He Dominican Health System It is based on hospital care of the patient with a poor emphasis on promotion and prevention,
The university study plans are based on the disease, development of third level centers, without alignment with the plans of the Ministry of Public Health from the country.
The approaches correspond to the Dr. Marcos Nunez Cuervodean of the Faculty of Health Sciences at the Universidad Iberoamericana (UNIBE). He is also one of the most prestigious hand surgeons in the country.
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The system in reverse
Care in the Health System is focused on the patient, instead of being dedicated to the person and the community.
Likewise, the academic analyzes that in the current system, the provision of consultation services in the Level III hospitals and private clinics and bring together specialists from specific areas of medicine. Currently, patients with a headache go directly to the neurology department, the professional laments.
Major pitfalls
Currently, the Health System has a limited expression of the Primary Health Care strategy and the use of the first level of care.
Likewise, the referral and counter-referral system is weak. The Health System lacks digitalization of patient data, which makes the information process difficult. The Dominican Health System is complex; with little fluid communication between its main actors, it refers to the Ministry, the academies, Medical College, Specialized Societies and with a legal framework that must be reviewed and adapted to the new times. Very basic education levels of the population are deficient and there is little empowerment over their health by the people.
The files
The monitoring of users is so poor that the same patient can have up to three records at the same time. The disorder that prevails with patient records makes it difficult to see previous information when consulting another area or department. It also makes it difficult to extract statistics quickly and accurately, which is very important for decision-making, says the academic.
Both the doctor and other experts agree that the Health System is stuck in curative medicine. More than prevention, it privileges the cure or treatment of diseases. The structures of the public and private sectors constitute the core of health care. A vision of centers, not an integral one.
Numerous studies and consultancies have been carried out to determine the shortcomings of the national health system, but no changes have been made.
The country gave birth to three laws that regulate the Health System, the 42-01 or General Health Law, the 87-01 that created the Dominican Social Security System and 123-15 which created the National Health Service (SNS)
More pitfalls
Health plan coverage is very heterogeneous, with significant gaps between contributory plans and subsidized plans, he says.
In the Dominican Republic it is high out-of-pocket expenses for individuals.
The diseases
There is a persistent increase in chronic non-communicable diseases, such as high blood pressure, diabetes mellitus and their complications due to a lack of early detection and monitoring, the specialist explains. In the same order, there is a high deficiency in the lack of compliance with the established treatment by the affected patients.
The most vulnerable
There is a deficit in the quality of life of the poorest, most vulnerable and those far from the cities, such as those in the border area.
Human resources
The entire line of human resources in the health system is a real challenge. It is the most important and relevant team within the health sector. Health workers and other disciplines that impact the results and indicators and represent part of the problem and its solution at the same time, says Núñez when analyzing the Health System.
In his opinion, it is a challenge to cultivate compassion and empathy between patients and health personnel. These personnel should receive more training in Primary Care in their curricula, as occurs in countries such as Canada and Argentina. In the country, medicine is not based on the person or on communities, which is a great weakness. The system based on hospitals is criticized.
