دانلود رایگان مقاله انگلیسی توزیع منابع و تمایز در سیستم بهداشت و درمان برزیل: خدمات پیوند اعضا بدن - اشپرینگر 2018

Abstract

Background: To date, few studies have assessed how Brazil’s universal healthcare system’s (SUS, Sistema Único de Saúde) systemic, infrastructural, and geographical challenges affect individuals’ abilities to access organ transplantation services and receive quality treatment. Discussion: In this article we evaluated the existing literature to examine the impact that SUS has had on an increasingly important healthcare sector: organ transplantation services. We assess how equity challenges within the transplantation system can be explained by wider problems within SUS. Findings suggest stark disparities in access to transplantation services both within and across Brazil’s regions. We found that these regional differences are partially due to logistical challenges, especially in loosely populated areas but are also a consequence of disparities in resource allocations within SUS and under-capacitated health care facilities affecting transplantation services. Summary: We suggest that Brazil needs to improve its health outcome measurement system for organ transplantations and epidemiological surveillance, to gain more comprehensive and comparable data. Finally, we recommend policy strategies to reduce barriers to access to transplantation services by increasing transplantation service coverage in some areas and investing in emerging technologies.

Conclusion

Current findings suggest stark disparities in access to transplantation services both within and across Brazil’s regions. These are partially due to logistical challenges, especially in loosely populated areas but are also a consequence of disparities in resource allocations within the health sector and under-capacitated basic health care facilities affecting transplantation services. Going forward, the MOH should aim at (a) narrowing the organ transplant supply gap, (b) improving health outcomes of transplants, and (c) decreasing barriers to access of transplantation services, particularly for the hardest to reach. Brazil needs to improve its health outcome measurement system for organ transplantations, to gain more comprehensive and comparable data that also facilitates international comparisons. Currently, standard ratios are used to calculate organ needs estimate which do not reflect regional differences in the burden of disease. Improved epidemiological data collection and evaluation could help better inform health service planners. Comprehensive information on health care spending to the various sub-services should be made publicly available to allow for scholarly evaluations. This is particularly important as Brazil has a history of mismatching health care funding with the actual burden of disease [38].