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Les Positions Des Medecins Generalistes Du Nord Pas De Calais Face A La Remuneration Sur Objectifs De Sante Publique
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Book Synopsis Les positions des médecins généralistes du Nord-Pas-de-Calais face à la Rémunération sur Objectifs de Santé Publique by : Stéphane Cousin
Download or read book Les positions des médecins généralistes du Nord-Pas-de-Calais face à la Rémunération sur Objectifs de Santé Publique written by Stéphane Cousin and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Contexte La convention médicale de 2011 introduit un système de paiement à la performance dans les revenus des médecins : la Rémunération sur Objectif de Santé Publique (ROSP). Le généraliste est évalué sur 29 indicateurs lui permettant de recevoir une prime annuelle. A deux ans de sa mise en oeuvre, quelles sont les positions des médecins face au dispositif et ses modalités? Comment intègrent-t-ils la ROSP dans sa rémunération, sa relation avec la sécurité sociale et sa vie professionnelle ? Méthode : étude quantitative descriptive par questionnaire envoyé par e-mail à 491 généralistes de la région Nord-Pas-de-Calais entre le 25 septembre et 5 novembre 2013. L'analyse des données était effectuée par le CERIM. Résultats : 109 réponses étaient analysées. Seuls 19% des généralistes étaient satisfaits de la ROSP trouvant à 49% les indicateurs de santé publique non pertinents, à 47 % le système de calcul injuste et à 78% la prime trop faible. 51,4% des médecins ne croyaient pas à un impact positif de la ROSP sur la qualité des soins. Plus le médecin était installé depuis longtemps, plus il risquait d'être insatisfait du dispositif (OR=0,04 IC [0-0,23] (p=0,00107) pour la tranche des 30-40 années d'installation). Les médecins ayant perçu plus de 5000 euros étaient plus satisfaits (OR 7,73 IC [1,88-45,29] (p= 0,00944)). Les objectifs de la ROSP étaient pour les généralistes : une surveillance des pratiques (69%), une maîtrise des dépenses de santé (62%), une récompense des bonnes pratiques (26%), une amélioration de la qualité et l'efficience des soins (23%) et la valorisation de la médecine générale (12%). Les rapports avec les CPAM étaient positifs pour 69% des généralistes. La ROSP remettait en cause leur indépendance pour 59% d'entre eux. Conclusion :Sceptiques sur les objectifs véhiculés par la ROSP et son efficacité sur la qualité des soins, insatisfaits par sa forme (indicateurs, système de calcul) et craignant une atteinte de leur indépendance professionnelle, les généralistes remettent en cause la ROSP.
Book Synopsis Etude descriptive sur la modification du comportement du médecin généraliste face à la rémunération sur objectifs de santé publique dans le Nord-Pas-de-Calais by : Benjamin Leitz
Download or read book Etude descriptive sur la modification du comportement du médecin généraliste face à la rémunération sur objectifs de santé publique dans le Nord-Pas-de-Calais written by Benjamin Leitz and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Contexte : L'incitation financière a montré ses effets sur le comportement dans plusieurs catégories professionnelles. La convention médicale signée le 26 juillet 2011 consacre un nouveau dispositif, la rémunération sur objectifs de santé publique (ROSP), qui est un paiement à la performance. Le comportement du médecin généraliste (MG), dans sa pratique et dans sa relation avec son malade, en sera-t-il modifié? Méthode : Etude quantitative à but descriptif par questionnaire en ligne destiné aux médecins généralistes de la région Nord-Pas-de-Calais, réalisée entre le 25 septembre et le 5 novembre 2013. L'analyse des données était réalisée par le CERIM. Résultats : La pratique du MG semble s'être modifiée depuis l'introduction de la ROSP : 26,85% ont augmenté leurs actes de prévention, 20,37% informent plus leur patient, 35,64% passent plus de temps sur informatique. La relation médecinmalade semble se modifier aussi : 36,45% des MG s'estiment plus exigeants sur les indicateurs ciblés par la convention, 31,13% pensent être moins tolérants face au patient refusant les génériques et 27,78% d'entre eux moins tolérants face à l'inobservance. 93,46% d'entre eux ne délaissent pas les autres critères de santé. La ROSP peut mener à une sélection de « bons » patients pour 43,52%. 60,75% des MG pensent que la ROSP impacte directement sur la relation médecin-malade et que cet impact serait négatif pour 80,3% d'entre eux. 61,47% y voient même un conflit d'intérêt sur le plan déontologique.
