Gestión de riesgos en la implementación del control previo en hospitales públicos. Una revisión conceptual
Risk management in the implementation of prior control in public hospitals. A conceptual reviewContenido principal del artículo
La gestión de riesgos en hospitales públicos ha adquirido una importancia creciente como componente esencial para garantizar la continuidad, seguridad y eficiencia de los servicios de salud, especialmente frente a emergencias y desastres. El objetivo del estudio es desarrollar un modelo teórico-conceptual para la integración de la gestión de riesgos en la implementación del control previo en hospitales públicos, a partir de la revisión y análisis de la literatura especializada. El enfoque es cualitativo, con diseño de revisión conceptual. Se identifican cuatro dimensiones clave: gobernanza del sistema, evaluación de riesgos con enfoque regional, implementación de controles con recursos limitados, y monitoreo con mejora incremental. La investigación se fundamentó en el análisis crítico y sistemático de un corpus bibliográfico compuesto por 35 documentos seleccionados por su relevancia y calidad conceptual. La literatura publicada entre 2018 y 2024. Las bases de datos utilizadas Elsevier, Scielo. Los resultados de este estudio confirman y amplían las bases teóricas revisadas, esta investigación aporta un marco conceptual integral y contextualizado para la modernización de los sistemas de control en hospitales públicos. Se concluye que el modelo teórico conceptual desarrollado ofrece un marco innovador para integrar la gestión de riesgos en la implementación del control previo en la ejecución presupuestaria de hospitales públicos.
Risk management in public hospitals has acquired increasing importance as an essential component for ensuring the continuity, safety, and efficiency of healthcare services, especially in the face of emergencies and disasters. The objective of this study is to develop a theoretical and conceptual model for integrating risk management into the implementation of prior control in public hospitals, based on a review and analysis of specialized literature. The approach is qualitative, with a conceptual review design. Four key dimensions are identified: system governance, risk assessment with a regional focus, implementation of controls with limited resources, and monitoring with incremental improvement. The research was based on a critical and systematic analysis of a bibliographic corpus composed of 35 documents selected for their relevance and conceptual quality. The literature was published between 2018 and 2024. The databases used were Elsevier, Scielo, and others. The results of this study confirm and expand the theoretical foundations reviewed. This research provides a comprehensive and contextualized conceptual framework for the modernization of control systems in public hospitals. It is concluded that the theoretical and conceptual model developed offers an innovative framework for integrating risk management into the implementation of prior control in budget execution in public hospitals.
Descargas
Detalles del artículo
Webste. B, Neville, S, Nobbs J, Ching J, van Gool, K. Incorporating Safety and Quality Measures Into Australia's Activity-Based Funding of Public Hospital Services. Health Services Insights. 2023; 16. https://doi.org/10.1177/11786329231187891
Senna P, Reis D, Leão I, Dias C. Healthcare supply chain risk management in Rio de Janeiro, Brazil: ¿What is the current situation? Work. 2022; 72(2): 405-417. https://doi.org/10.3233/WOR-205216
Passos C, de Castro I, Monteiro M, Fonteles M, Dos Santos D. Evaluation of safe practices in a public hospital in the northeast of Brazil. Revista Enfermagem. 2019; 27. https://doi.org/10.12957/reuerj.2019.44321
Camacho D, Carrasquilla A, Dominguez, A. Palmieri, P. A. Patient Safety Culture in Latin American Hospitals: A Systematic Review with Meta-Analysis. International Journal of Environmental Research and Public Health. 2022; 19(21); 14380. https://doi.org/10.3390/ijerph192114380
de Oliveira E, de Carvalho L, da Costa, C, Aguilar M, Saraceni V, Cruz O, Durovni B, Soranz, R, de Oliveira M. COVID-19 emergency operations center: experience of the Rio de Janeiro municipality, Brazil. Revista Panamericana de Salud Pública/Pan American Journal of Public Health. 2022; 27: 46: e9. doi: 10.26633/RPSP.2022.9
Moradi T, Kabir M, Pourasghari H, Ehsanzadeh J, Aryankhesal A. Challenges of budgeting and public financial management in Iran's health system: A qualitative study. Medical Journal of the Islamic Republic of Iran. 2023; 37(1). https://doi.org/10.47176/mjiri.37.80
Eslava J, Camelo A, Mina L, Vásquez, E, Mejía M. Analysis of the response capacity of the health information systems to oversee the risks affecting the right to health in Colombia. Revista Gerencia y Politicas de Salud. 2018; 17(35). https://doi.org/10.11144/Javeriana.rgps17-35.acrs
Ketelhöhn N, Sanz L. Healthcare management priorities in Latin America: Framework and responses. Journal of Business Research. 2016; 69(9): 3835-3838. https://doi.org/10.1016/j.jbusres.2016.04.008
Lois P Drogalas G, Nerantzidis M, Georgiou I, Gkampeta E. Risk-based internal auditing: Factors related to its implementation. Corporate Governance, 21(4), 645-662. 2020. https://doi.org/10.1108/CG-08-2020-0316
