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The introduction of family medicine residency training in developing countries is an important, positive quality development for RSCHs, whose usual model involves the presence of several other specialists, such as pediatricians, internists, and obstetricians/gynecologists.
RSCHs should complement and support primary care services already available in the community whenever possible.
RSCHs do not routinely enjoy the respect of tertiary care facilities, and few, already congested, public tertiary care facilities are enthusiastic about receiving patients from outlying areas.
The relationships are subject to frequent personnel changes and political manipulation that impedes this process; however, these relationships can be strengthened through administrative models of RSCHs that give the community an oversight role in guaranteeing transparency, patient advocacy, and verifying financial statements, where politics permit.
However, Ecuadorian RSCHs, public or private, have been a neglected, but critical, link between primary and tertiary medical care services.
Defining a typical RSCH in developing countries can be difficult.
Given the overhead cost of a high quality secondary-care hospital and the widespread indigence in rural areas, fee-for-service financing by itself is not a feasible option for a self-sustained RSCH. To achieve financial sustainability, an RSCH must identify the pockets of "wealth" or sufficient disposable income that exist in almost all communities so as to cover modest health care costs.
If the primary care network is largely public and the RSCH is not, this can result in an antagonistic relationship, with factors such as institutional policy barriers preventing cooperation.
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- RSCN (disambiguation)