Some Keys Aspects of the Hospital System in The Province of Córdoba, Argentina

Objective: to describe the Hospital System of the Córdoba Province, as regards availability of human resources, output of services, and role of the provincial system of reference. A qualitative approach was selected, using participant observation of official secondary document sources for the descri...

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Autores principales: Tafani, Roberto, Estario, Juan Carlos, Avevedo, Gabriel, Martínez, Gustavo, Cometto, María Cristina, Fernández, Ruth, Antuña, Ana, Gaspio, Nuria
Formato: Artículo revista
Lenguaje:Español
Publicado: Escuela de Salud Pública y Ambiente. Fac. Cs. Médicas UNC 2014
Acceso en línea:https://revistas.unc.edu.ar/index.php/RSD/article/view/7198
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Revista de Salud Pública de Universidad Nacional de Córdoba
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container_title_str Revista de Salud Pública
language Español
format Artículo revista
author Tafani, Roberto
Estario, Juan Carlos
Avevedo, Gabriel
Martínez, Gustavo
Cometto, María Cristina
Fernández, Ruth
Antuña, Ana
Gaspio, Nuria
spellingShingle Tafani, Roberto
Estario, Juan Carlos
Avevedo, Gabriel
Martínez, Gustavo
Cometto, María Cristina
Fernández, Ruth
Antuña, Ana
Gaspio, Nuria
Some Keys Aspects of the Hospital System in The Province of Córdoba, Argentina
author_facet Tafani, Roberto
Estario, Juan Carlos
Avevedo, Gabriel
Martínez, Gustavo
Cometto, María Cristina
Fernández, Ruth
Antuña, Ana
Gaspio, Nuria
author_sort Tafani, Roberto
title Some Keys Aspects of the Hospital System in The Province of Córdoba, Argentina
title_short Some Keys Aspects of the Hospital System in The Province of Córdoba, Argentina
title_full Some Keys Aspects of the Hospital System in The Province of Córdoba, Argentina
title_fullStr Some Keys Aspects of the Hospital System in The Province of Córdoba, Argentina
title_full_unstemmed Some Keys Aspects of the Hospital System in The Province of Córdoba, Argentina
title_sort some keys aspects of the hospital system in the province of córdoba, argentina
description Objective: to describe the Hospital System of the Córdoba Province, as regards availability of human resources, output of services, and role of the provincial system of reference. A qualitative approach was selected, using participant observation of official secondary document sources for the description of personnel structure, service output and interhospital transfer flow, plus depth interviews and key informants. The study is of the descriptive type, with a transversal retrospective design. The conceptual framework Healthcare Management, with an emphasis on Clinical Government, including process management of pathologies and non-clinical channels, and networking between hospitals and between hospitals and primary care centers, two current problem areas in the provincial hospital system. There is a fragmentation of the system outside Córdoba city. In the capital city, activity concentrates in a smaller number of establishments, with more rational bed occupation, higher density of specialized profiles and better allocation of human resources to those with higher demand and service output, a contrast with the rest of the province. However, a deficient articulation of the institutional hospital network hampers coordination of the system, despite individual efforts by institutions. Availability of human resources matches healthcare demands. By restrictive criteria measuring only external consultation, releases, treatments and operations, hospitals are working at two-thirds of their capacity, with marked disparities between regions and establishments. Main deficiencies in human resources are related to profesionalization, exhaustion, dating of operative skills, and disparities in specialized professional training. This state of affairs is made worse by faulty network coordination, lack of organization in pathology management, disparities between formal and functional organization of establishments and restrictions arising from the system public regulatory framework.
publisher Escuela de Salud Pública y Ambiente. Fac. Cs. Médicas UNC
publishDate 2014
url https://revistas.unc.edu.ar/index.php/RSD/article/view/7198
