Résumé
Dedica à análise do caso paradigmático do modelo de sistema de saúde baseado no seguro privado, ardorosamente defendido, a partir dos anos 80, por importantes atores sociais como a panacéia para a organizaçäo da atençäo da saúde em vários países (CPS)
Sujets)
Prestations des soins de santé , Financement des soins de santé , Systèmes de SantéRésumé
The national vaccination campaing carried out in Colombia in 1984 was aimed at increasing vaccination coverage of the child population under 4 years of age with DPT, oral polio, and measles vaccines. This study compares the cost of vaccinations performed during the campaign with that of vaccinations performed by the normal vaccination services in several departments of Colombia in the same year, and evaluates the cost-effectiveness of each strategy. It was found that the average cost per vaccination at units selected in the department of Bogotá, Cundinamarca, and Huila was similar to that of the campaign. However, for each infant receiving a third dose of DPT under the campaign the cost was more than twice that of the normal services. National vaccination coverage, measured as the number of infants that received a third dose of DPT, increased considerably both as a result of the campaign and of the normal services provided by the health units. Coverage rose from 42.3 per cent in 1983 to 66.7 per cent by the end of 1984. However, more than half this increase was attributable to the normal vaccination services
Sujets)
Coûts et analyse des coûts , Vaccination de masse , ColombieRésumé
This article presents an overview of a study carried out by the Public Health Special Service Foundation (Ministry of Health of Brazil) in association with the Pan Américan Health Organization; it compares the economic efficiency of the different vaccination strategies implemented by the National Immunization Program in Brazil in 1982. These strategies were classified in the following way: a) routine vaccination services, offered routinely by federal, state and municipal health service networks; b) mass vaccination campaigns; and c) intensified routine services, where scheduled vaccination services were provided in small villages in the interior of the country. These strategies were assessed by taking into account, on one hand, the costs of supplying the vaccines (in order words, of providing the services) and the costs of obtaining the vaccines (that is, transportation, costs, etc., which affect the user) and, on the other hand, the number of vaccinations and children completely vaccinated by means of each strategy. For this analysis, the study sample was the health units of differnt public institutions in 16 municipalities in the North and Northeast regions of Brazil. The results of the study show that, generally speaking, the mass campaign was the most efficient strategy, although in some municipalities the results of rutine services were almost as good