipertensivos en las farmacias de la obra social.


Subject(s)
Humans , Male , Female , Health Services Administration/economics , Antihypertensive Agents , Diabetes Mellitus/prevention & control , Hypertension , Pharmacology , Practice Guidelines as Topic , Health Systems/organization & administration
6.
Salud pública Méx ; 53(supl.2): s96-s109, 2011. tab
Article in Spanish | LILACS | ID: lil-597130

ABSTRACT

En este artículo se describe el sistema de salud de Argentina, que está compuesto por tres sectores: público, de seguridad social y privado. El sector público está integrado por los ministerios nacional y provincial, y la red de hospitales y centros de salud públicos que prestan atención gratuita a toda persona que lo demande, fundamentalmente a personas sin seguridad social y sin capacidad de pago. Se financia con recursos fiscales y recibe pagos ocasionales de parte del sistema de seguridad social cuando atiende a sus afiliados. El sector del seguro social obligatorio está organizado en torno a las Obras Sociales (OS), que aseguran y prestan servicios a los trabajadores y sus familias. La mayoría de las OS operan a través de contratos con prestadores privados y se financian con contribuciones de los trabajadores y patronales. El sector privado está conformado por profesionales de la salud y establecimientos que atienden a demandantes individuales, a los beneficiarios de las OS y de los seguros privados. Este sector también incluye entidades de seguro voluntario llamadas Empresas de Medicina Prepaga que se financian sobre todo con primas que pagan las familias y/o las empresas. En este trabajo también se describen las innovaciones recientes en el sistema de salud, incluyendo el Programa Remediar.


This paper describes the health system of Argentina.This system has three sectors: public, social security and private.The public sector includes the national and provincial ministries as well as the network of public hospitals and primary health care units which provide care to the poor and uninsured population. This sector is financed with taxes and payments made by social security beneficiaries that use public health care facilities. The social security sector or Obras Sociales (OS) covers all workers of the formal economy and their families. Most OS operate through contracts with private providers and are financed with payroll contributions of employers and employees. Finally, the private sector includes all those private providers offering services to individuals, OS beneficiaries and all those with private health insurance.This sector also includes private insurance agencies called Prepaid Medicine Enterprises, financed mostly through premiums paid by families and/or employers.This paper also discusses some of the recent innovations implemented in Argentina, including the program Remediar.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Argentina , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
7.
Salud pública Méx ; 53(supl.2): s109-s119, 2011. tab
Article in Spanish | LILACS | ID: lil-597131

ABSTRACT

En este trabajo se describen las características generales del sistema de salud de Bolivia: su organización y cobertura; sus fuentes de financiamiento y gasto en salud; los recursos físicos, materiales y humanos de los que dispone; las actividades de rectoría que desarrolla, y el nivel que ha alcanzado la investigación en salud. También se discuten las innovaciones más recientes que se han llevado a cabo en los últimos años, incluyendo el Seguro Universal Materno Infantil, el Programa de Extensión de Cobertura a Áreas Rurales, el Modelo de Salud Familiar, Comunitaria e Intercultural y el programa de subsidios monetarios Juana Azurduy, dirigido a fortalecer la atención prenatal y del parto.


This paper describes the Bolivian health system, including its structure and organization, its financing sources, its health expenditure, its physical, material and humans resources, its stewardship activities and the its health research institutions. It also discusses the most recent policy innovations developed in Bolivia: the Maternal and Child Universal Insurance, the Program for the Extension of Coverage to Rural Areas, the Family, Community and Inter-Cultural Health Model and the cash-transfer program Juana Azurduy intended to strengthen maternal and child care.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Bolivia , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
8.
Salud pública Méx ; 53(supl.2): s120-s131, 2011. tab
Article in Spanish | LILACS | ID: lil-597132

ABSTRACT

En este trabajo se describe el sistema de salud de Brasil, que está compuesto por un sector público que cubre alrededor de 75 por ciento de la población y un creciente sector privado que ofrece atención a la salud al restante 25 por ciento de los brasileños. El sector público está constituido por el Sistema Único de Salud (SUS) y su financiamiento proviene de impuestos generales y contribuciones sociales recaudadas por los tres niveles de gobierno (federal, estatal y municipal). El SUS presta servicios de manera descentralizada a través de sus redes de clínicas, hospitales y otro tipo de instalaciones, y a través de contratos con establecimientos privados. El SUS es además responsable de la coordinación del sector público. El sector privado está conformado por un sistema de esquemas de aseguramiento conocido como Salud Suplementaria financiado con recursos de las empresas y/o las familias: la medicina de grupo (empresas y familias), las cooperativas médicas, los llamados Planes Autoadministrados (empresas) y los planes de seguros de salud individuales. También existen consultorios, hospitales, clínicas y laboratorios privados que funcionan sobre la base de pagos de bolsillo, que utilizan sobre todo la población de mayores ingresos. En este trabajo se analizan los recursos con los que cuenta el sistema, las actividades de rectoría que se desarrollan y las innovaciones más recientemente implantadas, incluyendo el Programa de Salud de la Familia y el Programa Más Salud.


