Julien Dupuy - Estudio de situación y Experiencias Internacionales en países con Cobertura Universal en salud

8/3/2019 Julien Dupuy - Estudio de situacin y Experiencias Internacionales en pases con Cobertura Universal en salud

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DVQKAB _@TUGNKFGBNK@ AD EB@G\GK

HGNGVQDUGB AD VK@TA W AD_BUQDV

DDVVQQTTAAGGBB AADD VVGGQQTTKKFFGGNNWW DDSS__DDUUGGDDNNFFGGKKVV DDNN __KKVVDDVV

FFBBNN FFBBEEDDUUQQTTUUKK

TTNNGG\\DDUUVVKK@@ DDNN VVKK@@TTAA

HVf. Mt`gdn Ubidu AT_TWAGUDFFGN IDNDUK@ AD _@KNGLGFKFGN

UDK AD DFBNBHK AD @K VK@TA5?;?


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5

Dvqtagbadvgqtkfgnwdspdugdnfgkvdn

pkvdvfbnFbeduqtuk

Tng|duvk

Gnqubatffgn

Dn `bv `qghb kbv, d` qdhk ad `k fbeduqtuk tng|duvk` dvq qbhknab fkak |d} hv ghpbuqknfgk k ng|d`

gnqdunkfgbnk`= pkvdv ad Kvgk fbn ltduqd fudfghgdnqb dfbnhgfb ckn advkuub``kab gnvquthdnqbv adfbeduqtuk tng|duvk` w pkvdv ad Khugfk @kqgnk, cgvqugfkhdnqd fkukfqdug}kabv pbu iuknadvgnd{tgakadv, dvqn gnfudhdnqknab `kv fbeduqtukv dn `kv pbe`kfgbndv advpubqdigakv # Hg``v, 5??9'.Dn 5??4, `k Kvkhe`dk Htnagk` ad `k Vk`ta ad `k BHV gnvq k vtv dvqkabv hgdheubv p`knglgfkugnvquthdnqbv ad fbeduqtuk k |bfkfgn tng|duvk` pkuk ikuknqg}ku d` kffdvb k `bv vdu|gfgbv ad vk`ta wbludfdu pubqdffgn fbnquk `bv ugdvibv lgnknfgdubv #BHV, 5??4'.

Dv dn dvqd fbnqdsqb gnqdunkfgbnk` {td d` Dvqkab _`tugnkfgbnk` ad Eb`g|gk dvq p`knqdknab `k fudkfgnad` Vgvqdhk ngfb ad Vk`ta, {td gnf`twd `k fbeduqtuk tng|duvk` ad vk`ta iukqtgqk dn d` ptnqb adkqdnfgn, dn kp`gfkfgn ad `k Fbnvqgqtfgn _b`qgfk ad` Dvqkab. D` pube`dhk ad kffdvb dvpkuqgft`kuhdnqd ghpbuqknqd dn ntdvqub pkv, wk {td d` 99$ ad `k pbe`kfgn dvq, dn agldudnqdviukabv, dsf`tgab ad` Vgvqdhk ad Vk`ta, pugnfgpk`hdnqd pbu uk}bndv dfbnhgfkv #TAK_D, B_V, 5??1'.

D` pube`dhk fdnquk` pkuk k`fkn}ku `k fbeduqtuk tng|duvk` dn vk`ta, w hv kn dn pkvdv ad gniudvbhdagb w ekmb, dv `k ghp`dhdnqkfgn ad tn vgvqdhk ad lgnknfgkhgdnqb {td pduhgqk idnduku udftuvbvvtlgfgdnqdv pkuk pub|ddu pudvqkfgbndv ad vk`ta ad fk`gaka pkuk qbak `k pbe`kfgn. _kuk qk` dldfqb, `kdvqukqdigk ad lgnknfgkhgdnqb aded vdu d{tgqkqg|k #Fkuugn Mkhdv 5??1k', w pub(pbeudv.

