Clima organizacional y calidad de atención del profesional de la salud de un Centro de Salud de Huánuco, Perú / Organizational Climate and Quality of Care according to Professionals from a Health Center in Huánuco, Peru

Introducción: La calidad constituye un desafío y una prioridad en las instituciones de servicios de salud y uno de los aspectos principales y más influyentes para el logro de este atributo es el clima organizacional. Objetivo: Identificar la relación entre el clima organizacional y la calidad de atención. Métodos: Estudio observacional, de corte transversal y de tipo correlacional realizado el año 2020 en profesionales de la salud del Centro de Salud "Aparicio Pomares" de Huánuco, Perú. Población conformada por 53 trabajadores. Se aplicó el cuestionario de clima organizacional y el cuestionario de calidad de atención. El análisis de los datos consistió en el contraste de correlaciones de Rho de Spearman. Resultados: En general, el clima organizacional promedio fue de 3,43 (de 1 a 5) y la calidad de atención promedia fue de 3,44 (de 1 a 5). Se encontró relación significativa entre el clima organizacional y la calidad de atención, con p ≤ 8804; 0,000. Y, se encontró relación significativa entre la calidad de atención y las dimensiones del clima organizacional como Credibilidad (p ≤ 8804; 0,000), Respeto (p ≤ 0,000), Imparcialidad (p ≤ 8804; 0,000), Orgullo (p ≤ 8804; 0,022) y Camaradería (p ≤ 0,000). Conclusiones: Se evidenció relación entre el clima organizacional y la calidad de atención de los profesionales de Atención Primaria de Salud de un Centro de Salud de Huánuco, Perú(AU)

Introduction: Quality is a challenge and a priority in healthcare institutions. One of the main and most influential aspects for the achievement of this aspect is the organizational climate. Objective: To identify the relationship between organizational climate and quality of care. Methods: An observational, cross-sectional and correlational study was conducted in 2020 with health professionals of Aparicio Pomares de Huánuco Health Center, in Peru. The study population consisted of 53 workers. The organizational climate and quality of care questionnaires were applied. Data analysis consisted in Spearman's rho correlation test. Results: Generally speaking, the average organizational climate was 3.43 and the average quality of care was 3.44, both within a 1-5 scale. A significant relationship was found between organizational climate and quality of care, accounting for P≤ 8804; 0.000. In addition, a significant relationship was found between quality of care and organizational climate dimensions such as credibility (P≤ 8804; 0.000), respect (P ≤ 8804; 0.000), impartiality (P≤ 8804; 0.000), pride (P≤ 8804; 0.022), and camaraderie (P≤ 8804; 0.000). Conclusions: A relationship was shown between the organizational climate and the quality of care in primary level professionals from a Health Center in Huánuco, Peru(AU)

Knowledge and practice of nosocomial infection control among medical professionals in grassroots healthcare institutions / 预防医学

Objective@#To investigate the current status of knowledge and practice pertaining to nosocomial infection control among medical professionals in grassroots healthcare institutions, so as to provide the evidence of improving the level of infection control in grassroots healthcare institutions.@*Methods@#All medical professionals working in grassroots healthcare institutions in Pukou District, Nanjing City, were enrolled. The participants' demographic features and knowledge and practice of nosocomial infection control were collected using self-designed questionnaires and descriptively analyzed.@*Results@#A total of 402 participants were enrolled, included 116 men ( 28.86% ) and 286 women ( 71.14% ). The respondents were predominantly at ages of 41 years and older ( 187 subjects, 46.52% ), with bachelor and above as the predominant educational level ( 200 subjects, 49.75% ) and intermediate title and above as the predominant professional title ( 168 subjects, 41.79%) , and there were 236 participants ( 58.71% ) with the length of service for more than 10 years. The awareness rate of nosocomial infection control knowledge was 56.22% among medical professionals working in grassroots healthcare institutions, with the highest awareness for COVID-19 prevention and control ( 89.55% ) and the lowest awareness for the key aspects in nosocomial infection control ( 39.55% ). The formation rate of implementing nosocomial infection control practices was 84.08%, with a low rate for “Implement satisfactorily the isolation interventions for patients with multidrug resistant bacteria” ( 71.14% ) and “Implement satisfactorily the control measures for nosocomial infections in key departments and key aspects”( 64.68% ).@*Conclusions@#Low levels are seen in the awareness of nosocomial infection control, behaviors of multidrug resistance management and key aspects in nosocomial infection control among medical professionals in grassroots healthcare institutions in Pukou District.

