مقاله انگلیسی رایگان در مورد توزیع منابع و تمایز در سیستم بهداشت و درمان برزیل – اسپرینگر 2018

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.

Background

Addressing healthcare disparities in emerging nations is a new area of scholarly research. Among the BRICS nations, Brazil has stood out as a government that, while in principle is committed to establishing an effective universal health care system, in practice has not been fully dedicated to achieving this objective. Inadequate funding, poor health care infrastructure, insufficient human resources, and geographic distance have negatively affected patient access to adequate health care services through the government’s decentralized universal health care system, namely SUS (Sistema Único de Saúde). To date, however, few have analysed the impact that SUS has had on an increasingly important healthcare sector: organ transplantation services. As the number of noncommunicable diseases (NCDs) with potentially damaging effects on organs increases, such as diabetes, hypertension, and cancer, demands for transplantation services will inevitably rise. Yet, studies have paid insufficient attention to how SUS’ systemic, infrastructural, and geographical challenges affect individuals’ abilities to access transplantation services and receive quality treatment. We aim to fill in this lacuna in the literature by illustrating how regional differences in SUS human resources, medical infrastructure, waiting periods for medical attention and neurological exams lead to disparities in transplantation processes and provisions between the states. More specifically, Brazil’s wealthier southern states have seen better resources and infrastructure, in turn facilitating access and treatment in transplantation services; the converse holds for most poorer northeastern states.1 We also desire to highlight that geographical factors matter: that is, patients in poorer rural areas confront transportation difficulties in obtaining access to transplantation services, which is less the case in urban areas. Scope: We focus on the Brazilian public healthcare system in its wider national context (e.g. overall infrastructure). When conducting research for this article, the authors obtained referenced articles from personal databases of journal articles and reports, found mainly from on-line library systems and search engines, such as PubMed and Google.