Assessoria ao Conselho Diretivo da Administração Regional de Saúde de Lisboa e Vale do Tejo. Av. Estados Unidos da América 77, 1700-179 Lisboa.
Cien Saude Colet. 2020 Mar;25(4):1221-1232. doi: 10.1590/1413-81232020254.31422019. Epub 2019 Nov 10.
The scale of transformation required to achieve all Sustainable Development Goals (SDGs) is considerable. The third SDG (SDG3) is explicitly health-related to ensure healthy lives and well-being for all, at all ages. Primary care (PHC), in this context, is the backbone of a health system that can improve people's health, reduce spending and inequalities. A robust system orientation towards PHC must be temporally stable since its reformulation. This analysis uses an instrumental case study. This type of case study provides the opportunity to learn about events. We analyzed and debated 13 indicators, comparing over time, the results obtained by the type of Portuguese health units: USF-A, USF-B, UCSP, UCSP-M. The results show some discrepancies when comparing USFs and UCSPs and may contribute to the deterioration of access inequalities. This is a problem related to clinical governance and not the health unit model. Empowering coordination and improving the effectiveness of middle management is crucial.
实现所有可持续发展目标(SDGs)所需的变革规模相当大。第三个 SDG(SDG3)明确与健康相关,旨在确保所有人在所有年龄段都享有健康的生活和福祉。在这种情况下,初级保健(PHC)是能够改善人民健康、减少支出和不平等的卫生系统的支柱。一个强大的、面向 PHC 的系统必须具有时间稳定性,因为它是经过重新制定的。本分析采用了工具案例研究。这种类型的案例研究为了解事件提供了机会。我们分析和讨论了 13 个指标,随着时间的推移比较了 USF-A、USF-B、UCSP 和 UCSP-M 这几种葡萄牙卫生单位类型的结果。结果表明,在比较 USF 和 UCSP 时存在一些差异,这可能导致获得机会的不平等恶化。这是一个与临床治理有关的问题,而不是卫生单位模式的问题。赋予协调权力和提高中层管理的效力至关重要。