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[全面医疗保健与综合健康服务:评估“无边界系统”实施情况面临的挑战]

[Comprehensive health care and integrated health services: challenges for evaluating the implementation of a "system without walls"].

作者信息

Hartz Zulmira M de Araújo, Contandriopoulos André-Pierre

机构信息

Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.

出版信息

Cad Saude Publica. 2004;20 Suppl 2:S331-6. doi: 10.1590/s0102-311x2004000800026. Epub 2004 Dec 15.

Abstract

The premise of this paper is that comprehensive health care is a major component in the investigation and evaluation of health services and systems, structured as inter-organizational health care networks articulating clinical, functional, normative, and systemic dimensions in their operationalization and based on the understanding that no organization combines all the necessary resources and capabilities to solve the health problems of a population with its various life cycles. Given the complex nature of this "system without walls", eliminating barriers to access in the various health care levels in response to local and regional health, we take this opportunity to share a few "preliminary lessons" from our experience and from the literature on integrated health services which may interest researchers and managers concerned with the implementation of such services.

摘要

本文的前提是,全面医疗保健是卫生服务和系统调查与评估的一个主要组成部分,其构建为跨组织医疗保健网络,在实施过程中阐明临床、功能、规范和系统层面,并基于这样一种认识:没有任何一个组织能整合所有必要资源和能力来解决不同生命周期人群的健康问题。鉴于这个“无边界系统”的复杂性,为应对地方和区域卫生状况,消除各级医疗保健中的就医障碍,我们借此机会分享一些我们自身经验以及综合卫生服务文献中的“初步经验教训”,这可能会引起关注此类服务实施的研究人员和管理人员的兴趣。

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