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[初级保健政策与卫生改革:基于对巴西圣卡塔琳娜州弗洛里亚诺波利斯市家庭健康计划(1994 - 2000年)分析的评估方法]

[Primary care policies and health reforms: an evaluative approach based on an analysis of the Family Health Program in Florianópolis, Santa Catarina, Brazil, 1994-2000].

作者信息

Conill Eleonor Minho

机构信息

Núcleo de Apoio à Municipalização e Implementação do SUS, Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis, SC, 88063-070, Brasil.

出版信息

Cad Saude Publica. 2002;18 Suppl:191-202. Epub 2003 Jan 21.

PMID:12563513
Abstract

This article discusses the evaluation of primary health care policies based on a case study of the Family Health Program in Florianópolis, Santa Catarina, Brazil. The results are presented in two stages. First, the Program is placed in the context of the Municipality's policies, identifying perceptions of the Program at the administrative level. Second, the author studied the Program's practices based on a sample of five family health care teams using an evaluative framework including variables on accessibility and comprehensiveness. The Program began relatively late in the State capital, but developed a unique model. There is a greater supply of services available to the population not covered by private health plans, although there is a major diversity of practices. The degree of implementation is moderately adequate: the care provided is more comprehensive, but there are problems with access (in the ratio between staff and number of families covered). It is suggested that such proposals for reorienting health care models tend towards rationalization, political legitimization, or democratization of services. The accessibility policy can set the predominant direction.

摘要

本文基于对巴西圣卡塔琳娜州弗洛里亚诺波利斯市家庭健康计划的案例研究,探讨了初级卫生保健政策的评估。研究结果分两个阶段呈现。首先,将该计划置于该市政策的背景下,确定行政层面上对该计划的看法。其次,作者以五个家庭医疗团队为样本,运用一个包含可及性和全面性变量的评估框架,研究了该计划的实践情况。该计划在州首府启动相对较晚,但发展出了一种独特的模式。对于未被私人健康保险覆盖的人群,有更多的服务可供使用,尽管实践存在很大差异。实施程度中等适当:所提供的护理较为全面,但在可及性方面存在问题(工作人员与所覆盖家庭数量的比例)。有人认为,这种重新调整医疗保健模式的提议倾向于服务的合理化、政治合法化或民主化。可及性政策可以设定主要方向。

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