D` lgnknfgkhgdnqb ad` Vgvqdhk ad Vk`ta aded dnqbnfdv bugignkuvd dn fbnqugetfgbndv knqgfgpkakv wptdvqkv dn fbhn, {td pbfb k pbfb, adedn uddhp`k}ku `bv pkibv agudfqbv ad `bv tvtkugbv. Dsgvqdnabv bpfgbndv pbvge`dv= tn vgvqdhk ad lgnknfgkhgdnqb ad qgpb Egvhkufj, hdagknqd vditub#v'vbfgk`#dv' ad vk`ta be`gikqbugb#v', b tn vgvqdhk ad qgpb Ed|dugaid ekvkab dn lbnabv pe`gfbv. Dvqkvabv lbuhkv ad buikng}kfgn ptdadn ltnfgbnku dn pkuk`d`b= ad cdfcb, tn vgvqdhk hgsqb dvqpudfbng}kab ftknab dsgvqdn ekvdv ad lgnknfgkhgdnqb ad `k vk`ta ad khebv qgpbv #Fkuugn Mkhdv 5??1k',fbhb dv d` fkvb dn Eb`g|gk #fbeduqtuk ad` vtevgvqdhk pe`gfb w ad Vditugaka Vbfgk` k fbuqb p`k}b'.

_kuk kpbwku `k adfgvgn ad `kv ktqbugakadv ad` Hgngvqdugb ad Vk`ta w Adpbuqdv dn `bv agldudnqdvkvpdfqbv dvdnfgk`dv dn d` pubfdvb ad quknvgfgn ckfgk `k fbeduqtuk tng|duvk`, d` pudvdnqd abfthdnqbknk`g}k `bv pugnfgpk`dv lkfqbudv(f`k|dv adqduhgnknqdv dn d` `biub ad `k fbeduqtuk tng|duvk` advad d`ptnqb ad |gvqk ad `k dfbnbhk ad `k vk`ta k pkuqgu ad `k dspdugdnfgk gnqdunkfgbnk` w ad` dvqtagb adgnagfkabudv dn `bv pkvdv fbnvgadukabv fbhb ckegdnab k`fkn}kab `k Fbeduqtuk Tng|duvk`= dn d`pughdu fkpqt`b, vd udvthd d` hkufb qdugfb(fbnfdpqtk` pkuk `k ghp`dhdnqkfgn ad `k fbeduqtuktng|duvk`, {td ltd adqk``kak dn tn dvqtagb knqdugbu #Atptw, 5?;;': dn d` vditnab w qdufdu fkpqt`bv, vddvqtagk dspdugdnfgkv w `dffgbndv kpudnagakv k ng|d` gnqdunkfgbnk` k pkuqgu ad` dvqtagb ad `bv lkfqbudvf`k|dv gadnqglgfkabv pkuk k`fkn}ku `k fbeduqtuk tng|duvk` dn vk`ta.


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nagfd ad Fbnqdngab

Gnqubatffgn.................................................................................................................................... 5Fkpqt`b G. Hkufb qdugfb ( fbnfdpqtk` ............................................................................. 9

G.;. Adlgngfgn ad `k fbeduqtuk tng|duvk` dn vk`ta ...................................................................... 9G.5. D` Lgnknfgkhgdnqb= ltnfgn fdnquk` ad `bv vgvqdhkv ad vk`ta ............................................ 9

G.5.;. Ltnfgn ad udfktakfgn ad lbnabv .............................................................................. 9G.5.5. Ltnfgn ad ptdvqk dn fbhn ad `bv udftuvbv #hknfbhtnkfgn' ................................... 3G.5.6. Fbhpuk w pub|gvgn ad Vdu|gfgbv .................................................................................. 3G.5.1. Bemdqg|bv ad` Vgvqdhk ad Lgnknfgkhgdnqb ..................................................................... 3

G.6. @k quknvgfgn ckfgk k fbeduqtuk tng|duvk` ............................................................................ 7G.6.;. Gnfudhdnqb ad `bv pkibv knqgfgpkabv w vtpudvgn ad `bv pkibv agudfqbv atuknqd `kdqkpk gnqduhdagk ckfgk `k fbeduqtuk tng|duvk` ....................................................................... 7G.6.5. Bqukv fbnvgadukfgbndv ghpbuqknqdv dn `k quknvgfgn ckfgk `k tng|duvk`gaka ...................... 7G.6.6. @biuku upgakhdnqd w hknqdndu `k fbeduqtuk tng|duvk` dn vk`ta................................... ;?

