Conceptualising health services in terms of level and location of care : a view from the academic health complex.
The origin and characteristics of academic health complexes (AHCs) are briefly outlined, along with pressures for restructuring of health services towards primary levels of care within the primary health care (PHC) approach.
Weakness and strengthss of the AHCs together with imbalances in the overall health system of which they are part are discussed.
A method of service mapping is employed to aid an appreciation of the complexity of AHC services.
Planning for potential transformation may be facilitated by conceptualising services in two dimensions, viz. level and location of care.
Two important additional dimensions of service component linkage are integration across levels of care along a vertical axis, and integration across different services at primary level along a horizontal axis (comprehensiveness).
AHC services are managed by health professionals in specific academic disciplines.
They include PHC functions at the interface between primary and specialist care provision, and community health functions which are principally located outside the health care facilities in the community.
Resource redistribution requirements are therefore less straightforward than immediately apparent when one considers the relatively high proportion of funding that goes to AHCs, and the relative underdevelopment of the PHC infrastructure.
AHC functions are, after all, principally geared to the production of providers of PHC.
Mots-clés Pascal : Système santé, Politique sanitaire, Historique, Article synthèse, Homme, République Sud Africaine, Qualité, Afrique
Mots-clés Pascal anglais : Health system, Health policy, Case history, Review, Human, South Africa, Quality, Africa
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0422942
Code Inist : 002B30A11. Création : 01/03/1996.