La víspera del año 2000: Los sistemas de atención a la salud. Conceptos y ejemplos

Abstract

This is an introduction to the study of national health care systems, based on recent reports from both industrialized and developing countries. The context of economic, demographic and epidemiological changes is related to the distortions currently affecting health care systems and system “reforms” and to the challenges confronting them. These complex organisms can be described summarily as living bodies, with their “head” —health concepts, principle-objectives, orientations and policies—; “limbs” or pillars, namely the financing intermediaries, the financial sources, the providers of services and the users; and a “trunk” in which elements and mechanisms operate that make for the execution of the activities and the attainment of the results which constitute the finality of this kind of systems. The organs, cells and secretions perceived inside the trunk are: organization; management; planning; financial, human and technological resources; and the flows of services and resources inside the body and across its envelope. At the end, a commentary is included about the roles of the population and of physicians in the inception and workings of health care at different times and places.