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Vol. 9. Núm. 47.
Páginas 117-120 (marzo - abril 1995)
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Vol. 9. Núm. 47.
Páginas 117-120 (marzo - abril 1995)
Open Access
El plan de salud del estado de oregón para el acceso a los servicios sanitarios: contexto, elaboración y características
The Oregon Health Plan for the Access to Health Care: Context, Development and Characteristics
Visitas
5340
Joan. Benach de Rovira1,*, Jordi. Alonso2
1 Dpto. Epidemiología y Bioestadística. Escuela Nacional de Sanidad (ENS) / Instituto de Salud Carlos III, Madrid.
2 Dept. Epidemiología i Salut Pública, Institut Municipal d'investigació Médica (IMIM), Universitat Autònoma de Barcelona, Barcelona.
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Resumen
Bibliografía
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Resumen

El plan de salud del estado de Oregón en Estados Unidos representa el primer intento explícito y organizado a nivel comunitario de establecer la prioridad de los servicios sanitarios mediante un análisis sistemático de su coste-efectividad. La necesidad de afrontar problemas sanitarios comunes a los países desarrollados como el aumento de costes, o la mejora de la efectividad y equidad de los servicios, así como la polémica generada por el plan de Oregón en medios académicos, profesionales y el público en general aconsejan su revisión detallada. El presente artículo describe el contexto sanitario en el cual se originó el plan, revisa los aspectos más destacados de su elaboración, analiza los métodos usados y resumen las principales reacciones al plan.

Palabras clave:
Servicios sanitarios
Prioridades en salud
Acceso
Coste-efectividad
Equidad
Gasto sanitario
Oregón
Abstract

The Oregon Health Plan is the first explicit and public attempt to establish the priority of health services by a systematic assessment of their cost-effectiveness. The need to solve major health problems such as increasing costs or the effectiveness and equity of health services as well as the debate developed around the plan, deserves a detailed review. This article describes the health care context where the plan took place, reviews the most important elements of its elaboration, analyzes methods used and summarizes the main reactions to the plan.

Key words:
Health services
Health priorities
Access
Cost-effectiveness
Equity
Health expenditures
Oregon
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Bibliografía
[1.]
M. Specter.
Rising cost of medical treatment forces Oregon to ‘play God’.
The Washington Post, 1 (1988),
[2.]
L.W. Sullivan.
The Bush Administration's Health Care Plan.
N Engl J Med, 327 (1992), pp. 801-804
[3.]
General Accounting Office.
Health Insurance: a profile of the uninsured in selected states.
[4.]
OCDE.
Health Care Systems in Transition.
¿, (1990),
[5.]
U.S. Dept, of Health and Human Services Public Health Service. Health United States. 1989.
[6.]
OECD.
Health Systems: Facts and Trends.
Paris, (1993),
[7.]
ST Sonnenfeld, et al.
Projections of national health expenditures through the year 2000.
Health Care Financ Rev, 13 (1991), pp. 1-27
[8.]
CBO, Congressional Budget Office, 1990.
[9.]
T. Bodenheimer.
Should we abolish the private health insurance industry?.
Int J Health Serv, 20 (1990), pp. 199-220
[10.]
J. Foley.
Sources of health insurance and characteristics of the uninsured analysis of the March 1991 Current Population Survey.
Employee Benefit Research Institute, (1992),
[11.]
R.M. Brandon, M. Podhorzer, T.H. Pollak.
Premiums without benefits:. waste and inefficiency in the commercial health insurance industry.
Int J Health Serv, 21 (1991), pp. 265-283
[12.]
J.K. Iglehart.
The American Health Care System.
N Engl J Med, 326 (1992), pp. 962-967
[13.]
J. Holahan, D. Rowland, J. Feder, D. Heslam.
Explaining the Recent Growth in Medicaid Spending. Health Affairs, (1993), pp. 177-190
[14.]
D.M. Fox, H.M. Leichter.
Rationing Care in Oregon: The New Accountability.
Health Affairs, (1991), pp. 7-27
[15.]
J. Kitzhaber.
A Healthier approach to health care.
Issues in Science and Technology, (1991), pp. 59-65
[16.]
D.M. Eddy.
Oregon's Methods. Did Cost-effectiveness Analysis Fail?.
JAMA, 266 (1991), pp. 2135-2141
[17.]
K. Rutledge.
Rejection of Oregon Plan a setback to reform.
Hospitals, (1992), pp. 92
[18.]
D.M. Fox, H.M. Leichter.
State Model: Oregon. The Ups and Downs of Oregon's Rationing Plan.
Health Affairs, (1993), pp. 66-70
[19.]
Oregon Departmentof Human Resources. Office of Medical Assistance Programs. The Oregon Health Plan. 1993
[20.]
M.C. Weinstein, W.B. Stason.
Foundations of cost-effectiveness analysis for health and medical practices.
N Engl J Med, 296 (1977), pp. 716-721
[21.]
I. McDowell, C. Newell.
Measuring health: a guide to rating scales and questionnaires.
Nueva York,
[22.]
H.D. Klevit, A.C. Bates, T. Castanares, E.P. Kirk, P.R. Sipes-Metzler, R. Wopat.
Prioritization of Health Care Services. A Progress Report by the Oregon Health Services Commission.
Archives of Internal Medicine, 151 (1991), pp. 912-916
[23.]
D.C. Hadorn.
Setting Health Care Priorities in Oregon. Cost-effectiveness Meets the Rule of Rescue.
JAMA, 265 (1991), pp. 2218-2225
[24.]
R.M. Kaplan, J.W. Bush, C.C. Berry.
Health Status: types of validity and the Index of Well-being.
Health Serv Res, 11 (1976), pp. 478-507
[25.]
V. Morell.
Oregon puts bold health plan on ice.
Science, 249 (1990), pp. 468-471
[26.]
A. Jonsen.
Bentham in a box: technology assessment and health care allocation.
Law Med Health Care, 14 (1986), pp. 172-174
[27.]
D.C. Hadorn.
Health Care Effectiveness Research and Public Policy, (1988),
[28.]
R. Steinbrook, B. Lo.
The Oregon Medicaid Demonstration Project-Will it provide adequate medical care?.
N Engl J Med, 326 (1992), pp. 340-344
[29.]
D.L. Patrick, P. Erickson.
Health Status and Health Policy. Allocating resources to Health Care,
[30.]
D.M. Eddy.
Cost-effectiveness analysis. Is it up to the task?.
JAMA, 267 (1992), pp. 33428
[31.]
R.M. Kaplan.
Application of a general health policy model in the American health care crisis.
Journal of the Royal Society of Medicine, 86 (1993), pp. 277281
[32.]
D.S. Greenberg.
Washington Perspective. The Oregon plan on Capitol Hill.
Lancet, 338 (1991), pp. 808-809
[33.]
Definido segun el ‘US Preventive Services Task Force Report’.
Copyright © 1995. Sociedad Española de Salud Pública y Administración Sanitaria
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