Sollazzo Ana, Berterretche Rosario
Departamento de Medicina Preventiva y Social, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
Cien Saude Colet. 2011 Jun;16(6):2829-40. doi: 10.1590/s1413-81232011000600021.
The article examines the results of the overview of PHC (Primary Healthcare) in Uruguay in 2009, within the context of the multicentric study of PHC with a view to identifying possibilities of redefining PHC as a strategy to achieve universal healthcare systems, taking into account the healthcare system's segmentation and fragmentation. The methodology included document analysis, key informant interviews and triangulation of information sources. The results presented are based on the analytical model structured in five dimensions: delivery, financing, resources, and integrated and intersectoral PHC. At the macro level, one can observe the recent implementation of a sector reform through the creation of the Integrated National Health System (SNIS) that favors the development of the PHC from an integrative standpoint. Actions have been defined to overcome the segmentation of the system and the fragmentation of care. However, at an operational level, the segmentation that existed before the SNIS as well as the low levels of healthcare coordination have yet to be modified. This is related to management ability and organizational factors. The lack of adequate human resources for the implementation of the PHC strategy is identified as a relevant factor.
本文考察了2009年乌拉圭初级卫生保健（PHC）概况的研究结果，该研究是在初级卫生保健多中心研究的背景下进行的，旨在确定重新定义初级卫生保健作为实现全民医疗体系战略的可能性，同时考虑到医疗体系的分割和碎片化情况。研究方法包括文献分析、关键信息人访谈以及信息来源的三角互证法。呈现的结果基于一个由五个维度构建的分析模型：服务提供、筹资、资源以及综合和跨部门的初级卫生保健。在宏观层面，可以看到最近通过创建国家综合卫生系统（SNIS）实施了部门改革，这从整合的角度有利于初级卫生保健的发展。已经确定了一些行动来克服系统的分割和医疗服务的碎片化。然而，在操作层面，SNIS建立之前就存在的分割以及医疗协调水平较低的情况尚未得到改善。这与管理能力和组织因素有关。实施初级卫生保健战略缺乏充足的人力资源被确定为一个相关因素。
