Journal Information
Vol. 15. Issue 5.
Pages 453-460 (August - October 2001)
Vol. 15. Issue 5.
Pages 453-460 (August - October 2001)
Open Access
El informe de la Organización Mundial de la Salud 2000: un juego de ordenador políticamente incorrecto
The World Health Organization Report 2000: a politically incorrect computer game
Visits
6486
J.M. Fernández-Díaz
Corresponding author
jmfer@jet.es

Correspondencia: Dr. J.M. Fernández-Díaz. Foronda, 32. Foronda. 01196 Álava.
This item has received

Under a Creative Commons license
Article information
Resumen

El Informe de la Organización Mundial de la Salud 2000 trata de fundamentar el desarrollo de los sistemas de salud en el mundo en la evidencia disponible sobre políticas sanitarias. El informe ha suscitado un importante debate político y académico. Este artículo revisa las aportaciones del informe a la política de salud, y además analiza y comenta las principales críticas publicadas. A través de una recapitulación de la reformas acontecidas en los últimos 15 años en el panorama internacional, la OMS realiza un cambio sustancial en los planteamientos clásicos que ha mantenido, decantándose por los sistemas de salud con financiación universal y conducción gubernamental, donde exista una mayor compartición de riesgo financiero, colaboración público-privada y desregulación de la gestión pública. La OMS realiza al mismo tiempo una baremación de los 191 sistemas de salud de acuerdo con su logro y rendimiento, con una metodología artificial, opaca y débil en el aspecto técnico que ha sido desacreditada internacionalmente. A pesar de las críticas, la OMS ha empeñado su prestigio en continuar esta iniciativa sin cambios sustanciales en sus métodos y orientación, haciendo caso omiso a las críticas recibidas.

Palabras clave:
Política sanitaria
Servicios sanitarios
Salud mundial
Reforma de la atención sanitaria
Economía de la salud y organizaciones sanitarias
Agencias internacionales
Investigación de servicios de salud
Summary

The World Health Organization Report 2000 is aimed at supporting an evidence-based development of health care systems in the world. The report has brought about a significant political and academic debate. This article reviews the contribution of the WHO Report to current health care policy, as well as analyzes and comments the main published critiques. Through a commented compilation of the health care reforms implemented over the last fifteen years in the world, WHO shifts radically its traditional position supporting now universal access to health care and a strong government's conduction role, but within a financial risk sharing environment, public and private co-operation and deregulation of the public management of health care institutions. WHO ranks in this report the 191 countries according to their health care systems' goal attainment and performance using a very weak, obscure and artificial methodology which has been opposed internationally. WHO is, however, committed to continue this initiative without apparently any major changes in the general and methodological approach.

Key words:
Health policy
Health services
World health
Health care reform
Health care Economics and organizations
International agencies
Health services research
Full text is only aviable in PDF
Biblografía
[1.]
World Health Organization.
The World Health Report 2000 Health Systems: Improving Performance.
[2.]
V. Navarro.
Assessment of the World Health Report 2000.
Lancet, 356 (2000), pp. 1598-1601
[3.]
Bruntlandt GH. Statement by the Director-General to the Executive Board at its 107th session. EB107/2, 15 de junio de 2001. Disponible en: http://www.who.int/whr
[4.]
World Health Organization. Health systems performance assessment-Report by the Secretariat. EB107/9, 14 de diciembre de 2000. Disponible en: http://www.who.int/whr
[5.]
D. Osborn, T. Gaebler.
Reinventing government.
[6.]
E. Ollila, M. Koivusalo.
Values, ideologies and evidence-based recommendations: WHO's Health Policy drifting off course.
Themes from Finland: The World Health Report 2000. What does it tell us about health systems?, pp. 3-7
[7.]
Fundación Osvaldo Cruz [accedido el 26 de mayo de 2001]. Disponible en http://www.fiocruz.br/cict/dis/vering.htm.
[8.]
P. Van der Stuyft, J.P. Unger.
Improving the performance of health systems: the World Health Report as go-between for scientific evidence and ideological discourse.
Trop Med Int Health, 10 (2000), pp. 675-677
[9.]
S. Anand, K. Hanson.
Disability-adjusted life years: a critical review.
J Health Econ, 6 (1997), pp. 685-702
[10.]
A. Williams.
Calculating the global burden of disease: time for strategic reappraisal?.
Health Econ, 8 (1999), pp. 1-8
[11.]
G. Mooney, V. Wiseman.
Burden of disease and priority setting.
Health Econ, 9 (2000), pp. 369-372
[12.]
P. Rissanen, H. Sintonen.
Measurement of the State of Health in the World Health Report 2000.
Themes from Finland: The World Health Report 2000. What does it tell us about health systems?, pp. 17-20
[13.]
V. Wiseman, G. Mooney.
Burden of illness estimates for priority-setting: a debate revisites.
Health Policy, 43 (1997), pp. 243-251
[14.]
R.S. Cooper, B. Osotimehin, J.S. Kaufman, T. Forrester.
Disease burden in sub-Saharan Africa: what should we conclude in the abscence of data?.
[15.]
A. Williams.
Science or Marketing at WHO? A commentary on «World Health 2000».
Health Econ, 10 (2001), pp. 93-100
[16.]
A. Aalto.
Measuring the Responsiveness of Health Care System in the World Health Report 2000.
Themes from Finland: The World Health Report 2000. What does it tell us about health systems?, pp. 29-32
[17.]
J. Klavus.
The measure of fair financing in the World Health Report 2000.
Themes from Finland: The World Health Report 2000. What does it tell us about health systems?, pp. 21-24
[18.]
U. Häkkinen.
Assessment of the Goal Attainment and Efficiency of Health Systems in the World Health Report 2000.
Themes from Finland: The World Health Report 2000. What does it tell us about health systems?, pp. 9-15
[19.]
Wildner M, Brunner A. Health systems' performance and ethical yardsticks. Lancet [edición electrónica] 2000 [citado el 28 octubre de 2000]; 356. Disponible en: http://www.thelancet.com.
[20.]
R.G. Evans, G.L. Stoddart.
Producing health, consuming health care.
Soc Sci Med, (1990), pp. 1347-1363
[21.]
R. Blendon, M. Kim, J. Benson.
The Public versus the World Health Organization on Health System Performance.
Health Aff, 20 (2001), pp. 10-20
Copyright © 2001. Sociedad Española de Salud Pública y Administración Sanitaria
Idiomas
Gaceta Sanitaria
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?