Services In Spain Research Articles

How do immigrant women access the public healthcare services in the Basque Country (Spain)?

Background: Immigrant women face diverse barriers in order to access the public healthcare services in Spain. Furthermore, in 2012, a legislative change made the access conditions more difficult to ...

Translation and Cross-Cultural Adaptation with Preliminary Validation of GCOS-24 for Use in Spain.

The aim in this study was to translate and cross-culturally adapt the Genetic Counseling Outcome Scale (GCOS-24) for use in Spain and to carry out a preliminary psychometric validation in a sample of Spanish patients. With oversight by an expert panel, forward and backward translations were conducted to create the draft Spanish GCOS-24. Fourteen patients were recruited from a clinical genetics service in Madrid, Spain, to participate in cognitive interviews designed to explore readability and interpretability of the draft. Following qualitative analysis of interview transcripts, a final version of the Spanish GCOS-24 was agreed with the expert panel. No significant cross-cultural differences were identified. The Spanish GCOS-24 was then completed prior to and 2-4weeks after genetic counseling by 59 patients attending the service, and data were analysed using analysis of variance. Preliminary psychometric validation of the Spanish GCOS-24 showed significantly higher GCOS-24 scores after genetic counseling (p<0.0001), with good internal consistency (α=0.84) and sensitivity to change over time, with a medium-to-large size effect (Cohen's d=0.70). This compares well with the original English language GCOS-24. Findings demonstrate that the Spanish GCOS-24 has potential for use in evaluating clinical genetics services in Spain, but would benefit from assessment of test-retest reliability as well as structural and construct validity.

Research and secrecy: dealing with archives of intelligence services in Spain

This article offers a critical assessment of the normative framework, functioning, and problems concerning the records and documents that are generated by intelligence agencies in Spain and that essentially make up two major blocks, depending on their life cycle: historical and non-historical records. It does so by proposing the concept of integral inter-accessibility. The article addresses their legal regime, levels of accessibility, and consultation for the purposes of political, economic, and judicial control, as well as internal organisational efficiency. Furthermore, it deals with the manner in which they are generated, and the application of specific procedures and regulations for the protection of classified information, as well as its organisation, description, and integrated management in its active, semi-active, and inactive phases.

Weakening political connections by means of regulatory reform: Evidence from contracting out water services in Spain

One area of public policy where rent-seeking and favoritism is relatively common is the contracting out of public services. Private firms can improve their chances of obtaining contracts by bribing politicians or public servants and funding political parties. In the same vein, firms can gain access to policymakers by hiring influential former politicians—a practice commonly referred to as revolving-doors. In this paper, we use information from 922 privatizations of water services in Spanish municipalities between 1984 and 2016 and multinomial logistic regression techniques to study the association between specific firms securing contracts and the political parties ruling the municipalities. We find robust statistical evidence of an association between the Popular Party (Partido Popular or PP) and the firm Aqualia, part of the large Spanish holding company Fomento de Construcciones y Contratas (FCC), which is known to have funded the Popular Party. Furthermore, former PP politicians have been appointed to top positions in the FCC Board of Directors. However, this relationship weakened after the institutional reform of 2007 on public procurement and financing of political parties, which is empirically evaluated in this paper.

Gasparo Contarini’s Relazione of November 1525 to the Venetian Senate on the divergent dynamics of the Spanish and Portuguese world empires

