La presente tesis tiene por finalidad identificar los obstáculos excesivos que limitan la importación de dispositivos médicos en la subpartida nacional 90.18.39.00.10 con descripción comercial “los demás conjuntos para hemodiálisis, transfusiones o similares” en el periodo 2019. Los productos comprendidos en la subpartida mencionada están dirigidos al tratamiento de la insuficiencia renal dentro del sistema de salud peruano. En el primer capítulo, se detalla el marco teórico, términos relevantes, los antecedentes de investigación nacionales e internacionales, así como el sustento legal en el cual está enmarcada la presente investigación. En el segundo capítulo, se detalla el plan de investigación, lo cual abarca la realidad problemática, los objetivos e hipótesis principales y específicos. Asimismo, contiene también la justificación de la investigación teórica, práctica y metodológica. El tercer capítulo, detalla la metodología de trabajo. Es decir, el enfoque aplicado, siendo en esta ocasión del tipo cualitativo explicativo. Adicionalmente, se menciona las limitaciones, la población, la muestra, la recolección de datos y los aspectos éticos. En el cuarto capítulo, se lleva a cabo el desarrollo y análisis de resultados. En ese sentido, se detalla la información obtenida mediante la técnica de entrevista de profundidad, manejando un programa de atlas TI. Para el presente documento, se ha elaborado una muestra de las empresas representativas y se ha entrevistado al responsable de comercio exterior y al personal químico farmacéutico. Finalmente, en el quinto, sexto y séptimo capítulo, se presentan la discusión, consideraciones finales y recomendaciones. / The purpose of this thesis is to identify the excessive obstacles that limit the importation of medical devices in the national subheading 90.18.39.00.10 with a commercial description "the other sets for hemodialysis, transfusions or similar" in the period 2019. The products included in the mentioned subheading are aimed at the treatment of kidney failure within the Peruvian health system. In the first chapter, the theoretical framework, relevant terms, the national and international research background are detailed, as well as the legal basis in which this research is framed. In the second chapter, the research plan is detailed, which includes the problematic reality, the main and specific objectives and hypotheses. Likewise, it also contains the justification of the theoretical, practical and methodological research. The third chapter details the work methodology. That is to say, the applied approach, this time being of the qualitative explanatory type. Additionally, the limitations, the population, the sample, the data collection and the ethical aspects are mentioned. In the fourth chapter, the development and analysis of results is carried out. In this sense, the information obtained through the in-depth interview technique is detailed, using an Atlas TI program. For this document, a sample of representative companies has been prepared and the person in charge of foreign trade and the chemical-pharmaceutical staff have been interviewed. Finally, in the fifth, sixth and seventh chapters, the discussion, final considerations and recommendations are presented. / Tesis

Actualmente, el rubro de salud ha sufrido un golpe en todo el mundo debido a la pandemia que inició en el 2020, a partir de esta se ha puesto al descubierto muchas de las debilidades estructurales que afronta el Perú en este sector. A pesar de esto, la pandemia ha resultado ser una oportunidad de negocio y crecimiento para muchas personas y negocios. Por otro lado, la tecnología ha tenido un potencial desarrollo gracias a algunas medidas sanitarias que se tomaron como la cuarentena en donde se empleó lo que es el teletrabajo, clases remotas dentro de estos se encuentran las citas médicas virtuales.  Dado este contexto, es conveniente señalar nuestro objetivo con este proyecto, atender a las necesidades del mercado de consultas virtuales médicas. Nuestra propuesta es el desarrollo y lanzamiento de un aplicativo móvil el cual contará con tres especialidades el primer año las cuales son: medicina general, medicina interna y pediatría, ya que estas presentan un crecimiento positivo. La atención estará dirigida por médicos de gran experiencia y trayectoria. Además de esto, se podrá encontrar foros y comentarios sobre cada uno de los médicos, así como una interacción directa vía chat dentro del aplicativo. Se calcula que el tamaño de mercado para Salud App es de 342,000 habitantes, lo que representa en soles S/32,661,000 anualmente. En conclusión, se estima que durante los tres años del proyecto se alcanzarán ventas por S/. 1,903,587. Se tendrá un valor financiero de – 206,819 y un retorno de la inversión que no se llega a dar en los tres años a analizar / Currently, the health industry is suffering a blow around the world due to the pandemic that began in 2020. Since then, many structural weaknesses have been exposed in this industry in Peru. Despite this, the pandemic became a business and growth opportunity for many people and enterprises, along with the adaptation of technology in everyday life. Technology has had a potential development thanks to some sanitary measures applied during that period. For example, quarantine meant the beginning of online working and jobs, online classes, and online doctor appointments. Given this context, it is appropriate to point out our objective with this project, to meet the needs of the virtual medical consultation market. Our proposal is the development and launch of a mobile application which will have three specialties in the first year, which are: general medicine, internal medicine and pediatrics, since these show positive growth. The attention will be directed by doctors with great experience and trajectory. In addition to this, you can find forums and comments on each of the doctors, as well as direct interaction via chat within the application. The market size for Salud App is estimated to be 342,000 inhabitants, which represents S/32,661,000 soles annually. In conclusion, it is estimated that during the three years of the project, sales of S/. 1,903,587. There will be a financial value of – 206,819 and a return on investment that is not achieved in the three years to be analyzed. / Trabajo de investigación

