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.

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.

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.

Remuneraciones, beneficios e incentivos laborales percibidos por trabajadores del sector salud en el Perú: análisis comparativo entre el Ministerio de Salud y la Seguridad Social, 2009 / Remunerations, benefits and labor incentives perceived by health care workers in Peru: an analysis comparing the Ministry of Health and the Social Insurance, 2009

Objetivos. Describir las principales características de la situación remunerativa general y las políticas de incentivos en los trabajadores del sector salud de Perú comparándolos de acuerdo con la institución de procedencia y a la modalidad de contrato. Materiales y métodos. Se realizó un estudio de diseño mixto que incluyó un abordaje cualitativo y componentes cuantitativos durante los años 2008 y 2009 sobre personal profesional y técnico del Ministerio de Salud (MINSA) y la seguridad social (EsSalud); evaluándose la estructura salarial considerando los incentivos, bonificaciones y remuneraciones de acuerdo al puesto de trabajo, modalidad de contrato e institución. Resultados. La política de remuneraciones y bonificaciones está determinada por los cargos y el tiempo de servicio. Las modalidades de contratación se rigen por los regímenes para el sistema público (DL 276) y el sistema privado (DL 728); el Contrato Administrativo de Servicios (CAS) y exclusivamente en el MINSA por los Comités Locales de Administración de Salud (CLAS). La estructura salarial difiere entre ambas instituciones, sobre todo en función a los incentivos y beneficios, siendo menores los ingresos en el MINSA. La Asignación Especial por Trabajo Asistencial (AETA) es propia del MINSA pero la proporción en que se da varía de acuerdo con la región. Los profesionales CAS tienen un menor salario que sus pares nombrados en el MINSA, contrario a lo que ocurre en EsSalud. Los ingresos más bajos se presentan en la modalidad CLAS. Conclusiones. Existe diferencia en la estructura y los montos salariales de acuerdo a la institución y al tipo de contrato suscrito.

Objective. To describe the main characteristics of the general salaries situation and the incentive policies of health care workers of Peru, comparing them by their origin institution and type of contract. Materials and methods. A mixed design study was done including both quantitative and qualitative components during 2008 and 2009 with both professional and technical personnel of the Ministry of Health (MINSA) and the Social Insurance (EsSalud) in Peru. The salary structure was primarily evaluated considering incentives, bonuses and other remunerations according to position, type of contract and work place. Results. Remuneration and bonus policies at the national level are determined by the responsibilities and amount of time served. The type of contract is determined by the programs of the public system (DL 276) and the private system (DL 728), also by the Special Program of Contract Services Administration (CAS) and exclusively in MINSA contracting is determined by local health administration Committees (CLAS). The salary structure differs between both types of institutions, especially with respect to incentives and benefits. An special economic incentive for assistance (AETA) is unique to MINSA, but the proportion of assistance varies by region. The professionals of MINSA have lower salaries than those of EsSalud, in all types of contracts. A professional contracted through CAS generally has a lower salary than staff peers in MINSA, though this situation is reversed in EsSalud. The lowest salaries are found in contracts made through CLAS. Conclusions. The structure and salary amounts differ between MINSA and EsSalud, just as they differ by existing contracting types.

Multiplicidade de vínculos de médicos no Estado do Ceará / Multiple job contracts of physicians in Ceará, Northeastern Brazil

OBJETIVO: Analisar a multiplicidade de vínculos dos profissionais médicos do Sistema Único de Saúde no Estado do Ceará. MÉTODOS: Foi realizada pesquisa documental sobre os vínculos de trabalho dos médicos, a partir de um banco de dados de contratos de profissionais da saúde dos municípios no Estado do Ceará, em 2008. Foram criados índices para a quantidade de vínculos de cada médico, bem como para os municípios com os quais cada médico mantinha vínculos empregatícios. Foram computadas também as distâncias entre os municípios com os quais os profissionais mantinham vínculos, visando estimar os percursos realizados pelos médicos para cumprir os contratos de trabalho e sua carga horária semanal. RESULTADOS: Dos 7.008 médicos vinculados ao Estado, 3.751 (53,5 por cento) possuíam entre dois e quatro vínculos, e 39 (0,6 por cento) de 11 a 20 vínculos. Um profissional possuía 20 vínculos. Mais da metade (51,9 por cento) dos médicos possuía vínculos de trabalho que, quando somados, totalizavam uma jornada semanal acima de 40 horas e 27,0 por cento (1.894) mantinha vínculos em mais de um município. CONCLUSÕES: Para aumentar os ganhos com seu trabalho os médicos articulam vários empregos, exercendo a profissão em locais diferentes em um constante ir e vir, inclusive em variados municípios, contribuindo para a precarização da qualidade de suas vidas e, conseqüentemente, do sistema de saúde.

Study on the salary allowances of health workers who are working at medical stations under the health departments

Only 27.2% participants in the study had special allowances. 40.9% health workers had allowances on duty. The surgeons had average operation from 11.43 ± 11.26 to 12.68 ± 12.02 case/month and the money gained from duty from 71,480 to 156,900 VND/month. The health workers had poisonous allowances was 50%, responsible allowance was 29.1%, allowance against epidemic was 5.7%, roving allowance was 7.1%. Setting up the minimum salary for health workers must be based on real price (44.2%), the salary level was applied at present level (71.9%) and the period for increasing the salary should be 2 years (66.9%).

Gratificaçäo de estímulo à docência e prática docente no cotidiano da Escola de Enfermagem da UFMG / The implications of teaching encouragement bonus in the practice of the school of nursing of the UFMG / Gratificación de estimulo a la docencia y practica docente en el cotidiano de la escuela de enfermería de la UFMG

O objetivo deste estudo é analisar as implicações da gratificação de estímulo à docência (GED) na prática dos docentes da Escola de Enfermagem da Universidade Federal de Minas Gerais (EE/UFMG). Optamos por um estudo exploratório realizado à luz da abordagem qualitativa. Foram sujeitos deste estudo: docentes da EE/UFMG e gestores da UFMG. Foi possível constatar que a implementação da GED instalou uma nova cultura na EE/UFMG, denominada por nós "cultura do assoberbamento", a qual evidencia uma corrida produtivista, em que as pessoas empenham-se em fazer sempre mais, sem uma reflexão crítica sobre o significado político de tais ações

The objective of this study is to evaluate the performance of higher education teaching. Considering that the theme is new in the structuring of university careers, with little production in this area and the degree of references to support more intensive questioning is still preliminary, we have chosen an exploratory study using a qualitative approach. The subjects of the study were: teachers of the school of nursing and the administrators of the Federal University of Minas Gerais - UFMG. We found that the implementation of the bonus established a new culture in the school of nursing. We called it the "Culture of Overloading", which, exercised by teachers in their social labor relations, shows a production race in which people are trying to do more and more and are proud of this, without critical reflection about the political meaning of these actions.

Este estudio tiene la finalidad de analizar las implicaciones de la gratificación del estímulo a la docencia (GED) en la práctica de los docentes de la Escuela de Enfermería de la Universidad Federal de Minas Gerais (EE/UFMG). Optamos por un estudio exploratorio con un enfoque cualitativo. Se analizaron comportamientos de docentes de la EE/UFMG y administradores de la universidad. Se observó y constató que, al incorporar la GED, se instaló una nueva cultura en la escuela, cultura que llamamos "de la soberbia". Ésta pone en evidencia una carrera hacia la productividad donde las personas se empeñan en hacer más y más sin parar para pensar de forma crítica en el significado político de tales acciones.