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Calidad de la asistencia sanitaria primaria en China: desafíos y recomendaciones
Xi Li1, Harlan M Krumholz2, Winnie Yip3
1National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.
Lancet (London, England)
|June 8, 2020
Resumen
China también.
Área de la Ciencia:
- Salud pública
- Política de salud
- Sistemas de salud
Sus antecedentes:
- La inversión significativa de China en atención médica primaria tiene como objetivo controlar enfermedades crónicas como la hipertensión y enfermedades infecciosas como el COVID-19.
- A pesar del aumento de la financiación y las políticas, la calidad de la atención primaria de salud en China sigue siendo subóptima.
- Los problemas sistémicos existentes obstaculizan la prestación efectiva de la asistencia sanitaria primaria.
Objetivo del estudio:
- Identificar las causas profundas de la mala calidad de la asistencia sanitaria primaria en China.
- Proporcionar recomendaciones de políticas basadas en la evidencia para mejorar los servicios de atención primaria de salud.
- Explorar estrategias de modernización para el sistema de salud primaria de China.
Principales métodos:
- Revisión de la literatura existente y análisis de las políticas.
- Identificación de los desafíos sistémicos en el marco de la atención primaria de salud de China.
- Formulación de recomendaciones políticas basadas en las lagunas identificadas.
Principales resultados:
- Los principales desafíos incluyen la formación inadecuada de los profesionales, los modelos de pago por servicio que favorecen el tratamiento en lugar de la prevención, la atención fragmentada y la escasa continuidad.
- Educación y formación subóptimas de los profesionales de la salud primaria.
- Los sistemas de pago por servicio incentivan las pruebas y los tratamientos sobre la prevención.
Conclusiones:
- La mejora de la formación, el establecimiento de la rendición de cuentas sobre el rendimiento, la integración de los servicios clínicos y de salud pública y la mejora de la coordinación interinstitucional son fundamentales.
- Se recomienda modernizar el sistema de atención primaria de salud a través de datos digitales y tecnologías innovadoras.
- Abordar la fragmentación sistémica e incentivar la atención preventiva es clave para mejorar la calidad.
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