Kuschnir Rosana, Chorny Adolfo Horácio
Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21041-210.
Cien Saude Colet. 2010 Aug;15(5):2307-16. doi: 10.1590/s1413-81232010000500006.
The proposal of organization in health services networks has been included in the broad field of integrated health care, a general denomination which includes a wide range of interventions varying in objectives and scope, which have in common the pursuit of integration strategies and tools. Among the main experiences in the field are the American integrated delivery systems and the traditional regionalized networks of the national health systems, especially after the introduction of new cooperation strategies. However, while strategies and organizational arrangements might be similar, context is central to debate. Not considering differences concerning health systems nature may turn it difficult to grasp main distinctions in policy making which are responsible for possibilities and limitations of adopting integration strategies and tools. This article aims to look for references in the literature and international experience that might contribute to the debate on health networks building in the Brazilian Unified Health System (SUS). It discusses context regarding the creation of integrated health services networks in two cases, the British National Health Service and the American Health System, focusing specifically on the health services organization component.
卫生服务网络中的组织提议已被纳入综合医疗保健这一广泛领域,这一通用术语涵盖了一系列目标和范围各异的干预措施,它们的共同之处在于追求整合战略和工具。该领域的主要经验包括美国的综合服务体系以及国家卫生系统传统的区域化网络,特别是在引入新的合作战略之后。然而,尽管战略和组织安排可能相似,但背景对于辩论至关重要。不考虑卫生系统性质的差异可能会导致难以把握决策中的主要区别,而这些区别决定了采用整合战略和工具的可能性与局限性。本文旨在在文献和国际经验中寻找可能有助于巴西统一卫生系统(SUS)中卫生网络建设辩论的参考资料。它讨论了英国国家医疗服务体系和美国卫生系统这两个案例中综合卫生服务网络创建的背景,特别关注卫生服务组织部分。