The provision of health services in Chile: historical aspects, dilemmas and prospects
Autor(a) principal: | |
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Data de Publicação: | 1998 |
Tipo de documento: | Artigo |
Idioma: | spa |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/24368 |
Resumo: | The evolution of the health system in Chile, since its beginning and during the National Health Service period is discribed. The transfornations that this system underwent from 1980 on, during the military regime, and the changes introduced by the democratic governments from 1990 on, with the purpose of correcting distortions introduced in the previuos period, are commented on. The production of the health services is compared as between the public and private sub-sectors. The indicators used are outpatient attendance per thousand insured inhabitants, use of, lab texts on the same populational basis, hospitalization rates, discharges per thousand insured and surgery rates per thousand. Differences between the two sub-systems are commented on as also are those related to user satisfaction in the two sub-systems. The chief challenges to the public system are considered as well as their possible responses to them on the basis of current policies and the solutions implemented. The present situation in the Public/Private mix in health care in Chile gives rise to the positive expectation that the public subsystem may succed in maintaining its historical leadership in the orientation and health services offered in this country. This positive view is supported by the rigorous geographic and demographic logic of the public subsystem, the stable availability of financial resources (result of the 7% contribution for health applied on all salaries, complemented by tax funds), a not completely modern but reliable network of public health facilities and the considerable motivation shown by its statt. Some features of the Chilean health system's development are mentioned as potentially useful to the development of health systems in other countries, especially in Latin America, such as organization and management of regional health services, innovative methodologies in health service payment (diagnosed related payment, management agreements and per capita financing for primary care); the health surveilance system (especially for food and drugs) and the state regulation of private health care financers. |
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The provision of health services in Chile: historical aspects, dilemmas and prospects La provisión de servicios de salud en Chile: aspectos históricos, dilemas y perspectivas Sistema de saúde^i3^sorganização e administraPesquisa sobre serviços de saúdeExtensão de coberturaSistema de salud^i1^sorganización e administracInvestigación sobre servicios de saludExtensión de coberturaHealth system^i2^sorganization and administratHealth services researchExtension of health services coverage The evolution of the health system in Chile, since its beginning and during the National Health Service period is discribed. The transfornations that this system underwent from 1980 on, during the military regime, and the changes introduced by the democratic governments from 1990 on, with the purpose of correcting distortions introduced in the previuos period, are commented on. The production of the health services is compared as between the public and private sub-sectors. The indicators used are outpatient attendance per thousand insured inhabitants, use of, lab texts on the same populational basis, hospitalization rates, discharges per thousand insured and surgery rates per thousand. Differences between the two sub-systems are commented on as also are those related to user satisfaction in the two sub-systems. The chief challenges to the public system are considered as well as their possible responses to them on the basis of current policies and the solutions implemented. The present situation in the Public/Private mix in health care in Chile gives rise to the positive expectation that the public subsystem may succed in maintaining its historical leadership in the orientation and health services offered in this country. This positive view is supported by the rigorous geographic and demographic logic of the public subsystem, the stable availability of financial resources (result of the 7% contribution for health applied on all salaries, complemented by tax funds), a not completely modern but reliable network of public health facilities and the considerable motivation shown by its statt. Some features of the Chilean health system's development are mentioned as potentially useful to the development of health systems in other countries, especially in Latin America, such as organization and management of regional health services, innovative methodologies in health service payment (diagnosed related payment, management agreements and per capita financing for primary care); the health surveilance system (especially for food and drugs) and the state regulation of private health care financers. Se hace un breve análisis histórico del Sistema de Salud en Chile, desde el Sistema Nacional de Salud, con énfasis a las reformas ocurridas a partir de 1980, durante el régimen militar y los cambios introducidos desde 1990 por los gobiernos democráticos. Se compara la oferta actual de servicos por el subsistema público com aquella del privado utilizando como indicadores por mil beneficiarios: la tasa de consultas, de exámenes de laboratorio, de hospitalizaciones, de altas y de cirugías y la satisfación usuaria. Se analizan los principales dilemas del sistema de salud y las perspectivas de solución a la luz de las principales medidas tomadas en el presente. Hay buenas perpectivas de que el subsistema público mantenga su liderazgo histórico en la conducción y oferta de servicios en Chile debido a la rigurosa lógica geográfica y demográfica en la oferta de servicios, la disponibilidad estable de recursos financieros, una red de servicios suficiente y además, la considerable motivación de sus recursos humanos. Son mencionados aspectos innovadores que pueden ser útiles a otros sistemas, especialmente en América Latina, tales como: organización y gestión de servicios regionales de salud; metodologías innovadoras de pago de servicios; sistema de vigilancia sanitaria y la regulamentación estatal del financiamento privado en salud. Realiza-se breve análise histórica do sistema de saúde no Chile, a partir do Serviço Nacional de Saúde, com ênfase nas reformas ocorridas desde 1980,durante o regime militar, e as mudanças introduzidas a partir