Pisco Luis
Centro de Saúde da Foz do Arelho, Foz do Arelho, Portugal.
Cien Saude Colet. 2011 Jun;16(6):2841-52. doi: 10.1590/s1413-81232011000600022.
In 2005, Portugal began a reform of Primary Health Care. This reform process through to April 2010 is described and analyzed. During this period the Mission for Primary Health Care was responsible for conducting a profound reconfiguration. The main objectives for this reform were to improve accessibility, efficiency, quality and continuity of care and increase the satisfaction of professionals and citizens. The main features are voluntary adhesion, teamwork, mandatory information system, performance-sensitive payment, contracting and evaluation. The reconfiguration of health centers was two pronged. First, there was the formation of small autonomous functional units, known as Family Health Units (USF) providing services with proximity and quality. The second measure involved the aggregation of resources and management structures, groups of health centers (ACES), seeking to achieve efficiency and economies of scale. The FHU proved to offer simultaneously more efficiency, accessibility, better working environment, greater citizen satisfaction, namely better quality. The importance of strong political support, the creation of a structure responsible for the design and implementation of reform and good liaison with the media are stressed.
2005年，葡萄牙启动了初级卫生保健改革。本文描述并分析了截至2010年4月的这一改革进程。在此期间，初级卫生保健特派团负责进行深度重组。此次改革的主要目标是提高医疗服务的可及性、效率、质量和连续性，并提升专业人员和民众的满意度。主要特点包括自愿加入、团队合作、强制信息系统、绩效敏感型薪酬、签约和评估。卫生中心的重组有两个方面。首先，形成了小型自主功能单元，即家庭健康单元（USF），提供贴近民众且高质量的服务。第二项措施涉及资源和管理结构的整合，即卫生中心群组（ACES），旨在实现效率和规模经济。事实证明，家庭健康单元同时具备更高的效率、可及性、更好的工作环境、更高的民众满意度，即更高的质量。文中强调了强有力的政治支持、设立负责改革设计与实施的机构以及与媒体保持良好联络的重要性。
