Sherraden M S, Wallace S P
Social Work Department, University of Missouri-St Louis 63121.
Soc Sci Med. 1992 Dec;35(12):1433-43. doi: 10.1016/0277-9536(92)90046-s.
Providing adequate health care to a nation's citizens is a challenge in every country. Despite large differences in wealth, health care organization, and health politics, both Mexico and the United States undertook similar efforts to expand primary care to previously underserved populations during the past 30 years. This study analyzes common antecedents, contexts of change, elements of the innovations, problems with entrenched interests, and resources that have allowed both programs to survive in difficult environments. We show that new forms of primary health care can face similar problems and prospects in very different countries because of similar political, bureaucratic, and economic limitations.
为一个国家的公民提供充足的医疗保健服务在每个国家都是一项挑战。尽管在财富、医疗保健组织和卫生政策方面存在巨大差异，但在过去30年里，墨西哥和美国都做出了类似的努力，将初级保健扩展到以前服务不足的人群。本研究分析了共同的前因、变革背景、创新要素、既得利益问题以及使这两个项目在艰难环境中得以存续的资源。我们表明，由于政治、官僚和经济方面的类似限制，新型初级卫生保健在非常不同的国家可能面临类似的问题和前景。
