1000 resultados para Serveis


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In this paper we analyse some of the organisational aspects of the urban solid waste collection and, in particular, the privatization modality of contracting out. We start by discussing some of the theoretical aspects of contracting out. We then specify and estimate an explanatory model on a sample of municipalities that we surveyed. Our purpose is twofold: on the one hand, we identify the economic factors at work when deciding to contract out the service and, on the other hand, we analyse the role of ideological factors in choosing between the public production of the service or contracting it out. The results show a significant effect of the demand for waste collection on contracting out. There also appears to be a neighbouring effect as the municipalities close to other cities that contract out are also more prone to do so. Finally, the decisions to contract seem to have been motivated by pragmatic rather than ideological reasons.

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La literatura económica sobre los servicios municipales de residuos sólidos en España es muy escasa, aun cuando estos servicios han sido objeto d'intensas reformas organizativas y regulatorias. En esta investigación se estudia su estructura de costes con el objetivo de explicar la variabilidad entre los municipios de los costes soportados por el servicio. Se determina una función de costes y se estima de forma paramétrica. Los resultados del análisis empírico permiten estudiar la existencia de economías de escala con el output, y el efecto de algunos factores directamente asociados con el servicio como el grado de residuos selectivos, la frecuencia de recogida o la existencia de instalaciones de depósito en el municipio. Además, se analiza el impacto sobre los costes de otros factores como la densidad de población, los niveles salariales, la estacionalidad y la forma de producción, pública o privada.

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This paper analyses the behaviour of pharmaceutical companies that face the threat of having their drugs excluded from reimbursement and the markets characterised also by price caps. We conclude that price elasticity of demand and cost differentials cause the price discounts which drug firms offer to health care organisations. Additionally, we conclude that price cap regulations affect the time path of prices, resulting in higher prices for new products and lower prices for old products.

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One of the limitations of cross-country health expenditure analysis refers to the fact that the financing, the internal organization and political restraints of health care decision-making are country-specific and heterogeneous. Yet, a potential solution is to examine the influence of such effects in those countries that have undertaken decentralization processes. In such a setting, it is possible to examine potential expenditure spillovers across the geography of a country as well as the influence of the political ideology of regional incumbents on public health expenditure. This paper examines the determinants of public health expenditure within Spanish region-states (Autonomous Communities, ACs), most of them subject to similar financing structures although exhibiting significant heterogeneity as a result of the increasing decentralization, region-specific political factors along with different use of health care inputs, economic dimension and spatial interactions

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Improving public involvement in health system decision making stands as a primary goal in health systems reform. However, still limited evidence is found on how best to elicit preferences for health care programs. This paper examines a contingent choice technique to elicit preferences among health programs so called, willingness to assign (WTAS): Moreover, we elicited contingents rankings as well as the willingness to pay extra taxes for comparative purposes. We argue that WTAS reveals relative ( monetary-based) values of a set of competing public programmes under a hypothetical healthcare budget assessment. Experimental evidence is reported from a delibertive empirical study valuing ten health programmes in the context of the Catalan Health Services. Evidence from a our experimental study reveals that perferences are internally more consistent and slightly less affected by "preference reversals" as compared to values revealed from the willingness to pay (WTP) extra taxes approach. Consistent with prior studies, we find that the deliberative approach helped to avoid possible misunderstandings. Interestingly, although programmes promoting health received the higher relative valuation, those promoting other health benefits also ranked highly

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La aplicación de la encuesta Libqual+ como herramienta para medir la calidad de los servicios bibliotecarios, a partir de la percepción de los usuarios de los propios servicios. El caso práctico del CRAI de la Universidad de Barcelona.

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Selecció personal de 100 projectes de digitalització internacionals i locals actualment en funcionament. La tria s'ha fet seguint l'interès que poden tenir les obres incloses i en altres ocasions pels serveis, les eines i les aplicacions diferents que s'hi proposen. La major part dels recursos tenen com a objectiu oferir una còpia digital de llibres però també s'hi inclouen altres tipologies documentals: publicacions periòdiques, tesis, literatura grisa, fotografies, gravats, enregistraments sonors¿ Hi abunden els projectes fets per les biblioteques nacionals i universitàries, els projectes comercials més representatius i les col·leccions col·laboratives. Una tipologia a destacar és la de les plataformes que pretenen recuperar i difondre una cultura o una llengua. La llista inclou preferentment projectes de biblioteques digitals amb obres de domini públic, les obres de les quals es poden descarregar i imprimir; també hi són inclosos però materials de pagament. L'ordenació de la selecció està presentada alfabèticament.

