For a Comprehensive Health System

Providing quality, equality and universal access to all who, individually or collectively, seek a response to their needs are considered to be the great challenges in the health care area. In the current health context, countless countries of different levels of development have made efforts to guarantee meeting these objectives, differing from those of past decades; rapid ageing of the population, violence that is virtually an epidemic; the excessive burden of chronic conditions (communicable and non-communicable); accidents due to external causes; iatrogenesis of health care services; and service user safety, among others, all pose challenges for the health care and management field. Despite strengthened public policies and positive discrimination in favor of the elderly, their increase in number and in life expectancy has been vertiginous in the last few decades. It is estimated that, in some countries, the population aged over 60 will represent 30% of the general population (1). Such factors pose challenges for the different levels of care – primary, secondary and tertiary care – in which adults and the elderly make increasing use of care when faced with the individual characteristics of the ageing process. What is required, then, is appropriateness and innovation at the different levels of care, encouraging healthy ageing and reducing the risks that evolve from the physio-pathological processes of chronic diseases. The processed that generally affect quality of life in this population are those of non-communicable diseases which, when they become acute, increase early death despite the technical-scientific advances that have been made in the health care field. Such factors have had negative impacts from an economic point of view, from that of health care systems and of the families and individuals, aggravating social inequalities (2). As for violence, the World Health Organization has spread this concept globally, based on the idea of associating the intention to commit the act with actually committing it, irrespective of the result. Thus, health care services daily come across countless types of cases of violence, with immediate and latent repercussions on the most vulnerable groups in society, conditioning the health care services to adapt in order to tackle these processes. The consequences of violence affect different levels of the health care system differently, with increased treatment costs, as well as repercussions such as absenteeism and reduced productivity (3). In addition to the immeasurable social and emotional costs for families and individuals affected by violence. Non Communicable Chronic …