<p>The possibility to be able to better manage the Swedish public health care has been a focus from way back to the middle of the 20th century. This study focuses on a middle managerial position called Base-unit Executive Officer, which we feel is of great influence to the public health care. Because of the changes to the public health care organisations over a long period of time we find it important and interesting to research a managerial role in the midst of these changes. By going through information containing opinions, attitudes, and other information from employees within a CCDO we will try to enlighten what we feel are informational currents of opinions surrounding the notion of competence, leadership and management. The purpose of our study is to be able to help create an environment of open reflections and new ideas of what sort of competencies are required for the manager role.</p><p>The study is defined by our research problem which give use the following question:</p><p>What room is there for a broader comprehension of what kinds of competencies are desirable and useable in the role as a Base-unit Executive Officer?</p><p>To be able to interpret the primary data of the study a theoretic framework was created in the purpose to function as a tool for continuation of the study. The study was done with the use of hermeneutical paradigm together with a compromise between deductive and inductive approach.</p><p>The primary data of the study was collected with a qualitative method through semi-structured interviews with six employees of whom three were Base-unit Executive Officers. The reason for the use of a qualitative method was that it gives us conditions to gather the opinions, thoughts, values etc. of the respondents.</p><p>By merging the tools of our theoretic framework and the collected data we were able to establish an analysis. We concluded that the analysis consisted of both congruence and discrepancy related to our theoretical framework. The discrepancy showed that there exist a room for a broader comprehension of what kinds of competencies are desirable and useable in the role as a Base-unit Executive Officer. There is room to develop the comprehension of competence in areas such as management and leadership as defined by our theoretical framework.</p><p>Because of our path between deductive and inductive approach the reader should carefully evaluate the truth criteria in the study. Validation in the inductive sense is a tough task for a short and small study such as this one. We do however believe that give our preconditions have reached an acceptable level in the truth criteria. When taken into practical application we have hope that our initial thoughts of enlightment will enable a positive development of the managerial role of the Base-unit Executive Officers.</p>

<p>Broad access to healthcare services is a key factor of human development in any country. The current health care situation in South Africa can be diagnosed as critical. The hospitals are understaffed, over-occupied and the diseases like Human Immunodeficiency Virus (HIV) give health care workers additional challenges. The demand for management skills in the health sector including those for nurse managers is high. A recent World Health Organization (WHO) study of nurses working in maternal health services identified good management as more important than salary, unless the remuneration was dramatically higher. In South Africa, little empirical research exists about the management skills of nurse managers, even though proper management of human resources is vital to achieve better outcomes and access to health care around the world. In South Africa, a greater focus on human resource management in health care and more research is needed to develop new policies that will help to address the skills gap of nurse managers. The object of this research project was to identify the gaps between required and existing management skills of senior nurse managers in South Africa in private and public hospitals. Once identified, this skills gap assessment can be used by employers and policy-makers to define the management education that nurse managers require. The research is based on a survey of nurse managers in private and public hospitals using a questionnaire. The survey instrument was based on prior research of hospital managers&rsquo / competencies in South Africa, and a review of the related theoretical literature.</p>

The possibility to be able to better manage the Swedish public health care has been a focus from way back to the middle of the 20th century. This study focuses on a middle managerial position called Base-unit Executive Officer, which we feel is of great influence to the public health care. Because of the changes to the public health care organisations over a long period of time we find it important and interesting to research a managerial role in the midst of these changes. By going through information containing opinions, attitudes, and other information from employees within a CCDO we will try to enlighten what we feel are informational currents of opinions surrounding the notion of competence, leadership and management. The purpose of our study is to be able to help create an environment of open reflections and new ideas of what sort of competencies are required for the manager role. The study is defined by our research problem which give use the following question: What room is there for a broader comprehension of what kinds of competencies are desirable and useable in the role as a Base-unit Executive Officer? To be able to interpret the primary data of the study a theoretic framework was created in the purpose to function as a tool for continuation of the study. The study was done with the use of hermeneutical paradigm together with a compromise between deductive and inductive approach. The primary data of the study was collected with a qualitative method through semi-structured interviews with six employees of whom three were Base-unit Executive Officers. The reason for the use of a qualitative method was that it gives us conditions to gather the opinions, thoughts, values etc. of the respondents. By merging the tools of our theoretic framework and the collected data we were able to establish an analysis. We concluded that the analysis consisted of both congruence and discrepancy related to our theoretical framework. The discrepancy showed that there exist a room for a broader comprehension of what kinds of competencies are desirable and useable in the role as a Base-unit Executive Officer. There is room to develop the comprehension of competence in areas such as management and leadership as defined by our theoretical framework. Because of our path between deductive and inductive approach the reader should carefully evaluate the truth criteria in the study. Validation in the inductive sense is a tough task for a short and small study such as this one. We do however believe that give our preconditions have reached an acceptable level in the truth criteria. When taken into practical application we have hope that our initial thoughts of enlightment will enable a positive development of the managerial role of the Base-unit Executive Officers.

