Percepción de la satisfacción con la labor desempeñada y factores de motivación del personal de las instituciones prestadoras de servicios de salud (IPS) del valle de Aburrá, 2011 / Perception of the Performed Work Satisfaction and Motivational Factors among the Personnel of the Healthcare Service Suppliers in the Aburrá Valley during 2011 / Percepção de satisfação com o trabalho executado e fatores de motivação da equipe das instituições prestadoras de serviços de saúde (IPS) do vale do Aburrá, 2011

Resumen Introducción: el conocer las variables que influyen en el desempeño laboral permite ofrecer aquellos elementos que contribuyan a lograr la satisfacción laboral. Objetivo: examinar la percepción de la satisfacción con la labor desempeñada y los factores de motivación del personal de las instituciones prestadoras de servicios de salud (IPS) del valle de Aburrá, Colombia, en el año 2011. Materiales y métodos: estudio de corte transversal. La población fue el personal que laboraba en estas instituciones, el total de la muestra fue de 224 empleados y 69 instituciones elegidas de manera aleatoria. Resultados: 52,2% de los encuestados expresaron sentirse muy satisfechos con la labor que desempeñan en la institución y sentirse motivados, principalmente, por el ambiente de trabajo (70,5%), seguido por el salario y el cargo, con igual participación (49,6%); también mayor satisfacción con el trabajo realizado en los empleados asistenciales en comparación con los administrativos (p = 0,018). Entre los factores menos motivacionales se encontraron: las posibilidades de ascenso, bonificaciones y reconocimientos. Conclusión: gran parte de los empleados se sienten satisfechos con la labor desempeñada, y se destaca como principal factor motivador el ambiente de trabajo.

Abstract Introduction: Knowing the variables influencing the labor performance allows to provide the elements that will contribute to the work satisfaction. Objective: To examine the perception of the performed work satisfaction as well as the motivational factors among the personnel of the healthcare service suppliers in the Aburrá Valley, Colombia during 2011. Materials and Methods: this is a cross-sectional study and the population studied was the personnel working in the said companies. The total sample included 224 employees and 69 institutions randomly selected. Results: 52.2% of the interviewees stated to feel very satisfied with the work they performed at the institution and felt motivated mostly by the working environment (70.5%) and then by the wage and the position in equal percentages (49.6%). It was also found a greater satisfaction due to the work performed by the assistant employees as compared to those in managerial positions (p = 0.018). the less motivational factors included: the opportunities for promotion, bonuses and acknowledgements. Conclusion: A great deal of employees feel satisfied with their performed work and the working environment stands out as the main motivational factor.

Resumo Introdução: conhecer as variáveis que influenciam o desempenho laboral permite oferecer aqueles elementos que contribuem para a satisfação laboral. Objetivo: examinar a percepção da satisfação com o trabalho executado e os fatores de motivação do pessoal das instituições prestadoras de serviços de saúde (IPS) no vale do Aburrá, Colômbia, em 2011. Materiais e métodos: estudo de corte transversal. A população foi a equipe que laborava nestas instituições, o total da amostra foi de 224 funcionários e 69 instituições eleitas de forma aleatória. Resultados: 52,2% dos perguntados expressaram se sentir muito satisfeitos com o trabalho executado na instituição e se sentir motivados, principalmente, pelo ambiente de trabalho (70,5%), seguido pelo salário e o cargo, com igual participação (49,6%); mesmo maior satisfação com o trabalho realizado nos trabalhadores assistenciais em comparação com os administrativos (p = 0,018). Entre os fatores menos motivacionais encontraram-se: as possibilidades de promoção, bônus e reconhecimentos. Conclusão : grande parte dos funcionários sente-se satisfeita com o trabalho executado e o ambiente de trabalho se destaca como principal fator motivador.

