Encuesta colombiana de neurología 2016-2020 / Colombian neurology survey 2016-2020

RESUMEN INTRODUCCIÓN: La práctica de la neurología como especialidad clínica es relativamente reciente en Colombia, a pesar de que esta área ha mostrado progresos académicos significativos; la información sociodemográfica es limitada. OBJETIVO: Describir las características sociodemográficas de los neurólogos laboralmente activos en Colombia. METODOLOGÍA: Estudio descriptivo en dos periodos. La información se obtuvo mediante encuestas autodiligenciadas a los asistentes al Congreso Nacional de Neurología del año 2016; la del 2020 se recolectó empleando cuestionarios en línea a través de formularios Google. RESULTADOS: Se contabilizaron 549 neurólogos laboralmente activos en el territorio colombiano. El análisis de las muestras 2016 y 2020 mostró que la mayor proporción de estos especialistas se concentraba en Bogotá (45,4 %), Medellín (13,4 %) y Cali (8,4 %), con una ocupación escasa en ciudades no capitales. La comparación de horas laborales e ingresos económicos al analizar 2016 y 2020 no mostró diferencias. El mayor tiempo de ejercicio se correlacionó con mayores ingresos, tanto en el 2016 (p < 0,001) como en el 2020 (p < 0,01). CONCLUSIONES: Excepto por el incremento en la población de nuevos neurólogos, las características socio-demográficas de los neurólogos en Colombia se mantienen sin variaciones al comparar los años 2016 y 2020.

ABSTRACT INTRODUCTION: Neurology practice is relatively recent in Colombia. Even though this area has shown significant academic advances, information regarding sociodemographic conditions is limited. OBJECTIVE: To describe sociodemographic characteristics of neurologists who are currently active in Colombia. METHODS: Descriptive study over two time periods. The information was obtained by means of self-administered surveys to the neurologists attending the neurology national congress in 2016. In 2020, data was collected by means of on-line questionnaires using google forms. RESULTS: The sample included 549 neurologists. The largest proportion of these specialists were located in Bogotá (45.4 %), Medellín (13.4 %) and Cali (8.4 %). After comparing working hours per week and income we did not identify differences between these 2 years. The time of work experience was correlated with economic income both in 2016 (p<0.001) as in 2020 (p<0.01). CONCLUSION: Except for increasing number of neurologists of recent graduation, the sociodemographic characteristics of Colombian neurologists remain stable when comparing 2016 and 2020.

Impacto del uso de pruebas de laboratorio para descarte de Covid-19 sobre el ausentismo laboral en una empresa constructora de Lima. Reporte de caso

La Organización Mundial de la Salud recomendó utilizar pruebas de laboratorio en individuos sintomáticos que cumplan criterios de caso Covid-19 tan pronto como sea posible desde el inicio de la enfermedad con enfoque de casos. Con el objetivo de mostrar el beneficio del uso de pruebas de laboratorio para Covid-19 sobre el ausentismo laboral, reportamos el caso de una empresa constructora de la ciudad de Lima, cuya evaluación se realizó entre junio 2020 y 2021. Se observó que la utilización de pruebas de laboratorio para casos sospechosos de Covid-19 permitió una disminución del 54% de días de ausentismo laboral proyectado y un ahorro de 51% respecto al costo proyectado de días de ausentismo laboral por casos descartados de la Covid-19. El uso de pruebas de laboratorio para Covid-19 resultó beneficioso, disminuyendo el ausentismo innecesario.

SUMMARY The World Health Organization recommended to use laboratory tests in symptomatic individuals that fulfill suspicion criteria for Covid-19 as soon as symptoms started. To show the benefits of using laboratory tests on work absenteeism we report the case of a building company in Lima from June 2020 to 2021. Using laboratory tests work absenteeism reduced in 54% and savings were increased in 51% compared to a projected scenario. The use of Covid-19 tests was beneficial, reducing unnecessary work absenteeism.

Physicians' income in Brazil: a study on information sources

SUMMARY OBJECTIVE: Data on physicians' income are relevant for well-informed health policies, both due to their strategic role and the volume of resources that their activities represent to health systems. In Brazil, multiple sources of data measure the income of these professionals, each one with singularities that generate a complex and heterogeneous picture. This study explores the methodological aspects of different data sources, pointing to potentials and limitations to measuring the income of physicians. METHODS: We use the sources' documentation and data on the average monthly income in 2019, by gender and macro region, from four distinct surveys: Continuous Pnad (National Household Sample Survey), RAIS (Annual Listing of Social Information), Medical Demographics, and IRPF (Personal Income Tax). RESULTS: The results confirm the heterogeneity of definitions, variables, and methodologies. The data set can evidence phenomena such as the income difference between men and women. Regional inequalities are evident; however, the data interpretation is less assertive. CONCLUSIONS: Although eventual gaps and discrepancies among sources can limit some strong conclusions, the analysis of different methodologies employed can suggest relevant hypotheses for in-depth studies.

