At the “5th International Administration Congress: Integrated Healthcare Services Networks, a path to Universal Coverage,” the Brazilian doctor and professor Eugênio Vilaça Mendes presented his latest book, “Las Redes de Atención de Salud” (Healthcare Networks), financed by the Panamerican Healthcare Organization.
In addition, he presided over the opening ceremony held at the El Cruce – Néstor Kirchner Hospital in Buenos Aires, Argentina, during which he spoke about the state of healthcare networks in Latin America.
“Healthcare networks are in transition due to contextual and internal factors. The discrepancy between one and the other is the cause of the modern crisis in healthcare systems,” he said.
Today, the author explained, chronic diseases have become relatively predominant. A sedentary lifestyle, smoking, unhealthy diets and excessive consumption of alcohol and other drugs, would seem to be the causes of the increase in these diseases. “How does the world respond to these healthcare situations? Through two different ways of organizing the system: fragmented healthcare systems and integrated healthcare systems, and that is the purpose of healthcare networks.”
Fragmented systems are organized according to the principle of supply and operate episodically and reactively, focusing on care for acute cases and deterioration of conditions. “We are faced with a 21st Century healthcare issue, the preponderance of chronic conditions, and it is being answered by healthcare systems that were developed in the first half of the 20th Century, but at that time acute conditions predominated,” he said.
He also said that networks are sporadic organizations of healthcare services linked to each other by a single vision, common objectives and cooperative, independent action that makes it possible to offer continuous, comprehensive care to a certain population (coordinated and ordered by primary healthcare).
Vilaça Mendes placed special emphasis on primary care and the need to create a scaled economy via the centralization of high complexity hospitals. In fact, he said that primary care is the point of coordination for the entire network as it is where contact is made between the population and the healthcare system. “85% of cases should be resolved during primary care and the remaining 15% should be sent to secondary and tertiary care areas, as appropriate, due to the level of risk presented to the patient,” he said.
The development of a scaled economy is important when analyzing the efficacy and cost of investment in high complexity hospitals. After an analysis of cases in Brazil, Vilaça Mendes concluded that as the number of beds increases the results of operations improve and costs diminish exponentially.
Finally, to support his presentation with actual case studies, he presented two models of healthcare in integrated healthcare networks. The first was focused on the population and based on acute events, while the second was designed for chronic conditions.
At the end of the congress the next day the organizers once more allowed him to take the floor. Eugenio Vilaça Mendes congratulated the exhibitors, thanked the organizers for the invitation, lauded the efforts being made by the Argentine state to implement networks in healthcare systems and once more emphasized the importance of primary care, stating “Everything begins with primary care.”
