Correspondencia: Andreu Segura. Instituto de Estudios de la Salud. Barcelona.
se ha leído el artículo
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Políticas de salud pública</span>" "titulo" => "Políticas de salud (actuaciones poblacionales) en los servicios asistenciales. Informe SESPAS 2008" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "104" "paginaFinal" => "110" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Andreu Segura" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Andreu" "apellidos" => "Segura" "email" => array:1 [ 0 => "andreu.segurab@gencat.net" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Departamento de Salud Pública de la Universidad de Barcelona, Área de Salud Pública, Instituto de Estudios de la Salud, Generalitat de Catalunya, Barcelona, España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Andreu Segura. Instituto de Estudios de la Salud. Barcelona." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Health policies [population interventions] in health services" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec13650" "palabras" => array:2 [ 0 => "Sistema sanitario orientado a la comunidad" 1 => "Colaboración entre servicios de salud pública y de atención primaria" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec13649" "palabras" => array:2 [ 0 => "Community-oriented health system" 1 => "Public health and primary health care collaboration" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Las intervenciones sanitarias dirigidas colectivamente a la población desde los servicios asistenciales son escasas y sólo excepcionalmente (vacunaciones y en algunas comunidades autónomas, prevención secundaria del cáncer de mama) se llevan a cabo de forma coordinada con los servicios de salud pública. Aunque las actividades educativas dirigidas a escolares son de las más frecuentes, raramente se evalúan sus resultados.</p><p class="elsevierStyleSimplePara elsevierViewall">Sin embargo, los servicios de atención primaria realizan muchas actividades preventivas de carácter clínico que, a pesar de las buenas intenciones, padecen limitaciones considerables puesto que, además de generar dependencia e inducir consumo, son poco eficientes y poco equitativas. Ello justifica el ensayo de abordajes conjuntos con los servicios de salud pública y entidades ciudadanas para mejorar y proteger la salud de la comunidad.</p><p class="elsevierStyleSimplePara elsevierViewall">El desarrollo de programas de salud comunitaria basados en la cooperación entre la atención primaria de salud y los servicios de salud pública requiere estrategias que produzcan beneficios tangibles a corto plazo a ambos estamentos sanitarios, además de a la población de manera que estimulen positivamente el proceso y faciliten su evolución.</p><p class="elsevierStyleSimplePara elsevierViewall">Los ámbitos en los que resulta más prometedora la colaboración son los de la vigilancia de salud dirigida a la población de las zonas básicas de salud; el control conjunto de las enfermedades transmisibles y los brotes epidémicos; los programas de promoción de la salud y de prevención de enfermedades mediante intervenciones colectivas y asistenciales simultáneas y la mejora de la gestión del conjunto de los servicios sanitarios a disposición de las poblaciones locales a partir de la evaluación conjunta.</p><p class="elsevierStyleSimplePara elsevierViewall">Los recursos para llevar a cabo estas actividades deben proceder de una reorientación de la atención primaria que disminuya la carga de trabajo y el gasto sanitario asociado a la prevención clínica y del incremento en la dotación y en la capacitación de los servicios de salud pública.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Health interventions addressed to the population as a whole from health care services are scarce and only exceptionally involve coordination among public health services (vaccinations and, in some autonomous communities, secondary breast cancer prevention). Health education programs addressed to schools are one of the most frequent interventions but their outcomes are not systematically evaluated.</p><p class="elsevierStyleSimplePara elsevierViewall">However, primary health care services carry out many clinical preventive activities. While the aims of these activities are laudable, the interventions themselves have substantial limitations, because they are an important source of dependency, a powerful incentive to consume drugs, and are also inefficient and inequitable ways of spending health resources. These limitations justify the testing of combined approaches between public health services and citizens’ collectives to improve and protect community health.</p><p class="elsevierStyleSimplePara elsevierViewall">Developing community health programs based on cooperation between primary health care services and public health services requires strategies that produce appreciable results in the short term to both health sectors, as well as to the population, so that these programs stimulate the process and encourage further development.</p><p class="elsevierStyleSimplePara elsevierViewall">The settings in which collaboration is most promising are population health surveillance and monitoring in basic health areas, control of communicable diseases and epidemic outbreaks, health promotion and health protection programs through simultaneous clinical and community-based interventions, and improved management of all health services in local communities through joint evaluation.</p><p class="elsevierStyleSimplePara elsevierViewall">The resources needed to carry out these activities should be drawn from a reduction of clinical preventive activities that reduce workload and from an increase in the number and quality of the public health workforce.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:36 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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