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spelling I10-R360-article-71982025-04-03T12:07:18Z Some Keys Aspects of the Hospital System in The Province of Córdoba, Argentina Claves hospitalarias en la provincia de Córdoba Tafani, Roberto Estario, Juan Carlos Avevedo, Gabriel Martínez, Gustavo Cometto, María Cristina Fernández, Ruth Antuña, Ana Gaspio, Nuria Objective: to describe the Hospital System of the Córdoba Province, as regards availability of human resources, output of services, and role of the provincial system of reference. A qualitative approach was selected, using participant observation of official secondary document sources for the description of personnel structure, service output and interhospital transfer flow, plus depth interviews and key informants. The study is of the descriptive type, with a transversal retrospective design. The conceptual framework Healthcare Management, with an emphasis on Clinical Government, including process management of pathologies and non-clinical channels, and networking between hospitals and between hospitals and primary care centers, two current problem areas in the provincial hospital system. There is a fragmentation of the system outside Córdoba city. In the capital city, activity concentrates in a smaller number of establishments, with more rational bed occupation, higher density of specialized profiles and better allocation of human resources to those with higher demand and service output, a contrast with the rest of the province. However, a deficient articulation of the institutional hospital network hampers coordination of the system, despite individual efforts by institutions. Availability of human resources matches healthcare demands. By restrictive criteria measuring only external consultation, releases, treatments and operations, hospitals are working at two-thirds of their capacity, with marked disparities between regions and establishments. Main deficiencies in human resources are related to profesionalization, exhaustion, dating of operative skills, and disparities in specialized professional training. This state of affairs is made worse by faulty network coordination, lack of organization in pathology management, disparities between formal and functional organization of establishments and restrictions arising from the system public regulatory framework. El objetivo de este trabajo es describir el sistema hospitalario de la Provincia de Córdoba, en relación a la oferta de recursos humanos, la producción de los establecimientos, y el funcionamiento del sistema de referencia. Se utilizaron métodos cualitativos. La observación participante documental de fuentes oficiales secundarias para la descripción de la estructura de personal, la producción de servicios y los flujos de derivaciones. Entrevistas en profundidad e informantes claves en las visitas a los establecimientos. El alcance es descriptivo y el diseño es retrospectivo y transversal. El estudio presenta un marco conceptual referido a la Gestión Sanitaria, enfatizando la aparición del concepto de Gobierno Clínico que requiere tanto la gestión por procesos de patologías y vías no clínicas así como la conectividad o existencia de redes tanto entre hospitales como entre estos y los centros de atención primaria. Ambos temas aparecen como problemáticos en el sistema hospitalario Cordobés. En ese contexto el sistema hospitalario aparece como una red segmentada en el interior, con mayor presencia de perfiles especializados en Capital, donde la actividad se concentra en un menor número de establecimientos y con una racional logística agregada, pues la distribución de recursos humanos, se focaliza en las instituciones con mayor trabajo y servicios producidos. La ocupación de camas resulta razonable en Capital en oposición al Interior. Aparece sin embargo, insuficiente la articulación de la red institucional de Hospitales, que impide un funcionamiento armonioso del sistema, pese a los esfuerzos grandes que cada institución hace separadamente. La dotación de recursos humanos tiene una magnitud acorde a la demanda asistencial a resolver. Bajo los supuestos restrictivos utilizados que miden sólo la consulta externa, egresos, prácticas y cirugías, los hospitales aparecen funcionando cercanos a unos dos tercios de su capacidad, con fuertes asimetrías entre regiones y entre establecimientos. Los problemas de los recursos humanos disponibles refieren a su profesionalización, capacitación, desgaste profesional, desactualización operativa y la asimetría en la formación relativa a los perfiles de los servicios. Esta situación se agrava por la desarticulación de la red hospitalaria, la desorganización administrativa del manejo de patologías, la asimetría entre la organización formal y funcional de los establecimientos, y las restricciones derivadas del marco regulatorio público dentro del cual funciona el sistema. Escuela de Salud Pública y Ambiente. Fac. Cs. Médicas UNC 2014-04-08 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/RSD/article/view/7198 10.31052/1853.1180.v12.n2.7198 Revista de Salud Pública; Vol. 12 Núm. 2 (2008); 24-34 1852-9429 1853-1180 10.31052/1853.1180.v12.n2 spa https://revistas.unc.edu.ar/index.php/RSD/article/view/7198/8282 Derechos de autor 1969 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0

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