Top-level design and practice exploration of salary reform in public hospitals / 中华医院管理杂志

The salary reform of public hospitals has a positive incentive effect on enhancing the public welfare of public hospitals, stimulating the enthusiasm of medical staff, and promoting high-quality development. The authors introduced the practice and exploration of the sequential salary system reform in Union Hospital, Tongji Medical College of Huazhong University of Science and Technology since 2018. It included the reform of physician performance based on medical groups, the reform of nursing performance based on vertical nursing management, the reform of medical technology performance based on resource marginal utilization, and the reform of management performance based on job responsibilities and 360°evaluation. The practice has showed that the salary reform could promote the improvement of medical service ability, improve nurses′ satisfaction, shorten the waiting time for medical technical examination, and steadily improve the performance of " National Examination" and the comprehensive ranking of hospitals. When studying and implementing the policy requirements of salary system reform, hospitals in different regions should take measures in accordance with local conditions, with accurate and safe information systems as the support, and focus on the distribution mode, compensation structure and funding sources.

Discussion on the performance reform of administrative and logistics personnel in a large public hospital / 中华医院管理杂志

Because the work of administrative and logistics personnel in public hospitals is difficult to quantify and evaluate, its performance reform is difficult. A large public hospital in Wuhan has explored and established a distribution incentive mechanism that combines department performance appraisal, individual classification and grading, and secondary distribution within the department. Taking into account the completion of performance appraisal indicators of the national tertiary public hospital in the department, the results of the institutional " Excellent Management Team Ranking" , personal job grades, working years and other factors, a relatively mature and operable system has been formed, which could provide reference for the performance reform of other hospitals.

Diferenciais de salários dentro do Poder Executivo Brasileiro: uma análise de cluster / Diferenciales salariales en el Poder Ejecutivo brasileño: análisis de conglomerados / Salary discrepancy in the Brazilian executive branch: a cluster analysis

Resumo O objetivo principal do presente trabalho é verificar como evoluiu o padrão remuneratório das diferentes carreiras com nível superior dentro do Poder Executivo Federal ao longo do período de 1998 a 2015. A justificativa para se estudar esses diferenciais salariais é que, nos últimos anos, se verificou um aumento substancial dos salários do funcionalismo público brasileiro. No entanto, os resultados obtidos pela técnica de análise de agrupamento sugerem que existe um padrão de maior valorização das carreiras chamadas típicas de Estado, em detrimento de outras. Isso revela um padrão de apreciação de salários dentro do Poder Executivo e, principalmente, um conflito distributivo interno, em que aquelas carreiras mais próximas do poder central e com as características de "típicas de Estado" foram sendo gradativamente beneficiadas, estabelecendo uma grande mudança no padrão remuneratório relativo ao longo do período analisado.

Resumen El objetivo principal del presente trabajo es verificar cómo ha evolucionado el patrón retributivo de las distintas carreras con educación superior dentro del Poder Ejecutivo federal durante el período de 1998 a 2015. La justificación para estudiar estos diferenciales salariales es que, en los últimos años, se ha verificado un aumento sustancial de los salarios de los funcionarios públicos brasileños. Sin embargo, los resultados obtenidos por la técnica de análisis de conglomerados sugieren que existe un patrón de mayor apreciación de las carreras denominadas típicas del Estado, en detrimento de otras. Esto revela un patrón de apreciación salarial al interior del Poder Ejecutivo y, principalmente, un conflicto distributivo interno, en que las carreras más cercanas al poder central y con las características de "típicas del Estado" fueron paulatinamente beneficiadas, estableciendo un cambio importante en el patrón de remuneración relativa durante el período analizado.

Abstract This paper verifies the evolution of the remuneration pattern of different higher-level careers within the Brazilian federal executive branch from 1998 to 2015. In recent years, the differences in remuneration have substantially increased in the Brazilian civil service. However, the results obtained through cluster analysis suggest a pattern of greater pay raise for "typical state careers" to the detriment of others. This reveals a pattern of salary appreciation within the executive branch and, especially, an internal distributive conflict, in which those careers closer to the central power and with characteristics of "typical state careers" were gradually benefiting, establishing a major change in the relative remuneration pattern among different careers over the studied period.

