Gaceta Sanitaria最新文献

Objective

To explore the experiences of individuals who develop projects and interventions where community participation-action constitutes a strategic tool for reducing health inequalities.

Method

Qualitative study based on semi-structured, in-depth online interviews with individuals considered experts in the development of health promotion strategies involving community participation. A total of 12 individuals from the healthcare, social healthcare, academic, and associative backgrounds were selected. The texts were analyzed following the thematic content analysis approach.

Results

The prominent strength of the processes involving the interviewed individuals is their participatory approach. However, there is no genuine commitment to promoting community participation from primary healthcare, and precarity has been identified as a significant weakness in the development of participatory health promotion projects. The sustainability of participatory processes relies on the transfer of knowledge to the community and their empowerment.

Conclusions

Participatory processes have demonstrated their ability to reposition the community as an essential part of the healthcare system. It would be interesting to use a measurement tool for participation in all community health actions, both to guide their design and planning and to assess the depth of participation and its impact on the process. Enhancing community action expectations for health in the near future involves promoting a community-oriented approach in primary care and intersectoral collaboration, which requires a significant institutional and policy commitment.

Objective

To investigate the gender of the authors who publish articles of health economic evaluations in medicine and healthcare journals.

Method

We evaluated a random sample of economic evaluations indexed in MEDLINE during 2019. Gender of the first, last and corresponding author was determined by review of the author's first name. Data were summarized as frequency and percentage for categorical items and median and interquartile range (IQR) for continuous items. We also calculated the index of authors per paper.

Results

We included 200 studies with 1365 authors (median of 6 authors per paper; IQR: 4-9). Gender identification was possible for all authors in the study sample: 802 (59%) were men and 563 (41%) were women. The number of female first, last, and corresponding authors respectively were 78 (39%), 68 (34%), and 80 (40%) for health economic evaluations.

Discussion

Female scientists were underrepresented as co-authors and in prominent authorship positions in health economic evaluations. This study serves as a call to action for the scientific community to actively work towards equity and inclusion.

Objective

To evaluate the health information system (HIS) of Mexico according to the information reported to the Organization for Economic Co-operation and Development (OECD). The ultimate goal is to identify the improvements that should be considered.

Method

Health indicators published by the OECD (2017 to 2021) are analyzed according to 11 thematic groups. Coverage (quantity and type of indicators reported by thematic group) and quality of information were assessed, according to OECD guidelines.

Results

Mexico reported annually 14 of 378 indicators (3.7%), and discontinuously 204. In no group were all indicators reported annually, except for the two on COVID-19. Three out of 88 were reported annually on use of services; and none on health status, quality of care and pharmaceutical market. Twelve indicators (5.5% of those reported by Mexico, 3.2% of the full OECD set) had optimal quality and annual reporting. 57.7% of the reported indicators had at least one quality defect.

Conclusions

Within the framework of the standards set by the OECD, of which Mexico is a member, the Mexican HIS presents significant deficits in coverage and quality of information. These results should be considered to implement improvement initiatives.

The nursing shortage is a multi-causal phenomenon that affects all countries and currently a global concern. The shortage of nurses jeopardizes the sustainability of health systems and the population health outcomes. Spain has historically had no difficulties in attracting new generations of nurses. The shortage of nurses is caused by the precarious working conditions and lack of professional development that have led to episodes of high international migration and abandonment of the profession. In this paper we focus on the evolution of different indicators of the working conditions of non-specialist nurses, who make up the bulk of the profession. These indicators allow us to analyse the abandonment of the profession, the duration of contracts, their full-time or part-time dedication and the excessive hiring. We have analysed the effect of COVID-19 and the labour reform on these indicators. COVID-19 reduced the abandonment of the profession and is currently at its lowest level, it has also accelerated the need to improve working conditions by increasing the percentage of permanent contracts and reducing the multiplicity of contracts in the same month. The labour reform has helped reduce the percentage of temporary contracts until reaching around 80% of the total contracts, and has reduced the number of nurses in Spain with more than one contract in the same month to below 3000 nurses on a sustained basis.