En el presente trabajo se abordará el análisis conceptual de las distintas modalidades de inversión privada reguladas en el Perú. Precisamente, la que será materia de análisis es la referida a las Asociaciones Público-Privadas, las cuales cuentan con una regulación especial que data de hace más de diez años, contando sus distintas modificaciones y derogatorias. Lo mencionado se realizará con miras a adentrarnos en la utilización de la modalidad de Asociaciones Público-Privadas en el sector salud. Para ello, se analizará la normativa correspondiente, así como las experiencias tomadas de proyectos ya ejecutados en el Perú, así como las obras emblemáticas en el extranjero. Finalmente, se propondrán ciertas mejoras, tomando posturas de autores que han estudiado a profundidad el tema, así como, se propondrá un especifico tipo de Asociación Público-Privada que beneficie al sector salud y, en consecuencia, a los usuarios que utilizan día a día el sistema de salud público en el Perú. / This paper will address the conceptual analysis of the different modalities of regulated private investment in Peru. Precisely, the one that will be analyzed is the referred to Public-Private Associations, which have a special regulation that dates from more than ten years ago, counting their different modifications and derogations. The analysis will be carried out with a view to exploring the use of Public-Private Associations in the health sector. For this purpose, the corresponding regulations will be analyzed, as well as the experiences taken from projects already executed in Peru, as well as emblematic works abroad. Finally, certain improvements will be proposed, taking positions of authors who have studied the subject in depth, as well as a specific type of Public-Private Association will be proposed to benefit the health sector and, consequently, the users who use the public health system in Peru on a daily basis. / Trabajo de investigación