Rendimiento académico como predictor de la remuneración de egresados en Administración, Perú / Academic performance as a predictor of Administration graduate remuneration, Peru / Desempenho acadêmico como preditor da remuneração de egressos em Administração, Peru

Resumen Introducción: el finalizar los estudios de una carrera profesional no certifica que el graduado obtenga un trabajo, a lo que se agrega que la contracción económica ha impactado de modo significativo en el nivel de ingreso de los recientes egresados de diferentes universidades. A pesar de ello, en Perú, no se dispone de suficientes investigaciones que lo expliquen. Objetivo: identificar la relación que existe entre el rendimiento académico y la remuneración de los egresados de Administración de Universidades públicas del Perú. Materiales y métodos: fue un estudio retrospectivo, descriptivo y correlacional con diseño no experimental de corte transeccional. Los datos para el análisis estadístico corresponden a una muestra de egresados desde el 2011 al 2016. De una población de 248 se utilizó la muestra de 129 egresados. El rendimiento académico se midió mediante el promedio de calificaciones, registradas en las actas finales del Siga-web UNASAM. La hipótesis se corroboró estadísticamente utilizando el programa SPSS versión 25 mediante la correlación de Pearson. La remuneración mediante la técnica del análisis documentario con la ficha de registro de datos, a partir de las boletas de pagos de los egresados del mes de septiembre 2017. Resultados: muestran que, entre el rendimiento académico y la remuneración de los egresados de la carrera profesional de Administración existe una relación positiva. Conclusión: existe una relación directa entre el rendimiento académico y la remuneración de los egresados de Administración con un nivel de confianza de 95%.

Abstract Introduction: completing the studies of a professional career does not certify that the graduate obtains a job, to which it is added that the economic contraction has had a significant impact on the income level of recent graduates from different universities. Despite this, in Peru, there is not enough research to explain it. Objective: to study was to identify the relationship that exists between academic performance and remuneration of graduates of Administration from public universities in Peru. Materials and methods: it was a retrospective, descriptive and correlational study with a non-experimental, cross-sectional design. The data for the statistical analysis correspond to a sample of graduates from 2011 to 2016. From a population of248, the sample of129 graduates was used. Academic performance was measured through the average of grades, recorded in the final minutes of the Siga-web UNASAM. The hypothesis was statistically corroborated using the SPSS version 25 program using Pearson's correlation. The remuneration through the documentary analysis technique with the data record sheet, based on the pay slips of the graduates ofSeptember 2017. Results: to show that, between the academic performance and the remuneration of the graduates of the career Management professional there is a positive relationship. Conclusions: there is a direct relationship between academic performance and the remuneration of Administration graduates with a confidence level of 95%.

Resumo Introdução: a conclusão dos estudos de uma carreira profissional não certifica que o graduado consega um emprego, ao que se acrescenta que a contração económica teve um impacto significativo no nível de rendimento dos recém-licenciados em diferentes universidades. Apesar disso, no Peru, não há pesquisas suficientes para explicá-lo. Objetivo: identificar a relação que existe entre o desempenho acadêmico e a remuneração dos graduados em Administração de universidades públicas no Peru. Materiais e métodos: trata-se de um estudo retrospectivo, descritivo e correlacional, com desenho transversal não experimental. Os dados para a análise estatística correspondem a uma amostra de concluintes de 2011 a 2016. De uma população de 248, foi utilizada a amostra de 129 licenciados. O desempenho acadêmico foi medido por meio da média das notas, registrada nos minutos finais do Siga-web UNASAM. A hipótese foi estatisticamente corroborada pelo programa SPSS versão 25 por meio da correlação de Pearson. A remuneração através da técnica de análise documental com folha de registro de dados, com base nas folhas de vencimento dos egressos de setembro de 2017. Resultados mostram que, entre o desempenho acadêmico e a remuneração dos egressos da carreira Profissional de gestão existe uma relação positiva. Conclusão que existe uma relação direta entre o desempenho acadêmico e a remuneração dos graduados em Administração com um nível de confiança de 95%.

