Archivo en PDF (2 MB). Bogotá : Biblioteca Nacional de Colombia, 2010

Descripción física : [2] p. ; 34 cm

Título tomado del indice ms. del volumen que contiene la pieza

NEW-GRAL

NEW-GRAL

Bibliografía: página 26

1. Objeto y campo de aplicación -- 2. Términos y definiciones -- 3. Gobernanza -- 4. Evaluación de riesgos y establecimiento de frecuencias de aseo -- 5. Tareas de aseo -- 6. Medición y auditoría -- 7. Acción correctiva -- 8. Análisis del desempeño, revisión y acciones de mejora -- 9. Mejora continua del servicio -- 10. Informes

Descripción física : 20 p. ; 16 cm

Este estudio utiliza el Indicador de Luenberger para evaluar la eficiencia y productividad de los hospitales públicos en Colombia. El análisis empírico se realizó para una muestra de 336 hospitales durante el periodo 2003-2011. Los resultados indican una caída de la productividad de los hospitales públicos colombianos, sustentada en el deterioro del cambio tecnológico como resultado de una escasa inversión en tecnología. Evidencia de esto es que solo uno de cada veinticinco hospitales experimentó un desempeño eficiente y productivo, mientras uno de cada tres evidenció lo contrario. Por regiones, los hospitales de las zonas Central y Caribe fueron los más ineficientes e improductivos. Además, contribuyeron con dos terceras partes de la disminución de la productividad general.

This dissertation analyzes health human capital issues in developing countries. The first two essays examine the production of human capital at the household level, and the third essay analyzes supply of health care services. The first essay tests for noncooperative behavior using the Mexican Family Life Survey (MXFLS), a nationally representative longitudinal survey of households that identifies and keeps track of local and international migrants. Migration introduces asymmetries of information that might trigger noncooperative behavior of spouses left behind. I use the MXFLS to study noncooperative behavior in Mexican households and the way this behavior and effects children's human capital. I find that migration causes noncooperative behavior in the spouse left behind, namely spouses reduce the time in doing chores and do not change their labor supply. At the same time, boys do more agricultural work and girls have to spend more time in taking care of other members. Migration positively affects school enrollment, but nonlinear e effects suggest younger children are bearing most of the negative effect because, as the literature suggests, lower school enrollment at early ages means lower cognitive achievement later on. In the second essay I analyze production of health in Chinese children. Modernization and subsequent changes in lifestyle have caused a dramatic increase in prevalence of obesity in China. Since obesity is one of the main forces driving noncommunicable diseases (NCDs), increases in prevalence of obesity in children lead to higher incidence of NCDs and reduction in health human capital. Intervention in public policy must be based on an understanding of how health is produced in the household. I use the China Health and Nutrition Survey (CHNS) to carry out structural estimation of the health production function for children in China. Results suggest that calorie intake is the most important input in the production of excessive weight with an impact on weight three times larger than sedentary activities and six times larger than physical activities. Calorie intake also has a more than proportional effect on unhealthy extra weight. These results suggest that public health policies must focus on reducing excessive calorie intake. The third essay studies subsidies for public hospitals in Colombia. Health services in Colombia are provided by public and private hospitals that, by law, must compete with one another in a perfectly competitive environment. However, by constitutional mandate, public hospitals must guarantee health care for all - even in municipalities where market conditions cannot sustain a hospital and government subsidization is required. The subsidy should provide the hospital enough solvencies to operate as well as incentives to be efficient. I propose a method to estimate subsidies for public hospitals. The method combines measures of efficiency derived from cost frontiers and production frontiers. Estimations for 2008 suggest an aggregate subsidy of $4869.2 MM Colombian pesos. Also, the proportion of costs that must be subsidized is lower for hospitals that offer more complex health services.