En la actualidad, las empresas del sector salud soportan sus operaciones con procesos de negocio que les permiten alcanzar sus objetivos y aportan valor en la atención de sus clientes. Estos procesos son cada día más eficaces y eficientes gracias a la inversión que realizan las empresas en tecnologías para las actividades principales del negocio que les brindan una ventaja competitiva frente a otras del mismo rubro. El presente proyecto de tesis tiene como alcance el estudio de una entidad privada de salud; el análisis del problema del proceso de admisión de consulta externa; y el desarrollo de la propuesta de solución. Este proceso comprende actividades que inician con la identificación del paciente y generación de un número de atención, y finaliza cuando se realiza el pago y se da por concluida la atención. El problema actual es la demora en la identificación del paciente y el uso de más de cuatro sistemas diferentes. Debido a esto, se propone como solución el diseño de un sistema de reconocimiento facial e identificación de pacientes usando redes neuronales e integrado con los sistemas hospitalarios, con la finalidad de reducir los tiempos en la identificación de los pacientes y el número de actividades manuales del personal en varios sistemas. El documento de tesis comprende los capítulos de definición, desarrollo y gestión del proyecto, y en ellos se describen los procesos de negocio de la organización objetivo; se analiza el problema del proceso; y se desarrollan la propuesta de solución y el plan de gestión del proyecto. / Nowadays, companies in the healthcare sector manage their operations through business processes that allow them to reach their goals and provide an additional value when serving their customers. Day by day, such processes are getting more effective and efficient thanks to the investment made by technology companies in the main activities of their businesses. Thus, those processes provide them a competitive advantage over other companies in the sector. This research project encompasses the study of a private healthcare company, the analysis of the problematic regarding external consultation admission, and the development of a possible solution. This process includes activities that start with patient identification, the creation of a patient care number, and ends when the payment is submitted, and the service concludes. The current problem is that patient identification is time-consuming and that more than four different systems are being used. Therefore, the design of a facial recognition and patient identification system is introduced as a possible solution employing neural networks and integrating it into the hospital system. This proposal aims to reduce the time required to identify patients and decrease manual activities done by the personnel on various systems. This research project includes chapters on definitions, development, and project management. They include a description of the target organization’s business processes, as well as an analysis on the process problem, a development of a solution proposal, and a project management plan. / Tesis

No description available.

This study investigated the performance of health workers in the decentralised services in Uganda in order to develop a management framework that may be used to improve performance. The study followed a mixed research methodology and was descriptive. The survey design was used to collect quantitative data by means of a structured questionnaire. Qualitative data was collected using a semi-structured interview guide. The study population for the quantitative strand comprised 276 health workers including doctors, clinical officers, and professional nurses working in four districts: Kumi, Mbale, Sironko and Tororo. The health workers were selected using stratified random sampling. The population for qualitative strand was health services managers (N=21) from the same districts. The managers were selected purposively. Quantitative data was analysed using SPSS version 18.0, while qualitative data was coded and analysed manually. The findings revealed that the performance of health workers is generally affected by health systems and work environment related factors. The findings indicated that health workers are skilled, competent, and generally have positive attitudes and behaviours towards their clients. The study uncovered loop holes in performance management in the district health sectors. In most cases there is no target setting, no performance management planning, performance indicators are not clearly defined, and the schedules for performance measurement are not always followed. There is limited career progression and lack of functional performance feedback and rewarding mechanisms. Although health workers are committed, there is widespread political interference and nepotism in the district health sector management. Overall, the researcher is optimistic that if the proposed performance management framework is implemented, the performance of health workers might improve. / Health Studies / D. Litt. et Phil. (Health Studies)

Text in English / The aim of the research was to describe how Generation Y medical doctors working in the South African public health sector at a hospital in the Limpopo Province experienced a coaching intervention for burnout. Generally, there are limited empirically based coaching interventions for burnout, even for at-risk populations such as Generation Y medical doctors working in the South African public health sector. Burnout affects Generation Y medical doctors, the service they offer, private lives, and the recipients of their care. Most research focuses on identifying the risk factors for Generation Y medical doctors working in the debilitating South African public health sector, and rarely on potential intervention. This study offers findings from a coaching intervention that could be incorporated into a bigger burnout intervention strategy in the South African public health sector. This would involve all stakeholders at the different levels to ensure that burnout is combatted on a long-term basis. The study took a phenomenological approach using a collective case study method. The aim was to gather and analyse information to explore the experiences of a coaching intervention for burnout. The study was done in three phases, namely: Phase I – Pre-coaching intervention; Phase II – Coaching intervention; and Phase III – Post-coaching intervention. The study incorporated the Maslach Burnout Inventory to quantify the level of burnout before (Phase I) and after (Phase III) the coaching intervention. The findings emphasised certain structural issues, the impact that neglecting burnout has on medical doctors, including Generation Y medical doctors, and how burnout affects patient care. Certain recommendations were made for the public health sector, future research in the field of coaching psychology, and coaches/consultants working with burnout amongst Generation Y medical doctors. / Psychology / D. Phil. (Consulting Psychology)

