Redes integradas de servicios de salud en el marco de la atención primaria en salud en países seleccionados de América Latina

Resumen

Background: The organization of Integrated Health Services Networks is a growing trend in the health systems of countries in Latin America. Aim: Describe the conceptual, operational and evaluative elements of these networks in Cuba, Brazil, Chile and Bolivia. Materials and methods: Qualitative systematic review of 59 documents published between 2000 and 2016 on the networks in the selected countries. The Medline, Scielo, Lilacs and EBSCO databases were reviewed, and a search was made of documents in Google Scholar, documents from international organizations, Health Ministries and local health secretariats. Results: Cuba, Brazil and Bolivia incorporate into the networks the concept of the right to health, with universalist models in charge of the State. Chile has a mixed public-private model, with elements of universality that contrast with those of the free market model of service provision. In all countries, the central concept is Family and Community Medicine. The networks are organized in a hierarchical manner with coordinating teams that review epidemiological needs and community work teams by geographic territories. Network evaluation is limited in all countries reviewed. In Bolivia, elements of interculturality are incorporated into rural networks. Conclusions: Cuba, Brazil and Bolivia have networks within the framework of primary care that are universal and facilitate the population’s access to health services. Chile has obstacles in the integration of its networks and makes access to payment capacity dependent.