Um Novo Mundo de Cuidados de Saúde

NOVA IORQUE – Os sistemas de saúde tradicionais estão com problemas. Na OCDE, as clínicas e hospitais dispendiosos dominam os serviços de saúde e são responsáveis por 97% das despesas com saúde nos Estados Unidos. Estes sistemas estão em dificuldades pelas restrições em matéria de custos, pela exigência pública de maior qualidade, e pelas expectativas exageradas.

Mas há um sistema diferente, amplamente praticado em países mais pobres que não conseguem custear hospitais ao estilo Ocidental, e centrado nos cuidados comunitários de saúde. Precisamos das duas abordagens; e precisamos que funcionem em conjunto. Na verdade, o fosso crescente entre a promessa e a realidade dos cuidados de saúde criou espaço – tanto nos países desenvolvidos como nos países em desenvolvimento – para novos actores, que estão mais preocupados com a conduta social que com a biologia.

No seu artigo seminal de 1996 na Harvard Business Review, W. Brian Arthur identificou as importantes distinções entre um sistema de saúde definido através do planeamento, da hierarquia, e do controlo, e um outro caracterizado pela observação, posicionamento, e organizações pouco hierarquizadas. O primeiro tipo de sistema, segundo ele, preocupa-se com materiais, processamento, e optimização. Está principalmente centrado no acesso aos cuidados médicos, e enfrenta normalmente rendimentos decrescentes.

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