Ingresos económicos en médicos peruanos según especialidad: Un análisis transversal de la ENSUSALUD 2015 / Economic income in peruvian physicians according to the specialty: A cross-sectional analysis of the ENSUSALUD 2015

RESUMEN Objetivos Evaluar la asociación entre tener una especialidad médica y el ingreso económico mensual en médicos peruanos, y comparar los ingresos económicos entre áreas con mayor y menor densidad de médicos en Perú. Materiales y métodos Se analizaron los datos de la Encuesta Nacional de Satisfacción de Usuarios de Salud realizada en Perú el año 2015. Esta encuesta con nivel de inferencia nacional fue realizada a médicos que laboran en establecimientos de salud de Perú. Se evaluó el ingreso económico considerando todas las actividades remuneradas del médico. Se calcularon las razones de prevalencia crudas y ajustadas (RP y RPa) y sus intervalos de confianza al 95% (IC95%) mediante regresiones de Poisson con varianza robusta, tomando en cuenta el muestreo complejo de la encuesta. Resultados De 2219 médicos encuestados, se analizaron 2154 (97,0%) observaciones. La frecuencia de ganar >S/ 5000 (1572,3 USD) mensuales fue de 29,1% en médicos generales; 65,6% en especialistas; 63,0% en especialidades clínicas; 70,5% en especialidades quirúrgicas, y 55,7% en otras especialidades. En comparación a los médicos generales, los médicos con especialidades clínicas, quirúrgicas, y otras especialidades, tuvieron más probabilidades de ganar >S/ 5000 mensuales (RPa = 1,44, 1,49, y 1,26, respectivamente). La probabilidad de ganar >S/ 5000 fue mayor en quienes laboraban en departamentos con baja densidad de médicos. Conclusiones Los ingresos económicos fueron mayores en médicos especialistas que en no especialistas. Los ingresos económicos fueron mayores en departamentos con menor densidad de médicos, lo cual puede animar a que los médicos laboren en dichos departamentos.

ABSTRACT Objectives To evaluate the relationship between having a medical specialty and the monthly income of Peruvian doctors, and to compare the economic incomes among areas with higher and lower density of medical doctors in Peru. Materials and methods : We analyzed data of the National Satisfaction Survey of Health Users (in Spanish: ENSUSALUD) carried out in Peru in the year 2015. This survey, with a national level of inference, was performed on physicians working at health facilities in Peru. Monthly income was measured considering all paid activities of the physician. Crude and adjusted prevalence ratios (PR and aPR) and their 95% confidence intervals (95% CI) were calculated through Poisson regression models with robust variance, taking into account the complex sampling of the survey. Results Out of 2 219 Physicians surveyed, 2 154 (97.0%) observations were analyzed. The probability of earning > S/5 000 (1 572.3 USD) per month was 29.1% for general practitioners; 65.6% for specialists; 63.0% for clinical specialists; 70.5% for surgeons, and 55.7% for other specialties. Compared to general practitioners, physicians with clinical, surgical, and other specialties were more likely to earn > S/5 000 per month (aPR = 1.44, 1.49, and 1.26, respectively). The probability of earning > S/5 000 was higher in those working in departments with low medical density. Conclusions Monthly incomes were higher for specialist physicians than for non-specialists. Economic incomes were higher in departments with lower density of physicians, which may encourage physicians to work in these departments.

Focus and coverage of Bolsa Família Program in the Pelotas 2004 birth cohort / Foco e cobertura do Programa Bolsa Família na coorte de nascimentos de Pelotas, 2004

ABSTRACT OBJECTIVE To describe the focalization and coverage of Bolsa Família Program among the families of children who are part of the 2004 Pelotas birth cohort (2004 cohort). METHODS The data used derives from the integration of information from the 2004 cohort and the Cadastro Único para Programas Sociais do Governo Federal (CadÚnico – Register for Social Programs of the Federal Government), in the 2004-2010 period. We estimated the program coverage (percentage of eligible people who receive the benefit) and its focus (proportion of eligible people among the beneficiaries). We used two criteria to define eligibility: the per capita household income reported in the cohort follow-ups and belonging to the 20% poorest families according to the National Economic Indicator (IEN), an asset index. RESULTS Between 2004 and 2010, the proportion of families in the cohort that received the benefit increased from 11% to 34%. We observed an increase in all wealth quintiles. In 2010, by income and wealth quintiles (IEN), 62%-72% of the families were beneficiaries among the 20% poorest people, 2%-5% among the 20% richest people, and about 30% of families of the intermediate quintile. According to household income (minus the benefit) 29% of families were eligible in 2004 and 16% in 2010. By the same criteria, the coverage of the program increased from 43% in 2004 to 71% in 2010. In the same period, by the wealth criterion (IEN), coverage increased from 29% to 63%. The focalization of the program decreased from 78% in 2004 to 32% in 2010 according to income, and remained constant (37%) according to the IEN. CONCLUSIONS Among the families of the 2004 cohort, there was a significant increase in the program coverage, from its inception until 2010, when it was near 70%. The focus of the program was below 40% in 2010, indicating that more than half of the beneficiaries did not belong to the target population.

