RESUMO
OBJECTIVE: We identify economic costs associated with communicable disease (CD) monitoring/surveillance in Colorado local public health agencies and identify possible economies of scale. DATA SOURCES/STUDY SETTING: Data were collected via a survey of local public health employees engaged in CD work. Survey respondents logged time spent on CD surveillance for 2-week periods in the spring of 2014 and fall of 2014. Forty-three of the 54 local public health agencies in Colorado participated. STUDY DESIGN: We used a microcosting approach. We estimated a statistical cost function using cost as a function of the number of reported investigable diseases during the matched 2-week period. We also controlled for other independent variables, including case mix, characteristics of the agency, the community, and services provided. DATA COLLECTION/EXTRACTION METHODS: Data were collected from a microcosting survey using time logs. PRINCIPAL FINDINGS: Costs increased at a decreasing rate as cases increased, with both cases (ß = 431.5, p < .001) and cases squared (ß = -3.62, p = .05) statistically significant. CONCLUSIONS AND IMPLICATIONS: The results of the model suggest economies of scale. Cost per unit is estimated to be one-third lower for high-volume agencies as compared to low-volume agencies. Cost savings could potentially be achieved if smaller agencies shared services.
Assuntos
Doenças Transmissíveis/economia , Doenças Transmissíveis/epidemiologia , Administração em Saúde Pública/economia , Vigilância em Saúde Pública , Colorado , Comunicação , Custos e Análise de Custo , Notificação de Doenças/economia , Humanos , Modelos Econométricos , Fatores de TempoRESUMO
Se realizó una investigación sobre servicios y sistemas de salud, con vistas a evaluar la calidad de la ejecución del Programa de Bajo Peso al Nacer en el Policlínico Universitario "Julián Grimau García", desde enero del 2011 hasta igual mes del 2013. Se empleó la metodología para la evaluación de la calidad en atención primaria de salud. Se elaboraron criterios, indicadores y estándares, en tanto la dimensión de la calidad evaluada fue el proceso (competencia y desempeño profesional). Se contó con la participación del total de especialistas y residentes en medicina general integral que laboraban en la unidad durante ese periodo. La evaluación de la mayoría de los indicadores del proceso fue inadecuada.
An investigation on health services and systems was carried out, with the objective of evaluating the quality of the implementation of the Low Birth Weight Program in "Julián Grimau García" University Polyclinic from January, 2011 to the same month of 2013. The methodology for the evaluation of the quality in primary health care was used. Approaches, indicators and standards were elaborated, as long as the dimension of the quality evaluated was the process (competence and professional training). All the specialists and residents in comprehensive general medicine working in the institution during that period participated. The evaluation of most of the indicators of the process was inadequate.
Assuntos
Garantia da Qualidade dos Cuidados de Saúde , Peso ao Nascer , Recém-Nascido de Baixo Peso , Gestão da Qualidade Total , Capacitação ProfissionalRESUMO
Se realizó una investigación en Servicios y Sistemas de Salud, a fin de evaluar la calidad de la ejecución del Programa de Lepra en el Policlínico Universitario José Martí Pérez de Santiago de Cuba, desde febrero del 2010 hasta igual mes del 2011, para lo cual se empleó la Propuesta Metodológica para la Evaluación de la Calidad en Instituciones de Atención Primaria de Salud, diseñada por la Facultad de Salud Pública del Instituto Superior de Ciencias Médicas de La Habana, en tanto, las dimensiones evaluadas fueron la estructura, el proceso y los resultados. Se contó con la participación de los 65 profesionales que laboraron en el programa y de los 39 pacientes afectados. Se halló que dicho programa no se ejecutaba con la calidad requerida y que existían dificultades en el proceso y los resultados debido a la insuficiente competencia de los profesionales de la salud, así como la insatisfacción que ellos sentían.
An investigation on health services and systems was carried out in order to evaluate the quality of the implementation of the Leprosy Program in José Martí Pérez University Polyclinic in Santiago de Cuba, from February, 2010 to the same month of 2011, for which the Methodological Proposal for the Evaluation of Quality in Institutions of Primary Health Care was used, designed by the Public Health Faculty of the Higher Institute of Medical Sciences in Havana, while the evaluated dimensions were structure, process and results. There was participation of the 65 professionals who worked in the program and of the 39 affected patients. It was found that this Program was not implemented with the required quality and that there were difficulties in the process and the results due to the insufficient competence of the health professionals, as well as to the dissatisfaction they felt.