Book Synopsis Organizing Smart Buildings and Cities by : Elisabetta Magnaghi
Download or read book Organizing Smart Buildings and Cities written by Elisabetta Magnaghi and published by Springer Nature. This book was released on 2021-02-01 with total page 190 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United Nations included sustainable cities and communities in its 2030 SDGs. Cities and, on a smaller scale, neighborhoods, building managers and firms are now adopting technologies and information systems to help achieve the energy, economic, social and environmental transition. This volume gathers contributions on the key organizational success factors for this transition. To do so, it analyzes the role of information systems, use of data, and technological assistance solutions from multiple perspectives. The goal is to develop a framework that can successfully apply information systems to organizational and environmental issues for smart cities and smart buildings. Accordingly, the book addresses living-lab experiment evaluation techniques, and provides critical analyses of the role of the environment, context and users’ behavioral responses. In addition, it discusses key questions on the efficient management of resources, need for appropriate IT solutions, and employing co-creation with users to improve planning and organization.
Book Synopsis La rémunération sur objectifs de santé publique by : Bénédicte Girard-Wasilewski
Download or read book La rémunération sur objectifs de santé publique written by Bénédicte Girard-Wasilewski and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Contexte : Le rôle du médecin généraliste s'est modifié. Ses compétences ont évolué et ses missions de santé publique se sont développées. Son action dans les domaines de la prévention, du dépistage, de l'éducation en santé et de l'éducation thérapeutique s'accordait mal avec le paiement à l'acte. Un paiement à la performance a été introduit en France, pour les médecins généralistes, en 2009 sous la forme du Contrat d'Amélioration des Pratiques Individuelles (CAPI). Il a ensuite été généralisé et intégré en 2011 à la convention médicale comme Rémunération sur Objectifs de Santé Publique (ROSP). Le but de ce dispositif était de valoriser la qualité des soins et d'optimiser les dépenses de santé. L'objectif de ce travail était d'étudier les représentations qu'ont les médecins généralistes de ce nouveau mode de rémunération. Méthodes : Une étude qualitative a été réalisée par entretiens semi directifs individuels de médecins généralistes du Nord. Les entretiens ont été enregistrés et menés jusqu'à saturation des données puis retranscrits intégralement. Une analyse thématique triangulée des verbatims a été effectuée à l'aide du logiciel QSR NvivolO. Résultats : Aucun médecin interviewé n'a refusé la ROSP, soit parce qu'ils y étaient favorables ou indifférents ou ignorants des modalités de refus. Tous souhaitaient une revalorisation de leur profession et de leurs revenus. La ROSP recevait donc un accueil plutôt favorable même s'ils estimaient que l'impact sur leurs pratiques et sur l'économie était faible. Cependant, ils évoquaient la nécessité de faire évoluer les indicateurs. Ils alertaient également sur l'immixtion de l'Assurance Maladie dans leurs activités et sur la remise en cause de leur éthique professionnelle. Conclusion : Les médecins généralistes étaient plutôt favorables au développement d'une rémunération mixte à condition de préserver leur indépendance et de garder à l'esprit la problématique éthique relative à cette-ci.
