Papers by Beatriz Gonzalez
FEM: Revista de la Fundación Educación Médica, 2015
Welfare is a rather vague term whose meaning depends on ideology, values and judgments. Material ... more Welfare is a rather vague term whose meaning depends on ideology, values and judgments. Material resources are just means to enhance people's well-being, but growth of the Gross Domestic Production is still the standard measure of the success of a society. Fortunately, recent advances in measuring social performance include health, education and other social outcomes. Because "what we measure affects what we do" it is hoped that social policies will change. The movement Health in all policies and its associated Health Impact Assessment methodology will contribute to it. The task consists of designing transversal policies that consider health and other welfare goals, the short term and long-term implications and intergenerational redistributions of resources. As long as marginal productivity on health outside the healthcare system is higher than inside it, efficiency needs cross-sectoral policies. And fairness needs them even more, because in order to reduce social inequalities in health, a wide social and political response is needed. Unless we reduce the well-documented inefficiencies in our current health care systems the welfare states will fail to consolidate and the overall economic wellbeing could be in serious trouble. In this article we sketched some policy solutions such as pricing according to net benefits of innovation and public encouragement of radical innovation besides the small type incremental and market-led innovation. We proposed an independent agency, the National Institute for Welfare Enhancement to guarantee long term fair and efficient social policies in which health plays a central role.
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Gaceta Sanitaria
We developed a computer simulation model of Emergency Department Operations of the Hospital Ntra.... more We developed a computer simulation model of Emergency Department Operations of the Hospital Ntra. Sra. del Pino as a queue system. We designed and analyzed alternative functional structures of the Department and their implications on resources organization and reallocation. We programmed the operations, relations and flows between the components of the system with the simulation language SIMSCRIPT II.5. We have designed alternative configurations to assess how technical efficiency could be improved through the reallocation of human resources; how the system react would to interarrival time of patients changes; and what decisions must be taken about resources allocation in order to improve efficiency. Triage, Emergency Laboratory and radiology have the maximum average waiting times (11, 31 and 12 minutes, respectively). Some alternative organization patterns may improve this problem. Their social cost is also quantified in this work.
Ranking of health care centres, clinical services and health professionals by quality has become ... more Ranking of health care centres, clinical services and health professionals by quality has become an usual practice. Ranking health care providers has implications on funding and management. The purpose of ranking by quality is to improve effectiveness and effi ciency. But the ranking information should be used with extreme caution. The rankings should meet some properties relative to defi nition of the measurement scale, as well as some statistical properties. Statistical formula should be provided along with the ranking information to test the signifi cance of the differences among the ordered objects. Instructions to interpret health care providers rankings should be also given.
La regulacion y el alcance de la intervencion publica sobre los recursos humanos en sanidad, part... more La regulacion y el alcance de la intervencion publica sobre los recursos humanos en sanidad, particularmente sobre los profesionales, son muy intensos y de amplio espectro, desde la formacion en todas sus etapas hasta el empleo, pasando por la acreditacion profesional y la homologacion de titulos extranjeros. Sin embargo, la mayor parte de las decisiones en ese ambito son compartidas entre las Administraciones central y autonomica,entre distintos departamentos de la Administracion (educacion y sanidad) y entre esta y las asociaciones profesionales (sociedades cientificas y colegios profesionales). Paradojicamente, la sociedad civil –asociaciones, sociedades y colegios profesionales– contribuye quiza mas a la coordinacion, en el sentido de comunicacion que traspasa fronteras entre Comunidades Autonomas, de los profesionales sanitarios en Espana que la propia Administracion Publica, pero lo hace de forma segmentada y en funcion de los intereses particulares,mas que del interes general. Aunque formalmente se reconoce que la planificacion es necesaria,la fuerza de los mercados se impone en la asignacion de recursos.La planificacion no suele superar horizontes temporales cortos. Los cambios –de numerus clausus en Medicina,de numero de plazas de medico interno residente (MIR) en cada especialidad– suelen ser los resultantes de presiones “cortoplacistas” de procedencia diversa mas que del conocimiento preciso de causas y consecuencias.Haciendo un simil con la ejecucion musical se planifica “de oido”, sin partitura. La Administracion central conserva una gran parte de las competencias de formacion,acreditacion y homologacion de los profesionales sanitarios y la planificacion global del Sistema Nacional de Salud (SNS),mientras que
Revista Espanola de Financiacion y Contabilidad
ABSTRACT
L'auteur souhaite evaluer l'experience enseignante (quels contenus sont enseignes et selo... more L'auteur souhaite evaluer l'experience enseignante (quels contenus sont enseignes et selon quelle methode?) de la technologie educative et des nouvelles technologies a l'Universite de Saint-Jacques de Compostelle, en etablissant des criteres generaux en rapport avec la reforme des programmes de formation des enseignants, pedagogues, psychopedagogues et travailleurs sociaux. L'auteur presente des elements de reflexion sur les besoins de l'Universite et les themes, objectifs, lignes directrices des recherches developpees depuis la decennie 1990.
Page 1. investigaciones económicas. Volumen XX (3) - Septiembre, 1996, pp. 377-402 CHANGES IN THE... more Page 1. investigaciones económicas. Volumen XX (3) - Septiembre, 1996, pp. 377-402 CHANGES IN THE EFFICIENCY OF SPANISH PUBLIC HOSPITALS AFTER THE INTRODUCTION OF PROGRAM-CONTRACTS* Beatriz ...
Gaceta Sanitaria
Our objective is to analyze the frictions and imbalances related to the training and the employme... more Our objective is to analyze the frictions and imbalances related to the training and the employment of health professionals in Spain. Data are presented and the consequences of imbalances in the endowments of professionals are discussed, including absolute figures and relative figures of the endowments between nurses and physicians. The age pyramids of the physicians and their territorial distribution are analysed. We also studied the changes that have been made in the pregraduate programs of Health Sciences in Spain and their adaptation to the required professional profiles. The university has been deprived from its previous competences in the global training process of physicians. The current imbalances between training and employment emerge from the miopic planning of the past. After the diagnosis of imbalances, the paper provides some recommendations regarding educational and labour policies.
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Papers by Beatriz Gonzalez