This paper describes the Brazilian health system, which includes a public sector covering almost 75 percent of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans.The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Brazil , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
9.
Salud pública Méx ; 53(supl.2): s132-s142, 2011. graf, tab
Article in Spanish | LILACS | ID: lil-597133

ABSTRACT

En este trabajo se describe el sistema de salud de Chile, incluyendo su estructura, financiamiento, beneficiarios y recursos físicos, materiales y humanos de los que dispone. Este sistema está compuesto por dos sectores, público y privado. El sector público está formado por todos los organismos que constituyen el Sistema Nacional de Servicios de Salud y cubre aproximadamente a 70 por ciento de la población, incluyendo a los pobres del campo y las ciudades, la clase media baja y los jubilados, así como los profesionales y técnicos. El sector privado cubre aproximadamente a 17.5 por ciento de la población perteneciente a los grupos sociales de mayores ingresos. Un pequeño sector de la población, perteneciente a la clase alta, realiza pagos directos de bolsillo a proveedores privados de servicios de atención a la salud. Alrededor de 10 por ciento de la población está cubierta por otras agencias públicas, fundamentalmente los Servicios de Salud de las Fuerzas Armadas. Recientemente el sistema se reformó creando el Régimen General de Garantías en Salud, que establece un Sistema Universal con Garantías Explícitas que se tradujo, en 2005, en el Plan de Acceso Universal con Garantías Explícitas (AUGE), que garantiza el acceso oportuno a servicios de calidad para 56 problemas de salud, incluyendo cáncer en niños, cáncer de mama, trastornos isquémicos del corazón, VIH/SIDA y diabetes.


This paper describes the Chilean health system, including its structure, financing, beneficiaries, and its physical, material and human resources. This system has two sectors, public and private. The public sector comprises all the organisms that constitute the National System of Health Services, which covers 70 percent of the population, including the rural and urban poor, the low middle-class, the retired, and the self-employed professionals and technicians.The private sector covers 17.5 percent of the population, mostly the upper middle-class and the high-income population. A small proportion of the population uses private health services and pays for them out-of-pocket. Around l0 percent of the population is covered by other public agencies, basically the Health Services for the Armed Forces. The system was recently reformed with the establishment of a Universal System of Explicit Entitlements, which operates through a Universal Plan of Explicit Entitlements (AUGE), which guarantees timely access to treatment for 56 health problems, including cancer in children, breast cancer, ischaemic heart disease, HIV/AIDS and diabetes.


Subject(s)
Delivery of Health Care/organization & administration , Health Services Administration , Chile , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
10.
Salud pública Méx ; 53(supl.2): s144-s155, 2011. tab
Article in Spanish | LILACS | ID: lil-597134

ABSTRACT

En este trabajo se presenta una breve descripción de las condiciones de salud de Colombia y una descripción detallada del sistema colombiano de salud. Esta última incluye una descripción de su estructura y cobertura, sus fuentes de financiamiento, el gasto en salud, los recursos con los que cuenta, quién vigila y evalúa al sector salud y qué herramientas de participación tienen los usuarios. Dentro de las innovaciones más recientes del sistema se incluyen las modificaciones al Plan Obligatorio de Salud y a los montos de la unidad de pago por capitación, la integración vertical entre empresas promotoras de salud y las instituciones prestadoras de servicios, así como el establecimiento de nuevas fuentes de recursos para lograr la universalidad e igualar los planes de beneficios entre los distintos regímenes.


