Browsing by Person "Bonet, Mariano"

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Cuba's health system: Challenges ahead
(Oxford University Press, 2008-05-02) De Vos, Pol; De Ceukelaire, Wim; Bonet, Mariano; Van der Stuyft, Patrick
Cuba's exclusively public health system has been quite unique in pairing limited resources with excellent results. It continued to perform well during the economic crisis of the 1990s, and now that the hardships are being overcome, new opportunities are developing—as well as threats: (1) economic recovery should permit reinforcing of the system's effectiveness; (2) Cuba's increasing international solidarity in health also poses it corresponding challenges at home; (3) the ageing of the population necessitates adjustments to the health care system. However, the original principles of the health care system are not under question. Cuba can be considered a unique laboratory, and deserves more attention from the international public health community.
Cuba's international cooperation in health: An overview
(Baywood Publishing, 2007-10-01) De Vos, Pol; De Ceukelaire, Wim; Bonet, Mariano; Van der Stuyft, Patrick
In the first years after Cuba's 1959 revolution, the island's new government provided international medical assistance to countries affected by natural disasters or armed conflicts. Step by step, a more structural complementary program for international collaboration was put in place. The relief operations after Hurricane Mitch, which struck Central America in 1998, were pivotal. From November 1998 onward, the “Integrated Health Program” was the cornerstone of Cuba's international cooperation. The intense cooperation with Hugo Chávez's Venezuela became another cornerstone. Complementary to the health programs abroad, Cuba also set up international programs at home, benefiting tens of thousands of foreign patients and disaster victims. In a parallel program, medical training is offered to international students in the Latin American Medical School in Cuba and, increasingly, also in their home countries. The importance and impact of these initiatives, however, cannot and should not be analyzed solely in public health terms.
The functioning of the Cuban home hospitalization programme: A descriptive analysis
(BMC, 2007-05-31) De Vos, Pol; Barroso, Isabel; Rodríguez, Armando; Bonet, Mariano; Van der Stuyft, Patrick
Background Over the last decades hospital at home (HaH) programmes have been set up in many, mainly European, countries. The Cuban HaH programme is not hospital driven, but the responsibility of the first line health services, and family doctors play a pivotal role.
Health and human rights in Cuba [Letter]
(Elsevier, 2004-12-18) De Vos, Pol; Bonet, Mariano; Van der Stuyft, Patrick
Shifting the demand for emergency care in Cuba's health system
(Elsevier, 2004-07-09) De Vos, Pol; Murlá, Pedro; Rodriguez, Armando; Bonet, Mariano; Màs, Pedro; Van der Stuyft, Patrick
Cuba has developed a programme of quality improvement of its health services, which includes an extramural emergency care system in which polyclinics and general practitioner networks play an important role. Using routine health information from the decentralised first line emergency units (FLES) and from the hospital emergency service (HES) for the period 1995–2000, we evaluated the effects of the emergency care subsystem reform on the utilisation rates of first line and hospital services in Baracoa and Cerro, a rural and a metropolitan municipality, respectively. In the self-contained health system of Baracoa, the reform of the emergency subsystem resulted in a first phase of increased utilisation of the FLES, followed by a second phase of gradual decrease, during which there was an increased utilisation of general practitioners. In contrast, the overall results of the reform in Cerro were unclear. The proximity to a hospital seems to be the most important element in the patient's decision on which entry point to the Cerro health system to use. A potential adverse effect of the reform is an increased emergency services utilisation in situations where GP care remains below patients’ expectations. Given the current world-wide trends in health-care reform, the organisational alternatives developed in the Cuban health system might remain specific to the local contextual setting.
Uses of first line emergency services in Cuba
(Elsevier, 2007-08-17) De Vos, Pol; Vanlerberghe, Veerle; Rodríguez, Armando; García, René; Bonet, Mariano; Van der Stuyft, Patrick
Objectives To rationalise the use of hospital emergency units, the Cuban health system developed from 1996 onwards an extra muros first line emergency system (FLES). We analyse the use of the FLES and its determinants, in order to develop proposals to channel inappropriate users to their family doctor.