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Occupational Health , Social Behavior , Workplace , Humans , Occupational Diseases/etiologyABSTRACT
No disponible
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Female , Adult , Humans , Hospital Records , Confidentiality , Women's Health , Primary Health Care , Reproductive Medicine , Women's Health Services , Medical Records Systems, ComputerizedABSTRACT
BACKGROUND: The improvement of the efficiency of the hospitals is a common objective in all the Health Systems. In the last years, different management measures have been implemented in the territory directly managed by Insalud, looking for a continuous improvement of the hospital efficiency. In this paper we analyze the activity and the expenses during the last four years in the Insalud managed hospitals. METHODS: A descriptive study of activity and costs during the last four years has been done in all 88 hospitals and also by groups, using usual indicators of intermediary products and activity and costs measured by UPAs. RESULTS: A global increase of activity is shown: inpatients, outpatients and surgery (above all ambulatory surgery) with a decrease of the average stay and an increase of the rotation index. The activity measured in UPAs has increased in a 2.54% in 1993 compared to 1992 and the UPA cost in constant pesetas has been reduced in 688 pesetas in the same period. The different groups of hospitals are developing a more homogeneous behaviour regarding production indicators as well as costs. CONCLUSIONS: The different management measures implemented in the last years have produced an increase of the activity and of the expenses control leading to less financial increases to perform more hospital activity.
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Health Maintenance Organizations , Health Services/statistics & numerical data , Health Services/economics , Humans , Retrospective Studies , SpainSubject(s)
Clinical Competence/standards , Family Practice/standards , Accreditation , Certification , HumansSubject(s)
Delivery of Health Care , Aged , Humans , National Health Programs , Primary Health Care , Spain , State Medicine , United Kingdom , United StatesABSTRACT
The crowd pressure which is placed on Primary Care Services frequently overwhelms the capacity of response of said services. In certain cases the crowd pressure coincides with low demand per inhabitant and year (as compared with the expected average in our environment), while on other occasions there coexist high crowd pressures with high frequencies. The automatic assumption that excess crowding--larger need for human resources obviates the analysis of the organizational factors and of individuals who contribute to the crowding increase. Sometimes, assigning more resources to cope with excess crowding of unidentified origins contributes towards keeping those causes alive, rather than solving them. We propose a method of analysis of excess care demand based on the answer to a short series of questions, while at the same time proposing certain management measures which could be useful to cope with excess demand, depending on the cause or causes which have been found to apply.
