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Showing papers on "Integrated care published in 1991"


Journal ArticleDOI
TL;DR: Using an integrated theoretical framework, a continuous and comprehensive model system of care for dual diagnosis patients can be designed.
Abstract: Using an integrated theoretical framework, a continuous and comprehensive model system of care for dual diagnosis patients can be designed.

95 citations


Journal Article
TL;DR: Assessment of health policy needs both a quantitative and qualitative approach, and recent successful health policy issues are child health and HIV/AIDS, while water pollution and traffic accidents have been more problematic policy issues.
Abstract: The assessment and impact of health policy in Costa Rica considers validity generalizability and appropriateness. Assessment is compatible with the Health for All evaluation criteria of relevance adequacy progress efficiency effectiveness and impact. Qualitative and quantitative methods are essential. Sociocultural and political traditions influence the development of national health policy in a country. Discussion centers on the social economic political and geographic contexts in Costa Rica the health care system national health policy between 1986 and 1990 policy development and analysis and recent issues. The hospital health care system is regional and has a pyramidal service structure of integrated care under the Caja Costarricense de Seguro Social (CCSS). A constitutional amendment in 1961 established universal health care coverage. Between 1986 and 1990 policy objectives aimed to increase equal access to resources to maintain steady economic growth reduce extreme poverty and care for basic needs of the entire population and to promote social mobility. 10 specific goals are identified. Guidelines were developed that support the National Health Policy. These guidelines established: 1) Health for All as a goal and national commitment 2) the development of a national health care system 3) a strengthening of the Health Care Services Infrastructure 4) the application of new approaches to integrated care 5) community participation and 6) priorities of health care. Priorities in 1988 were to develop local health care systems train community leaders prevent Malaria reintroduction in emergencies regionalize prenatal care with a risk approach and food protection. Specific aims are identified for prevention and control of communicable and chronic diseases maternal and child health care environmental health disaster and emergency preparedness and physical infrastructure development. Questions are raised about whether health policy meets the needs of the population and affects the daily living of the population. Policy is a problem-centered activity and is concerned with planning and politics. Policy analysis must involve decision making and implementation; it reflects learning from the experience of failure. A distinction is drawn between analysis of and for policy. The emphasis has been on policy content but policy process is also relevant. The challenges for child health AIDS water pollution and traffic accidents are briefly summarized.

4 citations



Journal ArticleDOI

1 citations