This document briefly describes the health conditions of the Colombian population and, in more detail, the characteristics of the Colombian health system. The description of the system includes its structure and coverage; financing sources; expenditure in health; physical material and human resources available; monitoring and evaluation procedures; and mechanisms through which the population participates in the evaluation of the system. Salient among the most recent innovations implemented in the Colombian health system are the modification of the Compulsory Health Plan and the capitation payment unit, the vertical integration of the health promotion enterprises and the institutions in charge of the provision of services and the mobilization of additional resources to meet the objectives of universal coverage and the homologation of health benefits among health regimes.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Colombia , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
11.
Salud pública Méx ; 53(supl.2): s156-s167, 2011. tab
Article in Spanish | LILACS | ID: lil-597135

ABSTRACT

En este trabajo se describe el sistema de salud de Costa Rica, que presta servicios de salud, agua y saneamiento. El componente de servicios de salud incluye un sector público y uno privado. El sector público está dominado por la Caja Costarricense de Seguro Social (CCSS), institución autónoma encargada del financiamiento, compra y prestación de la mayoría de los servicios personales. La CCSS se financia con contribuciones de los afiliados, los empleadores y el Estado, y administra tres regímenes: el seguro de enfermedad y maternidad, el seguro de invalidez, vejez y muerte, y el régimen no contributivo. La CCSS presta servicios en sus propias instalaciones o contrata prestadores del sector privado con los que establece contratos denominados "compromisos de gestión". El sector privado comprende una amplia red de prestadores que ofrecen servicios ambulatorios y de especialidad con fines lucrativos. Estos servicios se financian sobre todo con pagos de bolsillo, pero también con primas de seguros privados. El Ministerio de Salud es el rector del sistema y como tal cumple con funciones de dirección política, regulación sanitaria, direccionamiento de la investigación y desarrollo tecnológico. Dentro de las innovaciones relativamente recientes que se han implantado en Costa Rica destacan la implantación de los equipos básicos de atención integral de salud (EBAIS), la desconcentración de los hospitales y clínicas públicos, la introducción de los acuerdos de gestión y la creación de las Juntas de Salud.


This paper describes the Costa Rican health system which provides health, water and sanitation services. The health component of the system includes a public and a private sector. The public sector is dominated by the Caja Costarricense de Seguro Social (CCSS), an autonomous institution in charge of financing, purchasing and delivering most of the personal health services in Costa Rica. CCSS is financed with contributions of the affiliates, employers and the state, and manages three regimes: maternity and illness insurance, disability, old age and death insurance, and a non-contributive regime. CCSS provides services in its own facilities but also contracts with private providers. The private sector includes a broad set of services offering ambulatory and hospital care. These services are financed mostly out-of-pocket, but also with private insurance premiums. The Ministry of Health is the steward of the system, in charge of strategic planning, sanitary regulation, and research and technology development. Among the recent policy innovations we can mention the establishment of the basic teams for comprehensive health care (EBAIS), the de-concentration of hospitals and public clinics, the introduction of management agreements and the creation of the Health Boards.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Costa Rica , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Sanitation/economics , Sanitation/statistics & numerical data , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
12.
Salud pública Méx ; 53(supl.2): s168-s176, 2011. tab
Article in Spanish | LILACS | ID: lil-597136

ABSTRACT

En este trabajo se describen las condiciones de salud de Cuba y el sistema cubano de salud, incluyendo su estructura y cobertura, sus fuentes de financiamiento, su gasto en salud, los recursos físicos, materiales y humanos de los que dispone, y las actividades de rectoría e investigación que desarrolla. También se discute la importancia de sus instituciones de investigación y se describe el papel de los usuarios de los servicios en la operación y evaluación del sistema, así como las actividades que en este sentido desarrollan la Federación de Mujeres Cubanas y los Comités de Defensa de la Revolución. La parte final de este trabajo se dedica a discutir las innovaciones más recientes dentro de las que destacan las redes de cardiología, la Misión Milagro y la Batalla de Ideas.


This paper describes the health conditions in Cuba and the general characteristics of the Cuban health system, including its structure and coverage, its financial sources, its health expenditure, its physical, material and human resources, and its stewardship functions. It also discusses the increasing importance of its research institutions and the role played by its users in the operation and evaluation of the system. Salient among the social actors involved in the health sector are the Cuban Women Federation and the Committees for the Defense of the Revolution. The paper concludes with the discussion of the most recent innovations implemented in the Cuban health system, including the cardiology networks, the Miracle Mission (Misión Milagro) and the Battle of Ideas (Batalla de Ideas).