Vastola P, Saracino D. Risk management project: ¿reactive or proactive approach? Igiene e Sanità Pubblica. 2006; 62(5): 493-508. ttps://europepmc.org/article/med/17206225
Fernández I, Valle P, Pagonessa L, Blazquez M, Tomás J. An experience in integrated management of clinical risks. Journal of Healthcare Quality Research. 2018; 33(6): 311-318. https://doi.org/10.1016/j.jhqr.2018.09.002
Pardo A, Claveria A, García, M, López J. (2008). Operational units for health risk management (patient safety). Medicina Clinica. 2008; 131(3): 64-71 64-71. https://doi.org/10.1016/S0025-7753(08)76464-9
Snyder H. Literature review as a research methodology: An overview and guidelines. Journal of Business Research. 2019; 104. https://doi.org/10.1016/j.jbusres.2019.07.039
Whetten D. What constitutes a theoretical contribution? Academy of Management Review. 1989; 14(4): 490-495. https://doi.org/10.5465/amr.1989.4308371
Organización Panamericana de la Salud. Las funciones esenciales de la salud pública en las Américas. Una renovación para el siglo XXI. Marco conceptual y descripción. 2020. https://doi.org/10.37774/9789275322642
Contraloría General del Estado. Normas de Control Interno. Acuerdo_004-CG-2023. 2023; (004):1-93. https://boletin.novedadesjuridicas.com.ec/4cg23/
Brancalion N, Lima F. Process-based Management aimed at improving health care and financial results. Revista Da Escola de Enfermagem Da USP. 2022; 56: 1-7. https://doi.org/10.1590/1980-220x-reeusp-2021-0333en
Ministerio de Salud Pública de Ecuador. Estatuto del Ministerio de Salud Pública del Ecuador. Acuerdo Ministerial. 2012; (00001034). https://www.salud.gob.ec/wp-content/uploads/downloads/2014/09/ESTATUTO-SUSTITUTIVO-MSP-ALCANCE-REFORMA-ABRIL17.pdf
Jalilvand M, Raeisi A, Shaarbafchizadeh N. Hospital governance accountability structure: a scoping review. BMC Health Services Research. 2024; 24(1): 1-18. https://doi.org/10.1186/s12913-023-10135-0
Correia B, Farrukh M, Moleiro J, Baheer R. Impact of green human resource management towards sustainable performance in the healthcare sector: role of green innovation and risk management. Cogent Business and Management. 2024; 11(1). https://doi.org/10.1080/23311975.2024.2374625
Nunes C, Gomes P, Santana J. Transparência, accountability e governance: revisão sistemática da literatura nos hospitais públicos. Revista de Administração Pública. 2023; 57(2): 1-33. https://doi.org/10.1590/0034-761220220238
Ministerio de Salud del Perú. Gestión presupuestaria del sector salud en el Perú. Desafíos y recomendaciones. https://bvs.minsa.gob.pe/local/MINSA/5471.pdf
Villarroel S. Health workforce planning: brief historic route of Chilean policies. Medwave. 2016; 16(10). https://doi.org/10.5867/medwave.2016.10.6611
Capasso A, Colomar M, Ramírez D, Serruya S, de Mucio B. Digital health and the promise of equity in maternity care: A mixed methods multi-country assessment on the use of information and communication technologies in healthcare facilities in Latin America and the Caribbean. PLoS ONE. 2024; 19: 1-20. https://doi.org/10.1371/journal.pone.0298902
Ministerio de Salud y Protección Social de Colombia. Informe de Gestión 2023. https://www.minsalud.gov.co/Ministerio/RCuentas/Documents/Informe-de-gestion-290124.pdf
Vlasova, J. Budget risks of Russian federation regions, determination and the application in the budget process. Mediterranean Journal of Social Sciences. 2015; 6(4): 362-368. https://doi.org/10.5901/mjss.2015.v6n4s4p362
Rozo I, Díaz F, de Jesús Y, Ordoñez M, Ospina L. Risk management framework as technovigilance support at sterilization unit in the San Jose Hospital (Colombia). Communications in Computer and Information Science. 2018; 877. https://doi.org/10.1007/978-3-319-95204-8_37
Fonseca M, da Shadlen K, Bastos I. The politics of COVID-19 vaccination in middle-income countries: Lessons from Brazil. Social Science and Medicine. 2021; 281(May):114093. https://doi.org/10.1016/j.socscimed.2021.114093
Marín C, Cruz M, Martín M. Qualitative analysis of health preparedness policies in Chile. Revista Panamericana de Salud Pública/Pan American Journal of Public Health. 2023: 47. https://doi.org/10.26633/RPSP.2023.131
Chi J, Hu S. Research on the Application of HRP-based Budget Management System in Hospitals. ACM International Conference Proceeding Series. 2021. https://doi.org/10.1145/3510858.3510947
¿Mira J, Carrillo I, García, E, Andrade D, Pavan P, ¿Franco A, ¿Campos, E, Poblete R, Limo J, Siu H, Sousa P. What Ibero-American hospitals do when things go wrong? A cross-sectional international study. International Journal for Quality in Health Care. 2020; 32(5). https://doi.org/10.1093/intqhc/mzaa031
Rocha S, da Santana N, Araújo E, Dancigelo A. Análise bibliométrica dos estudos no Brasil sobre gestão de custos em hospitais Bibliometric. Revista De Gestão E Secretariado. 2024; 15(12): 1-21. https://doi.org/10.7769/gesec.v15i12.4536
Banduhn C, Schlüchtermann J. Profitability analysis of clinical risk management. Gesundheitswesen. 2013; 75(5). https://doi.org/10.1055/s-0033-1343440
Schlüchtermann J. Betriebswirtschaft und Management. 2016. https://www.zvab.com/9783954662463/Schl%C3%BCchtermann-Betriebswirtschaft-Management-3954662469/plp
Agostinis G, Parthenay K. Exploring the determinants of regional health governance modes in the Global South: A comparative analysis of Central and South America. Review of International Studies. 2021; 47(4). https://doi.org/10.1017/S0260210521000206