Manuel A

Language: English
References: 20
Page: 60-68
PDF size: 115.27 Kb.

ABSTRACT

The Chilean health care system has been intensively reformed in the past 20 years. Reforms under the Pinochet government (1973-1990) aimed mainly at the decentralization of the system and the development of a private sector. Decentralization involved both a deconcentration process and the devolution of primary health care to municipalities. The democratic governments after 1990 chose to preserve the core organization but introduced reforms intended to correct the system’s failures and to increase both efficiency and equity. The present article briefly explains the current organization of the Chilean health care system. It also reviews the different reforms introduced in the past 20 years, from the Pinochet regime to the democratic governments. Finally, a brief discussion describes the strengths and weaknesses of the system, as well as the challenges it currently faces.

REFERENCES

1. World Bank. World Development Indicators 2000. Washington D.C.: World Banck. April 2000.

2. PAHO. Division of health systems and services development. Chile: Profile of the health services system. Washington, D.C.: PAHO, 1999. Available at http://www.americas.health-sector-reform.org/english/clhmchipr.htm Consulted in August 2000.

3. Székely M. La desigualdad en México: una perspectiva internacional. Superación de la pobreza. Diálogos nacionales. Washington, D.C.: Inter American Development Bank; 2000:45-74.

4. PAHO. Chile. Health in the Americas. Washington, D.C.: PAHO, 1998;II:163-180.

5. Instituto Nacional de Estadísticas. Santiago de Chile: INE 200. Chile. Estadísticas Demográficas. Available at: http://www.ine.cl/chile_cifras/ f_chile_cifras.htm. Consulted on August 2000.

6. Albala C, Vio F. Epidemiological transition in Latin America: The case of Chile. Public Health 1995;109:431-442.

7. Ministerio de Salud. Division of Primary Care. Santiago de Chile: Ministerio de Salud, 2000. Available at: www.minsal.cl Consulted on August 2000.

8. González-Reyes JL. Atención de la Salud en Chile. Santiago de Chile. Editorial Antártica S.A, 1995.

9. World Health Organization. The World Health Report 2000. Health Systems: Improving performance. Geneva: World Health Organization; 2000.

10. Bossert T, Larrañaga O, Infante A, Beauvais J, Bowser D. Applied research on decentralization of health systems in Latin America. Chile case study. Data for decision-making project. Boston: Harvard School of Public Health, 2000.

11. Beteta E, Cabezas M, Ferrecio C, Larrañaga O, Oyarzo C, Sanhueza R. Evaluación del proceso de reforma del sector público de salud chileno: una experiencia de 20 años. Santiago de Chile. Instituto de Economía, Universidad de Chile, 1998.

12. Duarte D. Asignación de recursos financieros al sector municipalizado de salud. Papeles de Trabajo Núm. 29. Santiago de Chile: Corporación Tiempo 2000. Programa de Estudio Prospectivo; 1993.

13. Callund J. Health care in Chile. Benefits Compensation Int 1992 June; 14-22.

14. Quesney F. El sistema privado de salud. Las ISAPRES: hacia la modernidad en salud. Santiago de Chile. Asociación de ISAPRES, A.G., CIEDESS 1996; 97-116.

15. Stocker K, Waitzkin H, Iriart C. The exportation of managed care to Latin America. N Engl J Med 1999;340(14):1131-1136.

16. Bossert T. Lessons from the Chilean model of decentralization: Devolution of primary care to municipal authorities ed: USAID Latin American and Caribbean Health and Nutrition Sustainability Project, 1993; Policy Report Nº 1.

17. Jiménez de la Jara J, Bossert T. Chile’s health sector reform: Lessons from four reform periods. Health Policy 1995;32:155-166.

18. Azevedo AC. La provisión de servicios de salud en Chile: aspectos históricos, dilemas y perspectivas. Rev Saude Publica 1998;32(2):192-199.

19. Carciofi R, Cetrangolo O, Larrañaga O. Desafíos de la Descentralización: educación y salud en Argentina y Chile. Santiago de Chile. Naciones Unidas, Comisión Económica para América Latina y el Caribe; 1996.

20. Larrañaga O. Eficiencia y equidad en el sistema de salud chileno. Naciones Unidas, Comisión económica para América Latina y el Caribe, 1997.