Salário de médicos contratados da Estratégia Saúde da Família e contexto municipal: estudo ecológico / Salary of physicians hired by the Family Health Strategy Program and the municipalities context: an ecological study

RESUMO O salário é um importante fator de atração, fixação e satisfação de profissionais médicos na Atenção Primária à Saúde (APS), sobretudo nas regiões mais remotas ou carentes. Este estudo tem o objetivo de identificar características contextuais municipais que estejam associadas ao valor do salário pago a médicos contratados da Estratégia Saúde da Família (ESF). Realizou-se um estudo ecológico e transversal com 78 municípios da Macrorregião de Saúde Norte, Minas Gerais, Brasil. A variável dependente referiu-se ao valor pago aos médicos contratados da ESF. Foram consideradas 22 variáveis independentes contextuais incluindo características sociodemográficas, de localização e indicadores assistenciais e de saúde de cada município, coletados de bases de dados oficiais. Conduziu-se Regressão Linear Múltipla. A média salarial encontrada foi de R$11.188,61 (±R$2.093,71), variando de R$6.388,20 até R$17.000,00. Após ajuste do modelo, somente a Distância ao Centro Regional manteve-se positivamente associada ao desfecho (R2=6,4%). O salário dos médicos não foi determinado por características municipais contextuais mensuráveis. Outros fatores mais subjetivos, de difícil mensuração, podem estar envolvidos na questão. Observa-se a necessidade do estabelecimento de parâmetros claros para definição do valor do salário de médicos contratados para atuação na ESF.

ABSTRACT Salary is an important factor of attraction, fixation and satisfaction of physicians in Primary Health Care (PHC), mainly in the most remote or poor regions. This study aims to identify characteristics related to municipalities that are associated to salaries paid to physicians hired from the Family Health Strategy (FHS) Program. An ecological and cross-sectional study was conducted with 78 municipalities of the Northern Health Macro-region of Minas Gerais State, Brazil. The dependent variable referred to the amount paid to the physicians hired from FHS. Twenty-two contextual independent variables were applied, including sociodemographic characteristics, location and health and care indicators of each municipality, all collected from public databases. Multiple Linear Regression was conducted. The outcome average salary was R$11,188.61 (±R$2,093.71), ranging from R$6,388.20 to R$17,000.00. After adjusting the model, only the variable 'Distance from Regional Center' remained positively associated to the outcome (R2=6.4%). The conclusion is that the salaries of physicians were not determined by measurable contextual municipal characteristics. Other more subjective and difficult to measure factors may be involved in the issue. Therefore, there is need to establish clear parameters so to define the salaries of physicians hired to work for FHS.

Foco e cobertura do programa Bolsa Família em crianças das coortes de nascimento BRISA, Ribeirão Preto (São Paulo) e São Luís (Maranhão), Brasil / Targeting and coverage of the Bolsa Família program in children from the BRISA Birth Cohorts, Ribeirão Preto (São Paulo State) and São Luís (Maranhão State), Brazil / Atención y cobertura del programa Bolsa Familia en niños procedentes de las cohortes de nacimiento BRISA, Ribeirão Preto (São Paulo) y São Luís (Maranhão), Brasil

Estudo transversal aninhado a uma coorte, que teve como objetivo descrever foco e cobertura do programa Bolsa Família em crianças de 13-35 meses de idade. Fez-se uso de dados das coortes de nascimento BRISA, em Ribeirão Preto, São Paulo, e São Luís, Maranhão, Brasil. O início das coortes ocorreu em 2010, com a inclusão de todos os nascimentos em Ribeirão Preto (7.794) e 5.236 em São Luís, abrangendo amostra aleatória de um terço. No seguimento, realizado de 2011 a 2013, retornaram 3.805 crianças em Ribeirão Preto e 3.308 em São Luís. Foram utilizados dados do momento do seguimento, e estes foram integrados às informações do Cadastro Único (CadÚnico). Consideraram-se dois critérios de elegibilidade para o benefício do Bolsa Família: renda familiar per capita mensal de até R$ 140,00 e classe econômica D/E. Estimaram-se percentuais de foco e cobertura do Bolsa Família. Realizou-se ponderação para perdas de seguimento. O foco do Bolsa Família, segundo renda familiar per capita mensal, foi de 33,8% em São Luís e 15,9% em Ribeirão Preto, e de acordo com a classe econômica foi de 33,7% em São Luís e 15,3% em Ribeirão Preto. A cobertura do Bolsa Família, de acordo com o critério de renda familiar per capita mensal, foi de 82,1% em São Luís e 71,6% em Ribeirão Preto; e segundo classe econômica foi de 68,9% em São Luís e 46,8% em Ribeirão Preto. Foram baixos os percentuais de foco e melhores os de cobertura do Bolsa Família, com estimativas destes indicadores maiores para São Luís em relação a Ribeirão Preto.