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El flux de la informació científica segueix uns camins entre la producció del document original i la difusió d'aquesta informació, al final dels quals hi trobem els centres de documentació. Així doncs, un centre de documentació té com a objectiu principal la difusió de la informació, cosa que s'aconsegueix amb unes eines i uns serveis que s'ofereixen als usuaris (utilització d'obres de referència, consulta de revistes d'abstracts, connexió amb bases de dades, etc.). A més, un centre de documentació pot també recollir i tractar els documents originals (majoritàriament revistes) d'interès per al camp científic que tracta.

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El dret universal d’accés a la informació ha estat reconegut internacionalment com un dret al llarg del segle XX tant per institucions d’àmbit general com per associacions professionals de biblioteconomia i documentació. Tant les Nacions Unides (Declaración, 2004) com la UNESCO (UNESCO, 2002) i l’IFLA (IFLA. Secció de Biblioteques Públiques; UNESCO, 2002) han reconegut el dret de totes les persones, independentment de la raça, el sexe, les creences i la condició social, a rebre informacions i opinions per qualsevol mitjà d’expressió i a gaudir dels serveis i dels materials que la biblioteca pública, com a institució fonamentada en la igualtat d’accés,posa a l’abast de tots els ciutadans i les ciutadanes...

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El presente texto es la actualización y reescritura en español de Els serveis d’informació electrònica: què són i per a què serveixen, obra publicada en 1997 por Edicions de la UB. Aunque sólo han pasado cuatro años desde su publicación, se han tenido que revisar bastantes aspectos, pues el texto se centra en un ámbito en el que se han producido muchos cambios en poco tiempo. A simple vista, una de las modificaciones más perceptibles se refleja en el mismo título de la obra. Si en 1997 adoptamos el término información electrónica para referirnos al sector, actualmente está plenamente consolidada y es más pertinente la denominación información digital. Por otro lado, comparando ambos sumarios se echa en falta, en la nueva edición, la inclusión de algunas formas de distribución que en aquel entonces aún tenían algún peso, como el videotexto —que ya iniciaba, no obstante, su declive imparable hacia la desaparición— u otras, como el audiotexto y el teletexto, que, aunque son sistemas de distribución en uso, se han descartado del presente análisis por su importancia secundaria y por el bajo nivel de interactividad que permiten...

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L’estudi realitzat aborda i caracteritza des de l’enfocament de la resiliència com l’alumnat de procedència estrangera s’enfronta a una etapa d’alt risc d’abandonament escolar com és l’Educació Secundària Obligatòria (ESO) –especialment en el segon cicle– i el moment de transició acadèmica cap a la Postobligatòria (PO). En altres paraules, s’analitzen i valoren els mecanismes resilients desplegats per l’alumnat immigrant que donen llum sobre com aconseguir que processos, a priori, qualificats com a problemàtics o dificultosos per aquests grups degut a la seva situació de major vulnerabilitat esdevinguin una xarxa protectora que afavoreixi trajectòries d’èxit escolar. L’emmarcament conceptual des de la resiliència educativa, en general, ha centrat la seva atenció en la capacitat de l’individu per “compensar” certes limitacions amb altres habilitats. Tanmateix, la definició de resiliència a la qual ens hem aferrat té un caire més ecològic i culturalment sensible. És la definició proposada pel Resilience Research Centre (RRC) i encunyada pel seu co-director Michael Ungar: In the context of exposure to significant adversity, resilience is both the capacity of individuals to navigate their way to the psychological, social, cultural, and physical resources that sustain their well-being, and their capacity individually and collectively to negotiate for these resources to be provided in culturally meaningful ways (Ungar, 2012). Entesa d’aquesta manera, la resiliència és un constructe social que identifica els processos i resultats relacionats amb allò que la gent conceptualitza com a “benestar”. Així, es més probable que la resiliència aparegui quan es proporcionin els serveis, suports i recursos que garanteixen el benestar de tots els nens/es des d’una perspectiva que sigui significativa tant per a l’individu, com per la seva família i comunitat...

