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RESUMEN Objetivo: Determinar la percepción de los médicos que realizan el Servicio Rural y Urbano Marginal de Salud (SERUMS) en Perú sobre el trabajo en el primer nivel de atención (PNA) y sus factores asociados. Materiales y métodos: Se realizó un análisis secundario de datos de una muestra de médicos que realizaron el SERUMS el 2016. Para evaluar la variable de interés se utilizó la escala de «Percepción sobre el trabajo en el PNA¼, cuyos puntajes más altos indican una peor percepción del trabajo en el PNA. Se aplicó una encuesta basal (antes del SERUMS) y una encuesta de seguimiento (8-12 meses de iniciado el SERUMS) y se evaluaron las diferencias en los puntajes. Resultados: De los 780 encuestados, 215 (27,6%) completaron la encuesta basal y de seguimiento. La media del puntaje incrementó considerablemente (de 3,4 a 6,7; p < 0,001), lo que indica una peor percepción del trabajo en el PNA tras iniciar el SERUMS. De los tres dominios de la encuesta, el de las percepciones sobre el médico que trabaja en el PNA y el de las percepciones sobre el trabajo asistencial en el PNA incrementaron los puntajes de percepción sobre el trabajo en el PNA. No se encontraron variables sociodemográficas asociadas al cambio en los puntajes. Conclusiones: La percepción de los médicos sobre el trabajo en el PNA se deteriora luego de iniciar el SERUMS. Se deben promover estrategias que incentiven el interés de los médicos en este nivel de atención.
ABSTRACT Objective: To determine the effect of the Rural and Marginal Urban Health Service (SERUMS) on the physicians' perception of work in the primary health care (PHC) setting and its associated factors. Materials and methods: A secondary data analysis of a sample of physicians who performed the SERUMS in 2016 was carried out. To evaluate the variable of interest, the scale "Perception of work in the PHC setting" was used, higher scores indicated a negative perception of work in the PHC setting. A baseline survey (before the SERUMS) and a follow-up survey (8-12 months after starting the SERUMS) were applied and differences in both scores were evaluated. Results: Of the 780 respondents, 215 (27.6%) completed the baseline and follow-up survey. The average score increased considerably (from 3.4 to 6.7; p < 0.001), which shows a negative perception of work in the PHC setting after participating in the SERUMS. Of the three parts of the survey, the one regarding perceptions by the physicians working in the PHC and the one about perceptions of medical work in the PHC setting increased the perception scores. No sociodemographic variables were found to be associated with the change in scores. Conclusions: Physicians' perception about work in the PHC setting deteriorated after participating in the SERUMS. Therefore, strategies to encourage physicians' interest in working at this level of healthcare should be promoted.
Subject(s)
Humans , Male , Female , Primary Health Care , Rural Areas , Rural Health , Suburban Health Services , Physicians, Primary Care , Peru , Surveys and Questionnaires , Health Strategies , Health Personnel , Rural Health Services , Sociodemographic FactorsABSTRACT
Objective To compare health status of senior high school graduates living as urban vs suburban areas in Beijing.Methods Wilcoxon rank sun test,Ridit analysis and fuzzy mathematics synthesis were used to evaluate body shape index,physical function index and health defects indicator of 39 982 senior high school graduates in Beijing.Results A total of 9 117 urban boys,9 299 suburban boys,10 380 urban girls and 11 186 suburban girls were studied.For the boys,the urban was superior to the suburban areas in body shape index (Rurt=0.518,Rsub=0.482,P＜0.05) and physical function index (Rurt=0.520,Rsub=0.480,P＜0.05),and the urban was inferior to suburban areas in health defects indicator (Rurb=0.501,Rsub=0.554,P＜0.05) and the composite index (Ruurb=0.484,Rsub=0.516,P＜0.05).For the girls,the urban was superior to the suburban areas in physical function index (Rurb=0.562,Rsob=0.442,P＜0.05),and the urban was inferior to the suburban areas in health defects indicator (Rurb=0.473,Rsub=0.523,P＜0.05).The differences between urban and suburban areas tended to be of no statistical significance in body shape (U=5.79,P＞0.05) and composite index (U=5.73,P＞0.05).In fuzzy mathematics synthesis,the scores of urban boys,suburban boys,urban girls and suburban girls were 68.37,69.13,69.83 and 69.79,respectively.Conclusion Our investigation identified some differences in body shape index,physical function index and health defects indicator among senior high school graduates living at urban vs.suburban areas,although the differences of synthetical health were not statistically significant.
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Objective To explore whether differences in high school student health exist between urban and suburban areas in Beijing.Metheds To make comparative analysis on the related data collected from the physical examinations conducted in the 19 districts in Beijing for senior high school admission and college admission in 2007.Results Differences in student health(including height,weight,eyesight)exist between urban and suburban areas in Beijing.There is significant difference in eyesight(t=2.321,P=0.033)between urban and suburban junior school graduates in Beijing.There are significant difierences in height(t=2.617,P=0.018)and the incidence of overweight(t=4.650,P=0.000)between urban and suburban boys junior school graduates.There is significant difference in height(t=3.792,P=0.001)between girls.Conclusions The health condition of high school students is being affected by the overloaded study tasks and unhealthy lifestyle.which needs to be intervened.