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Authors
Abstract(s)
A saúde é um bem social. Contudo, nestes tempos de incerteza económica e financeira, naturalmente se levantam graves problemas no acesso a cuidados de saúde, especialmente no sistema de saúde privado, para pessoas com fracos recursos económicos, o que gera níveis de insatisfação dos utentes/clientes, levantando questões éticas relevantes no âmbito da justiça e da equidade. Consideramos fundamental a adoção de políticas que promovam um Sistema Nacional de Saúde equitativo no acesso a cuidados de saúde física e mental e gerador de igualdade de oportunidades e de satisfação de todos os cidadãos. A imprevisibilidade constante das mudanças no sistema de saúde e das reformas neste setor provoca desigualdades, colocando obstáculos ao setor privado da saúde, não só na sua capacidade de responder aos desafios económicos e financeiros, mas também relativamente às questões éticas de um acesso justo e equitativo das pessoas particulares e protocoladas que utilizam os serviços e cuidados de saúde da Casa de Saúde São Mateus – Hospital (CSSM-H). Volvidos 61 anos de atividade da CSSM-H (1961-2022), algo se mantém inabalável - o respeito pelos valores humanos fundamentais do indivíduo. De facto, no decurso destes anos, naturalmente que houve mudanças na gestão e funcionamento desta emblemática instituição viseense. No entanto, houve igualmente constâncias, designadamente nos valores que sempre marcaram presença no dia a dia da Casa de Saúde São Mateus, agora Hospital Privado S.A. Procurando nortear a sua ação por elevados padrões de ética, os gestores e os profissionais de saúde que dão corpo a este projeto pressupõem como bem melhor o valor intrínseco da dignidade da pessoa humana, conforme nos apresenta e fundamenta a Bioética, como base do agir em saúde O objetivo principal da nossa investigação pretende avaliar se existe ou não satisfação do utente/cliente relativamente à equidade no acesso a tratamentos/cuidados de saúde na CSSM-H. e perceber quais os constrangimentos que lhe estão associados, bem como os benefícios usufruídos por aqueles que procuram este serviço de saúde. Com efeito, constata-se que, do ponto de vista da disponibilidade financeira, existem constrangimentos e, por isso, defendemos nesta investigação que o mercado das apólices dos seguros e da própria ADSE deve aumentar os seus serviços no nosso mercado nacional – com acesso global -, cativando indivíduos e empresas a elaborarem um plano de saúde, de modo a contribuírem mais ativamente para um melhor Sistema Nacional de Saúde (SNS). Com mais pessoas protocoladas, como propomos, a satisfação e a equidade no acesso a tratamentos e cuidados de saúde aumentam, promovendo, também, a qualidade dos serviços – públicos e privados –, na medida em que tal facto acarretará a diminuição dos tempos de espera das consultas de clínica geral, de especialidades, de exames de diagnósticos e das intervenções cirúrgicas. De acordo com o que tentamos evidenciar, o aumento de pessoas protocoladas vai contribuir para ajudar as pessoas mais necessitadas - as que não têm possibilidade de adquirir um seguro de saúde ou que não têm acesso à ADSE –, uma vez que a procura do setor privado, por parte dos menos carenciados, vai libertar o Serviço Nacional de Saúde (SNS), promovendo, assim, um atendimento mais eficiente e mais eficaz no setor público, para aqueles que mais necessitam da ajuda do estado. E, se mais eficaz e mais eficiente, mais justo e equitativo para as pessoas mais vulneráveis economicamente, fomentando uma maior satisfação do utente/cliente, tendo em conta que os tratamentos e o atendimento, de pessoas protocoladas e não protocoladas, num Hospital Privado alivia o Hospital Publico, propiciando um tratamento digno, e por isso mais equitativo, para com as pessoas mais necessitadas. O nosso estudo traduz-se num trabalho de cariz observacional, exploratório, com abordagem transversal, que procura indagar sobre a satisfação e a perceção dos utentes/clientes (protocolados e não protocolados) relativamente à equidade na CSSM-H e identificar possíveis fatores de constrangimento ao acesso equitativo a tratamentos e cuidados de saúde. A recolha da informação, para dar resposta às questões suscitadas na investigação, assentou na aplicação do questionário elaborado pela investigadora. Trata-se de um inquérito original.