The aim of this cross-sectional study nested in a cohort was to describe the targeting and coverage of the Family Income program in children 13 to 35 months of age. Data were obtained from the BRISA Birth Cohorts in Ribeirão Preto, São Paulo State, and São Luís, Maranhão State, Brazil. The cohorts started in 2010 with the inclusion of all the births in Ribeirão Preto (7,794) and 5,236 in São Luís, covering a random sample of one third. In the follow-up waves in 2011 and 2013, 3,805 children returned in Ribeirão Preto and 3,308 in São Luís. The data were used from the time of follow-up and were integrated with the information from the Single Registry (CadÚnico). Two eligibility criteria were considered for receiving the Family Income benefit: monthly per capita family income of BRL 140.00 or less (approximately USD 38.00) and economic classes D/E. The percentages of targeting and covering were estimated for Family Income. Weighting was performed for losses to follow-up. According to family income, the program's targeting was 33.8% in São Luís and 15.9% in Ribeirão Preto; according to economic class, it was 33.7% in São Luís and 15.3% in Ribeirão Preto. According to per capita family income, coverage was 82.1% in São Luís and 71.6% in Ribeirão Preto; and according to economic class it was 68.9% in São Luís and 46.8% in Ribeirão Preto. The program's targeting rates were low, while the coverage rates were better. Both indicators were higher in São Luís than in Ribeirão Preto.

Se trata de un estudio transversal anidado en una cohorte, cuyo objetivo fue describir la atención y cobertura del programa Bolsa Familia (PBF), en niños de 13 a 35 meses de edad. Se usaron datos de las cohortes de nacimiento BRISA, en Ribeirão Preto, São Paulo, y São Luís, Maranhão, Brasil. El inicio de las cohortes fue 2010, con la inclusión de todos los nacimientos en Ribeirão Preto (7.794) y 5.236 en São Luís, abarcando un tercio de la muestra aleatoria. En el seguimiento, realizado de 2011 a 2013, regresaron 3.805 niños en Ribeirão Preto y 3.308 en São Luís. Se utilizaron los datos recogidos cuando se realizó el seguimiento y, posteriormente, se integraron en la información que proporciona el Registro Único (CadÚnico). Se consideraron dos criterios de elegibilidad para ser beneficiario del Bolsa Familia renta familiar per cápita mensual de hasta BRL 140,00 y clase económica D/E. Se estimaron porcentajes de atención y cobertura del Bolsa Familia. Se realizó una ponderación respecto a las pérdidas en el seguimiento. La atención del Bolsa Familia, según renta familiar per cápita mensual, alcanzó a un 33,8% en São Luís y un 15,9% en Ribeirão Preto; y según la clase económica, fue de un 33,7% en São Luís y un 15,3% en Ribeirão Preto. La cobertura del Bolsa Familia, de acuerdo con el criterio de renta familiar per cápita mensual, fue de un 82,1% en São Luís y un 71,6% en Ribeirão Preto; y según la clase económica fue de un 68,9% en São Luís y un 46,8% en Ribeirão Preto. Fueron bajos los porcentajes de atención y mejores los porcentajes de cobertura del Bolsa Familia, con estimaciones mayores de esos indicadores en São Luís, en comparación con los de Ribeirão Preto.

Public social security burden of musculoskeletal diseases in Brasil-Descriptive study

SUMMARY BACKGROUND: To present data on the social security burden of diseases of the musculoskeletal system and connective tissue (DSOTC) in Brasil in 2014, and evolution of these social security expenditures between 2009 and 2014. METHOD: Compilation and analysis of data on the granting of disability pensions and sickness benefits in the year 2014, available on the official website of Social Security, classified according to ICD 10. It was evaluated the evolution between 2009 and 2014, using the F test to compare the curves with the growth of the active age population (PIA). RESULTS: Among the 22 disease groups classified according to ICD-10, the DSOTC group led benefits grants in 2014, with 19% of the sickness benefits and 13.5% of the disability pensions. The main causes of sickness benefit and disability retirement were, respectively: dorsopathies (43.3% and 41.2%), soft tissue diseases (27.3% and 19.7%), osteoarthritis (7.6% % And 27.8%) and chronic inflammatory arthropathies (2.8% and 7.9%). In the evolution of the number of sickness benefits granted between 2009 and 2014, both INSS and DSOTC totals showed an increasing tendency (35.9 and 35.3%, respectively, with p = 0.000 for both). As for disability retirement, there was a 5.9% increase in the INSS total (p = 0.039), while for the DSOTC there was a decrease of 7.6% (p = 0.005). CONCLUSIONS: These data point to a progressive increase in the granting of sickness pensions and disability benefits in the country, superior to the growth of the PIA, as well as a high participation of DSOTC in these benefits.