Book Synopsis Central Banking in Turbulent Times by : Francesco Papadia
Download or read book Central Banking in Turbulent Times written by Francesco Papadia and published by Oxford University Press. This book was released on 2018-03-09 with total page 347 pages. Available in PDF, EPUB and Kindle. Book excerpt: Central banks came out of the Great Recession with increased power and responsibilities. Indeed, central banks are often now seen as 'the only game in town', and a place to put innumerable problems vastly exceeding their traditional remit. These new powers do not fit well, however, with the independence of central banks, remote from the democratic control of government. Central Banking in Turbulent Times examines fundamental questions about the central banking system, asking whether the model of an independent central bank devoted to price stability is the final resting point of a complex development that started centuries ago. It dissects the hypothesis that the Great Recession has prompted a reassessment of that model; a renewed emphasis on financial stability has emerged, possibly vying for first rank in the hierarchy of objectives of central banks. This raises the risk of dilemmas, since the Great Recession brought into question implicit assumptions that the pursuit of price stability would also lead to financial stability. In addition, the border between monetary and fiscal policy was blurred both in the US and in Europe. Central Banking in Turbulent Times asks whether the model prevailing before the Great Recession has been irrevocably altered. Are we entering, as Charles Goodhart has hypothesized, into the 'fourth epoch' of central banking? Are changes to central banks part of a move away from the global liberal order that seemed to have prevailed at the turn of the century? Central Banking in Turbulent Times seeks to answer these questions as it examines how changes can allow for the maintenance of price stability, while adapting to the long-term consequences of the Great Recession.
Book Synopsis Community Psychology by : Geoffrey Nelson
Download or read book Community Psychology written by Geoffrey Nelson and published by Palgrave Macmillan. This book was released on 2005-01-15 with total page 608 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is the first up-to-date text written specifically for the international market on psychology in the community. Community Psychology covers the history and foundations of the field, key concepts and values, community research, community action, and the application of psychology in various settings, integrating the values/politics and scientific/research aspects of community work. Written by experienced authors in the field, this text will be internationally invaluable.
Book Synopsis Psychological Sense of Community by : Adrian T. Fisher
Download or read book Psychological Sense of Community written by Adrian T. Fisher and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 382 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this book, the authors have explored a series of different types of communities - moving from the basic idea of those based at a specific location all the way to virtual communities of the internet. A key feature of this book is the research focus that emphasizes the theory-driven analyses and the diversity of contexts in which sense of community is applied. The book will be of great interest to those concerned with understanding various forms of community and how communities can be mobilized to achieve wellbeing.
Book Synopsis Studies in Empowerment by : Robert E Hess
Download or read book Studies in Empowerment written by Robert E Hess and published by Routledge. This book was released on 2014-04-04 with total page 245 pages. Available in PDF, EPUB and Kindle. Book excerpt: This adaptable book offers diverse applications of the empowerment model to the promotion of mental health and the prevention of mental illness. Topics span the developmental trends of empowerment as an individual achievement, a community experience, and a professional aim in relation to social intervention strategies and tactics.
Book Synopsis Social Health Insurance by : Charles Normand
Download or read book Social Health Insurance written by Charles Normand and published by . This book was released on 1994 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Local Food Systems; Concepts, Impacts, and Issues by : Steve Martinez
Download or read book Local Food Systems; Concepts, Impacts, and Issues written by Steve Martinez and published by DIANE Publishing. This book was released on 2010-11 with total page 87 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive overview of local food systems explores alternative definitions of local food, estimates market size and reach, describes the characteristics of local consumers and producers, and examines early indications of the economic and health impacts of local food systems. Defining ¿local¿ based on marketing arrangements, such as farmers selling directly to consumers at regional farmers¿ markets or to schools, is well recognized. Statistics suggest that local food markets account for a small, but growing, share of U.S. agricultural production. For smaller farms, direct marketing to consumers accounts for a higher percentage of their sales than for larger farms. Charts and tables.
Book Synopsis Eat Sleep Bagpipes Repeat by : Mirako Press
Download or read book Eat Sleep Bagpipes Repeat written by Mirako Press and published by Createspace Independent Publishing Platform. This book was released on 2018-07-18 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: This adorable music notebook is perfect for staffs, kids and musicians. The high-quality manuscript book includes 110 pages of 12 staves. Let exercise your composing skills with this well-designed music sketchbook! Enjoy!
