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卫生系统的监管与绩效:分析框架综述

Regulation and performance of health systems: a review of analytical frameworks.

作者信息

Báscolo Ernesto, Debrott Sánchez David, Houghton Natalia, Vance Carina

机构信息

Pan American Health Organization Washington, DC United States of America Pan American Health Organization, Washington, DC, United States of America.

出版信息

Rev Panam Salud Publica. 2025 Apr 9;49:e34. doi: 10.26633/RPSP.2025.34. eCollection 2025.

Abstract

The private health sector has expanded significantly in recent decades, both in Latin America and other regions. Governments and international organizations have dealt with this process in a heterogeneous manner. A policy approach and, above all, a regulatory framework, are required in order to put health objectives and the right to health above the profit motive that drives private sector participation. This paper reviews frameworks for analyzing the performance of health systems and the regulation of financing and service provision, primarily (but not exclusively) in the private sector. This review covers the output of the main international health agencies (Pan American Health Organization and World Health Organization), international development agencies (World Bank and Organization for Economic Cooperation and Development), and academics involved in international health policy debates. Common aspects of the different frameworks are identified, as well as substantive divergences. The purpose of this article, which is part of a larger project, is to contribute to discussions on the regulation of health systems in the Region of the Americas, consider their particularities, and describe the current context.

摘要

近几十年来,无论是在拉丁美洲还是其他地区,私营卫生部门都有了显著扩张。政府和国际组织对这一进程的应对方式各不相同。为了将卫生目标和健康权置于驱动私营部门参与的利润动机之上,需要一种政策方法,尤其是一个监管框架。本文主要(但不限于)回顾了私营部门卫生系统绩效分析以及融资与服务提供监管的框架。该综述涵盖了主要国际卫生机构(泛美卫生组织和世界卫生组织)、国际发展机构(世界银行和经济合作与发展组织)以及参与国际卫生政策辩论的学者的成果。文中识别了不同框架的共同之处以及实质性分歧。本文是一个更大项目的一部分,其目的是为美洲地区卫生系统监管的讨论做出贡献,考虑其特殊性,并描述当前背景。

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