RESUMO OBJETIVOS: Apresentar dados sobre o ônus previdenciário das doenças do sistema osteomuscular e tecido conjuntivo (DSOTC) no Brasil no ano de 2014, e sua evolução entre 2009 e 2014. MÉTODO: Compilação e análise de dados sobre a concessão de aposentadorias por invalidez e auxílios-doença no ano de 2014 disponíveis no portal oficial da Previdência Social, classificados segundo o CID 10. Avaliação da evolução entre 2009 e 2014, utilizando-se o teste F para comparar as curvas com o crescimento da população em idade ativa (PIA). RESULTADOS: Entre 22 grupos de doenças classificados de acordo com o CID 10, o das DSOTC liderou as concessões de benefícios em 2014, com 19% dos auxílios-doença e 13,5% das aposentadorias por invalidez. As principais causas de concessão de auxílio-doença e aposentadoria por invalidez foram, respectivamente: dorsopatias (43,3% e 41,2%), doenças de partes moles (27,3% e 19,7%), osteoartrite (7,6% e 27,8%) e artropatias inflamatórias crônicas (2,8% e 7,9%). Na evolução do número de auxílios-doença concedidos entre 2009 e 2014, tanto o total do INSS quanto o do grupo DSOTC apresentaram tendência crescente (35,9 e 35,3%, respectivamente, com p = 0,000 para ambos). Já para aposentadoria por invalidez, houve aumento de 5,9% no total do INSS (p = 0,039), enquanto que para as DSOTC houve um decréscimo de 7,6% (p = 0,005). CONCLUSÕES: Verificou-se uma elevação progressiva na concessão de auxílio-doença e aposentadoria por invalidez no País, superior ao aumento da população em idade ativa. As DSOTC foram o grupo com maior participação relativa nesses benefícios.

Factores asociados al ingreso económico, carga laboral y clima laboral en un grupo de médicos generales jóvenes en Perú / Factors associated with wages, workload, and working environment in a group of young general practitioners in Peru

RESUMEN Objetivo: Evaluar los factores asociados al ingreso económico, carga laboral y clima laboral en un grupo de médicos generales jóvenes de Perú. ateriales y métodos: Estudio transversal analítico en médicos generales que asistieron a un evento del Colegio Médico del Perú. Durante dicho evento, se realizó una encuesta para recoger las características de sus dos últimos empleos. Para evaluar las asociaciones de interés se calcularon odds ratios crudos y ajustados (ORa) usando modelos de regresión logística de efectos mixtos. Resultados: Se analizaron 332 empleos reportados por 221 médicos. El ingreso económico bajo (S/ 16,00 por hora o menos) fue menos recuente para empleos en el Ministerio de Salud - MINSA (ORa: 0,38) o en el seguro social - EsSalud (ORa: 0,09) en comparación con el sector privado, pero más frecuente en mujeres (ORa: 1,94), y en quienes realizaban una labor asistencial (ORa: 4,31). El referir mucha carga laboral fue más frecuente en aquellos con = 30 años (ORa: 2,72), y para empleos en el MINSA (ORa: 3,13) o EsSalud (ORa: 7,98) en comparación con el sector privado. El referir un clima laboral inadecuado no presentó factores asociados. Conclusiones: Los médicos que tuvieron como empleador un establecimiento privado, las mujeres, y quienes realizaron labor asistencial reportaron empleos con menor ingreso económico. Los médicos de mayor edad y quienes tuvieron como empleador al MINSA o a EsSalud reportaron empleos con mayor carga laboral. El reportar un empleo con un clima laboral inadecuado no tuvo factores asociados

ABSTRACT Objective: To assess factors associated to income, workload, and working environment in a group of young general practitioners in Peru. Materials and methods: This is an analytical cross-sectional study performed in general practitioners who attended a meeting in the Peruvian College of Physicians. During this event, a survey was performed aiming to collect the characteristics of their last two jobs. Crude and adjusted odds ratios (OR, aOR) were calculated, and we assessed the measures of association with the use of mixed effect logistic regression models. Results: We analyzed 332 jobs reported by 221 physicians. Low income (16.00 PEN per hour or less) was less frequent for jobs in the Ministry of Health - MINSA (aOR: 0.38) or in social security - EsSalud (aOR: 0.09) compared with the private sector, and this low income was more frequent in women (aOR: 1.94), as well as in those who worked on patient care (aOR: 4.31). A higher workload was more frequently reported in those =30 years of age (aOR: 2.72), and for those working for MINSA (aOR: 3.13) or EsSalud (aOR: 7.98) compared to the private sector. Reporting an inadequate work environment did not show associated factors. Conclusions: Physicians who work for a private employer, female physicians, and those working in patient care reported lower income in their jobs. Older physicians and those who worked for the Ministry of Health or EsSalud reported they had a higher work load. Reporting a job with an inadequate work environment did not have associated factors

