La presente investigación se desarrolló con el objetivo de determinar la relación entre la capacitación y la satisfacción laboral en los colaboradores asistenciales del sector privado salud en las clínicas de la categoría III - I en Lima Metropolitana 2021. Para responder ello, se analizó a una muestra representativa y aleatoria de 349 colaboradores asistenciales de las clínicas de la categoría III - I en Lima Metropolitana 2021, mediante un enfoque cuantitativo y correlacional. En cuanto a la recolección de los datos, se aplicó una encuesta con 38 aseveraciones graduada por los 5 niveles de la escala de Likert. Este instrumento se diseñó a partir de la operacionalización de las variables capacitación y satisfacción laboral. Luego de haber finalizado la encuesta, se procesaron y analizaron los resultados mediante el programa estadístico SPSS Statics 25, para validar la hipótesis general e hipótesis específicas del estudio. Es así como, al rechazar la hipótesis nula y aceptar la hipótesis alterna, se evidenció la existencia de una relación entre la capacitación y la satisfacción laboral en los colaboradores asistenciales del sector privado salud en las clínicas de la categoría III - I en Lima Metropolitana 2021. A partir de lo desarrollado en la investigación, se concluyó que la satisfacción laboral de la población en estudio se relaciona con diversos factores, siendo uno de ellos la capacitación. Como recomendación, se planteó realizar estudios similares con enfoques mixtos y análisis multifactoriales, gestionar la capacitación de acuerdo a los resultados, y mejorar el paquete de compensación total. / This research was developed with the objective of determining the relationship between training and job satisfaction in healthcare employees from the private health sector in category III - I clinics in Lima Metropolitana 2021. To respond this, a representative and random sample of 349 healthcare collaborators from clinics of the category III - I in Lima Metropolitana 2021 was analysed, using a quantitative and correlational approach. In respect of the data collection, a survey was applied with 38 statements graded by the 5 levels of the Likert scale. This instrument was designed from the operationalization of the variables training and job satisfaction. After completing the survey, the results obtained were processed and worked using the statistical program SPSS Statics 25, in order to validate the general hypothesis and specific hypotheses of the study. Thus, by rejecting the null hypothesis and accepting the alternate hypothesis, the existence of a relationship between training and job satisfaction was evidenced in healthcare employees from the private health sector in category III - I clinics in Lima Metropolitana2021. As a result of the research, it was concluded that the job satisfaction of the healthcare workers is related to manifold factors, one of them being training. It is suggested to develop similar studies with mixed approaches and multifactorial analysis, manage training according to results, and improve the total compensation package. / Tesis

En este trabajo se propone un modelo integrado de protección de eventos para resguardar la información del paciente utilizando minería de procesos y visualización de datos. Por ello, el estándar 27001 se utiliza como relación para detectar diversos tipos de ataques informáticos orientados a la evaluación de datos recolectados en procesos de negocio, con el propósito de mejorar la gestión de sus riesgos de seguridad de la información del establecimiento médico. El modelo propuesto se basa en la aplicación de un conjunto de herramientas de análisis de ataques informáticos para aumentar el nivel de seguridad de los procesos de la empresa. La propuesta está conformada por 6 fases. 1. Evaluar riesgos, 2. Implementar controles, 3. Definir un plan de tratamiento, 4. Minería de Procesos, 5. Visualización de Datos y 6. Evaluación de Resultados. La propuesta fue validada mediante un caso de un ciberataque a un establecimiento médico el cual no contaba con controles y planes de contingencia adecuados dentro de sus procesos de negocio. Los resultados preliminares muestran que ante al apoyo de los instrumentos de nuestro modelo el nivel de seguridad ha aumentado en un 25% con nuestra propuesta. / In this work, an integrated event protection model is proposed to protect patient information using process mining and data visualization. Therefore, standard 27001 is used as a relationship to detect various types of computer attacks aimed at evaluating data collected in business processes, to improve the management of its information security risks in the medical establishment. The proposed model is based on the application of a set of computer attack analysis tools to increase the level of security of the company's processes. The proposal is made up of 6 phases. 1. Assess risks, 2. Implement controls, 3. Define a treatment plan, 4. Process Mining, 5. Data visualization and 6. Results evaluation. The proposal was validated through a case of a cyber-attack on a medical establishment which did not have adequate controls and contingency plans within its business processes. Preliminary results show that with the support of the instruments of our model, the level of security has increased by 25% with our proposal. / Trabajo de investigación

