<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0864-3466</journal-id>
<journal-title><![CDATA[Revista Cubana de Salud Pública]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Salud Pública]]></abbrev-journal-title>
<issn>0864-3466</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0864-34662020000200016</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Costos en salud: un asunto polémico]]></article-title>
<article-title xml:lang="en"><![CDATA[Healthcare costs. A polemic matter]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lauzán Carnota]]></surname>
<given-names><![CDATA[Orlando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Escuela Nacional de Salud Pública (ENSAP)  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<volume>46</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0864-34662020000200016&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0864-34662020000200016&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0864-34662020000200016&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Existen dos problemas que complican el manejo de los costos en las organizaciones sanitarias. Uno es el carácter humanista, solidario y ético de esta actividad al que, en consecuencia, no le son aplicables muchos de los criterios y métodos que se emplean en la industria, el comercio e incluso en otros servicios. El otro tiene que ver con el complejo entramado de los procesos en esas organizaciones, donde prácticamente cada paciente o cada especialidad tiene su propio recorrido que lo caracteriza en términos de: lugares físicos, secuencia, tipo de persona a intervenir, desplazamientos, intensidad, medios técnicos, instrumentos, materiales a emplear y características de los resultados que deben esperarse. Derivado del primero aparecen criterios sobre  &#8220;salud a cualquier costo&#8221;,  &#8220;la buena salud es cara&#8221;o  &#8220;mientras mayor porcentaje obtengamos del producto interno bruto mejor salud haremos&#8221;. Del segundo aparecen sistemas suficientemente complicados para no hacer notar que en muchas ocasiones los recursos consumidos no se convierten en efectos positivos para las personas y las poblaciones. Se trata entonces de despejar ambos problemas y sobre todo de alertar dónde están los puntos débiles y qué se puede hacer al respecto.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT There are two problems that complicate the management of costs in health organizations. One is the humanist, solidary and ethical character of this activity and to which, consequently, many of the criterions and methods are not applied as they are in industry, trade, and even other services. The other problem is related with the complex intertwining of processes in those organizations, where virtually every patient or specialty have their own follow-up features characterizing them in terms of physical spaces, sequence, type of intervened person, movement, intensity, equipment, instruments, used materials, and characteristics of expected outcome. The first one creates criterions about  &#8220;health at any costs,&#8221;  &#8220;quality health is expensive,&#8221;  &#8220;the higher percentage from the growth domestic product, the better health will be provided.&#8221;The second creates systems complicated enough to conceal that consumed resources mostly don&#8217;t turn into positive effects for people and populations. This is then about isolating both problems and, above all, warning about weaknesses and how to deal with them.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[costos]]></kwd>
<kwd lng="es"><![CDATA[gerencia]]></kwd>
<kwd lng="es"><![CDATA[sistemas de salud]]></kwd>
<kwd lng="es"><![CDATA[PIB]]></kwd>
<kwd lng="es"><![CDATA[habilidades]]></kwd>
<kwd lng="es"><![CDATA[tecnologías]]></kwd>
<kwd lng="es"><![CDATA[corrupción]]></kwd>
<kwd lng="es"><![CDATA[producto interno bruto]]></kwd>
<kwd lng="en"><![CDATA[costs]]></kwd>
<kwd lng="en"><![CDATA[management]]></kwd>
<kwd lng="en"><![CDATA[health system]]></kwd>
<kwd lng="en"><![CDATA[GDP]]></kwd>
<kwd lng="en"><![CDATA[skills]]></kwd>
<kwd lng="en"><![CDATA[technologies]]></kwd>
<kwd lng="en"><![CDATA[corruption]]></kwd>
<kwd lng="en"><![CDATA[growth domestic product]]></kwd>
</kwd-group>
</article-meta>
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