Thesis (MBA (Business Management))--Stellenbosch University, 2008. / ENGLISH ABSTRACT: Recent years have been witness to the co-existence of incredible advances in human well-being and healthcare development on the one hand and extreme deprivation and a significant drop in numerous health indicators on the other. Central among this paradox lies the key to accessible, comprehensive and dedicated healthcare - the health workforce and the numerous factors impacting on health professionals and health professional data. Key to health care human resource planning is a comprehensive understanding of the environment and demands that health professionals are faced with. This must be supported by knowledge of the profile of health professionals in a specific country and should lead to detailed health resource planning, based on benchmarks and analytical interpretation of the factors that both determine and influence the number of health professionals. This research report provides an abbreviated background to the local and international health sectors, profiles the current number and distribution of medical practitioners and selected medical specialists in the country and internationally, identifies the key factors for consideration in projecting the number of medical practitioners and medical specialists required for South Africa and proposes a framework for taking the process forward. The research showed that, while there are positive aspects to the South African health professional environment, the country faces dire regional disparities and does not compare favourably to many of its international peers in terms of health professional resources. The key aspects that influence health human resources were identified and it became clear that sustainable and comprehensive health resource planning is not a mere matter of ratios, but is indeed dependent on a number of critical success factors. It is critical that health human resource planning in South Africa requires urgent and comprehensive attention. Failure to address this urgently will result in a health care system continuing to struggle to meet the health care needs of the population. A structured approach is possible, but requires dedication and careful planning. / AFRIKAANSE OPSOMMING: Die laaste paar jare is gekenmerk deur die kontras van indrukwekkende vooruitgang in lewenskwaliteit en gesondheidsorg aan die een kant en ekstreme tekortkominge en die verswakking van gesondheidstatistieke aan die ander. Sentraal tot hierdie paradoks is die sleutel tot toeganklike, omvattende en toegewyde gesondheidsorg - die gesondheidswerkers en die vele faktore wat gesondheidswerkers en - data beinvloed. Die kern van gesondheidsorg menslike hulpbronne beplanning is 'n omvattende begrip van die omgewing en vereistes waaraan gesondheidswerkers blootgestel word. Dit moet ondersteun word deur in diepte kennis van die gesondheidswerker profiel binne in 'n spesifieke land en behoort te lei tot gedetaileerde gesondheidsorg menslike hulpbronne beplanning, na aanleiding van toepaslike verwysingsraamwerke en 'n analitiese interpretasie van die faktore wat die aantal gesondheidswerkers beide bepaal en noodwendig beinvloed. Hierdie navorsingsverslag verskaf 'n sinoptiese agtergrondskets van die nasionale en internasionale gesondheidsektore, gevolg deur die profiel (getalle en verspreiding) van die algemene praktisyns en geselekteerde mediese spesialiste, beide in Suid Afrika en internasionaal. Dit identifiseer die belangrikste faktore vir oorweging in die projeksie van die aantal algmene praktisyns en mediese spesialiste benodig en sluit af met 'n voorgestelde raamwerk vir voortgesette omvattende beplanning. Die navorsing het getoon dat, alhoewel die Suid Afrikaanse gesondheidswerker omgewing deur positiewe aspekte gekenmerk word, die land steeds onderworpe is aan daadwerklike streeks ongelykhede en boonop nie besonder positief vertoon teenoor ander soortgelyke lande nie. Die kern kwessies wat gesondheidswerkers beinvloed is geidentifiseer en dit is duidelik dat onderhoudende en omvattende gesondheidsorg beplanning nie bloot die toepassing van ratios is nie, maar dat dit onderhewig is aan 'n groot verskeidenheid kritiese sukses faktore. Dit is van kritiese belang dat gesondheid menslike hulpbronne beplanning in SA daadwerklike aandag geniet. Die nalaat van hierdie verantwoordelikheid, sal lei tot 'n gesondheidsisteem wat nie in staat is om aan die behoeftes van die land te voldoen nie. 'n Gestruktureerde benadering is moontlik, maar verdien toewyding en beplanning.