<p>Broad access to healthcare services is a key factor of human development in any country. The current health care situation in South Africa can be diagnosed as critical. The hospitals are understaffed, over-occupied and the diseases like Human Immunodeficiency Virus (HIV) give health care workers additional challenges. The demand for management skills in the health sector including those for nurse managers is high. A recent World Health Organization (WHO) study of nurses working in maternal health services identified good management as more important than salary, unless the remuneration was dramatically higher. In South Africa, little empirical research exists about the management skills of nurse managers, even though proper management of human resources is vital to achieve better outcomes and access to health care around the world. In South Africa, a greater focus on human resource management in health care and more research is needed to develop new policies that will help to address the skills gap of nurse managers. The object of this research project was to identify the gaps between required and existing management skills of senior nurse managers in South Africa in private and public hospitals. Once identified, this skills gap assessment can be used by employers and policy-makers to define the management education that nurse managers require. The research is based on a survey of nurse managers in private and public hospitals using a questionnaire. The survey instrument was based on prior research of hospital managers&rsquo / competencies in South Africa, and a review of the related theoretical literature.</p>

Due to the fact that the function of dispensing is not the exclusive practice of a single profession, there is much conflict surrounding the issue: it forms the crux of the pharmacy profession but it also forms part of doctors’ scope of practice. Separation of the acts of prescribing and dispensing would prevent the interest of the doctor, who has the potential to profit from selling medicines, being placed above the interest of the patient. It would, however, also affect the essential services that many dispensing doctors provide to pensioners, unemployed patients, those not covered by a medical scheme and those in rural areas. The implications of doctor dispensing are not clear as conflicting evidence suggests that dispensing doctors prescribe more medicine items, injections and antibiotics while preferring certain brand names on the one hand but on the other, evidence shows that dispensing doctors dispensed less expensive medicines compared to other health care providers. The main objective of this study was to analyse the prescribing patterns of dispensing doctors and other medicine providers in a section of the private health care sector of South Africa for 2005 to 2008 by using a medicine claims database. A retrospective drug utilisation review was conducted by extracting data from a medicine claims database for a four–year period, from 1 January 2005 to 31 December 2008. The results revealed that dispensing doctors had a lower cost per prescription compared to other health care providers (R112.66 ± R4.45 vs. R258.48 ± R23.93) and also had a lower cost per medicine item (R39.62 ± R2.18 vs. R112.43 ± R7.56) for the entire study period from 2005 to 2008. Dispensing doctors provided more items per prescription compared to other health care providers (2.85 ± 0.05 items vs. 2.30 ± 0.06 items) but other health care providers claimed more prescriptions per patient per year (7.50 ± 1.15 prescriptions vs. 3.29 ± 0.07 prescriptions). A higher percentage of generic medicine items were provided to patients visiting dispensing doctors. Dispensing doctors treated a majority of patients aged above 19 to 44 years of age while other health care providers treated a majority of patients above 59 years of age. Both dispensing doctors and other health care providers treated a majority of female patients and issued a majority of medicine items to treat acute conditions. The results also revealed that dispensing doctors generally provided relatively inexpensive medicine items, including generic and innovator items, for female and male patients of all ages while other health care providers showed the opposite trend and issued relatively expensive medicine items to these patients. However, when analysing the top twelve pharmacological groups claimed, dispensing doctors had relatively higher costs compared to other health care providers for nine of the pharmacological groups (central nervous system, analgesic, cardio–vascular, ear, nose and throat, dermatological, urinary system, antimicrobial, endocrine system and cytostatic). The pharmacological groups contributing to the highest number of medicine items and highest medicine cost contribution were the antimicrobial group for dispensing doctors and cardio–vascular group for other health care providers. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

