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Extra resources for Chile: the adult health policy challenge
Abuse of drugs has shown a gradual increase since the early 1960's, affecting an estimated 3-5 percent of adolescents and young adults, particularly those in the northern regions. Hypertension is estimated to be present in 10-16 percent of the adult population. Sedentarism is prevalent, particularly among lower income groups and women, as recreational exercise is not a widely accepted habit in Chile. Important nutrition-related risk factors include obesity, affecting in particular low-income women, high cholesterol among upper socioeconomic levels, and low calcium intake.
A significant feature of the reform program is the proposal to replace the current fee-for-service resource allocation mechanisms with fixed diagnosis-related payments for hospitals and a capitated system for primary health care facilities. Legislation has also been enacted to strengthen the MOH's regulatory role over the ISAPREs in order to mitigate the effects of certain market imperfections. Collectively these reforms will better enable the NHSS to meet the challenges posed by Chile's changing epidemiological profile.
The MOH should consider providing training and technical assistance to its staff to develop the capacity to undertake technology assessments and cost-effectiveness analysis in order to increase the efficiency and effectiveness of the resource allocation process, as well as to the HSAs to develop their own internal capacity to prepare budgets, monitor expenditures, and assess productivity, effectiveness, and quality. Page xxix B Strengthening Health Promotion, Disease Prevention and Health Protection Programs and Interventions Currently, activities to combat non-communicable illnesses and their risk factors are fragmented among different MOH programs which do not control the resources needed to implement the programs they plan.