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Atención primaria y salud. Una comparación transnacional
1Department of Health Policy Management, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205.
JAMA
|October 23, 1991
Resumen
La comparación de diez naciones industrializadas en atención primaria de salud, indicadores de salud y satisfacción de la población reveló calificaciones consistentemente altas para Canadá, Suecia y los Países Bajos. Los Estados Unidos y Alemania Occidental mostraron un bajo rendimiento en estas medidas clave del sistema de salud.
Área de la Ciencia:
- Servicios de salud Investigación Servicios de salud Investigación
- Análisis comparativo de los sistemas de salud Análisis comparativo de los sistemas de salud
- Política de salud pública Política de salud pública.
Sus antecedentes:
- Las comparaciones internacionales de los sistemas de salud son cruciales para identificar las mejores prácticas y áreas de mejora.
- Comprender la relación entre la atención primaria, los resultados de salud y la satisfacción pública es esencial para una política de salud efectiva.
- Estudios anteriores han destacado las variaciones en el rendimiento de la atención médica entre las naciones industrializadas.
Objetivo del estudio:
- Para comparar diez naciones industrializadas occidentales basadas en la extensión de la atención primaria de salud, los niveles de indicadores de salud y la satisfacción de la población en relación con los costos del sistema.
- Desarrollar índices para caracterizar la atención primaria y clasificar a los países en indicadores de salud.
- Para identificar patrones de concordancia o discordancia entre estas medidas en todas las naciones.
Principales métodos:
- Un análisis comparativo de diez naciones industrializadas occidentales utilizando datos publicados.
- Desarrollo de índices para medir el alcance de la atención primaria y clasificaciones de países en 12 indicadores de salud (por ejemplo, mortalidad infantil, esperanza de vida).
- Evaluación de la satisfacción de la población en relación con los costos del sistema de salud.
Principales resultados:
- Se observó una concordancia general entre la atención primaria, los indicadores de salud y las relaciones satisfacción-gastos en nueve de los diez países.
- Los Estados Unidos y Alemania Occidental recibieron calificaciones bajas en las tres medidas.
- Canadá, Suecia y los Países Bajos demostraron calificaciones generalmente altas para la atención primaria, los indicadores de salud y la relación satisfacción-gastos.
- El Reino Unido mostró una falta de concordancia, potencialmente relacionada con menores gastos en servicios sociales y educación pública.
Conclusiones:
- El rendimiento del sistema de salud, que abarca la atención primaria, los resultados de salud y la satisfacción pública, varía significativamente entre las naciones industrializadas.
- Países como Canadá, Suecia y los Países Bajos parecen sobresalir en la prestación de atención médica integral y satisfactoria en relación con los costos.
- Los hallazgos ofrecen información valiosa para el debate en curso sobre la organización de la atención médica y las reformas de financiación en los Estados Unidos.
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