Department of Public Health and Pediatric Science, University of Turin, Italy.
Institute of Public Health - Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy.
Ann Ig. 2021 Mar-Apr;33(2):141-151. doi: 10.7416/ai.2021.2420.
The Italian National Health Service (Servizio Sanitario Nazionale, SSN) is facing relevant challenges due to decreased financing and increased healthcare costs (1). In this complex framework, most of the Italian Medical Doctors, after obtaining their Specialization degree in Public Health, develop their careers in organizational and managerial roles in public and private health organizations, i.e. hospitals, local health units, health districts or national and international agencies (1, 2). Public health technical competencies, in particular policy and management, are of crucial importance to develop, run and support healthcare services. However, some gaps exist between current public health needs and the extent to which Public Health Residents are trained in the above fields (3, 4).
The study is a cross-sectional cognitive survey carried out through a questionnaire sent by e-mail to Residents and Directors of the Italian Schools of Public Health, from May to November 2018. The questionnaire was sent only to the accredited Schools which had all four years of the course running.
The questionnaire investigated 35 managerial topics divided into 4 macro-areas. It was sent to both Directors of the SPHs and the Residents of 32 Schools. The latter were asked to provide a single collective answer per School. Respondents could assign a score from 1 (topic not addressed at all) to 4 (topic addressed extensively and linked to other related topics) to each item, also taking into account the skills acquired through internships, seminars, etc. that involved all the Residents.
Answers were received from the Residents of 30/32 (93.8%) SPHs and from 15/32 (46.9%) of the Directors. Scores given by the Directors were higher than the ones of the Residents for every topic, and for 17 out of 35 items (48.6%) a statistically significant difference has been obtained. In the overall score of 3 macro-areas out of 4 (General issues, Managerial tools and macro-organisational Models) there are statistically significant differences. In Soft skills macro-area, the single scores of all topics are generally low for both Directors and Residents.
The study shows that the Residents declare a strong need for training improvement in the field pf healthcare organization and management: the median score is equal to or greater than 3 (topic addressed extensively) in only a few answers. The comparison between Directors' and Residents' scores highlights a different perception of the training offered in these areas. The study results could be pivotal for the improvement of the managerial skills provided to the Residents in Public Health of the Country.
由于资金减少和医疗成本增加，意大利国家卫生服务体系（Servizio Sanitario Nazionale，SSN）面临着重大挑战。在这个复杂的框架下，大多数意大利医生在获得公共卫生专业学位后，会在公共和私营卫生组织（如医院、地方卫生单位、卫生区或国家和国际机构）中从事组织和管理工作。公共卫生技术能力，特别是政策和管理能力，对于发展、运行和支持医疗保健服务至关重要。然而，当前公共卫生需求与公共卫生住院医师在上述领域的培训程度之间存在一些差距。
本研究是一项横断面认知调查，于 2018 年 5 月至 11 月通过电子邮件向意大利公共卫生学校的住院医师和主任发送问卷进行。该问卷仅发送给运行全部四年课程的认可学校。
问卷调查了 35 个管理主题，分为 4 个宏观领域。它被发送给 SPH 的主任和 32 所学校的住院医师。后者被要求为每所学校提供一个单一的集体答案。受访者可以对每个项目进行 1（根本没有涉及）到 4（广泛涉及并与其他相关主题相关联）的评分，同时还考虑了通过实习、研讨会等涉及所有住院医师的技能。
32 所 SPH 中有 30 所（93.8%）的住院医师和 15 所（46.9%）主任回复了问卷。主任给出的分数高于住院医师的分数，在 35 个项目中的 17 个项目（48.6%）中存在统计学显著差异。在 4 个宏观领域中的 3 个（一般问题、管理工具和宏观组织模型）的总体得分存在统计学差异。在软技能宏观领域，主任和住院医师对所有主题的单项评分普遍较低。
研究表明，住院医师表示强烈需要改善医疗组织和管理领域的培训：在只有少数回答中，中位数分数等于或大于 3（广泛涉及）。主任和住院医师分数的比较突出了对这些领域培训的不同看法。研究结果可能对提高意大利公共卫生领域住院医师的管理技能至关重要。