Good health is a social asset. However, in these times of financial and economic uncertainty, it is inevitable that serious issues arise with regard to accessing healthcare; particularly within the private healthcare system for people on low incomes. This raises ethical questions relating to notions of justice and equity. We believe in the importance of adopting policies to promote a National Health System [Sistema Nacional de Saúde] that will provide equitable access to healthcare, creating equal opportunities for all citizens. The constant unpredictability of changes to the healthcare system and reforms in this sector leads to a lack of equality,and puts obstacles in the way of the private health sector, not just in its capacity to respond to economic and financial challenges but also to ethical questions of fair and equitable access for the private and registered people who use the Casa de Saúde S- Mateus – Hospital (CSSM-H) health services. In the 60 years of the CSSM-H’s activities, from 1961 to 2021, fundamental human values, such as is the intrinsic value of human dignity, have always been evident in the day-to-day activities carried out at the Casa de Saúde São Mateus, now Hospital Privado S.A. Bioethics is the foundation for our healthcare activities, with each manager and health professional having a responsibility to be as competent as they should be, and to aim for the highest ethical standards in all their activities. The main objective of our research is to evaluate whether or not equity in accessing treatment – healthcare – exists at CSSM-H., and to understand what constraints are associated with this, as well as the benefits for those who use this health service. It appears that, from the point of view of financial availability, there are indeed constraints. This is why we advocate in our research that the health insurance market and the ADSE itself must increase the services it offers on the national market – with global access – involving companies and individuals in the creation of a health plan which will contribute to a better National Health System (SNS). With greater numbers of people registered, as we propose, equitable access to treatment and healthcare will increase, and the quality of services – both public and private – will improve, insofar as waiting times for general clinical consultations, specialists, diagnostic examinations and surgical interventions will be reduced. According to what we have tried to demonstrate, an increase in registered people will contribute to helping those who are most in need – those people who are not able to acquire health insurance, or who do not have access to the ADSE – as increased use of the private health system will free up the National Health System (SNS), thereby promoting more efficient and effective treatment in the public sector. The more effective and efficient the treatment, the fairer and more equitable it is for the most economically vulnerable sector of society, given that the treatment and care of registered and non-registered people in a private hospital will reduce the pressure on the public hospital, enabling fair treatment and, therefore, greater equity for those people with the greatest need. Our study is an observational, exploratory work, with a cross-sectional approach, which seeks to inquire about the satisfaction and perception of users/clients (protocol and non-protocol) of CSSM-H and identify possible factors that constrain access. equitable treatment and health care. The collection of information to answer the research questions raised was based on the application of a questionnaire prepared by the researcher. This is an original survey.
Good health is a social asset. However, in these times of financial and economic uncertainty, it is inevitable that serious issues arise with regard to accessing healthcare; particularly within the private healthcare system for people on low incomes. This raises ethical questions relating to notions of justice and equity. We believe in the importance of adopting policies to promote a National Health System [Sistema Nacional de Saúde] that will provide equitable access to healthcare, creating equal opportunities for all citizens. The constant unpredictability of changes to the healthcare system and reforms in this sector leads to a lack of equality,and puts obstacles in the way of the private health sector, not just in its capacity to respond to economic and financial challenges but also to ethical questions of fair and equitable access for the private and registered people who use the Casa de Saúde S- Mateus – Hospital (CSSM-H) health services. In the 60 years of the CSSM-H’s activities, from 1961 to 2021, fundamental human values, such as is the intrinsic value of human dignity, have always been evident in the day-to-day activities carried out at the Casa de Saúde São Mateus, now Hospital Privado S.A. Bioethics is the foundation for our healthcare activities, with each manager and health professional having a responsibility to be as competent as they should be, and to aim for the highest ethical standards in all their activities. The main objective of our research is to evaluate whether or not equity in accessing treatment – healthcare – exists at CSSM-H., and to understand what constraints are associated with this, as well as the benefits for those who use this health service. It appears that, from the point of view of financial availability, there are indeed constraints. This is why we advocate in our research that the health insurance market and the ADSE itself must increase the services it offers on the national market – with global access – involving companies and individuals in the creation of a health plan which will contribute to a better National Health System (SNS). With greater numbers of people registered, as we propose, equitable access to treatment and healthcare will increase, and the quality of services – both public and private – will improve, insofar as waiting times for general clinical consultations, specialists, diagnostic examinations and surgical interventions will be reduced. According to what we have tried to demonstrate, an increase in registered people will contribute to helping those who are most in need – those people who are not able to acquire health insurance, or who do not have access to the ADSE – as increased use of the private health system will free up the National Health System (SNS), thereby promoting more efficient and effective treatment in the public sector. The more effective and efficient the treatment, the fairer and more equitable it is for the most economically vulnerable sector of society, given that the treatment and care of registered and non-registered people in a private hospital will reduce the pressure on the public hospital, enabling fair treatment and, therefore, greater equity for those people with the greatest need. Our study is an observational, exploratory work, with a cross-sectional approach, which seeks to inquire about the satisfaction and perception of users/clients (protocol and non-protocol) of CSSM-H and identify possible factors that constrain access. equitable treatment and health care. The collection of information to answer the research questions raised was based on the application of a questionnaire prepared by the researcher. This is an original survey.
Description
Keywords
Bioética Justiça Equidade Satisfação do cliente Bioethics Justice Equity Customer satisfaction