The gap in human resources to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico.
The gap in human resources to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico.
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DOI：
10.1186/s12960-017-0220-5
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发表时间：
2017-08-03
影响因子：
4.5
通讯作者：
Darney BG
中科院分区：
文献类型：
--
作者：
Alcalde-Rabanal JE;Nigenda G;Bärnighausen T;Velasco-Mondragón HE;Darney BG
本研究的目的是估计在墨西哥城市和农村初级保健机构提供有保障的一揽子预防和健康促进服务的人力资源（医生、护士和健康促进员）的现有供应与理想供应之间的差距。我们使用方便样本进行了横断面观察研究。我们在墨西哥10个州的城市和农村地区选择了20个初级卫生设施。我们通过对提供健康预防和促进服务的可用时间、使用时间和所需时间的估计，计算了这些设施中现有和理想的人力资源供应。我们使用Wilcoxon和Friedman检验进行描述性统计和双变量假设检验。最后，我们进行了敏感性分析，以检验我们的时间变量的非正态分布是否偏倚估计可用和理想的人力资源供给。对城市和农村初级卫生保健设施的现有供应和理想供应的比较表明，医生的供应不足。按使用时间估计，初级卫生保健机构平均缺少5名医生，按所需时间估计，则缺少9名医生（P < 0.05）。在城市或农村初级卫生保健设施中，现有的护士供应与理想的护士供应没有差别。城市初级卫生机构健康促进员不足（P < 0.05）。医生和健康促进员的现有供应低于提供有保障的一揽子预防和健康促进服务的理想供应。政策必须解决初级卫生设施人力资源的水平和分配问题。
The purpose of this study was to estimate the gap between the available and the ideal supply of human resources (physicians, nurses, and health promoters) to deliver the guaranteed package of prevention and health promotion services at urban and rural primary care facilities in Mexico. We conducted a cross-sectional observational study using a convenience sample. We selected 20 primary health facilities in urban and rural areas in 10 states of Mexico. We calculated the available and the ideal supply of human resources in these facilities using estimates of time available, used, and required to deliver health prevention and promotion services. We performed descriptive statistics and bivariate hypothesis testing using Wilcoxon and Friedman tests. Finally, we conducted a sensitivity analysis to test whether the non-normal distribution of our time variables biased estimation of available and ideal supply of human resources. The comparison between available and ideal supply for urban and rural primary health care facilities reveals a low supply of physicians. On average, primary health care facilities are lacking five physicians when they were estimated with time used and nine if they were estimated with time required (P < 0.05). No difference was observed between available and ideal supply of nurses in either urban or rural primary health care facilities. There is a shortage of health promoters in urban primary health facilities (P < 0.05). The available supply of physicians and health promoters is lower than the ideal supply to deliver the guaranteed package of prevention and health promotion services. Policies must address the level and distribution of human resources in primary health facilities.
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影响因子：
3.7
作者：
Miranda JJ;Diez-Canseco F;Lema C;Lescano AG;Lagarde M;Blaauw D;Huicho L
通讯作者：
Huicho L
DOI：
10.1590/s0036-36342008000500015
发表时间：
2008-10-01
期刊：
Salud Pública de México
影响因子：
--
作者：
Córdova-Villalobos, José Ángel;Barriguete-Meléndez, Jorge Armando;Aguilar-Salinas, Carlos A
通讯作者：
Aguilar-Salinas, Carlos A
影响因子：
2.9
作者：
dos Reis Moreira, Erika Cardoso;O'Dwyer, Gisele
通讯作者：
O'Dwyer, Gisele
DOI：
10.1590/s0036-36342004000500006
发表时间：
2004-10-01
期刊：
Salud Pública de México
影响因子：
--
作者：
Gómez-Dantés, Octavio;Gómez-Jáuregui, Jesica;Inclán, Cristina
通讯作者：
Inclán, Cristina
影响因子：
9.7
作者：
Bodenheimer, Thomas;Chen, Ellen;Bennett, Heather D.
通讯作者：
Bennett, Heather D.