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Health or medical care system?: matters in efficiency


This work seeks to explore a country’s organization of its national health systems, its allocation of resources in the process and well as the efficiency of such organized system. The paper also aims to contribute in improving the organization of an integrated health system. The vast majority of countries in the world have formulated their national health system based on their medical care system, ignoring the importance of public and community health. In other words, they are more oriented towards waiting for people to get sick, than taking a preventive approach with early detection of disease to avoid the development of sickness and its complications. Such reactive, rather than proactive approach, continues to contribute to the high costs of medical care associated with the increased number of chronic patients and a greater population longevity. Their reactive formulation of their health systems makes the system inefficient. On the other hand, the practice of medical care is considered recuperative health; however, an increasing demand of chronic patients to medical care services raises the question if the medical practice is really recuperative or only treatment of a chronic disease. The existence of a functional divorce between public health and medical care limits and weakens efficiency. Therefore, it is urgent to integrate both practices into a single organized and coordinated health system that prioritizes prevention over disease treatment, primary prevention rather than secondary prevention (chronicity) or tertiary prevention (damage to other organs as a complication). The COVID_19 pandemic is predominantly public health issue rather than medical, although social behavior has been a major factor in the persistence of the pandemic.


health system, primary, secondary and tertiary prevention, primary care, first level of care