Pálizas F, Gallesio A, Wainsztein N, Ceraso D, Apezteguía C, Pacín J
Intensive Care Unit, Clinica Bazterrica, Buenos Aires, Argentina.
New Horiz. 1994 Aug;2(3):336-40.
For many years, the evolution of Argentina's healthcare system has been influenced by political and economic instability. Inflation and hyperinflation have led to anarchic development of both health administration systems and hospitals. Critical care grew in a similar manner, resulting in a mix of > 500 critical care units with very different levels of technology and trained personnel. Cost-containment policies have been implemented mainly by health administration systems. Public institutions (university and large provincial and county hospitals) have suffered hard budget cuts that have resulted in a decrease in the quality of care and the loss of trained human resources. Union organizations, which cover the healthcare costs of > 60% of the population, implemented a low reimbursement policy that resulted in low standards of care for critically ill patients. The country's private hospital system is extremely heterogenous, ranging from little, simple institutions with a 20- to 30-bed capacity to great private institutions with international standards of care. Cost-containment efforts have been sporadic and isolated, and statistical data to analyze the results are lacking. In order to formulate a strategy of cost-containment in the near future, accreditation and categorization of critical care units and human resources training are being implemented by health authorities and the Argentine Society of Critical Care Medicine.
多年来，阿根廷医疗体系的发展受到政治和经济不稳定因素的影响。通货膨胀和恶性通货膨胀导致了卫生管理系统和医院的无政府式发展。重症监护领域也以类似方式发展，最终形成了500多个技术水平和人员培训程度差异极大的重症监护病房。成本控制政策主要由卫生管理系统实施。公共机构（大学以及大型省级和县级医院）遭受了大幅预算削减，导致医疗质量下降和专业人力资源流失。覆盖60%以上人口医疗费用的工会组织实施了低报销政策，导致重症患者的护理标准较低。该国的私立医院系统极为参差不齐，从小型、仅有20至30张床位的简易机构到具备国际护理标准的大型私立机构都有。成本控制工作一直是零星且孤立的，并且缺乏用于分析结果的统计数据。为了在不久的将来制定成本控制策略，卫生当局和阿根廷重症医学协会正在对重症监护病房进行认证和分类，并开展人力资源培训。
