ABSTRACT
Healthcare professionals deserve good management, and Spain, stagnant in its productivity, needs it. Good management is possible, as evidenced during the states of alarm in 2020. None of the lessons learned have been consolidated. Dismissing the term "public management" as an oxymoron is extreme, as there has never been a greater need for a well-functioning state, along with a better market, for reasons beyond the consolidation of the welfare state. The opposite extreme of thinking that salvation lies only within the civil service is also unhelpful. Bureaucratic sclerosis, a sign of deterioration, focused on legality or its appearance, cannot continue to ignore the need for effectiveness. The quality of management, both in general and in the healthcare sector, can be measured, and there is knowledge on how to improve it. More flexible models of labor relations -for selection, recruitment, and retention based on improved criteria of "equality, merit, and capability"- require modifications in institutional architecture, as proposed in this article: competitor benchmarking among autonomous centers and responsible entities that share standardized rules. The healthcare system, the jewel of the country, thanks in large part to the quality of its human resources, not only deserves to have its potential unleashed but can also lead the necessary increase in its resolution capacity, ensuring its impact on social well-being. It can also document its research and innovative capabilities in intellectual property, thereby contributing to the gross domestic product.
Subject(s)
Personnel Management , Spain , Humans , Personnel Management/methods , Delivery of Health Care/organization & administration , Health WorkforceABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Sleep Apnea Syndromes/therapy , Continuous Positive Airway Pressure/methods , Telemedicine/methods , Coronavirus Infections/physiopathology , Pneumonia, Viral/physiopathology , Telemedicine/trends , Pandemics , Betacoronavirus , Treatment Adherence and Compliance , Continuous Positive Airway Pressure/economics , Cost-Benefit AnalysisABSTRACT
No disponible
Subject(s)
Humans , Periodicals as Topic/trends , Public Health/trends , Intersectoral Collaboration , Spain , Cooperative BehaviorSubject(s)
Periodicals as Topic , Public Health , Cooperative Behavior , Goals , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Information Dissemination , Internet , Periodicals as Topic/history , Public Health/history , Publishing/history , Publishing/trends , SpainABSTRACT
BACKGROUND: Obesity hypoventilation syndrome (OHS) is treated with either non-invasive ventilation (NIV) or CPAP, but there are no long-term cost-effectiveness studies comparing the two treatment modalities. OBJECTIVES: We performed a large, multicentre, randomised, open-label controlled study to determine the comparative long-term cost and effectiveness of NIV versus CPAP in patients with OHS with severe obstructive sleep apnoea (OSA) using hospitalisation days as the primary outcome measure. METHODS: Hospital resource utilisation and within trial costs were evaluated against the difference in effectiveness based on the primary outcome (hospitalisation days/year, transformed and non-transformed in monetary term). Costs and effectiveness were estimated from a log-normal distribution using a Bayesian approach. A secondary analysis by adherence subgroups was performed. RESULTS: In total, 363 patients were selected, 215 were randomised and 202 were available for the analysis. The median (IQR) follow-up was 3.01 (2.91-3.14) years for NIV group and 3.00 (2.92-3.17) years for CPAP. The mean (SD) Bayesian estimated hospital days was 2.13 (0.73) for CPAP and 1.89 (0.78) for NIV. The mean (SD) Bayesian estimated cost per patient/year in the NIV arm, excluding hospitalisation costs, was 2075.98 (91.6), which was higher than the cost in the CPAP arm of 1219.06 (52.3); mean difference 857.6 (105.5). CPAP was more cost-effective than NIV (99.5% probability) because longer hospital stay in the CPAP arm was compensated for by its lower costs. Similar findings were observed in the high and low adherence subgroups. CONCLUSION: CPAP is more cost-effective than NIV; therefore, CPAP should be the preferred treatment for patients with OHS with severe OSA. TRIAL REGISTRATION NUMBER: NCT01405976.
Subject(s)
Continuous Positive Airway Pressure/economics , Cost-Benefit Analysis , Obesity Hypoventilation Syndrome/therapy , Aged , Bayes Theorem , Female , Humans , Length of Stay/statistics & numerical data , Male , Middle Aged , Noninvasive Ventilation , Obesity Hypoventilation Syndrome/physiopathology , Polysomnography , Severity of Illness Index , Spain , SpirometryABSTRACT
No disponible
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Humans , Efficiency , Systems for Evaluation of Publications , Periodicals as Topic/standards , Editorial Policies , Scientific Publication Indicators , Access to InformationABSTRACT
Peer review in the scientific publication is widely used as a method to identify valuable knowledge. Editors have the task of selecting appropriate reviewers. We assessed the reasons given by potential reviewers for declining a request to review, and the factors associated with acceptance, taking into account the difference in the sex of the reviewer. This is a descriptive study of the review requests from a public health journal (Gaceta Sanitaria) with an enforced gender policy. The dependent variables were requests, response to requests, reasons potential reviewers gave for declining requests and time to review. We carried out a descriptive analysis of these indicators and applied logistic regression to analyze factors (professional and research/review experience) associated with having done at least one review in 2014-2015. Results were stratified by sex. Journal editors sent 1,775 requests to 773 potential reviewers; 52.3% of whom reviewed at least one manuscript. Of the 396 declined requests (22.3%), the most common reasons were lack of time and of experience (88.1%). No differences were observed by sex. In the multivariate analysis, having reviewed for the journal in previous years showed the strongest association with acceptance. Specific analyses of data on requests reviewers may be useful for improving the acceptance rates to review. This study did not show gender differences in several indicators of the reviewing process.
Subject(s)
Peer Review, Research/standards , Periodicals as Topic/statistics & numerical data , Periodicals as Topic/standards , Public Health , Editorial Policies , Humans , Professionalism , Qualitative Research , Sex Factors , Sexism/statistics & numerical data , Spain , Time FactorsABSTRACT
No disponible
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Humans , Biomedical Research/trends , Knowledge Management , Information Dissemination , Public Health/trends , Cooperative Behavior , Periodicals as Topic/trendsABSTRACT
No disponible
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Humans , Periodicals as Topic/trends , Editorial Policies , Health Information Management/organization & administrationABSTRACT
No disponible
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Humans , Periodicals as Topic/statistics & numerical data , 50230 , Delivery of Health Care/statistics & numerical data , Journal Impact FactorABSTRACT
No disponible
