Health Financing Department, Clinton Health Access Initiative , Pretoria, South Africa.
Harvard TH Chan School of Public Health , Cambridge, Massachusetts, USA.
Health Syst Reform. 2020 Sep 1;6(2):e1840825. doi: 10.1080/23288604.2020.1840825.
On the global health agenda, Universal Health Coverage has been displaced by the COVID-19 pandemic while disparities in COVID-19 outcomes have exposed stark gaps in quality, access, equity, and financial risk protection. These disparities highlight the importance of the core goals of Universal Health Coverage and the need for innovative approaches to working toward them. The newly codified concept of "Networks of Care" offers a promising option for implementation. The articles in this special issue present the Networks of Care lexicon and framework and demonstrate the development of leadership, responsibility, intra- and inter-facility cooperation, and dynamic cycles of quality improvement. These elements are associated with better access to services and better health outcomes, the ultimate goals of Universal Health Coverage. Increases in poverty, food insecurity, and deleterious impact on the status of women secondary to the COVID-19 pandemic add urgency to Universal Health Coverage, while the economic impact of pandemic mitigation may reduce availability of resources for years to come. The need for Universal Health Coverage and efficiency and flexibility in health spending, including the ability to contract directly, has become even more important. Countries where Universal Health Coverage efforts have yet to carry through to provision of good quality, accessible and equitable service delivery could potentially benefit from concurrent Networks of Care implementation. Documentation of Networks of Care in the context of Universal Health Coverage should be prioritized to understand how Networks of Care can be used to help realize the goals of Universal Health Coverage around the world.
在全球卫生议程上，全民健康覆盖已被 COVID-19 大流行所取代，而 COVID-19 结果的差异暴露了在质量、可及性、公平性和财务风险保护方面的明显差距。这些差异突出了全民健康覆盖的核心目标的重要性，以及需要创新方法来实现这些目标。新编纂的“关怀网络”概念为实施提供了一个有希望的选择。本期特刊中的文章介绍了关怀网络的词汇和框架，并展示了领导力、责任、机构内和机构间合作以及质量改进的动态循环的发展。这些要素与更好地获得服务和更好的健康结果有关，这是全民健康覆盖的最终目标。COVID-19 大流行导致贫困、粮食不安全和对妇女地位的不利影响增加，使全民健康覆盖更加紧迫，而大流行缓解的经济影响可能在未来几年内减少资源的可用性。对全民健康覆盖以及卫生支出的效率和灵活性的需求，包括直接签订合同的能力，变得更加重要。那些全民健康覆盖工作尚未落实到提供高质量、可及和公平的服务提供的国家，可能会从同时实施关怀网络中受益。在全民健康覆盖的背景下记录关怀网络的情况，应该优先考虑如何利用关怀网络来帮助实现全球范围内的全民健康覆盖目标。