Due to the fact that the function of dispensing is not the exclusive practice of a single profession, there is much conflict surrounding the issue: it forms the crux of the pharmacy profession but it also forms part of doctors’ scope of practice. Separation of the acts of prescribing and dispensing would prevent the interest of the doctor, who has the potential to profit from selling medicines, being placed above the interest of the patient. It would, however, also affect the essential services that many dispensing doctors provide to pensioners, unemployed patients, those not covered by a medical scheme and those in rural areas. The implications of doctor dispensing are not clear as conflicting evidence suggests that dispensing doctors prescribe more medicine items, injections and antibiotics while preferring certain brand names on the one hand but on the other, evidence shows that dispensing doctors dispensed less expensive medicines compared to other health care providers. The main objective of this study was to analyse the prescribing patterns of dispensing doctors and other medicine providers in a section of the private health care sector of South Africa for 2005 to 2008 by using a medicine claims database. A retrospective drug utilisation review was conducted by extracting data from a medicine claims database for a four–year period, from 1 January 2005 to 31 December 2008. The results revealed that dispensing doctors had a lower cost per prescription compared to other health care providers (R112.66 ± R4.45 vs. R258.48 ± R23.93) and also had a lower cost per medicine item (R39.62 ± R2.18 vs. R112.43 ± R7.56) for the entire study period from 2005 to 2008. Dispensing doctors provided more items per prescription compared to other health care providers (2.85 ± 0.05 items vs. 2.30 ± 0.06 items) but other health care providers claimed more prescriptions per patient per year (7.50 ± 1.15 prescriptions vs. 3.29 ± 0.07 prescriptions). A higher percentage of generic medicine items were provided to patients visiting dispensing doctors. Dispensing doctors treated a majority of patients aged above 19 to 44 years of age while other health care providers treated a majority of patients above 59 years of age. Both dispensing doctors and other health care providers treated a majority of female patients and issued a majority of medicine items to treat acute conditions. The results also revealed that dispensing doctors generally provided relatively inexpensive medicine items, including generic and innovator items, for female and male patients of all ages while other health care providers showed the opposite trend and issued relatively expensive medicine items to these patients. However, when analysing the top twelve pharmacological groups claimed, dispensing doctors had relatively higher costs compared to other health care providers for nine of the pharmacological groups (central nervous system, analgesic, cardio–vascular, ear, nose and throat, dermatological, urinary system, antimicrobial, endocrine system and cytostatic). The pharmacological groups contributing to the highest number of medicine items and highest medicine cost contribution were the antimicrobial group for dispensing doctors and cardio–vascular group for other health care providers. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

Made available in DSpace on 2016-12-23T13:47:03Z (GMT). No. of bitstreams: 1 Tullio Cezar de Aguiar Brotto.pdf: 1681883 bytes, checksum: 153d3e4b737f9a81589dd149dd61f490 (MD5) Previous issue date: 2012-02-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O trabalho tem sido afirmado como lugar de significações desejantes, fonte de auto-valoração, de auto-percepção e produção de sujeitos. Podendo ser encarado portanto, como palco de expressões subjetivas e lutas políticas. Desse modo, a relação que se constrói entre o trabalhador e seu fazer suplanta a mera execução de tarefas coordenadas visando um produto, influindo de maneira contundente na saúde deste trabalhador, tendo a organização do processo de trabalho papel fundamental neste processo. Todavia, o que a literatura científica afirma no setor saúde é a presença ainda marcante de modelos de gestão do trabalho focados na produção e que tratam os trabalhadores como recursos que devem ser preservados a fim de que tal produção se mantenha. Modelos inspirados na produção fabril. Não obstante, a literatura aponta também para o adoecimento expressivo de