Quality assessment of primary healthcare institutions entrusted to private hospitals / 中华医院管理杂志

Objective To evaluate the quality of primary healthcare institutions entrusted to private hospitals as seen by the consumers. Methods The vertical integrated model between Renhe Hospital and Lixian township health center was selected as the case study. Consumer survey data of both November 2016 and September 2017 were collected by using Primary Care Assessment Tool(PCAT) (n=376). Stata 14.0 and Excel 2013 were used for descriptive statistics and multiple linear regression. Results Scoring in such key domains as continuity, comprehensiveness and coordination, and the derivative domains was higher in 2017 than those of 2016. And the differences were significant except for the domain of continuity and coordination (referral). PACT total score in 2017 was 21.28,higher than 19.83 in 2016 and the difference was significant(P<0.01). Conclusions Under the vertical integrated model between Renhe and Lixian, the quality of primary healthcare institutions was improving from 2016 to 2017 from the perspective of consumers. First contact (accessibility), comprehensiveness (services availability) and community orientation of primary healthcare institutions need to be strengthened in the future.

Review on the regulation of traditional Chinese healthcare institutions / 中国卫生政策研究

Healthy China 2030 projected to accelerate the development of health care services, but the healthcare industry in China is still in the early stages of development, and is currently threatened by the lack of the relevant legislation, industry regulations and government supervision.The current plight of supervision on traditional Chinese health care consists of the following factors, lack of legislative guarantee, the overlap between the traditional Chinese medicine(TCM) and traditional Chinese health care services blurred the supervision scope, no unified standards of Chinese health care service industry, low cost of illegal misconduct, regulatory fragmentation without substantive supervision.Based on the domestic and foreign experience, the following recommendations were put forward: Strengthening government supervision of the whole process of the Chinese medicine health care, clearly identifying the monitoring and the main supervision responsibility by legislation, screening the pseudo-information and enhance public Chinese medicine literacy, improving the self-regulation and self-supervision, and a variety of innovated government led supervision methods should be elaborated and put into practice, such as grid monitoring, classification management, establishment of credibility system, joint supervision, and so on.

Exploration of the mechanism for performance appraisal and allocation of primary healthcare institutions in Suichang county of Zhej iang province / 中华医院管理杂志

In view of such outcomes of the performance pay practice at primary healthcare institutions as decline of motivation of medical workers,the county explored the mechanism of graded performance appraisal and allocation,against the macro background of ceiling setting for the total of performance pay andbalance subsidy and total amount controlfiscal policy.The following measures are taken,namely a dual linkage to relate the performance appraisal outcome of a township hospital with both allocation of fiscal subsidy and setting of the merit-based performance pay standard per person;higher ratio of merit-based performance pay;floating of the performance pay level per person for the institution in question;separation of the performance pay of the chief leader from others;and subsidies for remote mountainous areas.It is proposed by the author to build a routine increase mechanism for both the total of performance pay and fiscal subsidies,to combine specific subsidy with pay for services,and to join funding compensation with service performance.These measures are expected to create a new mechanism for performance pay allocation,featuring more pay for more work and more pay for better performance.

