RESUMO
This paper takes as its basis the concept of comprehensive health care. The need to try out complementary approaches to health care is emphasized in order to ameliorate the effects of the epidemiological transition. The approach of Primary Health Care as a basic strategy is also presented. The importance of applying health system population approach to health care is also analyzed. A number of health care alternatives are presented in order to stabilize the health of a community. Within these alternatives the training of human resources with a focus on prevention as well as the curative approach are presented. The role that the psychologist plays within the comprehensive health care is also described. Also the authors describe an innovative training program directed to Psychologists at this stage, that integrates a Master on Public Health with emphasis in mental health with a residence program in Comprehensive Health Care as an option to contribute to replicate the alternatives of care presented in the paper. Finally, the programs and their advances are presented.
Assuntos
Atenção Primária à Saúde , Psicologia/educação , Currículo , Humanos , Internato e Residência , Saúde Mental , México , Saúde Pública/educaçãoRESUMO
This study presents the analysis of the prescriptions given 2,782 clinical encounters. These clinical encounters were directly observed and recorded by trained observers in 164 health centers of the Federal District and nine states of the Mexican Republic. It was found that 70.9 per cent of the patients received a drug prescription. Sixty per cent of the compounds prescribed did not belong to the basic list of drugs. An strong influence of advertising by medical agents was detected in the use of some poly-drugs. Some specific needs for training and continued education of the physicians in the first level of care.
Assuntos
Prescrições de Medicamentos , Atenção Primária à Saúde , Prescrições de Medicamentos/estatística & dados numéricos , Quimioterapia Combinada , Uso de Medicamentos/estatística & dados numéricos , Humanos , México , Atenção Primária à Saúde/estatística & dados numéricosRESUMO
Quality of care was analyzed in 2,782 clinical appointments, focusing on the evaluation of the six basic steps of medical consultation: a) questionnaire, b) physical examination, c) diagnosis, d) prescription, e) information, and f) appointment management. Serious deficiencies were found, with variations depending on the motive of the visit, the type of unit in which the service was given, etc. In order to improve the quality of care a structural change is suggested, both in the health care services and in medical education.
Assuntos
Prescrições de Medicamentos , Atenção Primária à Saúde , Qualidade da Assistência à Saúde , Estudos de Avaliação como Assunto , HumanosRESUMO
This study assesses the current status of medical education in Mexico by evaluating the IX National Medical Residency Examination. The results indicate that the personal background of the candidates is related to the probability of their passing the examination: age; marital status; number of times they have presented the examination; length of time between graduation from medical school and the examination; place where social service was performed; and work experience. The authors observe a strong tendency toward specialization in the professional curricula of the medical schools in Mexico, with a consequent neglect of the national health system's present need for primary care. They therefore suggest that the educational institutions give thought to alternatives that would better equip the country's human resources to deal with current needs.