The recruitment and retention of professionals in indirectly managed and privately managed health care institutions is governed by a different regulatory framework than in directly managed institutions. That legal framework is the Workers’ Statute, which contains its own regulatory elements in terms of bargaining power and general basic conditions, among others. The regulatory framework of the Workers’ Statute allows for a broad capacity for management, negotiation and agreement in the field of human resources management, and specifically in the processes of recruitment, selection and retention, but for some years now basic legislation and interventions by public control bodies have been incorporated which have modified this discretionarily for indirect management entities, bringing them closer and closer to the system of administrative management for civil servants/statutory employees, and consequently limiting the capacity for decision making and adaptation typical of business/private management. This article attempts to explain the similarities and differences between the different areas of management and to explore the weaknesses and opportunities of each of them in terms of recruitment, selection, and retention policies, offering a specific reflection on the selection of executives and managers, as well as an analysis and assessment of the retention of professionals in healthcare institutions.

Objetivo

Describir el consumo de tabaco y el cumplimiento de la normativa en las terrazas de hostelería de Barcelona.

Método

Estudio transversal en una muestra de 120 terrazas de hostelería de Barcelona. Se realizaron observaciones de 30 minutos mediante una ficha de registro estandarizada. Las variables de estudio fueron personas fumando, número de cigarrillos fumados, presencia de colillas, nivel socioeconómico del barrio, momento de la observación, normativa de consumo, número de sillas y número de personas.

Resultados

En el 97,5% de las terrazas había personas fumando en el momento de la observación, sin diferencias según el nivel socioeconómico del barrio o la normativa de consumo de tabaco en la terraza. La ley se incumplía en el 100% de las terrazas en las que estaba prohibido fumar.

Conclusiones

El incumplimiento generalizado de la actual ley pone de manifiesto la necesidad de implementar la prohibición de fumar sin excepciones en las terrazas de hostelería.

Objective

To describe tobacco consumption and the compliance with the law on hospitality terraces in Barcelona.

Method

Cross-sectional study by observation in a sample of 120 hospitality terraces in Barcelona. 30-minute observations were made using a standardized record sheet. The study variables were number of people smoking, number of cigarettes smoked, cigarette butts, socioeconomic status of the neighborhood, time of observation, consumption regulation, number of chairs and number of persons.

Results

There were people smoking at the time of the observation in 97.5% of the terraces, with no differences according to socioeconomic level of the neighborhood or the regulation of the terrace. There was no compliance with the law in 100% of the terraces where smoking was banned.

Conclusions

The widespread non-compliance with the current law indicates the need to implement a smoking ban without exceptions on hospitality terraces.

In Spain, the compensation model for statutory health personnel is complex, heterogeneous, and more oriented to rewarding complementary functions and activities, than to paying for the actual performance in the position of employee. The various attempts to incorporate incentives have been distorted by a civil service egalitarianist culture, and weak systemic governance. External attractors (private practice, etc.) for healthcare professionals are becoming more important and neutralize many intramural incentives. There are few prospects of relevant or general changes, since the main actors involved are reforms-averse; but some environmental factors can lead to incremental improvements in employment contracts, in the information available to improve benchmarking, and in the creation of islands of good clinical governance and management. The economic scenario, increasingly concerned about inflationary trends and sustainability risks, may have a revitalizing effect of some governance and management reforms.

Objective

To describe the recent trends in Parkinson's disease mortality in Mexico during 2000-2020.

Method

The adjusted mortality rate per 100,000 inhabitants was calculated using the direct method and the world standard population. Trend analysis was performed with the Joinpoint software.

Results

The average mortality rate was 1.26/100,000 inhabitants (SD: 0.09), and males showed higher mortality than females (M/F ratio = 1.60). Older individuals ≥ 70 years old showed higher mortality rates than the rest of the age groups. During the period of study, a significant increase in mortality was observed from 2000 to 2005, while from 2005 to 2020 no significant trend was observed in all the studied groups.

Conclusions

In Mexico, males and older individuals showed the highest mortality rates. The socioeconomic regions with high levels of wellness showed the highest mortality rates levels. Parkinson's mortality rate has remained constant since 2005 in Mexico.