Suchergebnisse
Filter
Comparative Analysis of Public Administration Models on the Example of Healthcare Sector
In: Cuestiones políticas, Band 40, Heft 75, S. 522-563
The goal of this article is to disclose the main models of public administration in the example of healthcare sphere. The authors used such general scientific and special methods: historical and legal, comparative, relative and legal, system analysis and formal logics. Revealed the link between the models of public administration and the healthcare sphere. It was marked on the most typical manifestations of administrative influence inherent in particular model in the sphere of healthcare. It was established that different models of public administration function effectively in different states. However, national healthcare systems predominantly use a combination of several models by adding elements of other models to the dominant model. It was concluded that the current models of public administration in the field of healthcare are characterized by: verticalization and centralization of power responsibilities for OPM, implementation of market techniques in the public sector for NPM and an emphasis on human rights and growth for GG. Among modern paradigms of public administration, we have highlighted the LG model, the essence of which lies in continuous implementation of innovations to improve efficiency and prioritize the interests of the consumer, which is the patient in the sphere of healthcare.
Mental Healthcare for refugees: Atención en Salud Mental para refugiados
The aim of this paper is to highlight some of the difficulties that mental health providers face when trying to provide the best standard of mental healthcare to refugees, especially in countries where the political environment is skeptic of, or even hostile to, creating programs specifically designed to improve the standard of living of this population. We also focus briefly on the dichotomy between the need to do research in this population in order to obtain data that will help us offer the best care possible to them, and the peril of undermining their autonomy by subjecting them to studies they might have otherwise refused to be part of, if they were in a less precarious position. Throughout the article, we offer practical advice that mental healthcare providers can follow to ensure that they are offering the best possible care to their patients while remaining respectful of their rights. Keywords: Mental health providers; Mental healthcare; Refugees.
BASE
Social and Legal Healthcare Models and Their Functioning During a Global Crisis
In: Cuestiones Políticas; Nuevas realidades jurídico-políticas en el marco del orden mundial post-coronavirus, Band 38, Heft Especial, S. 248-265
ISSN: 2542-3185
The article analyzes the existing health models in terms of their legal, economic and social effectiveness, innovative potential, as well as in the context of their ability to resist modern threats caused by changes in the environment, ecology, bio-information development and other technologies. The authors used the methods of comparative analysis, synthesis, structural-functional and statistical analysis. Everything indicates the need for a major modernization of existing care models and / or their replacement by new ones that satisfy the basic needs of the majority of society at the current stage of its development. Among the most prominent findings, it is also highlighted that the health insurance model is a creation of the late 19th and early 20th centuries. It was developed and implemented at a time when the economy, society, the social sphere, and technologies were completely different. The 2020 pandemic has revealed the reasons for the unsatisfactory health care work, in a seemingly as prosperous country as the United States, where the largest amount of budget money traditionally goes to health care.
Scenario planning for emergent technology (big data & cloud) in healthcare industry
The emergence of big data, as well as advancements in data science approaches and technology, is providing pharmaceutical companies with an opportunity to gain novel insights that can enhance and accelerate drug development. It will increasingly help government, health agencies, players, and providers to make decisions about such issues as drug discovery, patient access, and marketing. In this paper we use scenario planning tools and system dynamic to evaluate the impact of emergent technology such as big data &cloud &in healthcare industry. In this case we have four scenarios of big data and emergent tech transformation in Iran health care industry.