This contribution seeks to present Gasparo Contarini’s diplomatic report (Relazione), made following three years in Venetian service in Spain between 1522–1525, to unfamiliar readers, as well as to elucidate its contents. It was a time when ground-breaking reports of the first global circumnavigation by Magellan/Elcano and conquests in the New World undertaken by Hernán Cortés were filtering back to the Spanish ruler, Charles V. Projects for the colonization of Brazil in neighbouring Portugal were afoot, as were attempts by other parties to reach the contested Spiceries by new routes. International juries were constituted to decide upon the division of the world’s spaces, culminating in the Treaty of Saragossa, and controversial maps were drawn up both to make sense of potentially new continents like the Americas, and to plead different cases at the upcoming tribunals. It is asked why such a polarized picture of successful Spanish and unsuccessful Portuguese imperial fortunes is provided by Contarini, at a time of great rivalry between Spain and Portugal, and it is suggested that Contarini – who did not personally travel to Portugal – may simply be following a rhetorical precedent fashioned by previous diplomats like Ca’Masser, Vincenzo Quirini and Pietro Pasqualigo. Historical, personal and documentary context (Contarini’s 400 dispacci, for example) is provided, and comparisons drawn to the letters and reports of other contemporary observers, like the Polish diplomat Jan Dantyszek at the Spanish court, as well as contemporary travellers and businessmen, like Jörg Pock in Lisbon.

El perfil de los preparadores laborales en el empleo con apoyo

This study analyzes the figure of the job coach in various Supported Employment services in Spain. A quality-oriented study carried out, based on the case study. Twenty-three semi-structured interviews held with professionals, along with thirtysix participant observations at different stages of Supported Employment. The results show disparity in the profiles associated with various areas of knowledge, as well as a diversity of functions related to the roles performed by the job coach depending on the number of staff taken on. The most significant competencies combined with personal skills and communicative abilities. It recommended that employment programs improve vocational retraining programs to make up for training deficiencies and provide professional skills for intervention in each service.

Determinant Factors of Satisfaction with Public Services in Spain

AbstractThe concept of marketing has evolved significantly, as have its applications in various sectors, including services. Diverse opinions have been expressed for and against the use of marketing techniques in public administration. In this paper, we present a conceptual and methodological review of the main contributions made by marketing to the public sector, measuring variables and related concepts that determine public satisfaction with public services. These elements, termed key drivers of opinion, were measured by reference to the information provided by the Spanish Sociological Research Centre (CIS), and provide an alternative way to display and analyse the data of interest, through perception models and figures using multivariate factor analysis. In this study, the components or factors containing the main drivers of opinion were found to be, on the one hand, commitment to efficient service, and on the other, user convenience.

Unidades de bibliometría y bibliotecas universitarias: hacia la transparencia

Bibliometric services are being consolidated in the Spanish academic field due to growing interest in academic performance by university managers and leaders. Academic librarians are a key part of the bibliometric services because of their expertise in providing support and training to researchers and advice in research assessment. Bibliometric services functions and the current landscape of bibliometric services in Spain are described.

Cost analysis for the implementation of a medication review with follow-up service in Spain.

Background Medication review with follow-up (MRF) is a professional pharmacy service proven to be cost-effective. Its broader implementation is limited, mainly due to the lack of evidence-based implementation programs that include economic and financial analysis. Objective To analyse the costs and estimate the price of providing and implementing MRF. Setting Community pharmacyin Spain. Method Elderly patients using poly-pharmacy received a community pharmacist-led MRF for 6months. The cost analysis was based on the time-driven activity based costing model and included the provider costs, initial investment costs and maintenance expenses. The service price was estimated using the labour costs, costs associated with service provision, potential number of patients receiving the service and mark-up. Main outcome measures Costs and potential price of MRF. Results A mean time of 404.4 (SD 232.2) was spent on service provision and was extrapolated to annual costs. Service provider cost per patient ranged from €196 (SD 90.5) to €310 (SD 164.4). The mean initial investment per pharmacy was €4594 and the mean annual maintenance costs €3,068. Largest items contributing to cost were initial staff training, continuing education and renting of the patient counselling area. The potential service price ranged from €237 to €628 per patient a year. Conclusion Time spent by the service provider accounted for 75-95% of the final cost, followed by initial investment costs and maintenance costs. Remuneration for professional pharmacy services provision must cover service costs and appropriate profit, allowing for their long-term sustainability.