This study investigated the performance of health workers in the decentralised services in Uganda in order to develop a management framework that may be used to improve performance. The study followed a mixed research methodology and was descriptive. The survey design was used to collect quantitative data by means of a structured questionnaire. Qualitative data was collected using a semi-structured interview guide. The study population for the quantitative strand comprised 276 health workers including doctors, clinical officers, and professional nurses working in four districts: Kumi, Mbale, Sironko and Tororo. The health workers were selected using stratified random sampling. The population for qualitative strand was health services managers (N=21) from the same districts. The managers were selected purposively. Quantitative data was analysed using SPSS version 18.0, while qualitative data was coded and analysed manually. The findings revealed that the performance of health workers is generally affected by health systems and work environment related factors. The findings indicated that health workers are skilled, competent, and generally have positive attitudes and behaviours towards their clients. The study uncovered loop holes in performance management in the district health sectors. In most cases there is no target setting, no performance management planning, performance indicators are not clearly defined, and the schedules for performance measurement are not always followed. There is limited career progression and lack of functional performance feedback and rewarding mechanisms. Although health workers are committed, there is widespread political interference and nepotism in the district health sector management. Overall, the researcher is optimistic that if the proposed performance management framework is implemented, the performance of health workers might improve. / Health Studies / D. Litt. et Phil. (Health Studies)

Submitted in fulfilment of the requirements of the degree of Doctor of Technology: Public Management, Durban University of Technology, 2017. / The world over, countries are burdened with existing and emerging diseases and while that affected all nations, sub-Saharan Africa carried the heaviest portion. This filtered to Zimbabwe where a myriad of health challenges are faced. Unavailability of medicines coupled with poor inventory management of these medicines has been prevalent. Insufficient financial resources and increasing cost of healthcare costs is one of the pressing matters. It is also important to note that these challenges are occurring at a time when government is realising the crucial role of procurement in addressing health challenges. Due to the extent, depth, breadth and nature of the health challenges and their criticality in establishing sustainable and affordable health system in Zimbabwe, a case study approach has been adopted where data from questionnaires, interviews, documents and observations were corroborated and triangulated in an effort to bring to the surface deep-seated procurement matters and how they are related to the challenges provided. Thus, in terms of the research findings, it was first revealed that the procurement legislative frameworks and processes are fragmented and not in one place resulting in multiple accountabilities. It was further shown that the framework is inappropriate in a healthcare set-up where issues of speed and flexibility in addressing requirements are paramount. It was also shown that procurement planning being a critical aspect is regrettably and detrimentally missing in procurements. In addition, the selection criteria as set out in the regulations and practiced by individual state health facilities indicated over-reliance on price and that being the case, key aspects such as quality and supply-lead time are missed and yet are very necessary in terms of evaluation among other factors. In the findings, the peripheral role of procurement staff with clinicians being also at the epicentre of purchasing decisions was presented. Perhaps related to that was the inadequacy of procurement skills and competences from the procurement personnel. Last on the findings, financing and the frequency of disbursement was unmatched with hospital requirements and thus resulting in unavailability of adequate medicines and equipment. / D