Lifestyle and cancer prevention in female employees at a health institution / Estilo de vida y la prevención de cáncer en mujeres trabajadoras en una institución de salud

Objective: To establish the relationship between lifestyle for prevention of cervix and breast cancer and perceptual cognitive factors from the Pender model in working women.Materials and methods: Correlation and cross-sectional study with a random sample of 143 working women. The Lifestyle index is the total score of 5 variables: Papanicolau test, breast self-exam, physical activity, body mass index, and cigarette smoking.Results: The mean age for the sample was 44.4 + 6.2; 87% of the women had higher education and 85% were working in health care services. A total of 89% of the women had unhealthy lifestyles because of the lack of regular physical activity, not having a Papanicolau test according to the norm, not practicing breast self-exams, and having an altered body mass index. There was significant correlation between lifestyle and occupation, and also with self-efficacy perception for breast self-examination.Conclusion: The lifestyles for most of the women sampled were unhealthy.Recommendations: It is recommend the reorientation of health services based on health promotion, which permit planning and executing health care, health education and nursing care programs specifically for working women. It is also recommend conducting culturally sensitive.

Objetivo: Establecer en mujeres trabajadoras la relación entre el estilo de vida para la prevención del cáncer de cérvix y de mama con factores cognitivos perceptuales del modelo de Pender.Material y métodos: Estudio correlacional de corte transversal. La muestra estuvo conformada por 143 mujeres trabajadoras captadas de manera aleatoria. El índice estilo de vida se calificó de acuerdo con el total obtenido de la suma de cinco variables: la citología cervicouterina, el autoexamen de mama, el ejercicio, el índice de masa corporal y el hábito de fumar.Resultados: El promedio de edad para la muestra fue 44.4 + 6.2; un alto porcentaje (87%) con educación superior; 85% laboraban en área asistencial en salud. Para 89% de las mujeres trabajadoras el estilo de vida fue no saludable, a expensas de no hacer ejercicio regularmente, no realizarse la citología cervicouterina, no realizar el autoexamen de mama con la autoeficacia ni con la frecuencia y en el tiempo adecuado y tener el índice de masa corporal aumentado para un alto porcentaje de ellas. Se observó relación significativa del estilo de vida sólo con las variables ubicación laboral y percepción de autoeficacia para realizar el autoexamen de mama.Conclusiones: El estilo de vida para la mayoría de las mujeres de la muestra no es saludable. Se recomienda la reorientación de los servicios de salud con base en la promoción de la salud, lo cual permitirá planear y ejecutar programas de atención y educación para la salud y de cuidado de enfermería específicos para la mujer trabajadora, campañas educativas y culturalmente sensibles, horarios flexibles o cómodos para las mujeres.

An Analysis of Cases Referred from the Primary Healthcare Institution with Suspected Developmental Dysplasia of the Hip: A Prospective Study / 대한정형외과학회잡지

PURPOSE: A prospective, epidemiological investigation was performed in the patients referred to our hospital with suspected developmental dysplasia of the hip (DDH). MATERIALS AND METHODS: Of the 121 patients referred from the primary healthcare institutions, with suspected DDH from January 2006 to December 2007, 82 patients who were able to be followed up for at least 2 years were enrolled in this study. Confirmation of the diagnosis was determined by patient history, physical examination, simple radiographs, and ultrasonography. Epidemiological investigation was performed in the total 82 cases which were referred from the primary healthcare institution and were confirmed as having DDH, and at least a 2-year follow up was performed in all these cases. RESULTS: Of the 82 cases, 56 cases (68.3%) were within normal limits (W.N.L.), 15 cases (18.29%) were confirmed as having DDH, and 11 cases (13%) were diagnosed with several different diseases other than DDH. Compared to the total 82 cases, the percentage of females, presence of family history was statistically higher in the cases confirmed as having DDH. However, the incidence of breech presentation was not statistically different between all cases. 61 cases were referred by pediatricians and 21 cases were referred by orthopedic surgeons to the primary healthcare institution, and the diagnostic rate of DDH was statistically higher in the cases referred by orthopedic surgeons (p>0.05). CONCLUSION: The rate of confirmation of the suspected diagnosis of DDH would hopefully increase through the establishment of physical examination protocols or radiologic study and systematic training programs that could be applied in the primary healthcare institution.

