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[Clinical management units in primary care: a question under debate]
M Alvarez Girón1, C García Gil, A Solano Parés
1Departamento de Ciencias Sociosanitarias. Facultad de Medicina. Universidad de Sevilla. España. solano@us.es
Objective:
To find the views of health professionals on how the terms of the new management agreement with clinical units affect the quality of health delivery.
Design:
Qualitative study to find professionals' views. Individual opinions of key informers were obtained, secondary sources were analysed and a discussion group rounded off the study. The categories for the analysis were established on the basis of the results obtained.
Setting:
Primary care districts in the provinces of Sevilla and Cádiz, in the Autonomous Community of Andalusia. Health districts of differing social-economic and geographical characteristics were chosen.
Participants:
9 professionals involved in the new system of management. The selection criteria refer to the kind of professional, the unit or work team and the characteristics of the health district.
Method:
The semi-structured interview with key informers and a discussion group were the basic techniques for gathering information.
Results:
A view that the clinical management units were designed as a savings strategy was detected. There were differences about primary care teams.
Conclusions:
Professionals think there is too much rigidity and adding-up in the measurement of targets and objectives. This creates unfavourable working conditions, which affects the quality of health service delivery.