trabalhadores do setor saúde. Por esta razão, políticas e diretrizes têm sido formuladas nos cenários nacional e internacional voltadas a este público-alvo, a ponto da Organização Mundial de Saúde (OMS) eleger o período de 2006 a 2016 como a década da valorização do trabalho e dos trabalhadores de saúde. Assim, a pesquisa investigou qual a compreensão que a Secretaria Municipal de Saúde de Vitória (SEMUS) tem sobre a saúde do trabalhador do setor saúde. Buscou com isto compreender qual a concepção deste órgão governamental a respeito das causas do adoecimento dos trabalhadores de saúde e as propostas de seu enfrentamento. Utilizou-se a metodologia da Análise Temática de Conteúdo (ATC) para analisar relatórios de gestão e a metodologia do Discurso do Sujeito Coletivo (DSC) para analisar as entrevistas. Foram entrevistadas 10 (dez) gestoras envolvidas com a discussão da temática de Saúde do Trabalhador de Saúde (STS). Observou-se que a SEMUS não tem consenso sobre o tema, todavia sugere haver um alto índice de adoecimento dos trabalhadores de saúde. Quanto as causas deste adoecimento houve uma preponderância de respostas que o atribuíram a características dos trabalhadores. A Secretaria afirmou ainda não haver política específica voltada à diminuição deste processo de adoecimento, apesar de haverem políticas indiretas como a de contratos efetivos e a de melhorias nas condições infra-estruturais de trabalho. Entretanto, afirmou que neste mesmo período os índices de adoecimentos e a insatisfação com o trabalho aumentaram. Uma das causas parece ser a diminuição da co-gestão. Assim, concluiu-se que estratégias que busquem a diminuição do processo de adoecimento dos trabalhadores de saúde não devem preterir a co-gestão do trabalho, pois estarão ratificando modelos de gestão hegemônicos que expropriam a autonomia dos trabalhadores, reduzindo possibilidades de gerir seu trabalho e obter prazer com isso / Working has been asserted as a place of desirable meaningness, source of self-evaluation, self-perception and subjects production. It can be seen therefore, as a stage for subjective expressions and political conflicts. Thus, the relationship built between the worker and his duties supersedes the mere execution of coordinated tasks aiming at a product, decisively influencing on this workers health, having the organization of the work process an essential role in this process. However, what the scientific literature states to the health sector is the presence still remarkable of work management patterns focused on the production process and treats the workers as resources to be preserved in order to sustain such production. Manufacturing inspired patterns. Nevertheless, the literature also points to the significant sickening of health sector workers. For this reason, policies and guidelines have been conceived in both national and international levels aiming at this group, which led the World Health Organization (WHO) to elect the period of 2006-2016 as the decade of the work and health workers appreciation. Thus, this essay investigated Vitória s Municipal Health Department s understanding of the health care workers health. Intended to understand what this government agency conception of the causes of the sickening amongst health workers was and their coping proposals. We used the Thematic Content Analysis methodology (TCA) to analyze management reports and the Collective Subject Discourse methodology (CSD) to analyze the interviews. We interviewed 10 (ten) managers involved in the discussion of the Health Workers Health (HWH) issue. It was observed that this is not a consensus to the Department, however, it suggests a high rate of sickening among health workers. As for the causes of this sickening process there was a preponderance of workers characteristics attributed responses. The Department also claimed not to have a specific policy aiming at the decrease of this sickening process, although there are indirect policies such as the effective contracts and the improvement of infrastructural work conditions. However, asserted the increase of illnesses and work dissatisfaction rates in this same period. One of the causes seems to be the decreased of co-management. It was concluded that strategies seeking the decrease of the sickening process of health workers should not underestimate the co-management, once they will be confirming hegemonic management patterns that expropriate workers autonomy, reducing their chances of managing their work and obtaining pleasure from it