BASE
Las paradojas de la asistencia sanitaria transfronteriza ; The Paradoxes of the Cross-Border Healthcare
La asistencia sanitaria está constituida por los servicios relacionados con la salud prestados por un profesional sanitario a pacientes para evaluar, mantener o restablecer su estado de salud. En 2014, España traspuso la Directiva 2011/24/UE del Parlamento Europeo y del Consejo, de 9 de marzo de 2011, relativa a la aplicación de los derechos de los pacientes en la asistencia sanitaria transfronteriza, que tiene como objetivos garantizar la movilidad de los pacientes, establecer unas reglas para facilitar su acceso a una asistencia sanitaria segura y de alta calidad en la Unión Europea, y promover la cooperación en materia de asistencia sanitaria entre los Estados miembros, respetando plenamente las responsabilidades de éstos en la organización y prestación de dicha asistencia. Sin embargo, los niveles de calidad de la atención sanitaria en los distintos Estados miembros distan de estar homologados. Por este motivo, la aplicación efectiva de la nueva política, lejos de homogeneizar la atención sanitaria, podría entrañar riesgos como el fomento del turismo sanitario ya existente o el aumento de diferencias entre los ciudadanos de los Estados miembros e, incluso, entre los ciudadanos del mismo Estado ; Healthcare is constituted by the services provided by healthcare professionals in order to assess, maintain or restore patients` health status. Spain adopted the Directive 2011/24/EU on the application of patients` rights in cross-border healthcare, of 9 March 2011, so as to ensure patient mobility and to promote cooperation on healthcare between Member States, whilst fully respecting the responsibilities of the Member States for the definition of social security benefits relating to health and for the organization and delivery of healthcare and medical care and social security benefits, in particular for sickness. However, the quality levels within the healthcare services in the different Member States are widely far to be equivalent. Thus, the new politic, far away to keep uniform the healthcare services, could bring risks as the encouragement of the healthcare tourism or the differences between the citizens of the Member States or, even, the citizens from the same country ; Ministerio de Economía y Competitividad (España) DER2013-41462-R
BASE
Ciudadanía, asistencia sanitaria y Unión Europea ; Citezenship, healthcare and the European Union
Nos proponemos en este trabajo realizar una reflexión sobre el concepto de ciudadanía sanitaria y su proceso de gestación, tanto en el ordenamiento español como en el ordenamiento comunitario. Hasta ahora la universalidad ha sido una de las notas básicas y más características de nuestro sistema público sanitario. La crisis económica, sin embargo, ha llevado a nuestros poderes públicos a adoptar importantes medidas con la intención de hacer sostenible nuestro sistema. Entre ellas, las más graves son las que afectan a la construcción del concepto de ciudadanía sanitaria por la exclusión de determinados colectivos de personas. Por el contrario, en el derecho comunitario se ha producido una notable expansión del concepto de ciudadanía sanitaria con la intención de garantizar la libre prestación de servicios sanitarios y los derechos de los pacientes en la asistencia sanitaria transfronteriza ; The object of our study consists of making a legal reflection on the concept of healthcare citizenship and its development, both in Spanish Law and in European Union Law. Until now, universal healthcare has been the most important element of our public health care system. The economic crisis has led our Government to take important political and administrative decisions in order to make our public healthcare system sustainable. Among them, the most serious are those which affect the construction of the concept of healthcare citizenship with the effect of excluding certain groups of people. In contrast, in European Union Law there has been a notable expansion of the concept of healthcare citizenship with the intention of guaranteeing the free provision of healthcare services and patients' rights in cross-border healthcare
BASE
Transformation of the State policy of Ukraine in the healthcare sector during martial law
In: Cuestiones políticas, Band 41, Heft 78, S. 296-308
The purpose of the article was to highlight the essence and specific features of the transformation of the Ukrainian state policy in the health sector during the development of martial law. The methodological basis of this research grouped a set of general and special scientific methods of scientific cognition (deductive, comparative and legal, comparative, systems analysis method, formal and logical method, etc.). Everything indicates that, the destabilizing factors affecting the state policy include the reaction to the armed aggression of another state and the subsequent introduction of martial law. The authors have emphasized the regulatory legal acts of the national legislation of Ukraine, which establish the principles for the formation and implementation of state policy in the health sector. Specific features of the transformation of state policy in the health sector during martial law have been identified and revealed. It has been concluded that the state policy in the health sector is characterized by a dual nature, which consists in its stability, on the one hand, and at the same time, wide adaptability to changes and needs caused by martial law.
Cobertura Universal de Salud -CUS- vs. Derecho a la Salud : Un análisis ético y político sobre lo "universal" en salud en "tiempos de restauración conservadora" ; Universal Healthcare Program -CUS- vs. The right to Healthcare. An Ethical and Political Analysis about what "Universal" Healthcare is in...
