Construir una nueva hegemonía institucional en el campo de la salud

Hugo Spinelli

doi:10.18294/sc.2020.3360

Constructing a new institutional hegemony in the health field

Hugo Spinelli Doctor en Salud Colectiva. Director del Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina.

Received: 19 December 2020, Accepted: 19 December 2020, Published: 23 December 2020

https://doi.org/10.18294/sc.2020.3360 | PMID: 33374088

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Abstract

This article argues for the construction of a new institutional hegemony with a rhizomatic design based on health centers with direct relations to a network of hospitals with increasing levels of complexity, which are put at the service of these health centers and not the other way around. The proposal for these centers includes community-based teams of workers carrying out humanized practice centered on the shift from health services to care within the community, respecting the particularities and idiosyncrasies of its residents and their cultures. First, a brief historical revision of the genesis of health centers and of hospitals is presented. Second, technical recommendations to restructure models of care and institutional organization in the health field are put forth, and technical-political proposals for this new institutional hegemony are outlined, which are developed along three dimensions: organization, policy, and service and care processes. Lastly, some barriers to the construction of this new hegemony are identified.

Keywords: Health Systems, Health Centers, Primary Health Care, Argentina

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