Submitted by marco antonio cezario de melo junior (cezarioj@hotmail.com) on 2018-07-26T15:42:50Z No. of bitstreams: 1 Tese Marco Cezario_25_07.pdf: 966243 bytes, checksum: 9b338d2d72d9cb293a1b926f270210f3 (MD5) / Rejected by Simone de Andrade Lopes Pires (simone.lopes@fgv.br), reason: Boa Tarde Marco, Recebemos seu trabalho na biblioteca digital, mas será necessário fazer alguns ajustes: Estou encaminhando por seu e-mail os ajustes necessários. Por favor, faça as alterações e submeta novamente na biblioteca digital. Atenciosamente, Simone - SRA on 2018-07-26T18:41:55Z (GMT) / Submitted by marco antonio cezario de melo junior (cezarioj@hotmail.com) on 2018-07-26T23:28:33Z No. of bitstreams: 1 Tese Marco Cezario_25_07_v1.pdf: 625767 bytes, checksum: fbe976d1be2bde075f2fd05092c707d2 (MD5) / Approved for entry into archive by Simone de Andrade Lopes Pires (simone.lopes@fgv.br) on 2018-07-27T15:50:32Z (GMT) No. of bitstreams: 1 Tese Marco Cezario_25_07_v1.pdf: 625767 bytes, checksum: fbe976d1be2bde075f2fd05092c707d2 (MD5) / Approved for entry into archive by Suzane Guimarães (suzane.guimaraes@fgv.br) on 2018-07-30T12:37:21Z (GMT) No. of bitstreams: 1 Tese Marco Cezario_25_07_v1.pdf: 625767 bytes, checksum: fbe976d1be2bde075f2fd05092c707d2 (MD5) / Made available in DSpace on 2018-07-30T12:37:21Z (GMT). No. of bitstreams: 1 Tese Marco Cezario_25_07_v1.pdf: 625767 bytes, checksum: fbe976d1be2bde075f2fd05092c707d2 (MD5) Previous issue date: 2018-05-29 / A ABRAMED (Associação Brasileira de Medicina Diagnóstica) foi fundada através da convergência dos interesses das maiores empresas do setor de serviços diagnósticos no Brasil e através dos mecanismos de políticas de ação inerentes a uma associação, contribui para o desenvolvimento do setor que representa. A análise histórica da ABRAMED demonstra a importância desta associação na cadeia de valor em saúde da medicina diagnóstica. Dessa forma, o mercado de saúde ganha em competitividade, desempenho dos processos e melhor custo-efetividade. Grandes conquistas foram alcançadas por meio do trabalho da ABRAMED em diversas vertentes com suas câmaras especializadas e concentradas por temas, como as câmaras técnica, jurídica e, mais recentemente, dos grupos de compliance e de comunicação, que realizam funções especificas. Atuações político-econômicas, regulatórias, jurídicas, fiscais, incluindo interlocução com outros setores da sociedade, como a imprensa, resultaram em uma sequência significativa de conquistas para o setor. A ABRAMED vem sendo ator na inclusão de novos procedimentos no rol de procedimentos da Agencia Nacional de Saúde Suplementar, auxiliou o Conselho Federal de Medicina no entendimento da responsabilização técnica dos estabelecimentos de medicina diagnóstica, e esclareceu ao Conselho Federal de Medicina a importância da regionalização do ato médico por estado de inscrição, para que se pudesse haver avaliação de exames anatomopatológicos ou mesmo imagens radiológicas advindos de outros estados. A ABRAMED também auxiliou a Agência Nacional de Vigilância Sanitária nas discussões quanto a segurança do transporte de material biológico, reprocessamento de materiais médicos e certificação digital dos laudos de exames. Não obstante a ABRAMED foi um balizador técnico auxiliando o posicionamento jurídico quanto aos processos de tributação e trabalhista, dada a expertise da associação na cadeia de produção e segurança dos trabalhadores do setor. A cada dia, a medicina diagnóstica vem ganhando força e solidez por meio da Associação Brasileira de Medicina Diagnóstica, a qual vem cumprindo os seus objetivos na defesa dos anseios da sociedade e de seus associados, na afirmação institucional, no aprimoramento técnico-científico do setor e na excelência dos serviços de diagnóstico em prol da qualidade de serviços prestados ao paciente. / ABRAMED (Brazilian Association of Diagnostic Medicine) was founded through the convergence of the interests of the largest diagnostic services companies in Brazil and through the mechanisms of action policies inherent to an association, contributes to the development of the sector it represents. ABRAMED's historical analysis demonstrates the importance of this association in the health value chain of diagnostic medicine. In this way, the healthcare market gains in competitiveness, process performance and better costeffectiveness. Great achievements have been catch up through ABRAMED's work in many areas with its specialized chambers and focused on themes such as technical, legal and, more recently, the communications group, which perform specific functions. Politicaleconomic, regulatory, legal, and fiscal actions, including interlocution with other sectors of society, such as the press, have resulted in a significant sequence of achievements for the health sector. The ABRAMED has been a player in the inclusion of new procedures in the roll of procedures of the National