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New challenges and demands for health systems in the post pandemic


In many countries, the aging of the population and the growing burden of the association between multiple comorbidities and chronic diseases, mean that current health systems are waging a battle to effectively meet the growing demands for care.


The cumulative effect of a series of sociodemographic, economic, environmental changes, as well as rising expectations for care, has brought new demands on health services to provide care that is proactive rather than reactive, comprehensive and continuous rather than episodic and specific. related to diseases, and that are based on sustainable relationships between users and providers.


The existing fragmentation is the result of over-medicalization, excessive subspecialization and curative care models oriented towards diseases. Such fragmented approaches, reduce the capacity of the health system to continue care, which leads to difficulties in timely access, provision of services with low quality, duplication of efforts and inefficient use of resources.


The health system needs to provide an answer to improve this integration, in order to overcome all these challenges faced. Such a response can generate significant benefits in the Brazilian system, related to:

  • Improve the user experience;

  • Improving access to care and reducing inequalities;

  • Build an Integrated Health Structure;

  • Provide an assessment of local health needs;

  • Identify priorities for system improvements;

  • Guarantee responsibility and sustainability of the health system.

Integrated care contributes to improving access to services, reducing the number of unnecessary hospitalizations and readmissions, improving treatment adherence, increasing user satisfaction, health education and self-care, greater job satisfaction for health professionals and better overall results of health.

A population health management approach can improve the

health and well-being of the population.


It is necessary to effectively support the transformation and actions towards the integrated health service, this includes the participation of the government and the whole of society. It is necessary to support the implementation of policies that are aligned and applied simultaneously to the different levels of health systems within a favorable environment. Including clear remuneration policies, whether in the public or private system, based on the value generated, on the result obtained and not on production.


This requires sustained political commitment and leadership, change management approaches and the mobilization and engagement of health professionals and communities at each level, guided by a person-centered view of health, rather than diseases or health institutions.

Dr. Bruno Cavalcanti Farras
Mara Machado

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