Primary care: an increasingly important contributor to effectiveness, equity, and efficiency of health services. SESPAS report 2012
Primary care: an increasingly important contributor to effectiveness, equity, and efficiency of health services. SESPAS report 2012
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DOI：
10.1016/j.gaceta.2011.10.009
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发表时间：
2012-03-01
期刊：
影响因子：
1.9
通讯作者：
Starfield, Barbara
中科院分区：
文献类型：
--
作者：
Starfield, Barbara
截至2005年，关于初级保健为导向的卫生系统的好处的文献一致显示出更大的效力、更高的效率和更大的公平。在随后的五年里，没有什么改变这一结论：但现在人们对实现初级保健益处的机制有了更深入的了解。我们现在知道，在一定范围内，一个国家的财富和卫生人员的总数都与健康水平无关。重要的是卫生政策（初级卫生保健）的主要特征：在政府控制或监管下的普遍财政覆盖，公平分配资源的努力，服务的全面性，以及初级卫生保健服务的低共同负担或零共同负担。所有这些结合起来，产生了更好的初级保健：更多的第一次接触和使用，随着时间的推移，更多的以人为本的护理，更多的服务，并在需要时提供，以及护理的协调。证据不再主要局限于工业化国家，新的研究表明，中低收入国家的情况也是如此。世界卫生组织（以健康问题社会决定因素委员会的报告和2008年世界卫生报告的形式）以及其他一些国际委员会的认可，反映了人们普遍接受初级保健的重要性。现在可以衡量和评估初级保健;这方面的所有创新和改进都必须服务于其基本特征，才能发挥作用。(C)2011年SESPAS。出版社：Elsevier Espana，S.L. All rights reserved.
As of 2005, the literature on the benefits of primary care oriented health systems was consistent in showing greater effectiveness, greater efficiency, and greater equity. In the ensuing five years, nothing changed that conclusion: but there is now greater understanding of the mechanisms by which the benefits of primary care are achieved. We now know that, within certain bounds, neither the wealth of a country nor the total number of health personnel are related to health levels. What counts is the existence of key features of health policy (Primary Health Care): universal financial coverage under government control or regulation, attempts to distribute resources equitably, comprehensiveness of services, and low or no copayments for primary care services. All of these, in combination, produce better primary care: greater first contact access and use, more person-focused care over time, greater range of services available and provided when needed, and coordination of care. The evidence is no longer confined mainly to industrialized countries, as new studies show it to be the case in middle and lower income countries. The endorsements of the World Health Organization (in the form of the reports of the Commission on Social Determinants of Health and the World Health Report of 2008, as well a number of other international commissions, reflect the widespread acceptance of the importance of primary health care. Primary health care can now be measured and assessed; all innovations and enhancements in it must serve its essential features in order to be useful. (C) 2011 SESPAS. Published by Elsevier Espana, S.L. All rights reserved.