Health System in Argentina Ada Berenstein, MD Glossary (PAHO) Health System: all organizations, people and actions whose primary intent is to promote, restore or maintain health Public health: an organized effort of society, to improve, promote, protect and restore the health of the population through collective actions Public health Services: health services targeted at the population as a whole. Health system Public Hospitals and primary care units Uninsured and poor people Taxes and payments made by social security beneficiaries Social security Social security clinics and providers Workers of formal economy and their families Contributions of employers and employees Private Private providers Prepaid medicine enterprises Individuals and private health insurance. Upper middle class Payments made by families and/or employers Health system in Argentina 10% GDP (gross domestic product) Fragmented Descentralized Poorly regulated by de goverment Increased demand of the public subsector History 1943 Perón goverment PUBLIC HEALTH as a major state interest. 1949 the Ministry of Health is created The state as responsible and guarantor of the rigth to health Unions organizations social security sector (obras sociales) Obras sociales are financed: 3% salary; 6% employers contribution 280 obras sociales nacionales 24 obras sociales provinciales PAMI ( retired ) 300 prepaid medicine enterprises ( Buenos Aires city and Great Buenos Aires) Public Health System BA city 33 hospitals General hospitals Children hospitals Specialist 38 Cesac (primary care centers) Centro de Salud y Acción Comunitaria nº 15 3rd. level complexity hospital Founded in 1875 250 beds 3 ICU Located in Abasto Primary care center Primary Health Care Strategy First contact between people and health system Provides comprehensive care Social participation Intersectoral actions, integrated Emphasis in promotion and prevention Equity Accessibility FAMILY Unit of planification Legal, institutional framework Continuous First level of care Provision of integrated, accesible health care services by clinicians who are accountable for adressing personl health care needs, developing a partnership with patients and in the context of family and community Defined population/territory under its responsibility Knowledge of health needs of this population PRINCIPLES OF PRIMARY HEALTH CARE PRINCIPIOS DE APS Some demographic data….. Total Population 40.000.000 Formosa 530.000 Santiago del estero 874.000 Buenos Aires City 2.890.000 Buenos Aires 15.000.000 Lugar de nacimiento Ocupación Desocupación Unsatisfied basic needs At least 1 of: Overcrowding (> 3 persons/room) Dwelling: inconvenient ( squatts, poor housing) Sanitary conditions : without toilet School attendance: at least 1 school-age child who doesn´t attend school 5. Ability to cope: houses with > 4 members for 1 worker 1. 2. 3. 4. Infant mortality rate (children under 1 year old) IMR- 2010 Argentina 11,9/00 Buenos Aires 12/00 Buenos Aires City 7/00 Misiones 13/00 Catamarca 15/00