Book Synopsis Alternative Food Networks by : David Goodman
Download or read book Alternative Food Networks written by David Goodman and published by Routledge. This book was released on 2012-02-20 with total page 352 pages. Available in PDF, EPUB and Kindle. Book excerpt: Farmers’ markets, veggie boxes, local foods, organic products and Fair Trade goods – how have these once novel, "alternative" foods, and the people and networks supporting them, become increasingly familiar features of everyday consumption? Are the visions of "alternative worlds" built on ethics of sustainability, social justice, animal welfare and the aesthetic values of local food cultures and traditional crafts still credible now that these foods crowd supermarket shelves and other "mainstream" shopping outlets? This timely book provides a critical review of the growth of alternative food networks and their struggle to defend their ethical and aesthetic values against the standardizing pressures of the corporate mainstream with its "placeless and nameless" global supply networks. It explores how these alternative movements are "making a difference" and their possible role as fears of global climate change and food insecurity intensify. It assesses the different experiences of these networks in three major arenas of food activism and politics: Britain and Western Europe, the United States, and the global Fair Trade economy. This comparative perspective runs throughout the book to fully explore the progressive erosion of the interface between alternative and mainstream food provisioning. As the era of "cheap food" draws to a close, analysis of the limitations of market-based social change and the future of alternative food economies and localist food politics place this book at the cutting-edge of the field. The book is thoroughly informed by contemporary social theory and interdisciplinary social scientific scholarship, formulates an integrative social practice framework to understand alternative food production-consumption, and offers a unique geographical reach in its case studies.
Book Synopsis Environmental Justice by : Brendan Coolsaet
Download or read book Environmental Justice written by Brendan Coolsaet and published by Routledge. This book was released on 2020-06-15 with total page 432 pages. Available in PDF, EPUB and Kindle. Book excerpt: Environmental Justice: Key Issues is the first textbook to offer a comprehensive and accessible overview of environmental justice, one of the most dynamic fields in environmental politics scholarship. The rapidly growing body of research in this area has brought about a proliferation of approaches; as such, the breadth and depth of the field can sometimes be a barrier for aspiring environmental justice students and scholars. This book therefore is unique for its accessible style and innovative approach to exploring environmental justice. Written by leading international experts from a variety of professional, geographic, ethnic, and disciplinary backgrounds, its chapters combine authoritative commentary with real-life cases. Organised into four parts—approaches, issues, actors and future directions—the chapters help the reader to understand the foundations of the field, including the principal concepts, debates, and historical milestones. This volume also features sections with learning outcomes, follow-up questions, references for further reading and vivid photographs to make it a useful teaching and learning tool. Environmental Justice: Key Issues is the ideal toolkit for junior researchers, graduate students, upper-level undergraduates, and anyone in need of a comprehensive introductory textbook on environmental justice.
Book Synopsis Community Psychology by : Julian Rappaport
Download or read book Community Psychology written by Julian Rappaport and published by New York : Holt, Rinehart and Winston. This book was released on 1977 with total page 508 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Health Care Systems in Transition by : Francis D. Powell
Download or read book Health Care Systems in Transition written by Francis D. Powell and published by SAGE Publications, Incorporated. This book was released on 1998-11-24 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book offers an overview of health care systems in advanced industrial nations and its relation to current challenges from the USA. Part One offers guidelines for comparing health care reforms. Parts Two to Five examine health care and attempts at health care reform in Germany, Canada, Sweden and the United Kingdom. Part Six considers the impact on reform of structural differences in health care systems, and how national reform measures might be reflected in regional and state programs in the United States.
Book Synopsis Euro-Arab Co-Operation by : Edmond Völker
Download or read book Euro-Arab Co-Operation written by Edmond Völker and published by Martinus Nijhoff Publishers. This book was released on 1976-11 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt:
