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Atención primaria orientada a la comunidad. La piedra angular de la reforma de la atención médica
1Community Health Services, Denver Health and Hospitals, CO 80204-4507.
JAMA
|May 19, 1993
Resumen
Los estadounidenses desean una revisión del sistema de salud, más allá de la costosa atención centrada en el hospital. La atención primaria orientada a la comunidad ofrece un modelo equilibrado y socialmente relevante para mejorar los servicios de salud.
Área de la Ciencia:
- Servicios de salud Servicios de salud Investigación Investigación.
- Política de salud pública Política de salud pública.
- Gestión de la Gestión de la Atención Médica.
Sus antecedentes:
- El actual sistema de salud de Estados Unidos es criticado por sus altos costos y el énfasis excesivo en la atención hospitalaria aguda.
- Hay una demanda pública y política para la reforma de la atención médica, pero las propuestas actuales a menudo carecen de un enfoque en la organización del servicio.
- Los modelos existentes no equilibran adecuadamente las intervenciones médicas agudas con los servicios primarios y preventivos basados en la comunidad.
Objetivo del estudio:
- Abogar por un cambio en la organización de la atención médica y la prestación de servicios hacia un modelo más equilibrado y socialmente relevante.
- Para resaltar las limitaciones de las actuales propuestas de contención de costos y de reformas centradas en las finanzas.
- Presentar la atención primaria orientada a la comunidad como un paradigma potencial para una reforma efectiva de la salud.
Principales métodos:
- Análisis conceptual de las deficiencias actuales del sistema de salud.
- Revisión de las propuestas de políticas y sus implicaciones organizativas.
- Examen de los principios y el potencial de la atención primaria orientada a la comunidad.
Principales resultados:
- Los esfuerzos actuales de reforma de la atención médica están fragmentados y no abordan cuestiones organizativas sistémicas.
- Se necesita un enfoque equilibrado, integrando la atención médica con la atención médica y la salud pública con los servicios personales.
- La atención primaria orientada a la comunidad ofrece un marco para un sistema de salud más racional, responsable y socialmente relevante.
Conclusiones:
- El modelo de atención primaria orientada a la comunidad es un paradigma viable para reformar el sistema de salud de los Estados Unidos.
- Las reformas deben equilibrar la atención curativa y preventiva, y los servicios hospitalarios agudos con la atención primaria basada en la comunidad.
- La adopción de un enfoque de medicina socialmente sensible puede mejorar la relevancia y la efectividad de la prestación de atención médica.
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