La presente investigación es un estudio para determinar la eficiencia de los recursos públicos invertidos en el Hospital General de Jaén, entre los años 2020 – 2021, sólo para el área COVID – 19, en el cual su metodología es de tipo cuantitativa no experimental, donde se utilizarán la base de datos brindado por el Hospital General de Jaén, y luego se utilizará la herramienta Solver, el cual se encuentra en Microsoft Excel, el cual ayuda a poder filtrar y seleccionar un rango de datos necesarios para las diferentes variables que se necesitan para determinar la eficiencia. Además, para determinar la eficiencia utilizaremos el método Análisis Envolvente de Datos, el cual nos dará resultado los veinticuatro meses de los dos años si han sido eficientes sí o no, donde el número 1 representará que ha sido eficiente, y los números que salgan alejados del 1 significarán que no ha sido eficiente. / The present investigation is a study to determine the efficiency of public resources invested in the General Hospital of Jaén, between the years 2020 - 2021, only for the COVID - 19 area, in which its methodology is quantitative, non-experimental, where The database provided by the General Hospital of Jaén will be used, and then the Solver tool will be used, which is found in Microsoft Excel, which helps to filter and select a range of data necessary for the different variables that are needed to determine efficiency. In addition, to determine efficiency we will use the Data Envelopment Analysis method, which will give us results for the twenty-four months of the two years if they have been efficient yes or no, where the number 1 will represent that it has been efficient, and the numbers that come out further away of 1 will mean that it has not been efficient.

The researcher used the integration of both qualitative and quantitative approaches. The respondents were drawn from three district, one regional, one academic and two private hospitals. Data was collected by means of questionnaires. The open-ended questions in the questionnaire allowed the respondents to respond in their own words (“etic” description). This enhanced the organisation and reduction of the relevant data for analysis as well as the validity and trustworthiness of the study. The study revealed that even though most of the South African government health policies were very advanced and among the best in the world, some crucial policies appeared to have encountered problems with implementation, from conflicting ideologies and opinions from hospital management, different unions, professional associations, the provincial government, the South African Nursing Council (SANC) and patients. Too many groups appeared to have discussed nurses‟ issues with government and made decisions for nurses, leaving nurses disillusioned. The majority of the respondents attributed this to poor representation at government level. Furthermore, some decisions, resolutions and strategies agreed upon between the unions and bargaining councils appeared to have worked against nurses, further dividing RNs and failing to accomplish the intended purpose. Although most of the respondents had hoped that the Occupational Specific Dispensation (OSD) for nurses would address chronic low salaries for all nurses in the PHS, it favoured certain specialty qualifications (which were based on the description of post-basic courses in R212 and R48, which were not clearly delineated). In addition, RNs were not informed about the meaning and implications of the OSD prior to implementation. The study thus found an information gap between government and RNs at the production level, which appeared not to be with the government and the nurses, but in between. Most importantly, nurses seemed to be represented more by unions to government and bargaining councils, as opposed to nurses, while most of the respondents did not favour the division of nurses between professional associations and unions. Decisions in the PHS appeared to have been dominated by leaders who had no experience with pragmatic issues of health care services (HCS), particularly at the operational level, and the dynamics of the nursing profession. The study therefore concluded that, if the right people (nurses, doctors and systems) were put in place, and nurses were represented by nurses at government level, bargaining councils and parliament, discontent among RNs in the PHS could be reduced significantly. Existing strategies were found to deal with the symptoms and not the root cause of discontent among RNs in the PHS. / Health Studies / D. Litt. et Phil. (Health Studies)

