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[实现卫生公平。对自治区卫生计划的分析。]

[Bringing in equity to health. An analysis of the autonomous communities health plans.].

作者信息

Barral Buceta Bran, Bouzas-Lorenzo Ramón, Cernadas Ramos Andrés, Fernández Da Silva Ángela

机构信息

Universidad de Santiago de Compostela. Facultad de Ciencias Políticas y Sociales. Departamento de Ciencia Política y Sociología. Santiago de Compostela. España.

出版信息

Rev Esp Salud Publica. 2021 Feb 19;95:e202102029.

Abstract

OBJECTIVE

The debate on equity in health, with long history and wide understanding, is more relevant today when considering the transcendence of this area. In the context of our system, it is appropriate to know the approach adopted by the autonomous communities. By analysing regional health plans in Spain it was intended to detect the perspectives applied in the search for equity, as well as to know the main goals of the plans and those groups or circumstances they try to deal with.

METHODS

Based on the procedure of constant comparative analysis and content analysis, whose statistical treatment was conducted with Nvivo software (v12) and the analysis of Jaccard and Pearson correlation indexes, along with the triangulation of methods, data and researchers, the most recent regional health plans in progress (fourth quarter of 2019) were screened.

RESULTS

Analized plans brought out that the search for equity is not given sufficient relevance. However, there are specific circumstances that standed out among the references to equity in the plans. Accessibility arised as a key category to understand the setup of health care as a public policy.

CONCLUSIONS

The main paradigm found in regional health plans is that of equality or equity in access to health. To a lesser extent, it is also present a search for equal opportunities for various specific groups, such as people suffering from mental illness, people with functional diversity or who face some of the barriers or difficulties associated with the gender gap. Other items or groups considered by the regional administrations in a more reduced way, but also in a different manner, are immigration, rural habitat and infrastructures and elderly people.

摘要

目的

关于健康公平的辩论历史悠久且理解广泛,在考虑该领域的超越性时,如今更具现实意义。在我们的体系背景下,了解自治区所采用的方法是恰当的。通过分析西班牙的地区卫生计划,旨在发现寻求公平所应用的视角,以及了解这些计划的主要目标和它们试图应对的群体或情况。

方法

基于持续比较分析和内容分析的程序,其统计处理使用Nvivo软件(v12)以及杰卡德和皮尔逊相关指数分析,同时结合方法、数据和研究人员的三角验证,对最新的正在实施的地区卫生计划(2019年第四季度)进行筛选。

结果

分析的计划表明,对公平的追求未得到足够重视。然而,在计划中提及公平的内容里,有一些特定情况较为突出。可及性成为理解将医疗保健作为一项公共政策的关键类别。

结论

地区卫生计划中发现的主要范式是获得医疗服务方面的平等或公平。在较小程度上,也存在为各种特定群体寻求平等机会的情况,比如患有精神疾病的人、功能多样性人群或面临与性别差距相关的一些障碍或困难的人。地区行政部门较少考虑但方式不同的其他项目或群体包括移民、农村居住环境和基础设施以及老年人。

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