The past few days have brought some fascinating opportunities to learn about Cuba’s health care system, and not surprisingly, all of our visits have started with a reference to their primary care health care system as the basis for all other services. The system clearly deserves more explanation than this abbreviated format, but in short, it’s based on a system of primary doctor-nurse teams, or “consultorios”, located in each neighborhood that provide care and get to intimately know the ~1200 individuals and families in that community. Together with an environmental (“vector”) specialist, they systematically identify, categorize, and make plans to address not only health needs of the people in that community, but also the issues of the physical community itself, including the infections diseases, chronic conditions, social issues, and physical health threats of the neighborhood. Each consultorio is linked to and supported by a local “polyclinic”, a primary care/specialist team that provides additional primary and emergency care, as well as dental, mental health, and other support services. We visited the “19th de Abril” polyclinic (ironically, named after the date of Cuba’s victorious effort to repel the US invasion at the Bay of Pigs!), and one of their associated family doctor-nurse teams.
Together, this system of care boasts impressive immunization, screening, and chronic care performance rates, as well as infant mortality and life expectancy rates that meet or beat those of many developed countries – all in a place with incredibly limited resources that spends less than half of US spending on health care. Seems like a great opportunity for learning!