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      Autonomía clínica y de gestión: Percepción de los coordinadores de los centros de salud de Mallorca Translated title: Clinical and managerial autonomy: Perception of the coordinators of the health centers in Mallorca, Spain

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          Abstract

          Fundamento: la autogestión se ha relacionado con un incremento de la eficiencia y de la satisfacción profesional. Ante cualquier cambio tendente a una gestión más autónoma es trascendente conocer el posicionamiento de sus profesionales y directivos. El objetivo del trabajo es conocer la importancia atribuida por los coordinadores de los centros de salud (CS) a la autonomía clínica y de gestión, así como su capacidad de decisión y sus expectativas sobre la factibilidad de implantar un proyecto de gestión autónoma. Métodos: Diseño: Descriptivo transversal, aplicación de cuestionario. Emplazamiento: Atención Primaria, año 2009. Participantes: Todos los coordinadores de los CS de Mallorca (47). Intervenciones y mediciones principales: 27 preguntas que exploran la opinión del coordinador sobre la importancia de los componentes de la autogestión, su capacidad de intervención actual, la propensión/aversión al riesgo, la capacidad de liderazgo, y la factibilidad de un proyecto de autogestión. Resultados: Tasa respuestas: 42/47 (89,4%). 42 (100%) atribuyeron la máxima importancia a la gestión de los recursos humanos, 41 (97,6%) a la gestión de la demanda y 40 (95,2%) a la gestión de las listas de espera. 15 (35,7%) asumirían un riesgo financiero, 14 (33,3%) se consideraban capacitados y 18 (42,9%) se mostraban dispuestos a liderar un proceso de autogestión. 14 (33,3%) pensaban que los profesionales de su equipo no estarían interesados en un proceso de autogestión y 29 (69%) creían que otros CS de Mallorca podrían desarrollarlo. Conclusiones: Los coordinadores encuestados manifestaron disponer de una limitada capacidad de decisión sobre los componentes de la autogestión, ser aversos al riesgo y presentar una escasa capacidad y disposición para liderar proyectos de autogestión.

          Translated abstract

          Background: The self-management has been linked with increased efficiency and job satisfaction. Before any changes aimed at a more autonomous management is important to know the position of professionals and managers. Objective: To assess the importance attached by the coordinators of the health centers (HC) to the clinical and managerial autonomy, knowing their decision making capacity and their expectations about the feasibility of implementing a project of self-management. Methods: Design: cross-sectional study, application questionnaire. Location: Primary Care, 2009. Participants: All the coordinators of the HC of Mallorca (N = 47). Interventions and Measurements: 27 questions that explore the coordinator's opinion about the importance of the components of the self-management, its ability to present intervention, the propensity / aversion to risk, leadership, and the feasibility of a self-management. Results: response rate: 42/47 (89,4%). 42 (100%) attaches the highest importance to the management of human resources, 41 (97,6%) to demand management and 40 (95,2%) to the management of waiting lists. 15 (35,7%) would take a financial risk, 14 (33,3%) were considered trained and 18 (42,9%) were willing to lead a process of self-management. 14 (33,3%) thought that the professionals in your team would not be interested in a process of self-management and 29 (69%) believed that others could develop HC of Mallorca. Conclusions: The respondents were coordinators have a limited ability to decide on the components of the self-management, being risk averse and make a little leadership ability and willingness to self-management projects.

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          Contribution of primary care to health systems and health.

          Evidence of the health-promoting influence of primary care has been accumulating ever since researchers have been able to distinguish primary care from other aspects of the health services delivery system. This evidence shows that primary care helps prevent illness and death, regardless of whether the care is characterized by supply of primary care physicians, a relationship with a source of primary care, or the receipt of important features of primary care. The evidence also shows that primary care (in contrast to specialty care) is associated with a more equitable distribution of health in populations, a finding that holds in both cross-national and within-national studies. The means by which primary care improves health have been identified, thus suggesting ways to improve overall health and reduce differences in health across major population subgroups.
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            The importance of human resources management in health care: a global context

            Background This paper addresses the health care system from a global perspective and the importance of human resources management (HRM) in improving overall patient health outcomes and delivery of health care services. Methods We explored the published literature and collected data through secondary sources. Results Various key success factors emerge that clearly affect health care practices and human resources management. This paper will reveal how human resources management is essential to any health care system and how it can improve health care models. Challenges in the health care systems in Canada, the United States of America and various developing countries are examined, with suggestions for ways to overcome these problems through the proper implementation of human resources management practices. Comparing and contrasting selected countries allowed a deeper understanding of the practical and crucial role of human resources management in health care. Conclusion Proper management of human resources is critical in providing a high quality of health care. A refocus on human resources management in health care and more research are needed to develop new policies. Effective human resources management strategies are greatly needed to achieve better outcomes from and access to health care around the world.
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              The predictive value of individual factors, work-related factors, and work-home interaction on burnout in female and male physicians: a longitudinal study

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                Author and article information

                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad, Consumo y Bienestar social (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                December 2011
                : 85
                : 6
                : 569-581
                Affiliations
                [01] Palma de Mallorca orgnameConselleria de Salut i Consum de les Illes Balears orgdiv1Ib-Salut orgdiv2Gerència d'Atenció Primària de Mallorca España
                [02] orgnameConselleria de Salut i Consum de les Illes Balears orgdiv1Ib-Salut orgdiv2Gerència d'Atenció Primària de Mallorca
                Article
                S1135-57272011000600006 S1135-5727(11)08500600006
                10.1590/s1135-57272011000600006
                2e3ebb2a-4931-4126-8f2d-8ce1d2a4e12f

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 41, Pages: 13
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                SciELO Public Health

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                Professional autonomy,centros de salud,Autonomía profesional,questionnaires,atención primaria de salud,cuestionarios,primary health care,health centers

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