A study on revitalization of primary healthcare organizations through development of standard functions

Primary care lays the foundation of national healthcare systems, but it has been weak in playing its role correctly because of legal and environmental attributes surrounding the healthcare industry in Korea. This study is conducted to concretize the definition and scope of primary care and to deduce its standard functions to contribute to establishing the healthcare delivery system and appropriate healthcare systems embracing socio-environmental leverage. The term primary healthcare institution was adopted based on literature review to achieve the research goal. The principle diseases appropriate for the primary healthcare institution based on ambulatory care sensitive conditions were analyzed, and the standard functions were deduced by matching these diseases with current procedural terminologies using CrossCoder package. Based on the analysis, the primary healthcare institution-specific diseases were 53 specific diseases under 23 broad disease groups. The standard functions were deduced in three categories of the standard functions of the entire primary healthcare institutions with 100% frequency, common standard functions with 70% frequency, and peculiar standard functions specific to diseases or body systems. These functions included outpatient evaluation and measurement, various factor tests through blood collection, and X-ray. Establishing the standard functions for the primary healthcare institution can promote patient reliability on primary care, alleviate health demand congestion toward large-sized advanced healthcare institutions. Furthermore, it contributes to establishing and reinforcing other healthcare policies related to the healthcare reimbursement system and referral system, and fosters primary care physician education. Most importantly, it reduces the national health expenditures by realizing efficient and effective healthcare delivery.

O Envelhecimento e a Moradia: Análise empírica em uma Instituição de Longa Permanência e a perspectiva do residente idoso / Aging and Housing: Empirical Analysis in a Long Staying Healthcare Institution and the residents' perceptions

O envelhecimento da população mundial (e brasileira) é um fato incontestável. Apesar disso, as pesquisas voltadas à compreensão dos aspectos que influenciam a qualidade de vida da população idosa (principalmente no Brasil) são incipientes. Há dificuldades teóricas em relação a temas ainda não completamente entendidos. Os estudos empíricos que procuram validar as hipóteses teóricas também são escassos. Uma das dificuldades encontra-se no conceito de moradia e na sua relação com o envelhecimento. A revisão daliteratura apresentada neste trabalho revela reflexões teóricas que propõem a moradia como um item essencial para se garantir o bem-estar amplo das pessoas idosas. O artigo testa as hipóteses sugeridas pela teoria através de uma pesquisa empírica desenvolvida no universo interno de uma instituição de longa permanência, a Instituição Assistencial "Nosso Lar" do município de Santo André. Os resultados sustentam a importância da moradia nas diferentes maneiras de se envelhecer. A institucionalização constitui a única possibilidade de moradia, dadas as condições precárias financeiras, de saúde e de conflitos familiares, dos residentes. Estes se adaptam à Instituição de formas distintas, gerando percepções múltiplas sobre o papel da moradia no processo de envelhecimento. Reafirma-se a dificuldade de se chegar a uma definição comum do conforto, o qual sempre envolverá questões objetivas e subjetivas da vida das pessoas. Alguns residentes conseguem aceitar a institucionalização não apenas como simples acomodamento, mas como uma "compreensão sábia", que lhes permite "aprender a lidar" com os outros residentes e com os acontecimentos diários da instituição asilar. Essas pessoas se permitem novas experiências, amizades e realizações. Assim, mesmo em um quadro de precariedade, encontram um ambiente de estímulo e de busca a novos desafios nos contextos em que vivem.

The aging of population worldwide (and in Brazil) is an undeniable fact. One of the difficulties related to aging is the definition of housing. The literature review presented in this paper shows the theoretical reflections suggesting the housing as an essential element to ensure the welfare of elder people. The article tests some of the hypotheses raised by the theory through an empirical research developed in the inner universe of a long stay institution, the Healthcare Institution "Nosso Lar" in the city of Santo André. The results back the importance of housing in the different ways of getting old. The institutionalization is the only possible solution for housing, considering the residents' precarious financial, health and familiar picture, marked by stress and conflicts. The residents adapt to the healthcare institution in different ways and with multiple perceptions regarding the role of housing in their aging process. The difficulty of reaching a common definition for the "house's comfort" is reaffirmed. Such subject will always involve objective and subjective questions related to people's life. Some residents accept the institutionalization as a "wise understanding," which allows them to deal better with the other residents and the daily endeavors (and difficulties) of the nursing home. These people allow themselves to enjoy the new experiences, friendships and accomplishments.