Planos de carreira, cargos e salários no âmbito do Sistema Único de Saúde: além dos limites e testando possibilidades / Career plans, positions and salaries in the scope of the Unified Health System: beyond the limits and testing possibilities

RESUMO Este estudo objetivou analisar experiências de planos de carreira, cargos e salários premiadas pelo Ministério da Saúde. Para tanto, foi realizada pesquisa descritiva e qualitativa, em 2013, mediante análise documental e entrevistas com gestores de secretarias de saúde com planos implantados. Dados foram analisados à luz das diretrizes nacionais para a instituição de planos no Sistema Único de Saúde. Os planos estudados, negociados com os trabalhadores e baseados nas diretrizes, consideram a avaliação de desempenho e a qualificação profissional para a progressão na carreira. Conclui-se que os planos necessitam incluir os diversos tipos de vínculos empregatícios e formas de remuneração compatíveis com as carreiras da saúde.

ABSTRACT This study aimed to analyze the experiences of career plans, positions and salaries awarded by the Ministry of Health. For this purpose, a descriptive and qualitative research was conducted, in 2013, through documentary analysis and interviews with managers of the health secretariats with implanted plans. Data were analyzed in the light of national guidelines for the establishment of plans in the Unified Health System. The studied plans, negotiated with the employees and based on the guidelines, consider performance evaluation and professional qualification for career progression. It is concluded that plans need to include the various types of employment bonds and forms of remuneration compatible with health careers.

Predictors of Turnover Intention among Nurses in Small and Medium-sized Hospitals / 간호행정학회지

PURPOSE: The purpose of this study was to explore the predictors of turnover intention among nurses working in small and medium-sized hospitals in South Korea. METHODS: Data were obtained from a survey conducted in 2016 on welfare policy and system improvement. The participants were nurses of the Korean Nurses Association who worked in small and medium-sized hospitals. The responses of 2,011 nurses were analyzed using hierarchical multiple regression analysis, which was performed to explore the predictors of nurses' turnover intentions. RESULTS: The findings of this study showed that the predictors significantly reducing nurses' desire to leave their hospitals were a 40-hour workweek, satisfaction with the salary, and six out of the 40 fringe benefits provided by their hospitals: the provision of uniforms and work shoes, paid menstrual leave, operational costs for the department, job-related educational costs, and in-house nurse training program. CONCLUSION: These findings suggest that hospitals should provide proper work hours and reasonable rewards for nurses' work in order to reduce turnover intention among their nurses.

Benefícios auxílio-doença concedidos aos trabalhadores empregados no ramo de carne e pescado no Brasil em 2008 / Sick leave benefits for workers in the Brazilian meat and fish industries in 2008 / Prestaciones sociales por enfermedad, concedidas por el Seguro Social, a los empleados en el sector de la carne y pescado en Brasil durante el año 2008

Este estudo objetivou identificar fatores associados à incidência de concessão de benefícios entre trabalhadores na atividade de carne e pescado no Brasil. Foram estudados os benefícios auxílio-doença concedidos pela Previdência Social aos empregados em carne e pescado no Brasil em 2008. As incidências por 10 mil vínculos empregatícios foram estratificadas por sexo, idade, diagnóstico, atividade econômica, unidade federada, espécie e duração dos benefícios auxílio-doença. Foram concedidos 31.913 benefícios auxílio-doença, com incidência de 788,7. O ramo abate de bovinos, equinos, ovinos e caprinos apresentou a maior incidência (1.223,2); o pescado, a maior duração (61 dias) de benefícios auxílio-doença. As mulheres apresentaram maior incidência, enquanto os homens, maior duração de benefícios auxílio-doença. Os grupos Lesões, doenças osteomusculares e transtornos mentais representaram 67,2% dos benefícios auxílio-doença. Os diagnósticos mais incidentes foram as dorsopatias, hemorragia no início da gravidez e episódios depressivos. O ramo de atividade, sexo, e a idade representaram importantes fatores associados à incidência de benefícios auxílio-doença, sugerindo uma precarização das condições/relações de trabalho.

This study aims to analyze factors associated with sick leave rates among workers in the meat, fish, and seafood industries in Brazil. The study analyzed all sick leave benefits granted by the country's social security system to workers in these industries in 2008. Incidence of sick leave per 10 thousand jobs was stratified by sex, age, diagnosis, job position, State, and nature and length of benefits. The study analyzed 31,913 sick leaves, with an annual incidence of 788.7. Meat processing and packaging showed the highest incidence, and fish and seafood processing and packaging showed the longest mean length of sick leave. Women showed a higher sick leave incidence, while men received longer average sick leaves. Injuries, musculoskeletal disorders, and mental disorders accounted for 67.2% of sick leaves. The most common diagnoses were lower back pain, first-trimester bleeding in pregnancy, and depression. The data suggest poor job protection and adverse working conditions in these industries.

