El costo en salud y la corresponsabilidad clínica desde un enfoque gerencial

Abstract

This paper focused on health costs, particularly their increase, from a management approach. This implied to underline those aspects associated with the resources used and the effectiveness of results for the health of individuals and populations. Five possible causes that might explain the multi-causality of the health cost increases were presented. Three of them had not been deeply analyzed in the studies on health costs and had a basic management component: corruption, poor organization of service and irresponsible management of resources on the part of providers. The analysis of the last mentioned cause is extensive since it has a greater management interest, accounts for a high percentage of costs and it is at the same time an element that can be changed at the primary and secondary care levels by the managers. In order to extend the analytical possibilities, the cause was seen as a problem to which Ishikawa´s cause/ effect diagram was applied. This allowed disclosing the subcauses upon which the managers might work to turn irresponsibility into co-responsibility. The last part of the paper analyzed each of these subcauses and made recommendations about the useful management methods, abilities and technologies to bring about the desired changes.

Caracterización de la prestación del servicio farmacéutico en el departamento de Sucre, Colombia

“…Entre otros, un elemento a resaltar es el hecho de que se hallan encontrado servicios farmacéuticos operando por fuera de la ley al no estar inscritos ante la Secretaría de Salud Departamental, entendiendo que es este el ente encargado del seguimiento y control del accionar de estos servicios, lo cual condiciona a la población usuaria de dicho servicio a riesgos asociados al uso de los servicios prestados y medicamentos allí comercializados. Según Carnota et al [20], la adulteración de medicamentos es un peligro latente en sistemas de salud no regulados debidamente [20].…”

Estudio económico de la aplicación de Ozonoterapia en la atención del dolor por hernia de disco intervertebral

“…El costo es un indicador que resume en términos monetarios el resultado de la utilización de los recursos humanos, materiales y financieros en el desarrollo de una actividad económica. A nivel mundial la atención a la salud ha pasado a ser una actividad económica de mayor relevancia, donde la participación de los profesionales médicos en la racionalidad económica del sistema de salud, es muy importante por ser los que deciden, según la objetividad y la calidad de sus decisiones diagnósticas 8 , siendo la confección de protocolos basados en su relación coste efectividad un aspecto a tener muy en cuenta.…”

Discrete simulation applied to the improvement of patient flows in hospital institutions

“…Organizing patient flows represents a significant challenge for administrators since medical activity alone has great variability intrinsic to it, which makes it very complex. The Hospital has a fixed and rigid capacity versus a variable and random demand [8].…”

“…In these institutions, patients circulate through different departments, floors, premises, and buildings to be attended by specialists, technicians, nurses, or other health professionals [8]. This patients movement, with a focus on its trajectory, is considered patient flow [9]- [12].…”