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¿Comprar resultados? Contratación para la prestación de servicios de salud en países en desarrollo
Benjamin Loevinsohn1, April Harding
1World Bank, 1818 H Street NW, Mailstop MC11-1106, Washington DC, USA. bloevinsohn@worldbank.org
Lancet (London, England)
|August 23, 2005
Resumen
La contratación con organizaciones no gubernamentales (ONG) mejora significativamente la prestación de atención médica primaria, mostrando resultados rápidos y sostenidos en diversos entornos. Esta estrategia rentable, que cuesta entre 3 y 6 dólares por persona al año, debería expandirse a nivel mundial.
Área de la Ciencia:
- Salud Pública La salud pública.
- Gestión de servicios de salud Gestión de servicios de salud.
- Salud internacional La salud internacional es la salud.
Sus antecedentes:
- La mejora de la prestación de servicios de salud es crucial para lograr los objetivos mundiales de salud.
- La contratación con entidades no estatales, como organizaciones no gubernamentales (ONG), es una estrategia propuesta para mejorar la atención médica.
- La experiencia global con la contratación de servicios de salud requiere una revisión exhaustiva.
Objetivo del estudio:
- Revisar las experiencias globales con la contratación para la prestación de servicios de salud.
- Evaluar la efectividad y sostenibilidad de la contratación de atención primaria.
- Determinar la rentabilidad de los servicios básicos de salud contratados.
Principales métodos:
- Revisión de diez estudios de caso globales sobre la contratación para la prestación de atención primaria.
- Análisis de la efectividad, sostenibilidad y costo de los servicios contratados.
- Evaluación de desafíos y éxitos en diversos entornos de atención médica.
Principales resultados:
- La contratación para la prestación de atención primaria demostró una eficacia significativa y mejoras rápidas en múltiples entornos.
- Las dificultades de contratación previstas fueron mínimas o no impidieron la efectividad.
- Siete de los nueve contratos a largo plazo (más de 3 años) se mantuvieron y ampliaron.
- El costo de un paquete de servicios básicos osciló entre aproximadamente US $ 3 y US $ 6 por persona al año en países de bajos ingresos.
Conclusiones:
- La contratación con entidades no estatales, en particular las ONG, es una estrategia altamente efectiva para mejorar la atención primaria de salud.
- El modelo es sostenible, escalable y rentable en entornos de bajos ingresos.
- Se recomienda la expansión de la contratación de servicios de salud, junto con evaluaciones rigurosas para los esfuerzos futuros.
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