Alimentos de producción local en los comedores escolares de España

ObjectiveTo identify and characterize initiatives that promote the purchase of locally-sourced foods to supply schools and the school centres carrying out the initiatives. MethodExploratory, descriptive study based on secondary data and key informant reports. A search of governmental and non-governmental initiatives was carried out at the autonomous community level. Government initiatives were located through school feeding programmes in the different autonomous communities, their nutritional guides and representatives of the councils for education and agriculture. Non-governmental initiatives were found through their own websites and the snowball technique. Initiatives were analysed by their geographic distribution, organizational area (government vs. non-government), number of school centres carrying out the initiatives, management style and organic food purchase. A descriptive analysis of the data was carried out. Results12 initiatives carried out by 318 schools (2.16% of all the schools with food service in Spain) were identified. Among these, 6 are governmental initiatives with a scope of 274 schools (1.86%), and 6 are non-governmental initiatives with a scope of 44 schools (0.30%). Most of these schools have a public management system in place (n=284). All the initiatives provide for the purchase of organic food. ConclusionLocal food purchase initiatives in Spain have a limited reach. However, the existence of a state directive could support and strengthen the development of such initiatives, given that school commitment is greater when initiatives are driven by the public sector.

Temporal scale efficiency in DEA panel data estimations. An application to the solid waste disposal service in Spain

The aim of this manuscript is analyse the long-term scale efficiency of the solid waste disposal service, with the application of a new method for calculating time-invariant and time-variant scale inefficiency using DEA panel data estimates, an approach that allows us to analyse the evolution of scale inefficiency over a period of time. The proposed method is applied to the solid waste collection service for the period 2002–2014 to determine the influence exerted by municipal size and form of service management, over an extended period, on service efficiency. The results obtained indicate that joint management forms obtain greater long-term scale efficiency. In addition, it is established that municipalities with populations between 20,000 and 50,000 inhabitants would improve their long-term scale efficiency if the service were outsourced.

Factor Structure and Internal Consistency of a Spanish Version of the Family Quality of Life (FaQoL)

This study examines the factor structure and internal consistency of the Spanish version of the Family Quality of Life scale (FaQoL). After translating and back-translating the instrument, we administered it to 324 families with a child with disabilities or developmental delays or who was at risk and who was enrolled in an early intervention (EI) program. Families were recruited from EI services in Spain, from 12 autonomous communities. Children’s average age was 38.6 months. Results showed the FaQoL scores had high internal consistency. Confirmatory factor analysis showed an adequate fit with the original factors, even slightly higher than the original four-factor solution. These results allow factors scores to be used reliably with Spanish families.

Mechanisms for participation in the public system of social services in Spain: opportunities for the development of social work with a citizenist approach

ABSTRACTThis article presents an analysis of the opportunities for participation of citizens in the public system of social services in Spain and their impact on the design, implementation, execution and evaluation of public policies of social services at a municipal level. The study also involved performing a comparative analysis of cases, assessing the impact, in terms of contributions and possibilities of the councils, upon the increased democratization of local public policies in terms of social welfare and the improvement of the efficiency with which social services and benefits are managed. The results of these investigations permit us, first of all, to present the diverse opportunities on offer for participation at a regional level in social services in Spain and then to identify, from its participants, dimensions that intensify processes of democratization and therefore help to improve efficiency of public well-being policies at a municipal level. In the case of the autonomous communities, we must highlight the changes that new social services laws have brought about in terms of widening citizens’ participation and opening up feedback for users of the system at a local level. In addition, this article discusses the role of different typologies and explores mechanisms, bodies and processes of participation that are applied in the design, management and assessment of social services policies at a local level. Finally, we determine which factors help to increase the efficiency of social public policies, as revealed by increases in citizens’ participation in local governance.

