[Comprehensive health care and integrated health services: challenges for evaluating the implementation of a "system without walls"].
The premise of this paper is that comprehensive health care is a major component in the investigation and evaluation of health services and systems, structured as inter-organizational health care networks articulating clinical, functional, normative, and systemic dimensions in their operationalization and based on the understanding that no organization combines all the necessary resources and capabilities to solve the health problems of a population with its various life cycles. Given the complex nature of this "system without walls", eliminating barriers to access in the various health care levels in response to local and regional health, we take this opportunity to share a few "preliminary lessons" from our experience and from the literature on integrated health services which may interest researchers and managers concerned with the implementation of such services.
Hartz
Zulmira M de Araújo
ZM
Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. zulmira.hartz@umontreal.ca
Contandriopoulos
André-Pierre
AP
D003191:Comprehensive Health Care / Q000458:organization & administration / Q000592:standards*; D019033:Delivery of Health Care, Integrated / Q000592:standards*; D006284:Health Plan Implementation / Q000592:standards*; D006801:Humans; D015397:Program Evaluation; D011785:Quality Assurance, Health Care