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巴西统一卫生系统中的工作与教育管理:三十年的进步与挑战

The Management of Work and Education in Brazil's Unified Health System: thirty years of progress and challenges.

作者信息

Machado Maria Helena, Ximenes Neto Francisco Rosemiro Guimarães

机构信息

Escola Nacional de Saúde Pública, Fiocruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.

Universidade Estadual do Vale do Acaraú. Sobral CE Brasil.

出版信息

Cien Saude Colet. 2018 Jun;23(6):1971-1979. doi: 10.1590/1413-81232018236.06682018.

Abstract

This article presents a historical analysis of work management and education in the healthcare field over the three decades since the creation of Brazil's Unified Health System (SUS, acronym in Portuguese). Using the sociology of professions as a frame of reference, it addresses the following topics: the health labor market; trends in healthcare employment; the healthcare workforce; and the regulation and dynamics of undergraduate programs in the health field. It analyzes each of the moments that characterize the area, from the pre-SUS period to the present day. The period has witnessed the following: a boom in health schools, largely in the private sector; an overall increase in the level of education of health professionals , an increase in regional inequity; an alarming increase in distance learning programs; an imbalance between labor supply and demand; the expansion of installed capacity; the municipalization of health employment; an increased focus on multiprofessional teams; and an increase in precarious work and informal contractual relationships and deterioration of pay levels.

摘要

本文对巴西统一卫生系统(SUS,葡萄牙语首字母缩写)创建以来三十年里医疗领域的工作管理与教育进行了历史分析。以职业社会学为参照框架,探讨了以下主题:卫生劳动力市场;医疗就业趋势;医疗劳动力;以及卫生领域本科项目的监管与动态。它分析了该领域从统一卫生系统创建前到如今各个阶段的特点。这一时期出现了以下情况:卫生学校大量涌现,主要集中在私立部门;卫生专业人员的教育水平总体提高;地区不平等加剧;远程学习项目惊人增长;劳动力供需失衡;装机容量扩大;卫生就业地方化;对多专业团队的关注度增加;不稳定工作、非正式合同关系增多以及薪资水平下降。

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