The researcher used the integration of both qualitative and quantitative approaches. The respondents were drawn from three district, one regional, one academic and two private hospitals. Data was collected by means of questionnaires. The open-ended questions in the questionnaire allowed the respondents to respond in their own words (“etic” description). This enhanced the organisation and reduction of the relevant data for analysis as well as the validity and trustworthiness of the study. The study revealed that even though most of the South African government health policies were very advanced and among the best in the world, some crucial policies appeared to have encountered problems with implementation, from conflicting ideologies and opinions from hospital management, different unions, professional associations, the provincial government, the South African Nursing Council (SANC) and patients. Too many groups appeared to have discussed nurses‟ issues with government and made decisions for nurses, leaving nurses disillusioned. The majority of the respondents attributed this to poor representation at government level. Furthermore, some decisions, resolutions and strategies agreed upon between the unions and bargaining councils appeared to have worked against nurses, further dividing RNs and failing to accomplish the intended purpose. Although most of the respondents had hoped that the Occupational Specific Dispensation (OSD) for nurses would address chronic low salaries for all nurses in the PHS, it favoured certain specialty qualifications (which were based on the description of post-basic courses in R212 and R48, which were not clearly delineated). In addition, RNs were not informed about the meaning and implications of the OSD prior to implementation. The study thus found an information gap between government and RNs at the production level, which appeared not to be with the government and the nurses, but in between. Most importantly, nurses seemed to be represented more by unions to government and bargaining councils, as opposed to nurses, while most of the respondents did not favour the division of nurses between professional associations and unions. Decisions in the PHS appeared to have been dominated by leaders who had no experience with pragmatic issues of health care services (HCS), particularly at the operational level, and the dynamics of the nursing profession. The study therefore concluded that, if the right people (nurses, doctors and systems) were put in place, and nurses were represented by nurses at government level, bargaining councils and parliament, discontent among RNs in the PHS could be reduced significantly. Existing strategies were found to deal with the symptoms and not the root cause of discontent among RNs in the PHS. / Health Studies / D. Litt. et Phil. (Health Studies)

The main aim of the study was to determine the prescribing patterns of antibiotics with an emphasis on fluoroquinolones in the private health sector of South Africa. The empirical study followed a quantitative, descriptive, observational method using retrospective, longitudinal medicine claims data provided by a nationally representative Pharmaceutical Benefit Management company (PBM) from 1 January 2005 to 31 December 2012. Penicillins, cephalosporins, carbapenems, aminoglycosides, chloramphenicol, fluoroquinolones, macrolides, tetracyclines, sulphonamides and trimethoprim were considered in the study. A total of 5 155 262 (44.8%) patients received at least one antibiotic prescription out of the total number of registered beneficiaries included in the database. The average number of antibiotic prescriptions per patient per year ranged from 2.22 ± 1.89 (95% CI 2.22-2.22) in 2005 to 1.98 ± 1.62 (95% CI 1.98-1.99) in 2012. The number of antibiotics per prescription per year remained fairly constant at 1.05 ± 0.19 (95% CI 1.05-1.05) in 2005 to 1.06 ± 0.21 (95% CI 1.06-1.06) in 2012. The prevalence of patients receiving antibiotic prescriptions decreased from 46.1% (n = 789 247) in 2005 to 38.2% (n = 480 159) in 2012. Antibiotics were mostly prescribed for females (54.9%, n = 2 831 686) and in patients aged 0 to 18 years (26.5%, n = 1 366 824) and least in patients above 65 years (9.5%, n = 490 496). The prevalence of patients receiving antibiotic prescriptions was highest in Gauteng (41.9%, n = 2 159 360) and lowest in the Northern Cape (1.7%, n = 87 720). Antibiotics were mostly prescribed during the winter period. Penicillins were the most prescribed antibiotics (43%) and carbapenem the least (0.1%) out of the total number of antibiotics claimed. No practically significant association was found between antibiotic prescribing and gender, age, province and season. A total of 1 983 622 prescriptions for fluoroquinolones were claimed in patients older than 18 years. The average number of fluoroquinolone prescriptions per patient per year ranged from 1.45 ± 0.92 (95% CI 1.44-1.45) in 2005 to 1.31 ± 0.71 (95% CI 1.31-1.32) in 2012. The highest prevalence of fluoroquinolone prescribing was observed in females (64.1%, n = 850 253) and in patients between 45 and 65 years (38.6%, n = 511 542). The total fluoroquinolone use by the study population decreased from 2.85 DID in 2005 to 2.41 DID in 2012. Norfloxacin was the only first-generation fluoroquinolone prescribed. The second-generation fluoroquinolones accounted for more than 50% of the total DID, with ciprofloxacin being the most used active ingredient in this generation. Moxifloxacin was the most prescribed third-generation fluoroquinolone; its use ranging from 0.51 DID in 2005 to 0.44 DID in 2012. Between 2005 and 2012, a total of 57 325 prescriptions for fluoroquinolones were claimed by patients 18 years and younger. The prevalence of patients receiving fluoroquinolone prescriptions decreased from 3.6% (n = 8 329) in 2005 to 2.9% (n = 3 310) in 2012. Fluoroquinolones were mostly prescribed to females and in patients between 12 and 18 years. In all age groups, prescribing was mainly done by general medical practitioners. Ciprofloxacin was the most prescribed fluoroquinolone, followed by levofloxacin. In conclusion, this study established estimates on the prevalence of antibiotic prescribing covering an eight-year period. Secondly, baseline estimates for fluoroquinolone prescribing in adults using the ATC/DDD methodology were determined. Fluoroquinolone prescribing patterns in children and adolescents were determined, with specific reference to the comparison between the prescribed daily and recommended daily dosages in the different age groups and by prescribers’ specialties. / MPharm (Pharmacy Practice), North-West University, Potchefstroom Campus, 2015

