Gestión

Abstract: Background: Rapidly occurring changes within the health care systems are creating an opportunity to re-orient the relationships between their different sectors. In order to know the locus of responsibility for various types of preventive activities, we undertook an inquiry on eight areas in six countries from Europe and North America. Methods: An inquiry among experts based on a matrix which arrayed the type of preventive health services against the target population. Eight clinical conditions were identified (childhood immunizations; adult influenza vaccination; mammography screening, tuberculosis screening, hypertension screening, PKU screening, HIV screening, and osteoporosis testing) trying to know their target population and the locus of responsibility for setting of policy, level to contact individuals for testing, follow-up of people with abnormal tests and maintenance of their medical records. Results: This pilot study showed very little results coincidence either within the eight surveyed areas or across them. There was no regular pattern for the preventive activities studied among the different countries, neither according to the type of health system, nor to the primary health care orientation of the different systems. Conclusions: There was a limited consensus in the activities studied concerning the best mode of doing public health interventions for personal health services.

 Primary Health Care;  management;  atención primaria de salud;  APS;  Prevención;  Hospital;  Salud Pública;  Organizaciones de gestión de servicios;  Inmunizaciones;  Hipertensión arterial;  VIH;  Tuberculosis;  Gestión;  Preventive Services;  Public Health;  Health Maintenance organizations;  Immunizations;  Hypetension;  

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Abstract: Objective. To construct useful indices for hospital management, based on descriptive multivariate techniques. Material and Methods. Data were collected during 1999 and 2000, on hospital admissions occurring during 1997-1998 at Hospital General de Algeciras, part of Servicio Andaluz de Salud (SAS) of Sistema Nacional de Salud Español (Spanish National Health Service). The following variables routinely monitored by health authorities were analyzed: number of admissions, mortality, number of re-admissions, number of outpatient consultations, case-mix index, number of stays, and functional index. Variables were measured in a total of 22486 admissions. We applied the Principal Components Analysis (PCA) method using the R correlation matrix. Results. The first two components were selected, accounting cumulatively for 62.67% of the variability in the data. Conclusions. The first component represents a new index representing the number of attended persons, which we have termed Case Load. The second PC represents or explains the difficulty of the attended cases, which we have termed Case Complexity. These two indices are useful to classify hospital services.

 management;  Spain;  Gestión;  calidad de atención de salud;  índices hospitalarios;  análisis de componentes principales;  epidemiología clínica;  España;  hospital management indices;  principal components analysis;  clinical epidemiology;  

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