RESUMEN
PIP: The rural health post at Catripulli, Chile, was studied throughout 1986 in attempt to determine the true direct and indirect costs of operating a primary health care facility. The Catripulli health post served 743 persons. It was visited once each month by a health team from its associated hospital. During 1986, the post provided .71 consultations for illness per inhabitant, 6.6 check-ups per child under 6, 1.6 midwife consultations per women aged 15-44, 1.8 home visits per family, 40 group education sessions, and 1.4 minor procedures per inhabitant. The equivalent cost per inhabitant was US $8.80. 51.6% of expenses were charged to the National Program for Supplementary Feeding. 36.6% of expenses were for personnel and .4% for the immunization program. The salary of the paramedical living at the post accounted for 58.6% of personnel costs, the physician 14.7%, the nurse 11.7%, the midwife 10.5%, and the driver 4.5%. Pharmacy expenditures accounted for 3.1% of expenditures. Other expenditures were for maintenance, fuel, cleaning, office supplies, and similar items. 20% of the annual cost of operation was for the 12 visits by the hospital health team. It was estimated that during 1986, each check-up of a child under 6 years cost US $5.80, each home visit cost $2.60, each group education session cost $1.60, and each minor procedure cost $.60. The relatively high cost of visits for children under 6 was due primarily to indirect costs of supplementary feeding. The relatively low cost of consultations for illness was due largely to the simplicity of the available drugs.^ieng
Asunto(s)
Instituciones de Atención Ambulatoria/economía , Atención Primaria de Salud/economía , Regionalización , Adolescente , Adulto , Preescolar , Chile , Costos y Análisis de Costo , Femenino , Humanos , Masculino , Embarazo , Salud RuralRESUMEN
PIP: Modern technology in the field of obstetrics has helped enormously to lower the incidence of maternal-infant mortality and morbidity. What is important at the present time is to expose an ever increasing number of expecting mothers to the advantages of modern medicine. About 10-20% of pregnancies are high risk and need specialized personnel, care, and equipment. To better distribute the cost of maternal health services in Mexico, and to better care for patients, the authors of this article propose division of services into 3 levels, from the least to the most specilized. This system presupposes an accurate selection of patients, and a careful detection of any eventual problem. The first level of medical attention can be given at a general hospital by a general practitioner, with no special equipment. The second level requires a specialized hospital, a specialist in gyneco-obstetrics, specially trained nurses, and a well equipped delivery room. The third level requires a higher degree of specialization from doctors and nurses, and a complete equipment for intensive prenatal, intrapartum, and postpartum care of mothers and newborns.^ieng