Evaluation in Primary Care Professionals: The Patient's Safety Culture

Abstract Introduction: Every day, millions of patients are safely and satisfactorily cared for in Primary Care centers (PC), although this care brings with it along a number of risks of involuntary harm or errors. Objectives: To describe the perception of Western Health District professionals in Almeria, regarding patient safety based on a translated and validated instrument for primary care services in Spain. Methodology: Transversal descriptive study. A sample of 216 self-completed questionnaires were obtained and sent to the District Quality Sub-Directorate. Statistical analysis was conducted on the characteristics of the responding professionals and the dimensions of the questionnaire. Results: The mean age of the professionals was 48 years and 66.70% were female. Their care activity had been carried out for a mean of 19 years (SD= 9). The main findings regarding aspects such as patient safety and quality have been presented ( = 4.08; IC 95%: 4.00-4.16). The dimensions receiving the worst responses in the Western Health District were “Error communication” ( = 1.97; IC 95%: 1.85-2.09), “Patient care follow up” ( = 1.88; IC 95%: 1.76-1.99), “Clear communication” ( = 2.19; IC 95%: 2.05-2.32) and “Workload and work rhythm” ( = 2.42; IC 95%: 2.29-2.54). Conclusions: Based on the information generated by professionals in Primary Care Centers, these results may allow for the design of patient care improvement strategies in the province of Almeria.

Transdiagnostic Cognitive Behavioral Therapy Versus Treatment as Usual in Adult Patients With Emotional Disorders in the Primary Care Setting (PsicAP Study): Protocol for a Randomized Controlled Trial.

BackgroundDemand for primary care (PC) services in Spain exceeds available resources. Part of this strong demand is due to the high prevalence of emotional disorders (EDs)—anxiety, depression, and somatic symptom disorders—and related comorbidities such as pain or chronic illnesses. EDs are often under- or misdiagnosed by general practitioners (GPs) and, consequently, treatment is frequently inadequate.ObjectiveWe aim to compare the short- and long-term effectiveness of group-delivered transdiagnostic cognitive behavioral therapy (TD-CBT) versus treatment as usual (TAU) in the treatment of EDs in the PC setting in Spain. We also aim to compare the effect of these treatments on disability, quality of life, cognitive-emotional factors, and treatment satisfaction.MethodsHere we present the study design of a two-arm, single-blind, randomized controlled trial (N=1126) to compare TAU to TD-CBT for EDs. TAU will consist primarily of pharmacological treatment and practical advice from the GP while TD-CBT will be administered in seven 90-minute group sessions held over a period ranging from 12 to 14 weeks. Psychological assessments are carried out at baseline (ie, pretreatment); posttreatment; and at 3-, 6-, and 12-month follow-up. The study is conducted in approximately 26 PC centers from the National Health System in Spain.ResultsThis study was initiated in December 2013 and will remain open to new participants until recruitment and follow-up has been completed. We expect all posttreatment evaluations to be completed by December 2017, and follow-up will end in December 2018.ConclusionsWe expect the TD-CBT group to have better results compared to TAU on all posttreatment measures and that this improvement will be maintained during follow-up. This project could serve as a model for use in other areas or services of the National Health System in Spain and even in other countries.ClinicalTrialInternational Standard Randomized Controlled Trial Number (ISRCTN): 58437086; http://www.isrctn.com/ISRCTN58437086 (Archived by WebCite at http://www.webcitation.org/6mbYjQSn3)

Children’s services in Spain: a study of the organisation and implementation of children’s services in three regions in response to European recommendations

Purpose The purpose of this paper is to map the current organisation and implementation of children’s services in three regions of Spain, to identify strengths and gaps and to suggest proposals for improvement in line with European recommendations. Design/methodology/approach Spain features a decentralised approach when it comes to the organisation of children’s services. This means that relevant themes for children’s services refer to decentralised policies, which diverge within the regions in the country and therefore to illustrate this the authors focus on three specific regions. The study used an exploratory case study design and relied on qualitative methods, including the answers to open questionnaires provided by senior civil servants at key regional child welfare agencies, children’s services directors and service providers. Findings The main finding from the review of the legislation and the answers to the questionnaires is that public social services still follow an assistance logic rather than a social investment approach in regards to children’s services. Although a significant development of laws and policies has taken place, ensuring the implementation, monitoring and evaluation of programmes and services for children remains a challenge. Research limitations/implications The answers provided by the respondents may be subject to limitations imposed by the agencies for which they work. A general disadvantage of qualitative research is the use of subjective criteria to interpret the relevance of the results. The study was further challenged by differences across regions when it comes to their legal and policy frameworks, development of provisions and implementation and outcomes’ evaluation. Practical implications The findings could be used to assess the state of play in regards to children’s services across the regions studied and beyond with a focus on children being placed at the centre of public services’ intervention, using a comprehensive approach and promoting critical thinking and reflective practice. Social implications The three selected case studies provide additional insight into policy and legal developments, implementation and evaluation of activities and efforts to improve policy and practice in children’s services. Originality/value This paper contributes to the evaluation of the current situation of children’s services in Spain from a decentralised perspective with the aim to facilitate changes to improve planning, implementation and evaluation of children’s services and secure better outcomes for children.