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Cuba , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Government/economics , Financing, Government/organization & administration , Financing, Government/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Organizational Innovation , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , State Medicine/economics , State Medicine/organization & administration , State Medicine/statistics & numerical data , Universal Health Insurance/economics , Universal Health Insurance/statistics & numerical data , Vital Statistics
13.
Salud pública Méx ; 53(supl.2): s177-s187, 2011. tab
Article in Spanish | LILACS | ID: lil-597137

ABSTRACT

En este trabajo se describen las condiciones de salud en Ecuador y, con mayor detalle, las características del sistema ecuatoriano de salud, incluyendo su estructura y cobertura, sus fuentes de financiamiento, los recursos físicos, materiales y humanos de los que dispone, las tareas de rectoría que desarrolla el Ministerio de Salud Pública, la generación de información en salud, las tareas de investigación, y la participación de los ciudadanos en la operación y evaluación del sistema. También se discuten las innovaciones más recientes que se han implantado en el sistema ecuatoriano de salud dentro de las que destaca la incorporación de un capítulo específico sobre salud a la nueva Constitución que reconoce a la protección de la salud como un derecho humano y la construcción de la Red Pública Integral de Salud.


This paper describes the health conditions in Ecuador and, in more detail, the characteristics of the Ecuadorian health system, including its structure and coverage, its financial sources, the physical, material and human resources available, and the stewardship activities developed by the Ministry of Public Health. It also describes the structure and content of its health information system, and the participation of citizens in the operation and evaluation of the health system. The paper ends with a discussion of the most recent policy innovations implemented in the Ecuadorian system, including the incorporation of a chapter on health into the new Constitution which recognizes the protection of health as a human right, and the construction of the Comprehensive Public Health Network.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Ecuador , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Human Rights/legislation & jurisprudence , Information Services/organization & administration , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
14.
Salud pública Méx ; 53(supl.2): s197-s197, 2011. tab
Article in Spanish | LILACS | ID: lil-597139

ABSTRACT

En este trabajo se describen las condiciones de salud y el sistema de salud de Guatemala, incluyendo su estructura y cobertura, sus fuentes de financiamiento, las actividades de rectoría que en él se desarrollan, así como las tareas de generación de información en salud e investigación. También se discuten los esfuerzos por ampliar la cobertura de servicios básicos, sobre todo a las comunidades rurales pobres. Destacan dentro de las innovaciones recientes del sistema guatemalteco de salud el Programa de Extensión de Cobertura de Servicios Básicos y el Programa de Accesibilidad de Medicamentos, así como los acuerdos del Ministerio de Salud con organizaciones de la sociedad civil para prestar servicios básicos en comunidades rurales.


This paper describes the health conditions in Guatemala and, in more detail, the characteristics of the Guatemalan health system, including its structure en coverage, its financial sources, the stewardship functions developed by the Ministry of Health, as well as the generation of health information and the development of research activities. It also discusses the recent efforts to extend coverage of essential health services, mostly to poor rural areas.The most recent innovations also discussed in this paper include the Program for the Expansion of Coverage of Essential Services, the Program to Expand Access to Essential Drugs and the agreements between the Ministry of Health and several non-governmental organizations to provide essential services in rural settings.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Guatemala , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
15.
Salud pública Méx ; 53(supl.2): s209-s219, 2011. tab
Article in Spanish | LILACS | ID: lil-597140

ABSTRACT

En este trabajo se describe el sistema de salud de Honduras, incluyendo los retos que enfrenta, su estructura y cobertura, su financiamiento, los recursos con los que cuenta y las actividades de rectoría que en él se desarrollan. Este sistema cuenta con un sector público constituido por la Secretaría de Salud (SS) y el Instituto Hondureño de Seguridad Social (IHSS), y un sector privado en el que predomina el uso de servicios con pago de bolsillo. El Plan Nacional de Salud 2010-2014 se plantea una ambiciosa reforma del sistema que contempla la universalización del aseguramiento mediante un sistema de salud integrado y plural, en el que la SS funcionaría como una institución rectora y reguladora, y que contaría con un seguro público nacional de salud para la población pobre y un IHSS que funcionaría exclusivamente como aseguradora al contratar servicios para sus afiliados con proveedores públicos y privados, que operarían bajo un modelo de salud familiar y comunitaria.


