Rebuilding a US Federal Data Strategy After the End of the "Community Health Status Indicators".

For nearly 2 decades, the Community Health Status Indicators tool reliably supplied communities with standardized, local health data and the capacity for peer-community comparisons. At the same time, it created a large community of users who shared learning in addressing local health needs. The tool survived a transition from the Health Resources and Services Administration to the Centers for Disease Control and Prevention before being shuttered in 2017. While new community data tools have come online, nothing has replaced Community Health Status Indicators, and many stakeholders continue to clamor for something new that will enable local health needs assessments, peer comparisons, and creation of a community of solutions. The National Committee on Vital and Health Statistics heard from many stakeholders that they still need a replacement data source. (Am J Public Health. 2021;111(10):1865-1873. https://doi.org/10.2105/AJPH.2021.306437).

[New professional field in France: Analysis of the training needs of case managers]. / Nouveau champ professionnel en France. Les besoins de formation des gestionnaires de cas.

Case management is a relatively new career field in France. It was first introduced on an experimental basis in 2007-2008, and was then developedfollowing the National Alzheimer Plan and finally enshrined in legislation in 2012. This careerfield is based on a set of tasks widely described internationally: identifying the right level of intervention, standardized multidimensional assessment, planning all aid (care and social services), implementation of the plan, monitoring and reassessment and periodic reassessment of all needs in a continuous and long-term process. The specific, systematic and dedicated nature of these tasks to these tasks makes training essential. Regulations also stipulate that the professional must acquire additional training by a dedicated inter-university degree. This requirement is a French specificity The authors present the history of case management and training in France and analyze the various international training frameworks identified by an Internet search. Moreover, based on the opinions expressed by case managers at different times of the scientific assessment and a review ofseveral studies conducted by inter-university case management program students, this article highlights the specific training needs of case managers and how the proposed training can meet these needs.

Evaluación de un programa de subvenciones para la mejora de la seguridad y salud laboral de las PYMES en Andalucía / Evaluation of a grant program for improving health and safety in small and medium companies in Andalusia (Spain)

Objetivos: Evaluar un programa de subvenciones para proyectos de prevención de riesgos laborales en PYMES de Andalucía. Se analizan datos y resultados del programa entre 2006 y 2008. Métodos: Se analizaron las características del programa en términos de presupuesto, solicitudes y proyectos financiados. Se evaluó la percepción de las empresas solicitantes en cuanto a adecuación y resultados del programa mediante cuestionario postal anonimizado. Se calculó la incidencia de accidentes de trabajo en 2006 y 2007 en una submuestra de las empresas participantes en el programa en 2006. Resultados: El importe total de las subvenciones (algo más de 17 millones de euros) cubrió el 44% de las inversiones comprometidas por las empresas subvencionadas. Se concedieron en torno al 50%de las ayudas solicitadas. Se recibieron 573 cuestionarios completados (24% del total remitido). Entre las empresas subvencionadas, el 89% considera efectiva la inversión realizada y un 87% estima que han mejorado las condiciones de trabajo en la empresa. La inmensa mayoría de las empresas (>90%) considera que la falta de recursos económicos es un obstáculo para la prevención y que este tipo de ayudas son necesarias. La incidencia de accidentes de trabajo se redujo entre 2007 y 2006 (razón de incidencia 0,93; IC95% 0,78-1,11). Conclusiones: El programa ha tenido una valoración positiva, observándose una reducción de la incidencia de accidentes en las empresas que recibieron incentivos. Es necesario incorporar en el diseño de estos programas los criterios e indicadores necesarios para su evaluación(AU)

Objectives: To evaluate a grant program for the development and support of occupational safety projects in small and medium companies (SMC) in Andalusia. The analysis includes data and results of the program between 2006 and 2008. Methods: We analyzed the program characteristics in terms of budget, proposals submitted and projects financed. The views of participating companies regarding the program were evaluated through a voluntary and anonymous postal survey. Occupational injury rates in 2006 and 2007 in a subgroup of companies that had obtained a grant in 2006 were calculated. Results: Public investment in the program (> 17 million euros) covered 44% of the investment in occupational health projects proposed by participating companies. Nearly 50% of the projects presented received grant funding. The survey was completed by 573 companies (24% of the submitted questionnaires). Among grantee companies, 89% considered the investment to have been effective and 87% considered that working conditions in the company had improved. Most of the companies (>90%) considered that lack of economic resources is an obstacle for prevention activities and that these kinds of public subsidies are necessary. Occupational injury rates decreased between 2006 and 2007 (incidence rate 0.93; 95% confidenceinterval, 0.78-1.11). Conclusions: The grant program was viewed positively by participating companies and was accompanied by a reduction of occupational injury rates among grantee companies. These programs should incorporate evaluation criteria and indicators in their design(AU)