Dans l’ensemble des pays de l’Organisation de coopération et de développement économiques (OCDE), le secteur public de la santé fait face à un environnement complexe qui se caractérise par la rapidité des changements technologiques et scientifiques. Face à une demande accrue des citoyens pour des services fiables, accessibles et efficaces, les organisations publiques de santé se voient aussi contraintes par la rareté des ressources, notamment financières et budgétaires. Pour répondre à la mission publique qui leur est confiée, elles se tournent de plus en plus vers les outils et principes du management stratégique, dont la veille stratégique. Au Québec, la veille stratégique a fait son apparition dans le plan stratégique d’organisations publiques de santé dans le milieu des années 2000. Des initiatives de veille ont également vu le jour, comme en témoigne la Communauté de pratique de veille en santé et services sociaux créée en 2009. Notre thèse a pour but d’explorer ce qu’est la veille stratégique dans le secteur public de la santé au Québec. La recherche a pour objectifs de (1) décrire les caractéristiques de la veille telle qu’elle est implantée dans des organisations publiques de santé du Québec; (2) décrire les finalités de la veille dans les organisations publiques de santé du Québec : (a) décrire les types de soutien qu’apporte la veille à la stratégie des organisations publiques de santé du Québec; (b) décrire les types de soutien qu’apporte la veille à la prise de décision des gestionnaires publics de santé du Québec; (c) décrire, s’il y en a, les autres types de soutien qu’apporte la veille aux organisations publiques de santé du Québec; (3) identifier les caractéristiques d’une veille stratégique dans le secteur public de la santé. Au travers d’une étude de cas multiples, la recherche examine trois projets de veille (cas) autour de quatre composantes, soit le produit de veille, les acteurs de la veille, le processus de veille et les finalités de la veille. En tout, 5 veilleurs et 16 gestionnaires clients de la veille (11 cadres supérieurs et cinq cadres intermédiaires) ont été interrogés, en suivant les principes de la théorie ancrée. D’après nos résultats, une veille serait stratégique si elle est centrée sur les besoins informationnels des gestionnaires clients de la veille et selon l’utilisation que ces derniers font du produit de veille. Un produit de veille stratégique devrait être fortement personnalisé, dynamique et évolutif, concis et attrayant. De plus, il devrait reposer sur des critères de qualité de l’information et sur une analyse et une interprétation de l’information. Le fait d’intégrer un veilleur aux équipes de gestion pourrait contribuer à développer un tel produit de veille stratégique. Le processus de veille stratégique devrait comprendre des étapes d’évaluation / réévaluation des besoins informationnels, identification des sources d’information, traitement, analyse et interprétation de l’information, et diffusion et utilisation du produit de veille. Enfin, la veille stratégique poursuit des finalités de soutien à la prise de décision et de soutien à la planification stratégique. Ces soutiens ont été regroupés en utilités d’apprentissage, d’exploration, d’analyse, symbolique, de comparaison et stratégique. / In every Organisation for Economic Co-operation and Development (OECD) country, the public health sector is facing a complex environment characterized by rapid technological and scientific change. Public health organizations are experiencing increased demand from citizens for reliable, accessible, and efficient services, but are constrained by a shortage of resources — particularly financial and budgetary resources. To meet the public mission that has been entrusted to them, they are increasingly turning to the tools and principles of strategic management, including strategic intelligence. In Quebec, strategic intelligence appeared in the strategic plans of public health organizations in the mid-2000s. Intelligence initiatives have also emerged, as evidenced by the Communauté de pratique de veille en santé et services sociaux, which was established in 2009. The purpose of our thesis is to explore what strategic intelligence is in the public health sector in Quebec. The objectives of the research are (1) to describe the characteristics of strategic intelligence as implemented in public health organizations in Quebec; (2) to describe the purposes of strategic intelligence in public health organizations in Quebec: (a) describe the types of support that intelligence provides to the strategy of public health organizations in Quebec; (b) describe the types of support that intelligence provides to the decision-making process of public health managers in Quebec; (c) describe, if any, other types of support that intelligence provides to public health organizations in Quebec; (3) identify the characteristics of strategic intelligence in the public health sector. Through a multiple case study, the research examines three intelligence projects (cases) involving four components: the intelligence product, its actors, its process, and its goals. In total, five intelligence professionals and sixteen intelligence client managers (eleven senior executives and five middle managers) were interviewed, following the principles of grounded theory. According to our results, intelligence will be strategic if it is focused on the information needs of the intelligence client managers and their use of the intelligence product. A strategic intelligence product should be highly customized, dynamic, scalable, concise, and attractive. In addition, it should be based on information quality criteria and the analysis and interpretation of the information. Embedding intelligence professionals in management teams could contribute to the development of such a strategic intelligence product. The strategic intelligence process should include the following steps: assessment/reassessment of information needs, identification of information sources, information processing, analysis, and interpretation, and the dissemination and use of the intelligence product. Finally, strategic intelligence pursues the goals of supporting decision-making and strategic planning. This support is grouped into learning, explorative, analytical, symbolic, comparative, and strategic uses.