This paper describes the health system of Honduras, including its challenges, structure coverage, sources of financing, resources and stewardship activities. This system counts with a public and a private sector. The public sector includes the Ministry of Health (MH) and the Honduran Social Security Institute (HSSI). The private sector is dominated by a set of providers offering services payed mostly out-of-pocket. The National Health Plan 2010-2014 includes a set of reforms oriented towards the creation of an integrated and plural system headed by the MH in its stewardship role. It also anticipates the creation of a public health insurance for the poor population and the transformation of the HSSI into a public insurance agency which contracts services for its affiliates with public and private providers under a family medicine model.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Honduras , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
16.
Salud pública Méx ; 53(supl.2): s220-s232, 2011. tab
Article in Spanish | LILACS | ID: lil-597141

ABSTRACT

En este trabajo se describe el sistema mexicano de salud. En la primera parte se discuten las condiciones de salud de la población mexicana, con énfasis en los padecimientos emergentes que constituyen las principales causas de muerte: diabetes, enfermedades isquémicas del corazón, padecimientos cerebrovasculares y cáncer. En la segunda parte se describe la estructura básica del sistema: las instituciones que lo conforman, la población a la que cubre, los beneficios que reciben los afiliados de las distintas instituciones, las fuentes de financiamiento del sistema, los niveles de protección financiera alcanzados, los recursos físicos, materiales y humanos con los que cuenta y las principales tareas de rectoría que desarrollan la Secretaría de Salud y otros actores. También se describen los mecanismos de participación de los ciudadanos en la vigilancia y evaluación del desempeño del sistema y su nivel de satisfacción con los servicios recibidos. La tercera parte se dedica a discutir las innovaciones más recientes y su impacto en la operación del sistema. Destaca la discusión del recién creado Sistema de Protección Social en Salud y su brazo operativo, el Seguro Popular de Salud. El trabajo concluye con un análisis de los principales retos que enfrenta en el corto y mediano plazo el sistema mexicano de salud.


This paper describes the Mexican health system. In part one, the health conditions of the Mexican population are discussed, with emphasis in those emerging diseases that are now the main causes of death, both in men and women: diabetes, ischaemic heart disease, cerebrovascular diseases and cancer. Part two is devoted to the description of the basic structure of the system: its main institutions, the population coverage, the health benefits of those affiliated to the different heath institutions, its financial sources, the levels of financial protection in health, the availability of physical, material and human resources for health, and the stewardship functions displayed by the Ministry of Health and other actors. This part also discusses the role of citizens in the monitorization and evaluation of the health system, as well as the levels of satisfaction with the rendered health services. In part three the most recent innovations and its impact on the performance of the health system are discussed. Salient among them are the System of Social Protection in Health and the Popular Health Insurance. The paper concludes with a brief analysis of the short- and middle-term challenges faced by the Mexican health system.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , Mexico , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
17.
Salud pública Méx ; 53(supl.2): s233-s242, 2011. tab
Article in Spanish | LILACS | ID: lil-597142

ABSTRACT

En este artículo se describen las condiciones de salud de Nicaragua y las características de su sistema de salud, incluyendo su estructura y cobertura, sus fuentes de financiamiento, los recursos físicos, materiales y humanos con los que cuenta, las actividades de rectoría que desarrolla el Ministerio de Salud, los mecanismos de participación ciudadana en la gestión y evaluación de los sistemas de salud, y la satisfacción de los usuarios con los servicios recibidos. También se discuten las innovaciones más recientes, dentro de las que destacan la promulgación de una nueva Ley General de Salud, la descentralización de la regulación de los establecimientos de salud y el diseño de un nuevo modelo de atención a la salud denominado Modelo de Salud Familiar y Comunitario.


This paper describes the health conditions in Nicaragua and discusses the characteristics of its national health system including its structure and coverage, its financial sources its physical, material and human resources the stewardship functions developed by the Ministry of Health the participation of citizens in the operation and evaluation of the system and the level of satisfaction of health care users. It also discusses the most recent policy innovations, including the new General Health Law, the decentralization of the regulation of health facilities and the design and implementation of a new health care model known as Family and Community Health Model.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/legislation & jurisprudence , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , Models, Theoretical , Nicaragua , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Public Health , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
18.
Salud pública Méx ; 53(supl.2): s243-s254, 2011. tab
Article in Spanish | LILACS | ID: lil-597143

ABSTRACT

En este trabajo se describen las condiciones generales de salud de la población peruana y, con mayor detalle, el sistema peruano de salud: su estructura y cobertura, sus fuentes de financiamiento, los recursos físicos, materiales y humanos con los que cuenta, y las actividades de rectoría que en él se desarrollan. Asimismo se discute el estado en el que se encuentran la generación de información y la investigación, y la participación de los ciudadanos en la gestión y evaluación del sistema. El artículo concluye con una discusión de las innovaciones más recientes, dentro de las que destacan el Seguro Integral de Salud, el sistema de Empresas Prestadoras de Salud, el proceso de descentralización y los Comités Locales de Administración de Salud. El reto principal que enfrenta este sistema es ampliar la atención a la salud a poco más de 10 por ciento de la población que todavía no recibe servicios básicos.