Agency of Supplementary Health, assisted the Federal Medical Council in understanding the technical responsibility of diagnostic medicine establishments, and emphasized to the Federal Medical Council the importance of the regionalization of the medical work by state of origin, so that there could be pathological evaluations on samples or even medical images originating from other federation states. The ABRAMED also assisted the National Sanitary Surveillance Agency in discussing the safety of biological material transportation, reprocessing of medical materials, and digital certification of examination reports. Nevertheless, the ABRAMED was a technical benchmark helping the legal positioning regarding tax and labor processes, given the association's expertise in the production and safety chain of the sector's workers. Each day, diagnostic medicine has been gaining strength and solidity through the Brazilian Association of Diagnostic Medicine, which has been fulfilling its objectives in defense of its members' wishes, in institutional affirmation, in the technical and scientific improvement of the sector and in excellence of diagnostic services for the quality of services rendered to the patient.

Magister Commercii - MCom / Broad access to healthcare services is a key factor of human development in any country. The current health care situation in South Africa can be diagnosed as critical. The hospitals are understaffed, over-occupied and the diseases like Human Immunodeficiency Virus (HIV) give health care workers additional challenges. The demand for management skills in the health sector including those for nurse managers is high. A recent World Health Organization (WHO) study of nurses working in maternal health services identified good management as more important than salary, unless the remuneration was dramatically higher. In South Africa, little empirical research exists about the management skills of nurse managers, even though proper management of human resources is vital to achieve better outcomes and access to health care around the world. In South Africa, a greater focus on human resource management in health care and more research is needed to develop new policies that will help to address the skills gap of nurse managers. The object of this research project was to identify the gaps between required and existing management skills of senior nurse managers in South Africa in private and public hospitals. Once identified, this skills gap assessment can be used by employers and policy-makers to define the management education that nurse managers require. The research is based on a survey of nurse managers in private and public hospitals using a questionnaire. The survey instrument was based on prior research of hospital managers' competencies in South Africa, and a review of the related theoretical literature. / South Africa

This research study explored the effects of a public servants‟ strike on psychiatric patients. This is achieved through investigating the subjective lived experiences of events prior to, during and ensuing a public servants' strike. In addition, strike action within the health care sector as a worldwide phenomenon is discussed. This provides a conceptual understanding of strike action within the health care sector, as well as critical issues raised around the use of strikes as a medium of communication. During the public servants' strike of August 2010, 446 patients were discharged from a specialized psychiatric facility in the greater Gauteng region. The sample for this research was taken from this population and comprises of three (n=3) psychiatric patients, two Afrikaans speaking males and one Sotho speaking male. At the time of the interview, all three participants had been hospitalized and received further psychiatric treatment. The researcher made use of Interpretive Phenomenological Analysis (IPA) as the method to gather and interpret the raw data. The data is discussed within three subordinate themes, namely the subjective experiences prior to, during and ensuing the strike. In addition global themes throughout the patient‟s subjective lived experiences are discussed without sequential significance. The results from this study support current literature that strikes have a direct impact on the treatment of psychiatric patients. In addition the subjective accounts of the patients did not indicate any significant deterioration in functioning during the strike. However in subsequent months following their discharge, all of the participants experienced some form of conflict which contributed to their rehospitalisation. Copyright / Dissertation (MA)--University of Pretoria, 2013. / Psychology / unrestricted