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Inicio Revista Portuguesa de Saúde Pública Racionamento dos cuidados de saúde e a participação da sociedade: revisão do...
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Vol. 28. Issue 2.
Pages 119-126 (July - December 2010)
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Vol. 28. Issue 2.
Pages 119-126 (July - December 2010)
Artigo original
DOI: 10.1016/S0870-9025(10)70002-X
Open Access
Racionamento dos cuidados de saúde e a participação da sociedade: revisão do debate
Health care rationing and community participation: a review of the debate
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Micaela Moreira Pinhoa,??
Corresponding author
michaelapinho@hotmail.com

Autor para correspondência.
, Paula Veigab
a Universidade Lusíada do Porto e Universidade Portucalense; membro do Núcleo de Investigação em Microeconomia Aplicada (NIMA). Porto, Portugal
b Escola de Economia e Gestão da Universidade do Minho; membro do Núcleo de Investigação em Microeconomia Aplicada (NIMA). Porto, Portuga
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Abstract
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Resumo
Introdução

O tradicional modelo discricionário de estabelecer prioridades na saúde tem vindo a ser questionado por muitos decisores políticos que procuram lidar com esta realidade de forma mais explícita. Explicitar o modo de estabelecer prioridades tem suscitado intensos debates, sobretudo e em particular no que respeita à contribuição da economia e ao envolvimento da população.

Material e métodos

A revisão bibliográfica permitiu, não apenas, rever o debate em torno da evolução a que tem estado sujeito o processo de priorização dos serviços de saúde ao longo das três últimas décadas como também descrever a problemática associada à participação da comunidade no debate sobre o racionamento e conhecer algumas reformas internacionais que procuraram conferir ao racionamento um carácter mais transparente.

Resultado

A par das reformas para a adopção de critérios sistemáticos de racionar os cuidados de saúde surge o debate sobre o papel a conferir à população nesse processo. Apesar de algum consenso sobre a necessidade de conferir um papel mais interventivo às populações, não há consenso sobre os limites e modelos de participação. A tarefa, na prática, tem-se revelado complexa e conflituosa.

Conclusão

A implementação de sistemas de racionamento com carácter mais explícito e transparente continua em discussão na literatura. As soluções parecem depender essencialmente da vontade política e do contexto cultural de cada país.

Palavras-chave:
Racionamento
Sistemas de saúde
Envolvimento da comunidade
Keywords:
Rationing
Health care systems
Community involvement
Abstract
Introduction

The traditional discretionary model to set priorities in health care have been questioned by policy makers who seek to address this issue more explicitly. Setting priorities in an explicit way has sparked an intense debate, especially and particularly in what concerns economics contribution and public involvement.

Material and methods

A literature review allowed not only an account of the debate about the evolution of the process concerning the setting of priorities within the health care services during the last three decades but also to describe the problematic discussion related to the community participation in the rationing debate, as well as to know some international reforms that tried to implement a more transparent rationing process.

Results

Alongside with the reforms to adopt systematic principles to ration health care services, there is a debate about the role that population should play in that process. Although there is some consensus that population should be more involved, there is no consensus about the limits and model of participation. The task, in practice, has proved to be complex and a source of conflict.

Conclusions

The implementation of a more explicit and transparent health care rationing process is still under debate. The solutions seem to depend on the political will and the cultural context of each country.

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Copyright © 2010. Escola Nacional de Saúde Pública
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