RESUMO OBJETIVO Descrever a focalização e a cobertura do Programa Bolsa Família nas famílias de crianças que fazem parte da coorte de nascimentos de Pelotas, 2004 (coorte de 2004). MÉTODOS Os dados utilizados derivam da integração de informações da coorte de 2004 e do Cadastro Único para Programas Sociais do Governo Federal, no período de 2004 a 2010. Estimamos a cobertura do programa (percentual de elegíveis que recebem bolsa) e seu foco (proporção de elegíveis entre os beneficiários). Utilizamos dois critérios para definir elegibilidade: a renda familiar per capita relatada nas avaliações da coorte e pertencer aos 20,0% mais pobres pela classificação do Indicador Econômico Nacional, um índice de bens. RESULTADOS Entre 2004 e 2010, a proporção de famílias beneficiárias da coorte passou de 11% para 34%. Houve aumento em todos os quintis de riqueza. Em 2010, por quintis de renda e Indicador Econômico Nacional, 62%-72% das famílias eram beneficiárias entre os 20% mais pobres, 2%-5% entre os 20% mais ricos, e cerca de 30% das famílias do quintil intermediário. Pelo critério de renda familiar, excluindo-se o valor do benefício do programa, 29% das famílias eram elegíveis em 2004 e 16% em 2010. Pelo mesmo critério, a cobertura do programa passou de 43% em 2004 para 71% em 2010. No mesmo período, pelo critério de riqueza (Indicador Econômico Nacional), a cobertura passou de 29% para 63%. A focalização do programa caiu de 78% em 2004 para 32% em 2010 de acordo com a renda e permaneceu constante (37%) de acordo com o Indicador Econômico Nacional. CONCLUSÕES Entre as famílias da coorte de 2004, observa-se aumento importante da cobertura do programa, de seu início até 2010, quando ficou perto de 70%. O foco do programa ficou abaixo de 40% em 2010, indicando que mais da metade dos beneficiários não pertencem à população alvo.

Ingresos laborales, transferencias y seguridad económica de los adultos mayores de Medellín, Colombia / Labor income, transfers and economic security for the elderly of Medellin, Colombia

Objetivo: Explorar la seguridad económica de los adultos mayores en Medellín, Colombia, así como sus fuentes de ingreso y transferencias económicas, desde una mirada comprensiva. Materiales y métodos: Estudio cualitativo exploratorio de fuente primaria, con selección por bola de nieve por medio del método histórico-hermenéutico. Se entrevistaron quince adultos mayores y cinco especialistas en el tema, a los cuales se les indagó por aspectos relacionados con sus condiciones económicas y se analizó la información, como una teoría fundamentada, donde emergen categorías de los textos. Resultados: Los mayores se sienten inseguros económicamente al no contar con ingresos fijos y suficientes que les permitan vivir de manera autónoma e independiente; menos de una tercera parte cuenta con ingresos provenientes de un empleo, el cual es informal en la mayoría de los casos Por otro lado, las transferencias por pensión y jubilaciones están determinadas por la ocupación y tipo de vinculación en su anterior vida laboral y muchos de ellos deben recurrir a las transferencias económicas de sus familiares. Conclusión: Los adultos mayores entrevistados ven comprometida su seguridad económica por no contar con un ingreso económico para la cobertura de necesidades básicas, ya que una gran mayor parte de ellos carecen de ingresos fijos, que los lleva a la informalidad para vivir el día a día, conscientes de que cada vez se envejecerá más, aumentará la dificultad para seguir laborando y se reducen los espacio para laborar y por ello deben depender del Estado o la familia.

