Integrate the health system from a common quality floor

There is no more diagnosed patient in the country than the health system. All the specialists who studied it coincide in identifying fragmentation as the chronic disease from which it cannot recover.

Its ramifications, inconsistencies and overlaps, added to the irrational expenditures of capabilities and efforts, found during the pandemic the argument to set aside divisions, forcing it into a tumultuous and forced integration.

That path of cooperation between the public and private sectors, between providers and financers –Done to the stumbling block and in the midst of the health tragedy in which Covid-19 plunged us–, must now find the way to a smart, sustainable and orderly integration of a system in which millionaire resources are dumped annually from the State, without these efforts reaching satisfactory benefits to the users of the system.

Days ago, the national government launched an initiative that will contribute to the essential integration of the different subsectors, a valuable contribution to begin to close inequity gaps in access to health. True integration can and must occur in the care that the population receives from a homogeneous platform that guarantees a minimum and common quality floor in that care.

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Its about National Health Quality Plan, which aims to ensure that from the most humble neighborhood ward to the most advanced high-complexity center, they have the same quality standards in the care of citizens, regardless of the origin and condition of the provider and / or financier of the services.

Unlike the traditional normative approach that indicates what should be done, the plan seeks to generate a culture of quality in our health services, for which we need to generate a paradigm shift that excites and empowers workers, to be them those who embrace the program and star in it with the community.

Another substantive aspect is the focus on people’s rights, by promoting a systematic measurement of their perceptions through surveys or by survey systems and commitment to the opinion of users. Thus the traditional complaint books that are hidden and that no one takes into account are displaced.

In this regard, there is already a lot of work developed with valuable antecedents, which gives us institutional technical strength due to the expertise of those people who have been working on clinical guidelines or on patient safety and quality in our health system. For example, the essential obstetric and neonatal conditions (CONE) that have been promoted, to which they have already adhered and comply with more than 70% of maternity wards in the country, which translates into safe and respected deliveries.

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There are four axes that structure the plan: strengthen stewardship and governance in quality and patient safety to reduce inequities in the health system; implement permanent processes to improve the quality of health care with a rights-based approach, centered on individuals, families and communities; establish processes to promote patient safety, and establish strategies for health teams that promote quality and safety in work management, training and permanent education and the protection of the health of workers.

Consensus with different organizations and institutions, and in a rare event, The National Health Quality Plan has already managed to bring various referents in the National Health Quality Advisory Council to the same table for its execution, made up of provincial ministers, the Superintendence of Health Services, PAMI, national social works, provincial social works, universities, private providers and PAHO, among other actors in the health field.

With the step taken, we are moving towards a more integrated, efficient, sustainable and predictable health system in which the quality of the practices and services offered does not vary according to the economic capacity of the person receiving them or the place where they are produced, but rather the starting point is similar and guarantees dignified and safe care for all.

The author is Secretary of Quality in Health of the Nation

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