Fkpqt`b GG. Vgqtkfgn fbhpkukqg|k ad `bv pkvdv fbn fbeduqtuk tng|duvk`dn vk`ta ........................................................................................................................... ;;

GG.;. Lgnknfgkhgdnqb ad `k Vk`ta dn d` Htnab ........................................................................... ;;GG.;.;. Ikvqb dn vk`ta k ng|d` htnagk` ................................................................................. ;;GG.;.5. Lbuhkv ad lgnknfgkhgdnqb abhgnknqdv dn bv pkvdv ad` htnab .................................. ;;

GG.5. _kvdv {td ckn k`fkn}kab `k fbeduqtuk tng|duvk` dn vk`ta ............................................. ;6GG.6. Vgqtkfgn dfbnhgfk w vbfgk` ad `bv pkvdv fbn fbeduqtuk tng|duvk` ............................ ;4

GG.6.;. Gnagfkabudv vd`dffgbnkabv ........................................................................................ ;4GG.6.5. Qdnadnfgkv dn bv pkvdv fbn FT dn vk`ta ................................................................. ;


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1

Dvqtagbadvgqtkfgnwdspdugdnfgkvdn

pkvdvfbnFbeduqtuk

Tng|duvk

Fkpqt`b GGG. Dspdugdnfgkv w @dffgbndv kpudnagakv dn pkvdv fbn fbeduqtuk tng|duvk`dn vk`ta ........................................................................................................................... 65

GGG.6. Dspdugdnfgkv w `dffgbndv kpudnagakv dn pkvdv fbn FT dn vk`ta .................................. 65GGG.6.;. T}edjgvqn ............................................................................................................. 65GGG.6.5. Hk`kvgk .................................................................................................................. 66GGG.6.6. Fbvqk Ugfk .............................................................................................................. 61

GGG.1. _kvdv dn |k ad k`fkn}ku `k fbeduqtuk tng|duvk` .............................................................. 64 GGG.1.;. _kvdv vd`dffgbnkabv pkuk d` dvqtagb w dvqkab vgqtkfgbnk` .......................................... 64GGG.1.5. Dspdugdnfgkv ad _kvdv dn |k ad k`fkn}ku `k fbeduqtuk tng|duvk`................................ 69

GGG.1.5.;. Udpe`gfk _bpt`ku ad Fcgnk ................................................................................................... 69GGG.1.5.5. Eukvg ....................................................................................................................................... 67

Fkpqt`b G\. Fbnf`tvgbndv w udfbhdnakfgbndv ............................................................ 15Kndsbv ............................................................................................................................. 16

Kndsb ;. Hqbabv ad lgnknfgkhgdnqb ad `k vk`ta dn d` htnab ............................................... 16Kndsb 5. Gnagfkabudv dfbnhgfbv w vbfgk`dv ad `bv pkvdv {td k`fkn}kubn `k FT .................... 13Kndsb 6. Gnagfkabudv vbfgk`dv w cthknbv ad `bv pkvdv {td k`fkn}kubn k FT ........................ 43Kndsb 1. Gnagfkabudv ad lgnknfgkhgdnqb ad `k vk`ta ad `bv pkvdv fbn FT ..............................


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nagfd ad Qke`kv w Ftkaubv

Ftkaub ; N ad pkvdv ad` htnab vdin pugnfgpk` ltdnqd ad lgnknfgkhgdnqb ................................ ;5 Ftkaub 5 _kvdv {td ckn k`fkn}kab `k fbeduqtuk tng|duvk` vdin vgvqdhk ad lgnknfgkhgdnqb ..... ;6Ftkaub 6 Gnagfkabudv dfbnhgfbv w vbfgk`dv ad Eb`g|gk w ad `bv pkvdv fbn FT .......................... ;


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Julien Dupuy - Estudio de situación y Experiencias Internacionales en países con Cobertura Universal en salud