Objective: To explore the economic security of the elderly in Medellin, Colombia as well as their sources of income and economic transfers from a comprehensive perspective. Materials and methods: An exploratory qualitative study of primary source with selection by snowball through historical hermeneutic method was conducted. 15 seniors and 5 specialists in the field selected by snowball were interviewed and asked for aspects related to their economic conditions. The given information was analyzed, as a grounded theory, where categories from the texts emerge. Results: Elderly people feel insecure financially because they do not have fixed and sufficient income to live autonomously and independently. Less than one-third have income from employment, which in most cases is informally. On the other hand, transfers from pension and retirement benefits are determined by the occupation and type of labor relationship in their previous jobs and many of them must rely on financial transfers from their families. Conclusion: Elderly people, who were interviewed, see their economic security compromised by not having an income to cover basic needs, since a large majority of them lack of fixed incomes. This situation leads them to work informally to live day to day knowing that every time they are getting older, it is more difficult to continue working, the job opportunities are reduced and therefore they must rely on the State or their families

Diferencias según género en la intención de emigración en médicos recién egresados / Gender differences in the intention of recent Peruvian medical graduates to emigrate

Introducción: La emigración médica en el Perú supone un importante problema en la búsqueda de la consolidación de un sistema de salud sostenible. Objetivos: Estimar la prevalencia de intención de emigración y sus factores asociados según género en médicos peruanos recién egresados. Diseño y lugar de estudio: Estudio analítico de corte transversal llevado a cabo en Lima, Perú, durante el año 2010. Participantes: Se incluyó a 289 médicos egresados de universidades de peruanas. Intervenciones: Se aplicó una encuesta anónima y autoadministrada que evaluaba la intención de emigración para laborar y sus factores asociados. Los datos fueron analizados con el paquete estadístico STATA 11.2; se utilizó un modelo lineal generalizado log-binomial como método de regresión de múltiples variables. Principales medidas de resultados: Intención de emigración autorreportada. Resultados: La prevalencia de intención de emigración fue de 42,1%; esta fue mayor en el género masculino (50,0% versus 36,4%; p<0,01). Un manejo intermedio/avanzado del idioma inglés (RP: 1,77; IC95%: 1,04 a 2,98) y expectativas de ingreso económico mayor o igual a 3 600 dólares americanos mensuales en los siguientes cinco años (RP: 1,55; IC95%: 1,09 a 2,21) se encontraron asociados con la intención de emigrar en varones. En mujeres, estuvieron asociados el haber culminado la carrera sin retraso (RP: 1,66; IC95%: 1,02 a 2,71) y proyectarse a ganar 3 600 dólares o más (RP: 1,71; IC95%: 1,14 a 2,57). Conclusiones: Existe una alta prevalencia de intención en emigración médica; el factor económico se asocia independientemente; los idiomas y la regularidad académica difieren según género.

Introduction: Medical emigration is a really important problem for Peru in order to consolidate a sustainable health system. Objectives: To determine the prevalence of emigration intention and associated factors according to gender in recently Peruvian graduated physicians. Design and setting: Cross-sectional, analytic study developed in Lima, Peru in 2010. Participants: Two hundred eightynine recently graduated physicians from Peruvian universities were included. Interventions: An anonymous and auto-administered questionnaire was handed to the study subjects to measure their intention to work abroad. Data was analyzed using the statistical package STATA 11.2, and a log-binomial generalized lineal model was used as regression model for multiple variables. Main outcome measures: Self-reported emigration intention. Results: Prevalence of intended emigration was 42.1%, higher in males (50.0% versus 36.4%; p<0.01). For males, an intermediate/advanced level of English proficiency (PR=1.77; 95%CI: 1.04-2.98) and a monthly income expectation greater than or equal to 3600 U.S. dollars in five years (PR=1.55; 95%CI: 1.09-2.21) were associated with the intention of emigrating. In women there was association with fulfilling the career without delay (PR:1.66; 95%CI: 1.02-2.71) and expectation to win 3600 USD or more in five years (PR:1.71; 95%CI: 1.14-2.57). Conclusions: There was high prevalence of emigration intention in the studied population; the economic factor was associated independently. However, English proficiency and academic regularity differed by gender.