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政府的角色以及少数群体和发展中国家相互竞争的优先事项。

The role of government and competing priorities in minority populations and developing nations.

作者信息

Depine Santos

机构信息

Committee for Nephrology Development and National Problems, Latin American Society of Nephrology and Hypertension, Maracaibo, Venezuela.

出版信息

Ethn Dis. 2009 Spring;19(1 Suppl 1):S1-73-9.

Abstract

OBJECTIVE

The purpose of this article is to analyze the role of governments in relation to the burden of chronic diseases and the potential response within the framework of competing priorities that determine resource allocation.

METHODS

The following variables were analyzed both in retrospect and prospectively: the epidemiologic transition and the current effect of degenerative chronic diseases, the epidemic of diabetes and kidney disease in minority populations and developing countries, the potential response from healthcare systems, the relationship of chronic kidney disease vs quality of life and costs, and the differences between developed and developing countries.

RESULTS

In Latin America, as in many other regions, cardiovascular diseases (ie, heart diseases and stroke) kill many people at early stages of renal disease. Only some survivors have access to renal replacement therapy. Those deaths can be attributed to the lack of systematized prevention and control programs to encompass chronic diseases and relate to poor engineering of adequate financial support. The Latin American Society of Nephrology and Hypertension is fostering a cardiovascular, cerebral, renal, and endocrine-metabolic health program in which 12 countries in the Latin American region implement different strategies, including allocation of national funds and strengthening of transplant programs. The focus of these strategies is on promotion, prevention, rehabilitation, research, and teaching.

CONCLUSION

Developing countries should implement cardiovascular, cerebral, renal, and endocrine-metabolic health programs to improve efficiency of sanitary regulations and retrieve the huge amount of money that is spent on illnesses associated with the absence of systematized kidney disease control and follow-up programs.

摘要

目的

本文旨在分析政府在慢性病负担方面的作用,以及在决定资源分配的相互竞争的优先事项框架内可能的应对措施。

方法

对以下变量进行了回顾性和前瞻性分析:流行病学转变和退行性慢性病的当前影响、少数族裔人群和发展中国家的糖尿病和肾病流行情况、医疗系统的潜在应对措施、慢性肾病与生活质量和成本的关系,以及发达国家和发展中国家之间的差异。

结果

在拉丁美洲,与许多其他地区一样,心血管疾病(即心脏病和中风)在肾病早期导致许多人死亡。只有一些幸存者能够获得肾脏替代治疗。这些死亡可归因于缺乏涵盖慢性病的系统化预防和控制计划,以及适当财政支持的设计不佳。拉丁美洲肾脏病和高血压学会正在推动一项心血管、脑、肾和内分泌代谢健康计划,拉丁美洲地区的12个国家在该计划中实施不同的策略,包括国家资金分配和加强移植计划。这些策略的重点是促进、预防、康复、研究和教学。

结论

发展中国家应实施心血管、脑、肾和内分泌代谢健康计划,以提高卫生法规的效率,并挽回因缺乏系统化的肾病控制和随访计划而花费在疾病上的巨额资金。

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