This paper describes the health conditions in Peru and, with greater detail, the Peruvian health system, including its structure and coverage, its financial sources, its physical, material and human resources, and its stewardship functions. It also discusses the activities developed in the information and research areas, as well as the participation of citizens in the operation and evaluation of the health system. The article concludes with a discussion of the most recent innovations, including the Comprehensive Health Insurance, the Health Care Enterprises system, the decentralization process and the Local Committees for Health Administration. The main challenge confronted by the Peruvian health system is the extension of coverage to more than I0 percent of the population presently lacking access to basic health care.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Peru , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
19.
Salud pública Méx ; 53(supl.2): s255-s264, 2011. tab
Article in Spanish | LILACS | ID: lil-597144

ABSTRACT

En este trabajo se describen las condiciones de salud de la República Dominicana y, con mayor detalle, el sistema de salud dominicano, incluyendo su estructura y cobertura, sus fuentes de financiamiento, el gasto en salud, los recursos físicos, materiales y humanos de los que dispone, las tareas de rectoría que desarrolla el Ministerio de Salud Pública y la generación de información. También se discuten la participación de los usuarios en la operación y evaluación del sistema de salud y las más recientes innovaciones implementadas, dentro de las que destacan la nueva Ley General de Salud, la nueva Ley de Seguridad Social y el Plan Decenal de Salud.


This paper describes the health conditions in Dominican Republic and the characteristics of the Dominican health system, including its structure and coverage, its financial sources, the health expenditure, the physical, material and human resources available, the stewardship functions developed by the Ministry of Public Health and the generation of health information. The participation of health care users in the operation and evaluation of the system and the most recent policy innovations, including the new General Health Law, the new Social Security Law and the Decennial Health Plan are also discussed.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Community Participation/statistics & numerical data , Demography , Dominican Republic , Delivery of Health Care/economics , Delivery of Health Care/legislation & jurisprudence , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Vital Statistics
20.
Salud pública Méx ; 53(supl.2): s265-s274, 2011. tab
Article in Spanish | LILACS | ID: lil-597145

ABSTRACT

En este trabajo se describe el sistema uruguayo de salud: su estructura y cobertura, sus fuentes de financiamiento, el nivel y distribución del gasto en salud, los recursos físicos, materiales y humanos de los que dispone, las actividades de rectoría que en él se desarrollan, las instituciones encargadas de generar la información y la investigación, y el nivel de participación de los ciudadanos en la operación y evaluación del sistema. También se describen las innovaciones más recientes, incluyendo la creación del Sistema Nacional Integral de Salud, el Seguro Nacional de Salud, el Fondo Nacional de Salud y el Programa Integral de Atención a la Salud. Finalmente se discute el impacto que estas innovaciones han tenido en el gasto en salud, en la justicia en el financiamiento del sistema, en los niveles de cobertura y en los principales indicadores de salud.


This paper describes the Uruguayan health system, including its structure and coverage, its financial sources, the level and distribution of its health expenditure, the physical, material and human resources available, its stewardship functions, the institutions in charge of information and research, and the level and type of citizen's participation in the operation and evaluation of the system. The most recent policy innovations are also discussed, including the creation of the National Comprehensive Health System, the National Health Insurance, the National Health Fund and the Comprehensive Health Care Program. Finally, the impact of these innovations in health expenditure, fairness of health financing, coverage levels and main health indicators is analyzed.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Services Administration , Community Participation/statistics & numerical data , Demography , Delivery of Health Care/economics , Delivery of Health Care/statistics & numerical data , Financing, Organized/economics , Financing, Organized/organization & administration , Financing, Organized/statistics & numerical data , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Health Status Indicators , Health Expenditures/statistics & numerical data , Health Resources/organization & administration , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Health Services Administration/economics , Health Services Administration/statistics & numerical data , Health Services/economics , Health Services/statistics & numerical data , Insurance Benefits/economics , Insurance Benefits/statistics & numerical data , Insurance Coverage/economics , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/organization & administration , Insurance, Health/statistics & numerical data , National Health Programs/economics , National Health Programs/organization & administration , National Health Programs/statistics & numerical data , Organizational Innovation , Occupational Health/economics , Private Sector/economics , Private Sector/organization & administration , Private Sector/statistics & numerical data , Quality Assurance, Health Care/organization & administration , Social Security/economics , Social Security/organization & administration , Social Security/statistics & numerical data , Uruguay , Vital Statistics
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