Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses
Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses
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DOI：
10.1377/hlthaff.2015.0514
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发表时间：
2015-09-01
期刊：
影响因子：
9.7
通讯作者：
Frenk, Julio
中科院分区：
文献类型：
--
作者：
Knaul, Felicia Marie;Bhadelia, Afsan;Frenk, Julio
低收入和中等收入国家的卫生系统旨在为急性疾病提供间歇性护理。然而，疾病负担已转变为以慢性病和疾病占压倒性优势，这需要卫生系统在从预防到缓解的一系列疾病阶段以综合方式发挥作用。低收入和中等收入国家还力求通过全民医保确保人人享有医疗保健。本文提出了一个有效的全民健康覆盖框架，旨在应对慢性病的挑战。它概述了通过“对角线方法”加强卫生系统的战略。“我们认为，卫生系统面临的核心挑战是需要持续和长期卫生保健的慢性疾病。在墨西哥卫生系统改革的更广泛背景下，乳腺癌的例子被提出来说明有效的全民健康覆盖沿着慢性病连续体和跨卫生系统的功能。文章最后提出了加强卫生系统以实现有效的全民健康覆盖的建议。
Health systems in low- and middle-income countries were designed to provide episodic care for acute conditions. However, the burden of disease has shifted to be overwhelmingly dominated by chronic conditions and illnesses that require health systems to function in an integrated manner across a spectrum of disease stages from prevention to palliation. Low-and middle-income countries are also aiming to ensure health care access for all through universal health coverage. This article proposes a framework of effective universal health coverage intended to meet the challenge of chronic illnesses. It outlines strategies to strengthen health systems through a "diagonal approach." We argue that the core challenge to health systems is chronicity of illness that requires ongoing and long-term health care. The example of breast cancer within the broader context of health system reform in Mexico is presented to illustrate effective universal health coverage along the chronic disease continuum and across health systems functions. The article concludes with recommendations to strengthen health systems in order to achieve effective universal health coverage.