Subject(s)
Delivery of Health Care/trends , Hospitals, Rural , Quality of Health Care , Rural Health Services , Adult , Delivery of Health Care/standards , Ecuador , Family Practice/education , Family Practice/trends , Female , Hospitals, Rural/economics , Humans , Infant, Newborn , Internship and Residency , Male , Maternal Health Services/standards , Maternal Health Services/trends , Politics , Pregnancy , Primary Health CareSubject(s)
Health Education/organization & administration , Smoking/epidemiology , Tobacco Use Disorder/epidemiology , Tobacco Use Disorder/prevention & control , Adolescent , Adolescent Behavior , Age Distribution , Age of Onset , Child , Child Behavior , Child Welfare , Female , Humans , Incidence , Male , Needs Assessment , Risk Assessment , Sex Distribution , United States/epidemiologyABSTRACT
En Ecuador, el acceso de la población rural a servicios adecuados de atención secundaria de salud se ha hecho cada vez más difícil. A pesar de que los sectores público y privado han acertado en dedicar esfuerzos a la atención primaria y a la salud pública, la mayoría de las poblaciones rurales no tienen acceso a una adecuada atención secundaria. Por lo general, los modelos tradicionales de atención médica secundaria en zonas rurales no se han adaptado a las nuevas situaciones, como la tendencia general a la descentralización, el énfasis en el desarrollo de capacidades locales, el antagonismo entre el acceso universal y la autonomía financiera, las alternativas financieras innovadoras y los recién llegados médicos de familia. En 2001, la organización no gubernamental con sede en los Estados Unidos de América Andean Health & Development (Saludesa en Ecuador) inauguró un hospital rural de 17 camas, construido conjuntamente con el municipio local y el Ministerio de Salud de Ecuador. El hospital atiende a una comunidad rural de 50000 personas que antes no tenían acceso local a servicios secundarios de salud. Los esfuerzos de AHD/Saludesa para desarrollar una red autosostenible pública/privada de atención primaria/secundaria de salud y de alta calidad han generado una considerable experiencia en la administración de un hospital rural. El proyecto piloto de AHD se concentró en un hospital rural y logró su autosostenibilidad total en 2007. Esto se logró mediante una combinación de mecanismos financieros, entre ellos la venta de paquetes prepagados de atención sanitaria, un contrato con el Instituto Ecuatoriano de Seguridad Social, contribuciones municipales y el pago tradicional por los servicios.
Subject(s)
Adult , Female , Humans , Infant, Newborn , Male , Pregnancy , Delivery of Health Care/trends , Hospitals, Rural , Quality of Health Care , Rural Health Services , Delivery of Health Care/standards , Ecuador , Family Practice/education , Family Practice/trends , Hospitals, Rural/economics , Internship and Residency , Maternal Health Services/standards , Maternal Health Services/trends , Politics , Primary Health CareSubject(s)
Hospitals, Rural , Rural Health Services , Ecuador , Hospitals, Rural , Rural Health Services , Secondary Care , Hospitals, Rural , Family Practice , Internship and Residency , Politics , Delivery of Health Care , Quality of Health Care , Rural Health Services , Maternal Health Services , Primary Health CareSubject(s)
Child Welfare/trends , Morbidity/trends , Child , Child Mortality/trends , Forecasting , Health Status , Humans , Infant , Infant Mortality/trends , Infant, NewbornSubject(s)
Health Policy , Public Health , Smoking Prevention , Adolescent , Adult , Cause of Death , Child , Humans , Middle Aged , Smoking/adverse effects , Smoking/epidemiology , Smoking/legislation & jurisprudence , Smoking Cessation/economics , Taxes/legislation & jurisprudence , Tobacco Industry , United States/epidemiologySubject(s)
Health Education/organization & administration , Health Planning/organization & administration , Health Status , Primary Health Care/organization & administration , Adult , Aged , Aged, 80 and over , Female , Humans , Life Expectancy , Longevity , Male , Middle Aged , Primary Prevention/organization & administration , Southeastern United StatesABSTRACT
Historically, public and private providers of health and welfare services have functioned in separate, often incompatible, arenas. Drawing from the experience of a private child mental health center, the authors suggest that a more coordinated and collaborative approach would benefit both the public and private sectors, as well as their client populations.