de 1990 pelos governos democráticos. Compara a oferta atual de serviços pelo sistema público com a do setor privado utilizando como indicadores por mil beneficiários: a taxa de consultas, de exames de laboratório, de hospitalização, de altas e de cirurgias e a satisfação dos usuários. Analisa os principais dilemas do sistema de saúde e suas perspectivas à luz das medidas presentemente tomadas. Há boas perspectivas de que o subsistema público mantenha sua liderança histórica na condução e oferta de serviços no Chile devido à rigorosa lógica geográfica e demográfica na prestação de serviços, a disponibilidade estável de recursos financeiros, uma rede de serviços suficiente e ainda a considerável motivação de seus recursos humanos. São mencionados aspectos inovadores que podem ser aproveitados por outros sistemas, especialmente na América Latina, como: organização e gestão de serviços regionais de saúde, metodologias inovadoras de remuneração de serviços, sistema de vigilância sanitária e a regulamentação estatal do financiamento privado em saúde. Universidade de São Paulo. Faculdade de Saúde Pública1998-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/2436810.1590/S0034-89101998000200016Revista de Saúde Pública; Vol. 32 No. 2 (1998); 192-199 Revista de Saúde Pública; Vol. 32 Núm. 2 (1998); 192-199 Revista de Saúde Pública; v. 32 n. 2 (1998); 192-199 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPspahttps://www.revistas.usp.br/rsp/article/view/24368/26292Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessCarlos Azevedo, Antonio2012-05-29T16:57:18Zoai:revistas.usp.br:article/24368Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-05-29T16:57:18Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
The provision of health services in Chile: historical aspects, dilemmas and prospects La provisión de servicios de salud en Chile: aspectos históricos, dilemas y perspectivas |
title |
The provision of health services in Chile: historical aspects, dilemmas and prospects |
spellingShingle |
The provision of health services in Chile: historical aspects, dilemmas and prospects Carlos Azevedo, Antonio Sistema de saúde^i3^sorganização e administra Pesquisa sobre serviços de saúde Extensão de cobertura Sistema de salud^i1^sorganización e administrac Investigación sobre servicios de salud Extensión de cobertura Health system^i2^sorganization and administrat Health services research Extension of health services coverage |
title_short |
The provision of health services in Chile: historical aspects, dilemmas and prospects |
title_full |
The provision of health services in Chile: historical aspects, dilemmas and prospects |
title_fullStr |
The provision of health services in Chile: historical aspects, dilemmas and prospects |
title_full_unstemmed |
The provision of health services in Chile: historical aspects, dilemmas and prospects |
title_sort |
The provision of health services in Chile: historical aspects, dilemmas and prospects |
author |
Carlos Azevedo, Antonio |
author_facet |
Carlos Azevedo, Antonio |
author_role |
author |
dc.contributor.author.fl_str_mv |
Carlos Azevedo, Antonio |
dc.subject.por.fl_str_mv |
Sistema de saúde^i3^sorganização e administra Pesquisa sobre serviços de saúde Extensão de cobertura Sistema de salud^i1^sorganización e administrac Investigación sobre servicios de salud Extensión de cobertura Health system^i2^sorganization and administrat Health services research Extension of health services coverage |
topic |
Sistema de saúde^i3^sorganização e administra Pesquisa sobre serviços de saúde Extensão de cobertura Sistema de salud^i1^sorganización e administrac Investigación sobre servicios de salud Extensión de cobertura Health system^i2^sorganization and administrat Health services research Extension of health services coverage |
description |
The evolution of the health system in Chile, since its beginning and during the National Health Service period is discribed. The transfornations that this system underwent from 1980 on, during the military regime, and the changes introduced by the democratic governments from 1990 on, with the purpose of correcting distortions introduced in the previuos period, are commented on. The production of the health services is compared as between the public and private sub-sectors. The indicators used are outpatient attendance per thousand insured inhabitants, use of, lab texts on the same populational basis, hospitalization rates, discharges per thousand insured and surgery rates per thousand. Differences between the two sub-systems are commented on as also are those related to user satisfaction in the two sub-systems. The chief challenges to the public system are considered as well as their possible responses to them on the basis of current policies and the solutions implemented. The present situation in the Public/Private mix in health care in Chile gives rise to the positive expectation that the public subsystem may succed in maintaining its historical leadership in the orientation and health services offered in this country. This positive view is supported by the rigorous geographic and demographic logic of the public subsystem, the stable availability of financial resources (result of the 7% contribution for health applied on all salaries, complemented by tax funds), a not completely modern but reliable network of public health facilities and the considerable motivation shown by its statt. Some features of the Chilean health system's development are mentioned as potentially useful to the development of health systems in other countries, especially in Latin America, such as organization and management of regional health services, innovative methodologies in health service payment (diagnosed related payment, management agreements and per capita financing for primary care); the health surveilance system (especially for food and drugs) and the state regulation of private health care financers. |
publishDate |
1998 |
dc.date.none.fl_str_mv |
1998-04-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/24368 10.1590/S0034-89101998000200016 |
url |
https://www.revistas.usp.br/rsp/article/view/24368 |
identifier_str_mv |
10.1590/S0034-89101998000200016 |
dc.language.iso.fl_str_mv |
spa |
language |
spa |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/24368/26292 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 32 No. 2 (1998); 192-199 Revista de Saúde Pública; Vol. 32 Núm. 2 (1998); 192-199 Revista de Saúde Pública; v. 32 n. 2 (1998); 192-199 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
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1800221778464735232 |