El objetivo del presente estudio fue identificar factores asociados a la incidencia de concesión prestaciones sociales por enfermedad a los trabajadores del sector cárnico y pesquero en Brasil. Se estudiaron las prestaciones sociales por enfermedad, concedidas por el Seguro Social, a los empleados de los sectores anteriormente mencionados durante el año 2008. Las incidencias por cada 10 mil empleados fueron estratificadas por sexo, edad, diagnóstico, actividad económica, departamento, tipo y duración de las prestaciones por enfermedad. Se concedieron 31.913 prestaciones sociales por enfermedad, con una incidencia de 788,7. El colectivo perteneciente a mataderos de ganado vacuno, equino, bovino y caprino presentó la mayor incidencia (1.223,2) y el de pesca la mayor duración (61 días de prestaciones sociales por enfermedad). Las mujeres presentaron una mayor incidencia, mientras los hombres una mayor duración de las prestaciones por enfermedad. Los grupos de lesiones, enfermedades osteomusculares y trastornos mentales representaron un 67,2% de los beneficios de auxilio por enfermedad. Los diagnósticos más incidentes fueron las dorsopatías, hemorragias en el principio de la gestación y episodios depresivos, según las ramas de la actividad ejercida, el sexo y la edad son importantes factores, sugiriendo precariedad en las condiciones de trabajo.

Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China / 보건의료교육평가

PURPOSE: To produce competent undergraduate-level medical doctors for rural township health centers (THCs), the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs) starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. METHODS: An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. RESULTS: Among 4,669 medical students, 1,523 (33%) had a positive attitude and 2,574 (55%) had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. CONCLUSION: Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

Trends in Salaries for Registered Nurses Compared with Elementary School Teachers and Salary Differences by Workplace Size and Geographic Location / 간호행정학회지

PURPOSE: To analyze trends in salaries for registered nurses when compared with salaries for elementary school teachers from 2002 to 2009 and identify salary gaps of nurses according to workplace size and geographic location. METHODS: Data were obtained from the Occupational Employment Statistics collected by the Korea Employment Information Services each year from 2002 to 2009. The study sample consisted of 2,281 registered nurses and 2,578 elementary school teachers. Linear multiple regression analyses were conducted to analyze salary trends and differences. RESULTS: Elementary school teachers had higher monthly salaries than nurses with a baccalaureate degree after adjusting for years of work. Salary differences increased significantly by 40,000 won every year (p<.001). Nurses working in large facilities in Seoul had the highest salaries, whereas those in small/medium, non-Seoul facilities had the lowest salaries consistently over time. Salary differences between the two groups increased by 47,000 won every year (p=.001); salary differences between nurses in large, non-Seoul facilities and those in small/medium, non-Seoul facilities also increased by 40,000 won annually (p=.001). CONCLUSION: Geographical imbalances in the nurse workforce and nurse shortages in small/medium, non-capital facilities could be reduced by increasing the salary of nurses working in those facilities.

Allende y la realidad médico-social, a 75 años / Allende and medical social reality: 75 year later

A 75 años de la publicación del libro ‘La Realidad Médico-Social Chilena’, escrito en 1939 por el Dr. Salvador Allende (Presidente de Chile, 1970-73) en su condición de Ministro de Salud del Presidente P. Aguirre Cerda, se re-visita con detalle, parte por parte, los diferentes capítulos de la Salubridad, vistos por el ojo del especialista que luego dirigiese la República, haciendo una breve relación con su vigencia actual. El articulista concluye que el Dr. Allende debió recibir un grado académico honorario en Salud Pública (no existía entonces en el país) y que su análisis, -con las adecuaciones epidemiológicas y políticas del caso-, podría ser el eje de un nuevo Programa de gobierno en el siglo XXI.

75 years later, a re-visiting of the book ‘The medical and social reality of Chile’, finds that it could still be the back-bone of a government policy and plan for the XXI century, given that suitable epidemiological and political upgradings are introduced. The book, written by Dr. Allende in 1939 when he was Minister of Health for President P. Aguirre Cerda, is a thorough and systematic presentation of all factors involved in the diagnosis and planning of health and medical services. The reviewer concludes that Dr. Allende would have deserved an honorary degree in Public Health (none existed at the time in the country).