El objetivo del trabajo es el análisis crítico de la "Cobertura Universal de Salud" -CUS- impuesta por el actual gobierno argentino bajo el Decreto de Necesidad de Urgencia 908/2016. Nuestra hipótesis general gira en torno a mostrar cómo las políticas neoconservadoras, que se esconden bajo el discurso universalista del CUS, hacen uso del poder estatal para transferir fondos públicos al sector privado. Esto es, no sólo usan al mismo Estado -criticado por éstas políticas como ineficiente-; sino que dejan en peligro al mismo derecho a la salud que dicen proteger. A través de la metodología de "equilibrio reflexivo", propia del análisis ético y político, indagaremos sobre la filosofía subyacente al CUS, estudiando: (I) sus finalidades y el modelo sanitario propuesto; (II) sus métodos de apropiación de conceptos populares igualitarios para perseguir efectos neutralizadores, al igual que lo hiciera antes el Banco Mundial (De la APS Integral a la APS selectiva). Por último (III), mostraremos cómo el CUS, lejos de favorecer el derecho a la salud priorizando la medicina preventiva y la Evaluación Integral de Determinantes Sociales, desplaza ésta prioridad de nuestra sociedad por la extrapolada Evaluación de Tecnologías Sanitarias y la modernización informática sanitaria propia de sociedades desarrolladas. ; The objective of this paper is a critical analysis of the Cobertura Universal de Salud -a Universal Healthcare Program in Argentina- (CUS, in its Spanish acronym). My general hypothesis revolves around demonstrating how neoconservative policies, which hide behind by a CUS universalist discourse, make use of State power in order to transfer public funds to the private sector. In other words, not only do they use the State -which is criticised as being inefficient for these policies- but they also endanger the right to healthcare that they claim they protect. Through an ethical and political analysis of the philosophy behind the CUS, I will explore: (I) its purposes and the model of healthcare proposed. (II) How it appropriates popular egalitarian concepts in order to pursue neutralising effects, as it did before the World Bank (from Integral Primary Healthcare to Selective Primary Healthcare). Finally (III) I will show how the CUS does not favour the right to healthcare by prioritising preventative medicine and the integral evaluation of social determinants. Rather, it displaces this priority in our society for an extrapolated Health Technology Assessment and modernised Health Informatics, characteristic of developed societies. ; Facultad de Humanidades y Ciencias de la Educación
BASE
The six myths of healthcare privatization ; Los seis mitos de la privatización sanitaria
Health, one of the rights of the Welfare State, is being harassed in Spain and in the West by the economic crisis. Many Spaniards fear for our current healthcare system. The media consciously, sometimes unconsciously, have woven a series of myths around health that defend always interested and ambiguous purposes that are difficult to refute. The six myths about health that are exposed in this article, and strive to be a reasoned and judicious proposal of our political and social reality. ; La salud, uno de los derechos del Estado de Bienestar, está siendo acosada en España y en Occidente por la crisis económica. Muchos españoles temen por nuestro actual sistema de salud. Los medios de comunicación de manera consciente, unas veces, inconsciente, otras, han tejido en torno a la salud una serie de mitos que defienden propósitos siempre interesados y equívocos difíciles de rebatir. Los seis mitos que sobre la salud se exponen en este artículo, quieren ser una propuesta razonada y juiciosa de nuestra realidad política y social.
BASE
Cobertura Universal de Salud -CUS- vs. Derecho a la Salud : Un análisis ético y político sobre lo "universal" en salud en "tiempos de restauración conservadora" ; Universal Healthcare Program -CUS- vs. The right to Healthcare An Ethical and Political Analysis about what "Universal" Healthcare is in ...