Implementation of a comprehensive cancer plan. A health planning experience

Here we describe the working method used to implement an Integrated Cancer Health Plan in Andalusia (Spain) and to set out some of the lines of work for improving quality of care and health network planning. Four main initial considerations were made: (1) work must be centred on patients and respect for their autonomy; (2) cancer requires action at every healthcare level; (3) integration of expert professionals is to be encouraged; and (4) relevant information and data should be systematically used for planning. Two operative approaches were also established: structured participation and evidence-based healthcare. This methodology was used in various planning programmes, largely in relation to healthcare resources. In this article, as examples, we describe the development of two types of programmes: one for radiotherapy equipment and another for the management of lymphoedema in breast cancer patients. Analysis of results obtained against cancer is always controversial. It is necessary to review the healthcare structure used in terms of effectiveness and excellence. Comprehensive or integrated health plans are a useful model for a wide-ranging and multi-level approach to cancer. The structured and real participation of experts and an evidence- based healthcare strategy proved very useful in this public health planning experience (AU)

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Self-study of values, beliefs, and conflict of interest: the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.

STUDY DESIGN: Observation and survey of values, beliefs, and conflicts of interest. OBJECTIVE: To study the values, beliefs, and potential conflicts of interest that the Neck Pain Task Force brought to their deliberations. SUMMARY OF BACKGROUND DATA: Researchers' values and beliefs were studied to uncover areas of divergence and to develop guiding principles to assist decision making. METHODS: An observer used direct observation and survey of the Neck Pain Task Force, facilitated discussion, and developed a "disclosure tool" to collect information about relationships between researchers, funders, and others with a vested interest in the outcome. RESULTS: Clinicians and research methodologists brought different imperatives to the research process. Clinicians focused on offering useful advice, whereas methodologists guarded investigative rigor to ensure that evidence actually supported advice. Group conflict did not polarize along "clinical discipline lines." The Advisory Committee had greater impact when given a clear task and time to work as a group. The Neck Pain Task Force agreed on a set of "guiding principles," which became an overarching doctrine to guide their work. The disclosure questionnaires described relationships between Neck Pain Task Force members and other entities that might have had a financial interest in the topic. CONCLUSION: This study describes a process used to assess values, beliefs, and conflicts of interest among members of a scientific task force, and how this was used to create "guiding principles" to assist the research team in deliberations, particularly when conflict arose. Most members of the Neck Pain Task Force had potential conflicts of interest with various stakeholders, but there was marked diffusion of these potential conflicts and no evidence that any funder or other vested interest stakeholder was likely to have a significant impact on the deliberations or conclusions of the Neck Pain Task Force.

Coordinación entre servicios de urgencias. Un modelo eficaz en la planificación sanitaria / Coordination among emergency services. An effective model for healthcare planning

Objetivo: Evaluar, mediante un estudio de intervención con controles históricos, la optimización del traslado de pacientes desde el servicio de urgencias de un hospital de alta complejidad -centro emisor (CE)- a un hospital de menor complejidad -centro receptor (CR)- durante el invierno. Material y método: La intervención consistió en la creación de los siguientes recursos y dispositivos: criterios de selección de pacientes aptos para ser trasladados, sistema exclusivo de comunicación, un horario de traslados, obtención de resultados pendientes de pruebas efectuadas en el CE, una unidad de hospitalización específica en el CR, circuito de altas y prealtas en el CR, normas escritas de coordinación entre la unidad asistencial, la Unidad de Trabajo Social y el Servicio de Farmacia Hospitalaria, hoja de acogida y un circuito de información a las residencias sanitarias. Resultados: Se trasladó a 247 pacientes. Ningún paciente permaneció en el área de urgencias del CR. No hubo ninguna desprogramación de ingresos en el CR. El índice de reingreso a los 30 días fue del 2,4 por ciento. La estancia media en el CR fue de 5,63 días. El índice funcional fue de 0,6; la razón de funcionamiento estándar, 0,6; la diferencia atribuible al funcionamiento, 4,0 y el impacto, 706.Conclusiones: La intervención en el traslado de pacientes desde un servicio de urgencias de un centro de alta complejidad a un centro de menor complejidad, para evitar el colapso del primero, mejora la calidad asistencial de los pacientes trasladados y evita mermar la del hospital receptor (AU)

