Challenges for work in healthcare: comparative study on University Hospitals in Algeria, Brazil and France.

Abstract:

:This study compares the challenges for work in emergency services of publicuniversity hospitals in Algeria, Brazil and France. The description and analysis are organized in three topics: context and trajectory of the health systems; hospitals and emergency services; and the challenges that are faced. The research carried out interviews, surveys, observation and "groupes de rencontre du travail" / GRT. The data analysis was done using participatory appraisal techniques associated to triangulation of sources and data. The main challenges found were: workforce deficit; lack of hospitals beds in inpatient units; deficit of infrastructure and materials; excess of "chronophagic activities"; generational transition; and violence by patients and families.Despite their particularities, the countries coincide regarding the challenges. Measures to rationalize and restrain spending have a greater impact on Algeria and Brazil due to the low level of public funding, but they also occur in France. The hospital management cannot be dissociated from healthcare system planningconsidering the increasing pressures of the demographic and epidemiological transition. In medium term, measures that may mitigate "chronophagic activities", materials deficit and the violence should be considered to improve work in emergencies. :O estudo compara os desafios no trabalho em serviços de emergência de hospitais universitários públicos na Argélia, Brasil e França. A descrição e a análise estão organizadas em três eixos: contexto e trajetória dos sistemas, hospitais e serviços de emergência, e os desafios enfrentados. Nos serviços foram feitas entrevistas, questionários, observação e “groupes de rencontre du travail”/GRT. Para o processo analítico utilizou-se técnicas do “participatory appraisal” complementadas com triangulação de fontes e dados. Os principais desafios referidos foram: déficit da força de trabalho; falta de leitos nos serviços de internação; déficit de infraestrutura e materiais; excesso de atividades cronofágicas; transição geracional; violência pelos usuários e familiares. Medidas de racionalização e contenção de gastos repercutem de modo mais intenso na Argélia e no Brasil onde há um baixo patamar de financiamento público. Nota-se que a gestão hospitalar não pode estar dissociada do planejamento da rede de atenção, tendo em vista as crescentes pressões do complexo produtivo, da transição demográfica e epidemiológica. A médio prazo, medidas que possam atenuar atividades cronofágicas, o deficit de materiais e a violência devem ser consideradas na melhoria do trabalho em emergências.

journal_name

Cien Saude Colet

journal_title

Ciencia & saude coletiva

authors

Scherer MDDA,Conill EM,Jean R,Taleb A,Gelbcke FL,Pires DEP,Joazeiro EMG

doi

10.1590/1413-81232018237.08762018

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

2265-2276

issue

7

eissn

1413-8123

issn

1678-4561

pii

S1413-81232018000702265

journal_volume

23

pub_type

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