Descargue la revista aquí - Colegio Médico de Chile
Descargue la revista aquí - Colegio Médico de Chile
Descargue la revista aquí - Colegio Médico de Chile
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Resumen<br />
Diseño <strong>de</strong> un Sistema Público<br />
<strong>de</strong> Atención <strong>de</strong> Salud:<br />
El Caso <strong>de</strong> <strong>Chile</strong><br />
Dr. Carlos Montoya-Agui<strong>la</strong>r*<br />
Se <strong>de</strong>fine “sistema <strong>de</strong> atención <strong>de</strong> salud” y, en el contexto <strong>de</strong> <strong>la</strong> formu<strong>la</strong>ción <strong>de</strong> una política <strong>de</strong> salud,<br />
se le diferencia <strong>de</strong>l concepto “mo<strong>de</strong>lo <strong>de</strong> atención”.<br />
Se <strong>de</strong>scriben los aspectos estructurales <strong>de</strong>l sistema. Se recomienda basar el diseño <strong>de</strong>l sistema público<br />
para <strong>Chile</strong> sobre <strong>la</strong>s tres realida<strong>de</strong>s geo<strong>de</strong>mográficas (RGD) <strong>de</strong>l país: gran<strong>de</strong>s ciuda<strong>de</strong>s, ciuda<strong>de</strong>s intermedias<br />
y conglomerados semi-rurales. A cada RGD correspon<strong>de</strong> una modalidad tipo <strong>de</strong> subsistema <strong>de</strong><br />
atención compuesta por establecimientos o unida<strong>de</strong>s tipo. A <strong>la</strong> combinación <strong>de</strong> RGD que se da en cada<br />
región <strong>de</strong>l país correspon<strong>de</strong> una combinación <strong>de</strong> modalida<strong>de</strong>s que configura una red <strong>de</strong> atención.<br />
Esta es <strong>la</strong> organización <strong>de</strong> base resi<strong>de</strong>ncial, <strong>la</strong> más importante (también para otros sistemas). A el<strong>la</strong> se<br />
superponen <strong>la</strong> base ocupacional y <strong>la</strong> base esco<strong>la</strong>r <strong>de</strong> organización <strong>de</strong> <strong>la</strong> atención.<br />
Es necesario <strong>de</strong>finir individualmente <strong>la</strong> posición, funciones y recursos <strong>de</strong> cada establecimiento <strong>de</strong>ntro<br />
<strong>de</strong>l subsistema, tomando en cuenta <strong>la</strong>s complementarida<strong>de</strong>s e interacciones entre ellos.<br />
Pa<strong>la</strong>bras c<strong>la</strong>ve: sistema <strong>de</strong> atención, mo<strong>de</strong>lo <strong>de</strong> atención, realidad geo<strong>de</strong>mográfica, modalidad <strong>de</strong> atención,<br />
unidad tipo <strong>de</strong> atención, red <strong>de</strong> atención, base resi<strong>de</strong>ncial <strong>de</strong> <strong>la</strong> atención<br />
Abstract<br />
The concept of “health care system” is <strong>de</strong>fined and, in the context of health policy formu<strong>la</strong>tion, it is<br />
differentiated vis a vis the concept of “health care mo<strong>de</strong>l”.<br />
The structural aspects of a system are briefly <strong>de</strong>scribed. It is suggested that the public health care system<br />
of <strong>Chile</strong> be <strong>de</strong>signed on the substratum of the three main geo<strong>de</strong>mographic situations (GDS) that exist in<br />
the country: <strong>la</strong>rge cities, intermediate cities and semi-rural agglomerations. Each GDS should be matched<br />
with a typical health care subsystem modality ma<strong>de</strong> up of typical units or facilities. For the particu<strong>la</strong>r<br />
combination of GDSs existing in each region a combination of modalities is required; this combination<br />
constitutes the regional health care network.<br />
This pattern is based on the resi<strong>de</strong>ntial location of the popu<strong>la</strong>tion. It is the most important organizational<br />
criterion for the health care system (also for other systems); but an occupational basis and a schools<br />
system basis are also recognized.<br />
The position, functions and resources of each facility within the system should be <strong>de</strong>fined, taking into<br />
account their complementarities and interactions.<br />
Key words: health care system, health care mo<strong>de</strong>l, geo<strong>de</strong>mographic situations, health care modality, health<br />
care unit type, resi<strong>de</strong>ntial basis of health care.<br />
* Profesor titu<strong>la</strong>r <strong>de</strong> Salud Pública, Universidad <strong>de</strong> <strong>Chile</strong>. <br />
Cuad Méd Soc (<strong>Chile</strong>) 2005; 45: 11 - 16<br />
The Design of a Public Health Care<br />
System: The Case of <strong>Chile</strong><br />
11