Ámbito y objetivos de la compatibilidad de gestión / Environment and objectivees of management accounting

En este artículo se analiza la evolución de las diferentes formas de contabilidad hacia la gestión basada en actividades y se valora su posible aplicación al sector sanitario en nuestro medio en entornos de gestión de procesos en el marco de la gestión de calidad total (AU)

Strengthening the public health system.

Although the American public health system has made major contributions to life expectancy for residents of this country over the past century, the system now faces more complex health problems that require comprehensive approaches and increased capacity, particularly in local and State public health agencies. To strengthen the public health system, concerted action is needed to meet these five critical needs: First, the knowledge base of public health workers needs to be supplemented through on-the-job training and continuing education programs. To this end, self-study courses will be expanded, and a network of regional training centers will be established throughout the country. Second, communities need dynamic leadership from public health officials and their agencies. To enhance leadership skills and expand the leadership role of public health agencies, focused personal leadership development activities, including a Public Health Leadership Institute, and national conferences will provide a vision of the future role of public health agencies. Third, local and State public health agencies need access to data on the current health status of the people in their communities and guidance from the nation's public health experts. To improve access to information resources, state-of-the-art technologies will be deployed to create integrated information and communication systems linking all components of the public health system. Fourth, local and State agencies need disease prevention and health promotion plans that target problems and develop strategies and the capacity to address them. To provide communities with structured approaches to this process, planning tools have been developed and distributed, and technical assistance will be provided to local and State health agencies to involve each community in planning,priority setting, and constituency building.Finally, public health agencies need adequate resources to fund prevention programs. To improve the use of existing Federal support and enhance the availability of new community resources, grant programs will be modified, and innovative approaches to local resource enhancement will be developed and shared.Activities in these five key areas are designed to improve the infrastructure of the public health system and its capacity to carry out effectively the core functions of public health assessment, policy development, and assurance of the availability of the benefits of public health. If the nation is to achieve the health objectives for the year 2000, the public health system-the individuals and institutions that, when working effectively together, promote and protect the health of the people-must be strengthened.

Seguridad social sistema de subsidio familiar y colsubsidio dentro del sistema de subsidio familiar / Social security familiar subsidy system and colsubsidy within the familiar subsidy system

Trabajo presentado durante el ano de servicio social obligatorio en la Clinica Infantil Colsubsidio. Las perspectivas de la seguridad social son las siguientes: politicas: que afectan toda la sociedad y es el estado al que le corresponde alcanzarla con el fin de proteger al individuo y su familia. Juridicas: hacen referencia a los medios y normas para cumplir con la finalidad de la seguridad social. Historicamente, ha ido evolucionando y ha recibido influencias como la revolucion industrial en Europa. Con el tiempo se han llegado a establecer tres teorias a saber: la de riesgo, la de cargas y la teoria de bienestar. La seguridad social se basa en la justicia social. Otro aspecto de la seguridad social es el subsidio familiar. Este se inicio desde el siglo XIX, evolucionando en Francia, Italia y Alemania. En Colombia la primera empresa que pago subsidio familiar fue el ferrocarril de Antioquia. Actualmente es obligatorio su pago por medio de las Cajas de Compensacion Familiar. Este subsidio familiar tiene como objetivo compensar al padre de familia de bajos ingresos, el sustento y desarrollo de la familia y de las personas a su cargo. Se clasifica segun su origen y segun las formas de pago. En Colombia la Caja Colombiana de Subsidio Familiar fue creada en 1957 y presta servicios de salud, educacion, vivienda mercadeo, recreacion. Especificamente, la Clinica Infantil Colsubsidio, es una entidad hospitalaria ejemplar para el mundo y presta sus servicios a los hijos de los afiliados a dicha caja de compensacion