Challenges for ensuring availability and accessibility toin health care services under Brazil’s Unified Health System (SUS)
Challenges for ensuring availability and accessibility toin health care services under Brazil’s Unified Health System (SUS)
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DOI：
10.1590/1413-81232017224.31382016
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发表时间：
2017-04-01
期刊：
影响因子：
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通讯作者：
Dussault, Gilles
中科院分区：
文献类型：
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作者：
Oliveira, Ana Paula Cavalcante de;Gabriel, Mariana;Dussault, Gilles
卫生人力短缺和分布不平衡是社会和政治问题，加上社会经济不平等，减少了人口获得卫生服务的机会。本研究旨在了解 SUS 政策制定者和管理者在确保卫生服务提供者的可用性和地理可达性方面面临的挑战。该分析以卫生劳动力市场和卫生政策干预框架为指导。已经确定了两个主要问题：医生短缺以及卫生保健级别之间和地理区域之间专业人员分布不均。本次回顾重点关注了过去 30 年来的八项干预措施，其主要目的是纠正 SUS 医生分布不均的情况，如 Rondon 项目、卫生工作内部化计划、医学专家培训计划、初级卫生保健计划和更多医生计划。讨论的重点是影响这些干预措施结果的因素。
Shortages and imbalances in the distribution of the health workforce, are social and political problems that, along with the socio-economic inequality, reduce the access of the population to the health services. This study aims to understand the challenges of SUS policy-makers and managers to ensure the availability and geographical accessibility to health service providers. The analysis was guided by a framework of the health labour market and health policy interventions. Two main problems have been identified: shortage of doctors and maldistribution of professionals between levels of health care and between geographical areas. This review focused on eight interventions in the last 30 years, whose mainly aim was to correct the maldistribution of physicians in the SUS such as Rondon Project, Interiorization of Health Work Program, Medical Specialists Training Program, PHC Program and More Doctors Program. The discussion focuses on the factors that influence the outcome of these interventions.