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[加泰罗尼亚职业健康服务中医务人员的需求与障碍]

[Needs and barriers of medical personnel in Catalonian occupational health services].

作者信息

Vargas Leguás Hernán, Porcel Pérez Eva, Cortès Franch Imma

机构信息

Unitat de Salut Laboral de Barcelona. Servei de Salut i Treball. Agència de Salut Pública de Barcelona, Barcelona, Spain.

Xarxa de Unitats de Salut Laboral de Cataluña. Agència de Salut Pública de Cataluña, Barcelona, Spain.

出版信息

Arch Prev Riesgos Labor. 2021 Apr 15;24(2):46-66. doi: 10.12961/aprl.2021.24.02.05.

Abstract

OBJECTIVE

to identify the difficulties and needs of medical professionals in occupational health services in Catalonia with respect to carrying out their functions, as prescribed by law.

METHODS

Delphi study in three rounds. The selection of participants was carried out sepa - rately for in-house versus outsourced occupational health services. The first round included two open-ended questions: What difficulties do you encounter when performing your duties in your occupational health service? And, what are your needs in terms of being able to per - form your duties in your occupational health service? In the second and third rounds, partic - ipants ranked the categories identified in the first round according to their importance and relevance. We calculated an inter-rater agreement index (ICC) and an "index of concern (IP)".

RESULTS

Among in-house occupational health services, the most highly ranked difficulties were case management of workers with limitations and the low quality of medical sur - veillance systems. Among outsourced occupational health services, the most notable dif - ficulties were the lack of communication with other organizations and the prioritization of economic and profitability criteria associated with the high work volume. For both types of services, there was a clear need to establish communication channels with other institu - tions or organizations such as primary care, mutual insurance companies, public medical evaluation units and public occupational health units.

CONCLUSIONS

The different type of occupational health services reflects important differ - ences in the types of difficulties encountered, but not in needs, where there are more points in common.

摘要

目的

确定加泰罗尼亚地区职业健康服务领域的医学专业人员在依法履行职能方面所面临的困难和需求。

方法

三轮德尔菲研究。针对内部与外包职业健康服务分别进行参与者的选择。第一轮包括两个开放式问题:你在职业健康服务中履行职责时遇到哪些困难?以及,就能够在职业健康服务中履行职责而言,你的需求是什么?在第二轮和第三轮中,参与者根据重要性和相关性对第一轮确定的类别进行排序。我们计算了评分者间一致性指数(ICC)和“关注指数(IP)”。

结果

在内部职业健康服务中,排名最高的困难是对有身体限制工人的病例管理以及医疗监测系统质量低下。在外包职业健康服务中,最显著的困难是与其他组织缺乏沟通以及与高工作量相关的经济和盈利标准的优先级。对于这两种类型的服务而言,都明显需要与其他机构或组织建立沟通渠道,如初级保健机构、互助保险公司、公共医疗评估单位和公共职业健康单位。

结论

不同类型的职业健康服务反映出在遇到的困难类型上存在重要差异,但在需求方面不存在差异,需求方面有更多共同点。

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