Made available in DSpace on 2015-05-14T12:47:11Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1549919 bytes, checksum: c6a9da6784f10e81487fa61a840b2f2b (MD5) Previous issue date: 2012-02-23 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The aging of the population is occurring at an unprecedented level, so it became the subject of discussions in various sectors of society. The process of aging of the population of João Pessoa, the state capital of Paraiba, challenges the government and its public health policies, to attend the needs for improvement of hospital services, because in the near future there will be more elderly than that hospital structures to meet the standards established by Ordinance No. 249/SAS/MS, 2002 that addresses the standards for registration of Reference Centers for the Elderly Health Care. Among the physicians, the option by specialties with a focus on elderly, such as geriatrics is not accompanying the growth curve of the elderly population. To analyze the situation in the city of Joao Pessoa, it was held an exploratory-descriptive and inferential study, developed from quantitative and qualitative approaches to deepening of the phenomenon in focus. Data related to hospitals, were collected through a questionnaire with closed questions in the healthcare institutions that agreed to participate of this research and the Regional Council of Medicine of Paraiba (CRM / PB) provided information on the specialties and number of medical professionals in office. The data related to hospitals were analyzed and then it was checked the similarities and differences of these institutions compared to that proposed Ordinance No. 249/SAS/MS of 2002 in order to classify them as Reference Centers for the Elderly Health Care. In relation to the data of the doctors, they were analyzed statistically using the methodologies of Time Series and Regression Analysis. The results showed that the city of João Pessoa, in 2011, did not have hospitals that met the Ordinance of the Ministry of Health regarding the standards for registration of Centers of Reference on Health Care of the Elderly. In relation to medical professionals, it was observed that, the number exceeds the ratio recommended by the World Health Organization. However, the number of physicians in the most demand specialties by the elderly has an unfavorable trend in the relation doctor elderly, and the specialty of geriatrics present the major deficiency without a perspective of a better situation in the short time. / O envelhecimento da população brasileira está ocorrendo em um nível sem precedentes, por isso tornou-se tema de discussões em diversos setores da sociedade. O processo de envelhecimento da população de João Pessoa, capital do Estado da Paraíba, desafia o governo e suas políticas públicas de saúde, a atender às necessidades de aperfeiçoamento dos serviços hospitalares, pois em um futuro próximo haverá mais idosos do que estruturas hospitalares que atendam aos padrões estabelecidos na Portaria nº249/SAS/MS, de 2002, que trata das normas para cadastramento de Centros de Referência em Atenção à Saúde do Idoso. Entre os médicos a opção pelas especialidades com foco no idoso, como a Geriatria, não está acompanhado a curva de crescimento da população idosa. Para analisar a situação na cidade de João Pessoa, realizou-se um estudo do tipo exploratório-descritivo e inferencial, desenvolvido a partir de abordagens quanti-qualitativas para aprofundamento do fenômeno em foco. As informações, referentes aos hospitais, foram coletadas por meio de um questionário com perguntas fechadas junto às instituições hospitalares que concordaram em participar da pesquisa e o Conselho Regional de Medicina da Paraíba (CRM/PB) forneceu as informações relativas às especialidades e número de profissionais médicos em exercício. Os dados referentes aos hospitais foram analisados, e então, verificadas as aproximações e distanciamentos destas instituições em comparação ao que propõe a Portaria nº249/SAS/MS, de 2002 de modo a classificá-los como Centros de Referência em Atenção à Saúde do Idoso. Quanto aos dados dos médicos, estes foram analisados estatisticamente por meio das metodologias de Séries Temporais e Análise de Regressão. Os resultados demonstraram que a cidade de João Pessoa, no ano de 2011, não possuía hospitais que atendessem a Portaria do Ministério da Saúde quanto às normas para cadastramento de Centros de Referência em Atenção à Saúde do Idoso. Em relação aos profissionais médicos, observou-se que na cidade, o número excede a relação recomendada pela Organização Mundial da Saúde. No entanto, o número de médicos nas especialidades mais procuradas pelos idosos apresenta uma tendência desfavorável de relação médico para idoso, sendo a especialidade de Geriatria a grande deficiência atual e sem perspectivas de uma situação melhor a curto prazo.

A quantitative survey was conducted in two Canberra hospitals that aimed at ascertaining the impact of information provided by medical libraries on clinical decision making. Specifically, this research study investigated clinical, cognitive and quality value of information provided by the medical librarians to the management of patients and doctors' ability to handle clinical cases differently as a result of such information. Furthermore, the relative value of information received from the library was assessed by comparing it to the value of information received from other sources in dealing with clinical problems. The research involved medical specialists and registrars affiliated with these hospitals. Doctors were asked to select any clinical situation which they frequently or currently encounter and for which further information would be useful to them. Once their information requests were identified, they were then asked to present such requests to the hospital library. In order to avoid any special treatment, participants were urged not to identify themselves to the library staff as partaking in the study. It was important that participants did not search for the information themselves. The doctors were asked to evaluate the material provided by the library in relation to clinical care and, thereafter, complete a short questionnaire. This research took place between October 1994 and March 1995. The questionnaires were sent to 288 doctors. This represented the total population of specialists and registrars affiliated with both hospitals at the time of the study. Analysis of the results is based on a 34% useable response rate. Medical specialists were by far the higher number of respondents (70%) as compared with registrars (30%). Eighty-one per cent of the doctors said that the information provided by the library refreshed their memory and 82% said that it would contribute to better quality of medical care. Eighty-six per cent indicated that some of this information was new to them and 99% said that the information provided was up to date. Ninety-four per cent said that the information provided by the library was of clinical value to them. As the result of the information provided by the library 75% of respondents would either definitely or probably handle some aspects of the clinical situation differently than they would have done it otherwise. The level of importance of the change for the optimal care of patients was assessed with 54% regarding it as important, 42% as moderately important. Specifically, as the result of the information provided, the doctors were able to change the following: diagnosis 10%, choice of lab tests 20%, choice of other diagnostic investigations 24%, choice of drugs 27%, choice of other management 58%, reduce length of hospitalisation 10%, post-operative care of patients 25%, advice given to patients 47%. On the basis of the received information the doctors were able to avoid the following: hospitalisation of patients 11%, risk of hospital acquired infection 8%, surgical intervention 19%, tests or other investigation 23%, additional out-patient visits 12%. Discussions with colleagues were reported to be most valued sources of information for the purpose of clinical decisions (59%), followed by diagnostic imaging (49%), librarian (45%), lab tests (42%) and patients' medical records (30%). The librarian's role as contributing to the process of clinical decisions was rated highly with 88% ranking it as either important or moderately important. The results of significance p test statistic performed at 0.05 significance level suggested that, for this study, there was a significant relationship between the frequency of library use and doctors' ability to change the choice of laboratory tests, diagnostic investigations, and the choice of prescribed drugs. The results of this research study demonstrate that medical librarians can positively contribute to clinical management of patients by providing timely and accurate information. Further research is recommended in order to determine the impact of the whole range of library services on health care outcomes.