Satisfacción de usuarios y profesionales en la evaluación de programas sociales

The study of customers´ satisfaction is usually included in most of the quality management models and it is a relevant element in any process of assessment and improvement of services. This trend, deeply rooted in the private field, has also spread over the public services and in social services. This paper sustains the relevance of developing satisfaction studies in general social services, not only from customers´perspective, but also from professionals. It is a proved trend that citizens make a good judgement of social services provision, in line with several opinion polls about public services in Spain. On the same line, although there are little studies about people working in social services opinion, it is relevant the high satisfaction expressed by front line staff, that shows an important vocation in most of social services employees.

Cost and price auditing: effectiveness in the procurement of defense services in Spain

Abstract Contract auditing, or cost and price auditing, has been applied in Spain as a means of determining prices in non-competitive defense contracts since 1989. Factors such as Spain's participation in international defense organizations, the characteristics of the defense market and the contractual legal framework for the procurement of defense goods and services help underscore the need for the Spanish Ministry of Defense to implement cost and price auditing. With the evolution of cost and price auditing in Spain in mind, this paper analyses the entire process, describes the audit procedures that are most commonly used today and assesses the main results achieved, in terms of financial savings. The results obtained show that cost and price auditing does indeed contribute to a more efficient use of public resources.

Public–private partnerships (PPPs) in local services: risk-sharing and private delivery of water services in Spain

ABSTRACTLocal governments are increasingly utilising the public–private partnership (PPP) model as a means of organising service delivery in the public–private domain. This article examines the experiences with construction and operation of 131 PPP wastewater treatment plants in the region of Aragon, Spain. The study highlights how an inadequate management of construction risk and unsuitable transfer of demand and revenue risk resulted in significant time delays in execution of the PPP projects. The research also shows how the involvement of public bodies at local, regional and national level further added to the complexity of implementing the projects. The findings contribute to the literature on local service delivery and provide insights regarding risk transfer in long-term PPP contracts for the delivery of local services in general and water services in particular.

The Rectal Cancer Project of the Spanish Association of Surgeons

The Spanish Rectal Cancer Project was established in 2006, inspired by the Norwegian Rectal Cancer Project. It consisted of an educational project aiming to introduce mesorectal excision surgery to surgeons, pathologists and radiologists to establish a network of the Spanish National Health Service in Spain. MethodsAll hospitals covering a population area of at least 300,000 inhabitants and operating on more than 12 patients per year were invited to participate. The project was carried out similarly to the Norwegian one. Several “hands on” workshops were arranged yearly between 2006 and 2012. A central registry measured the effectiveness of the project with feedback to participating institutions of their own results compared with the national average. ResultsThe National Health System consists of 261 hospitals of which 103 were included in the project. Of these 23 were excluded due to non-compliance with data registration. Therefore, the analysis included results from 80 hospitals covering a geographical area with 19,329,992 inhabitants. From 2006 to 2015 a total of 14,815 patients had a curative resection. The postoperative mortality rate was 1.8%; postoperative complications were observed in 39.9% patients; 10% developed anastomotic leakage and 9% required reoperation. The outcomes observed in 3088 cancer patients who have completed a five-year follow-up were: 6.2% local recurrence, metastasis 18.8% and 73.5% overall survival. ConclusionsThis project shows that the results obtained in Scandinavia have been reproduced in a larger population in Spain applying a similar methodology focused on the spread of competence and auditing of results.