The main aim of the study was to determine the prescribing patterns of antibiotics with an emphasis on fluoroquinolones in the private health sector of South Africa. The empirical study followed a quantitative, descriptive, observational method using retrospective, longitudinal medicine claims data provided by a nationally representative Pharmaceutical Benefit Management company (PBM) from 1 January 2005 to 31 December 2012. Penicillins, cephalosporins, carbapenems, aminoglycosides, chloramphenicol, fluoroquinolones, macrolides, tetracyclines, sulphonamides and trimethoprim were considered in the study. A total of 5 155 262 (44.8%) patients received at least one antibiotic prescription out of the total number of registered beneficiaries included in the database. The average number of antibiotic prescriptions per patient per year ranged from 2.22 ± 1.89 (95% CI 2.22-2.22) in 2005 to 1.98 ± 1.62 (95% CI 1.98-1.99) in 2012. The number of antibiotics per prescription per year remained fairly constant at 1.05 ± 0.19 (95% CI 1.05-1.05) in 2005 to 1.06 ± 0.21 (95% CI 1.06-1.06) in 2012. The prevalence of patients receiving antibiotic prescriptions decreased from 46.1% (n = 789 247) in 2005 to 38.2% (n = 480 159) in 2012. Antibiotics were mostly prescribed for females (54.9%, n = 2 831 686) and in patients aged 0 to 18 years (26.5%, n = 1 366 824) and least in patients above 65 years (9.5%, n = 490 496). The prevalence of patients receiving antibiotic prescriptions was highest in Gauteng (41.9%, n = 2 159 360) and lowest in the Northern Cape (1.7%, n = 87 720). Antibiotics were mostly prescribed during the winter period. Penicillins were the most prescribed antibiotics (43%) and carbapenem the least (0.1%) out of the total number of antibiotics claimed. No practically significant association was found between antibiotic prescribing and gender, age, province and season. A total of 1 983 622 prescriptions for fluoroquinolones were claimed in patients older than 18 years. The average number of fluoroquinolone prescriptions per patient per year ranged from 1.45 ± 0.92 (95% CI 1.44-1.45) in 2005 to 1.31 ± 0.71 (95% CI 1.31-1.32) in 2012. The highest prevalence of fluoroquinolone prescribing was observed in females (64.1%, n = 850 253) and in patients between 45 and 65 years (38.6%, n = 511 542). The total fluoroquinolone use by the study population decreased from 2.85 DID in 2005 to 2.41 DID in 2012. Norfloxacin was the only first-generation fluoroquinolone prescribed. The second-generation fluoroquinolones accounted for more than 50% of the total DID, with ciprofloxacin being the most used active ingredient in this generation. Moxifloxacin was the most prescribed third-generation fluoroquinolone; its use ranging from 0.51 DID in 2005 to 0.44 DID in 2012. Between 2005 and 2012, a total of 57 325 prescriptions for fluoroquinolones were claimed by patients 18 years and younger. The prevalence of patients receiving fluoroquinolone prescriptions decreased from 3.6% (n = 8 329) in 2005 to 2.9% (n = 3 310) in 2012. Fluoroquinolones were mostly prescribed to females and in patients between 12 and 18 years. In all age groups, prescribing was mainly done by general medical practitioners. Ciprofloxacin was the most prescribed fluoroquinolone, followed by levofloxacin. In conclusion, this study established estimates on the prevalence of antibiotic prescribing covering an eight-year period. Secondly, baseline estimates for fluoroquinolone prescribing in adults using the ATC/DDD methodology were determined. Fluoroquinolone prescribing patterns in children and adolescents were determined, with specific reference to the comparison between the prescribed daily and recommended daily dosages in the different age groups and by prescribers’ specialties. / MPharm (Pharmacy Practice), North-West University, Potchefstroom Campus, 2015

