[The Vaccination Program of Andalucía: the identification of evaluation indicators in the framework of quality assurance]. / Programa de Vacunaciones de Andalucía: identificación de indicadores de evaluación en el marco de garantía de calidad.

Quality assurance constitutes a major element in the evaluation of health services and has recently been introduced into our field. From this perspective, we intend to identify indicators for the evaluation the Andalusian Vaccination Programme, following the scheme proposed by Donabedian. A group of experts with different training backgrounds agreed upon the techniques on which the methodology used was based. Panels of experts were formed and the nominal group technique was used to identify criteria and standards. Mail surveys were made in order to select the most relevant standards from a multiple perspective: importance, ease of measurement and intervention capability. The aspects to be evaluated were defined about structure process and result. A total of 175 criteria and standards were identified, 42 related to structure, 68 related to process and 65 to results. The aspects to be evaluated, selected according to the priority technique used, are proposed to be employed systematically. The possibility of using them in the different structural levels of the health services is discussed.

[Primary health care: an analysis of the transition in Anadalucía]. / Atención primaria de salud: un análisis sobre la transición en Andalucía.

The article develops an analysis of the process of transformation of primary health care in Andalucía (Spain), related to two fundamental aspects. On the one hand, the strategic aspects of reform are analysed, inspiring principles, as well as legislation and administration. So called "central" changes, that is, those that really suppose transformations in the services: geographic distribution, donation, organisation, human resources, etc., are also analyzed. The second aspect approached is an analysis of the situation of the system related to the limitations and malfunctions, important conditioners of the present functioning and immediate future of primary care.