El objetivo del trabajo es el análisis crítico de la "Cobertura Universal de Salud" -CUS- impuesta por el actual gobierno argentino bajo el Decreto de Necesidad de Urgencia 908/2016. Nuestra hipótesis general gira en torno a mostrar cómo las políticas neoconservadoras, que se esconden bajo el discurso universalista del CUS, hacen uso del poder estatal para transferir fondos públicos al sector privado. Esto es, no sólo usan al mismo Estado -criticado por éstas políticas como ineficiente-; sino que dejan en peligro al mismo derecho a la salud que dicen proteger. A través de la metodología de "equilibrio reflexivo", propia del análisis ético y político, indagaremos sobre la filosofía subyacente al CUS, estudiando: (I) sus finalidades y el modelo sanitario propuesto; (II) sus métodos de apropiación de conceptos populares igualitarios para perseguir efectos neutralizadores, al igual que lo hiciera antes el Banco Mundial (De la APS Integral a la APS selectiva). Por último (III), mostraremos cómo el CUS, lejos de favorecer el derecho a la salud priorizando la medicina preventiva y la Evaluación Integral de Determinantes Sociales, desplaza ésta prioridad de nuestra sociedad por la extrapolada Evaluación de Tecnologías Sanitarias y la modernización informática sanitaria propia de sociedades desarrolladas. ; Fil: De Ortúzar, María Graciela. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación. Instituto de Investigaciones en Humanidades y Ciencias Sociales (UNLP-CONICET); Argentina.
BASE
Cobertura Universal de Salud -CUS- vs. Derecho a la Salud : Un análisis ético y político sobre lo "universal" en salud en "tiempos de restauración conservadora" ; Universal Healthcare Program -CUS- vs. The right to Healthcare An Ethical and Political Analysis about what "Universal" Healthcare is in ...
El objetivo del trabajo es el análisis crítico de la "Cobertura Universal de Salud" -CUS- impuesta por el actual gobierno argentino bajo el Decreto de Necesidad de Urgencia 908/2016. Nuestra hipótesis general gira en torno a mostrar cómo las políticas neoconservadoras, que se esconden bajo el discurso universalista del CUS, hacen uso del poder estatal para transferir fondos públicos al sector privado. Esto es, no sólo usan al mismo Estado -criticado por éstas políticas como ineficiente-; sino que dejan en peligro al mismo derecho a la salud que dicen proteger. A través de la metodología de "equilibrio reflexivo", propia del análisis ético y político, indagaremos sobre la filosofía subyacente al CUS, estudiando: (I) sus finalidades y el modelo sanitario propuesto; (II) sus métodos de apropiación de conceptos populares igualitarios para perseguir efectos neutralizadores, al igual que lo hiciera antes el Banco Mundial (De la APS Integral a la APS selectiva). Por último (III), mostraremos cómo el CUS, lejos de favorecer el derecho a la salud priorizando la medicina preventiva y la Evaluación Integral de Determinantes Sociales, desplaza ésta prioridad de nuestra sociedad por la extrapolada Evaluación de Tecnologías Sanitarias y la modernización informática sanitaria propia de sociedades desarrolladas. ; Fil: De Ortúzar, María Graciela. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación. Instituto de Investigaciones en Humanidades y Ciencias Sociales (UNLP-CONICET); Argentina.
BASE
Nuevo profesionalismo, educación médica y sistemas de salud ; New professionalism, medical education and healthcare systems
[ES] El propósito de este artículo es discutir de qué modo el denominado "nuevo profesionalismo" puede ayudar a que la educación de los médicos se haga teniendo en cuenta los efectos de la globalización tanto sobre la situación de salud como sobre las necesidades de profesionales sanitarios, con particular énfasis en los países de la Unión Europea los cuales están inmersos en un profundo proceso de reforma de sus enseñanzas universitarias. Para ello, en primer lugar se presentan los conceptos básicos del "nuevo profesionalismo" y de las estrategias fundamentales de la educación médica actual que trata de formar médicos capaces de afrontar los retos éticos, científicos y profesionales que se plantean a comienzos del presente siglo. A continuación, se insiste en la interdependencia de las reformas del pregrado, del posgrado y de la formación continuada. Se plantean luego los retos y dificultades que han de afrontarse a la hora de cambiar las distintas etapas de la educación médica. Y se concluye que, pese a lo reciente de las reformas de la educación médica, a su gran complejidad, y a la todavía escasa disponibilidad de evaluaciones contrastadas sobre sus resultados, existen fuertes sinergias entre los principios y valores del "nuevo profesionalismo" y los objetivos de las reformas. [EN] The scope of this paper is to discuss how so-called "new professionalism" can help in how the education of physicians is conducted, by taking into account the effects of globalization both on the situation of health and on the needs of health professionals with particular emphasis on European Union countries, which are engaged in a profound process of reform in university education. To achieve this, first we present the