Asunto(s)
Masculino , Femenino , Humanos , Atención Primaria de Salud , Equidad en el Acceso a los Servicios de Salud , Estudios de Evaluación como Asunto , Prestación Integrada de Atención de Salud , Satisfacción del Paciente , Sistemas de Salud/organización & administración , Accesibilidad a los Servicios de SaludRESUMEN
BACKGROUND: Health care research has demonstrated that the primary care level can provide effective services. AIM: To propose a basic package of services for primary health care in medium income countries, based on evidences about its effectiveness. MATERIALS AND METHODS: Scientific evidence for the effectiveness of primary care services was first sought through a systematic literature research. Interventions with evidences of effectiveness and appropriate for the Chilean epidemiological profile were selected. The cost in US dollars for a 100,000 inhabitant population was established. RESULTS: Fourteen programs with evidence of effectiveness were selected: immunizations, infant growth and development surveillance, pregnancy surveillance, family planning, cervical cancer screening, diabetes, hypertension, prevention of stroke, smoking cessation, treatment of problem drinkers, depression, lower respiratory infections in children of less than 6 years old, tuberculosis and palliative care. The total cost was calculated in US$ 36 per person/year. CONCLUSIONS: This proposal must be flexible, according to local conditions and changes in evidence. It is based in the "new universality" proposed by WHO, that combines a high coverage in key zones with economical realism.