Yavich Natalia, Báscolo Ernesto Pablo, Haggerty Jeannie
Consejo Nacional de Investigaciones Científicas y Técnicas, Centro de Estudios Interdisciplinarios, Universidad Nacional de Rosario. Rosario, Argentina.
McGill University, Department of Family Medicine, St. Mary's Hospital Research Centre. Montreal, Canada.
Salud Publica Mex. 2016 Sep-Oct;58(5):504-513. doi: 10.21149/spm.v58i5.7827.
: To analyze the relationship between health system financing and services organization models with costs and health services performance in each of Rosario's health sub-systems.
: The financing and organization models were characterized using secondary data. Costs were calculated using the WHO/SHA methodology. Healthcare quality was measured by a household survey (n=822).
: Public subsystem:Vertically integrated funding and primary healthcare as a leading strategy to provide services produced low costs and individual-oriented healthcare but with weak accessibility conditions and comprehensiveness. Private subsystem: Contractual integration and weak regulatory and coordination mechanisms produced effects opposed to those of the public sub-system. Social security: Contractual integration and strong regulatory and coordination mechanisms contributed to intermediate costs and overall high performance.
: Each subsystem financing and services organization model had a strong and heterogeneous influence on costs and health services performance.
分析罗萨里奥市各卫生子系统中卫生系统融资与服务组织模式与成本及卫生服务绩效之间的关系。
利用二手数据对融资和组织模式进行特征描述。成本采用世界卫生组织/卫生账户体系方法进行计算。通过家庭调查(n = 822)对医疗质量进行衡量。
公共子系统:垂直整合的资金投入以及将初级卫生保健作为提供服务的主导策略,带来了低成本和以个体为导向的医疗服务,但可及性条件较差且全面性不足。私人子系统:契约整合以及薄弱的监管和协调机制产生了与公共子系统相反的效果。社会保障:契约整合以及强大的监管和协调机制导致了中等成本和总体较高的绩效。
每个子系统的融资和服务组织模式对成本和卫生服务绩效都有强大且各异的影响。