Indicadores para Monitoreo de Sistemas de Atencion de la Salud

By Dra Laura Cartuccia on febrero 7, 2009

Indicadores para Monitoreo de Sistemas de Atencion de la Salud
Dr. Camilo Marracino, Dr. Juan P. Abadie, Dr. Miguel Vera Figueroa

Antecedentes
A partir de distintas experiencias de evaluación, surgió la necesidad de desarrollar un estudio sobre indicadores para el monitoreo de sistemas organizados por entidades financiadoras de coberturas médicas: Mutuales, obras sociales, seguros privados; o de redes de efectores de
atención (Marracino, C y col., 1998).

El término monitoreo se trata de un neologismo procedente de la lengua inglesa cuyo empleo en el campo de la evaluación de la calidad fue descripto en diversos trabajos, principalmente del Prof. Donabedian (Donabedian, A., 1988)[1].

El objeto de este documento es mostrar la aplicación del monitoreo como herramienta de gestión en los sistemas de salud.

Nos referiremos al monitoreo de sistemas, encarado desde el ente financiero de coberturas o redes de servicios, para poblaciones determinadas. No se incluye el monitoreo de efectores propios o prestadores institucionales que requieren un análisis independiente (Paganini J.M. y Novaes. OMS-OPS 1992).

amedica_38 indicadores para monitoreo de sistemas de atencion de la salud

Espero a todos los seguidores de MedicalAudit les sea de su total satisfaccion.

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Auditoria Posterior o de facturacion – Tutorial

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Auditoria Posterior o Auditoria de Facturación: “Comprende la investigacion analítica del total de los componentes de la facturación de cada prestador y de la documentación de apoyo avalatoria de las prestaciones brindadas, en base a los contratos vinculantes”. Misión: “Mejorar la eficiencia y la calidad global de la atención médica. Contribuir a incrementar su rendimiento”.

Calidad Aprobada »

Auditoria de Alta Complejidad – Tutorial

septiembre 30, 2009

El paciente confía en el médico respecto a la calidad y no está en condiciones de juzgar la necesidad y calidad antes, ni emitir juicio después. “Decide quien no gasta, y gasta quien no decide ” El creciente costo global de la atención médica, debe resolver la cobertura de modo eficiente, seguro y equitativo. Desafío [...]

Calidad Aprobada »

Auditoria en Terreno – Tutorial

septiembre 30, 2009

La auditoria médica puede efectuarse mediante un: a) Control anticipado por medio de la autorización previa y reglada por normas b) Control concurrente es la auditoria en Terreno. Se realiza verificando especialmente la situación del paciente en internación durante la asistencia médica. c) Control a posteriori es auditoria de facturación, compartida.

Calidad Aprobada »

Auditoria Compartida – Tutorial

septiembre 30, 2009

Concepto y Finalidad – Lugar y desarrollo – Conclusión y acuerdo – Acta de Auditoria Conjunta – Motivos de débitos más frecuentes – Sin criterio de internación – Demora en pase a piso – Sin criterio de UTI – Alta Postergada

seguros de salud »

Seguros de Salud

abril 1, 2008

Governing Mandatory Health Insurance: Learning from Experience Edited by William D. Savedoff and Pablo Gottret March 26, 2007 – Los Seguros de Salud, su Gobernabilidad, una traduccion muy buena Introduccion ver tema Chapter 1 (Savedoff) – Concepts, Framework and Cases – ver tema Chapter 2 (Hansl, Rahola, and Gottret) – Measuring [...]