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Background: Attention to patients with acute minor-illnesses requesting same-day consultation represents a major burden in primary care. The workload is assumed by general practitioners in many countries. A number of reports suggest that care to these patients may be provided, at in least in part, by nurses. However, there is scarce information with respect to the applicability of a program of nurse management for adult patients with acute minor-illnesses in large areas. The aim of this study is to assess the effectiveness of a program of nurse algorithm-guided care for adult patients with acute minor illnesses requesting same-day consultation in primary care in a largely populated area. Methods: A cross-sectional study of all adult patients seeking same day consultation for 16 common acute minor illnesses in a large geographical area with 284 primary care practices. Patients were included in a program of nurse case management using management algorithms. The main outcome measure was case resolution, defined as completion of the algorithm by the nurse without need of referral of the patient to the general practitioner. The secondary outcome measure was return to consultation, defined as requirement of new consultation for the same reason as the first one, in primary care within a 7-day period. Results: During a two year period (April 2009-April 2011), a total of 1,209,669 consultations were performed in the program. Case resolution was achieved by nurses in 62.5% of consultations. The remaining cases were referred to a general practitioner. Resolution rates ranged from 94.2% in patients with burns to 42% in patients with upper respiratory symptoms. None of the 16 minor illnesses had a resolution rate below 40%. Return to consultation during a 7-day period was low, only 4.6%. Conclusions: A program of algorithms-guided care is effective for nurse case management of patients requesting same day consultation for minor illnesses in primary care.

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Background: Attention to patients with acute minor-illnesses requesting same-day consultation represents a major burden in primary care. The workload is assumed by general practitioners in many countries. A number of reports suggest that care to these patients may be provided, at in least in part, by nurses. However, there is scarce information with respect to the applicability of a program of nurse management for adult patients with acute minor-illnesses in large areas. The aim of this study is to assess the effectiveness of a program of nurse algorithm-guided care for adult patients with acute minor illnesses requesting same-day consultation in primary care in a largely populated area. Methods: A cross-sectional study of all adult patients seeking same day consultation for 16 common acute minor illnesses in a large geographical area with 284 primary care practices. Patients were included in a program of nurse case management using management algorithms. The main outcome measure was case resolution, defined as completion of the algorithm by the nurse without need of referral of the patient to the general practitioner. The secondary outcome measure was return to consultation, defined as requirement of new consultation for the same reason as the first one, in primary care within a 7-day period. Results: During a two year period (April 2009-April 2011), a total of 1,209,669 consultations were performed in the program. Case resolution was achieved by nurses in 62.5% of consultations. The remaining cases were referred to a general practitioner. Resolution rates ranged from 94.2% in patients with burns to 42% in patients with upper respiratory symptoms. None of the 16 minor illnesses had a resolution rate below 40%. Return to consultation during a 7-day period was low, only 4.6%. Conclusions: A program of algorithms-guided care is effective for nurse case management of patients requesting same day consultation for minor illnesses in primary care.

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This case study identifies the elements that compose the Quality of Life (QofL) of individuals who were 75 years old or older and receive care at home. The study's sample was composed of individuals 75 years or older cared for by a home health care service in the primary health care unit in Vilafranca del Penedès, Spain (n=26). The variables included: a) socio-demographic data; b) concept of QofL; c) perception of QofL; d) reasons for their perception; d) satisfaction with life and related aspects; and f) feeling of happiness. Face to face interviews were conducted. A total of 76.9% of the individuals reported a good perception of QofL and the main reasons related to it were: health, family and social relationships, and the ability to adapt. Role Theory and Disengagement Theory explain the adaptation process of these individuals at this point in life.

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Se objetivó detectar los elementos que participan en la Calidad de Vida (CV) de las personas mayores de 75 años que reciben cuidados domiciliarios. El diseño fue de un estudio de caso. La muestra del estudio la configuraron las personas con 75 años o más, atendidos por el servicio de Atención Domiciliaria del Área Básica de Vilafranca del Penedès (n=26). Las variables fueron: a) datos socio demográficos, b) concepto de CV; c) percepción de CV, d) motivos; e) satisfacción con la vida y aspectos relacionados; f) sentimiento de felicidad. Se aplicó la técnica de la entrevista cara a cara. El 76,9% presentó una buena percepción de CV y los principales elementos relacionados fueron la salud, las relaciones familiares y sociales y la adaptación. La teoría de los roles y la teoría de la desvinculación explican el proceso de adaptación de estos individuos en esa etapa de la vida.