[Comparative analysis of Andean and Caribbean region health systems].
OBJECTIVE
Carrying out a comparative analysis of Andean and Caribbean health systems contributing towards the general panorama of Andean and Caribbean region health care system experience.


METHODS
This study was aimed at carrying out a comparative analysis of health systems in Bolivia, Colombia, Ecuador, Peru, Venezuela, the Dominican Republic and Cuba between 1990 and 2004. Documentary information from secondary sources was used. Reform and changes during the aforementioned period were compared, as well as the systems' current configurations. Described typologies were used for studying the health systems.


RESULTS
Different organisational designs were found for the systems: a national health system (NHS), segmented systems and systems based on mandatory insurance. The trend of reforms introduced in the 1990s and current proposals in almost all systems are directed towards adopting mandatory insurance via a basic packet of services and strengthening competition in providing services through a public and private mix.


CONCLUSIONS
The organisation and structure of most systems studied have introduced and continue to introduce changes in line with international guidelines. The generality of these structures means that efforts must still be made to adopt designs strengthening them as instruments improving populations' quality of life. Comparative analysis is a tool leading to studying health systems and producing information which can nourish debate regarding current sector reform. This work took shape during the first approach to a comparative study of Andean region and Caribbean health systems.
Gómez-Camelo
Diana
D
diana_gomez_camelo@yahoo.com
D001838:Bolivia; D017691:Caribbean Region; D003105:Colombia; D003695:Delivery of Health Care / Q000458:organization & administration*; D004484:Ecuador; D018166:Health Care Reform; D010568:Peru; D014687:Venezuela