basic concepts of "new professionalism" and the key strategies of current medical education, which is to train physicians capable of dealing with ethical, scientific and professional challenges that are arising at the beginning of this century. The interdependence of reforms in the undergraduate, graduate and ongoing training areas is then emphasized. The challenges and difficulties to be faced when switching to different stages of medical education are then outlined. It was concluded that, notwithstanding recent reforms in medical education, their great complexity and the still limited availability of contrasting assessments of their results, there are strong synergies between the principles and values of the "new professionalism" and the objectives of the reforms. ; Sí
BASE
Barriers to the normalization of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts ; Barreras para la normalización de la telemedicina en un sistema de salud basado en la concertación de servicios
Objective, despite the clear political will to promote telemedicine and the large number of initiatives, the incorporation of this modality in clinical practice remains limited. The objective of this study was to identify the barriers perceived by key professionals who actively participate in the design and implementation of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts. Methods, we performed a qualitative study based on data from semi-structured interviews with 17 key informants belonging to distinct Catalan health organizations. Results. The barriers identified were grouped in four areas: technological, organizational, human and economic. The main barriers identified were changes in the healthcare model caused by telemedicine, problems with strategic alignment, resistance to change in the (re)definition of roles, responsibilities and new skills, and lack of a business model that incorporates telemedicine in the services portfolio to ensure its sustainability. Conclusions, in addition to suitable management of change and of the necessary strategic alignment, the definitive normalization of telemedicine in a mixed healthcare model based on purchasing of healthcare services using providers' contracts requires a clear and stable business model that incorporates this modality in the services portfolio and allows healthcare organizations to obtain reimbursement from the payer. ; Objetivo, a pesar de la gran cantidad de iniciativas de telemedicina y de la decidida voluntad política por impulsar su uso, la incorporación a la práctica clínica habitual es todavía reducida. El objetivo del estudio fue identificar las barreras percibidas por los profesionales que participan activamente en el diseno y la puesta en marcha de proyectos de telemedicina en un modelo sanitario de concertación de servicios. Métodos, estudio cualitativo realizado a partir de los datos obtenidos mediante entrevistas semiestructuradas a 17 informantes clave de diferentes organizaciones del ámbito de la salud en Cataluna. Resultados. Las barreras identificadas se agrupan en cuatro ámbitos: tecnológico, organizativo, humano y económico. Como barreras principales se senalan las relacionadas con las transformaciones en el modelo ¿ asistencial que comporta la telemedicina, la no siempre coincidente alineación estratégica, la resistencia al cambio ante la (re)definición de roles y responsabilidades, y la adquisición de nuevas habilidades y la ausencia de un modelo de negocio que incorpore la telemedicina a la cartera de servicios y permita asegurar su sostenibilidad. Conclusiones. Además de una adecuada gestión del cambio y del necesario alineamiento estratégico, la incorporación definitiva de la telemedicina en la práctica clínica habitual en un sistema de salud público basado en la concertación de servicios requiere la definición de un modelo de negocio claro y estable, que incorpore la telemedicina en la cartera de servicios de la Administración y ofrezca a las organizaciones de salud la posibilidad de obtener el reembolso de la actividad realizada.
BASE
The importance of stakeholder perception in understanding impact: The Basic Integrated Health System (sibasi) program and quality of primary healthcare in El Salvador
Rev. Gerenc. Polit. Salud, Bogotá (Colombia), 6 (12): 12-30, enero-junio de 2007 12 Abstract Using a methodology which examines the perceptions of stakeholders, including policy-makers, healthcare professionals and community members, this paper details a preliminary evaluation of the impact thus far of the Basic Integrated Health System ( Sibasi) program on quality of healthcare in El Salvador. The paper gives a brief overview of health systems reform in El Salvador, outlines the logic behind the sibasi and presents theoretical perspectives on quality in healthcare. The study found that although the sibasi was "good on paper" and had definite potential, it had not met with a great deal of success. Additionally, existing barriers in the health system in El Salvador- extreme poverty, ineffective governance, politicization, poor financing, and contention in the reform process- severely limited the success of the Sibasi program.
BASE