The healthcare strike action that rocked South Africa in 2007 and 2010 highlighted the trend of professional nurses towards exercising their rights as employees to embark on strike actions, often also in solidarity with other categories of employees. This study aimed to highlight the problem brought about by the lack of proactive strategies to maintain a balance between human and professional rights and responsibilities of nurses within the legal framework of South Africa. The theoretical grounding of the study included both organisational change models and transformational leadership models. A descriptive and analytic design was followed, using both qualitative and quantitative non-probability sampling approaches to meet the research objectives of determining factors for nurses‘ involvement in strikes and their impact. Eighty professional nurses were included as the total sample of the study with 53 that did not participate in strike action and 27 that participated in strike action. A sample of eleven nurse managers was also included in the study to determine their views on strikes by nurses and their understanding of the changing work environment. To determine the overall impact of the nurses‘ strike, 40 healthcare consumers were included. The sample was selected from four provinces: Eastern Cape, KwaZulu-Natal; Western Cape and Gauteng. The study was limited to professional nurses, nurse managers within the public-health sector and healthcare consumers using public-health facilities. The findings and the relevant literature referred to in this study indicate that though there are different reasons for strike action in the public-health sector by area or by country, remuneration is undoubtedly the most mentioned reason. Important to note is that salary per se is not the most critical actor but it is a tangible measure of the value that the employer places on people. In the absence of other incentives in the nursing environment, it becomes the focal point. However, addressing salary issues alone will not prevent strike action in the public-health sector / Health Studies / D. Litt. et Phil. (Health Studies)

The purpose of this study was to examine the extent to which human resources capacity of the Ministry of Health and Social Services (MoHSS), Namibia, influences health care services delivery to the Namibian population. A qualitative research model using exploratory and descriptive study designs was adopted. Data were collected through semi-structured interviews with 46 health workers from two referral hospitals and two directorates in Windhoek District. The study found that there is severe staff shortage in the MoHSS, which has resulted in high workload and poor health care. Health worker migration, new services and programmes, emerging diseases, and population growth were reported to have contributed to staff shortage and high workload in the MoHSS. Study findings suggested a need to create more posts to accommodate emerging needs, and to introduce an effective retention strategy to attract and retain health professionals with scarce skills, and those working under difficult conditions. / Public Administration & Management / M. Tech. (Public Management)

Sous l’effet d’une concurrence de plus en plus forte et d’un nouveau système de tarification, les cliniques privées de court séjour françaises sont confrontées à des contraintes économiques de plus en plus nombreuses auxquelles elles tentent de s’adapter. Cette recherche a pour objet d’identifier quels sont les déterminants organisationnels et stratégiques de la performance financière des cliniques privées. Une revue de littérature française et étrangère conduite sur la performance des établissements de santé a révélé la présence de nombreux déterminants de la performance financière. Pour identifier les facteurs influençant celle des cliniques privées, une étude statistique a été réalisée sur la totalité des cliniques privées françaises de court séjour dont les données sont exploitables, soit 463 établissements. Les résultats des statistiques montrent que la performance financière des cliniques privées, mesurée par un score financier et par les ratios financiers le composant, subit l’impact de variables que les directeurs d’établissements peuvent influencer à moyen et à long terme. Le volume et la productivité de la masse salariale employée par les établissements, le volume d’activité, la présence d’un projet stratégique bien défini et dont la mise en œuvre est effective, ainsi que la qualité des soins, celle-ci étant mesurée par les résultats des cliniques privées sur les différentes démarches d’amélioration de la qualité des soins, sont des facteurs qui présentent un fort impact sur la performance financière. / Private short-stay clinics are confronted with increasing economic constraints, to which they are trying to adapt, due to stronger competition and a new system of pricing. This research identifies which are the organizational determinents and financial performance strategies of private clinics. A review of French and foreign literature pertaining to the performance of these health establishments revealed the presence of numerous determinents of the financial performance. To identify the factors influencing the private clinics, a statistical study was performed on 463 French short-term clinics, where the relevent data was available. The results of these statistics indicated that the financial performance of these clinics, as measured by financial scores and ratios, underwent an influential impact in the short and long term. The productivity of the paid employees, the volume of activity, the presence of a well-defined and effective strategic project, so that the quality of the care given, as measured by the results of these clinics on different steps towards improvement on the quality of care, are the factors which presented a strong impact on the financial performance.