Capítulo 1. Mejorando la información y el conocimiento para las intervenciones sobre la salud
¿Cómo mejorar la efectividad (calidad) reduciendo la brecha de la investigación a la acción? Informe SESPAS 2008
How can we improve effectiveness [quality] by reducing the gap between research and action?
Enrique Bernal Delgado
Autor para correspondencia
ebernal.iacs@aragon.es
Correspondencia: Enrique Bernal Delgado. Instituto Aragonés de Ciencias de la Salud.
Correspondencia: Enrique Bernal Delgado. Instituto Aragonés de Ciencias de la Salud.
Unidad de Investigación de Servicios Sanitarios, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España
Leído
1114
Vecesse ha leído el artículo
402
Total PDF
712
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S0213911108760710" "issn" => "02139111" "doi" => "10.1016/S0213-9111(08)76071-0" "estado" => "S300" "fechaPublicacion" => "2008-04-01" "aid" => "76071" "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria" "copyrightAnyo" => "2008" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Gac Sanit. 2008;22 Supl 1:19-26" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1938 "formatos" => array:3 [ "EPUB" => 124 "HTML" => 1306 "PDF" => 508 ] ] "itemSiguiente" => array:19 [ "pii" => "S0213911108760722" "issn" => "02139111" "doi" => "10.1016/S0213-9111(08)76072-2" "estado" => "S300" "fechaPublicacion" => "2008-04-01" "aid" => "76072" "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Gac Sanit. 2008;22 Supl 1:27-36" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2401 "formatos" => array:3 [ "EPUB" => 159 "HTML" => 1592 "PDF" => 650 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Capítulo 1. Mejorando la información y el conocimiento para las intervenciones sobre la salud</span>" "titulo" => "El marketing como herramienta para incrementar la eficacia de los planes de salud pública. Informe SESPAS 2008" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "27" "paginaFinal" => "36" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Marketing as a tool to increase the effectiveness of public health plans" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Asunción Beerli-Palacio, Josefa D. Martín-Santana, Miquel Porta" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Asunción" "apellidos" => "Beerli-Palacio" ] 1 => array:2 [ "nombre" => "Josefa D." "apellidos" => "Martín-Santana" ] 2 => array:2 [ "nombre" => "Miquel" "apellidos" => "Porta" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108760722?idApp=WGSE" "url" => "/02139111/00000022000000S1/v1_201301221349/S0213911108760722/v1_201301221349/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0213911108760709" "issn" => "02139111" "doi" => "10.1016/S0213-9111(08)76070-9" "estado" => "S300" "fechaPublicacion" => "2008-04-01" "aid" => "76070" "copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Gac Sanit. 2008;22 Supl 1:14-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2012 "formatos" => array:3 [ "EPUB" => 144 "HTML" => 1360 "PDF" => 508 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Capítulo 1. Mejorando la información y el conocimiento para las intervenciones sobre la salud</span>" "titulo" => "Integración de la información para las intervenciones sanitarias: de los datos a la información; de la información a la acción. Informe SESPAS 2008" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "14" "paginaFinal" => "18" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Integration of information for health interventions: from data to information and from information to action" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos Campillo Artero" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Carlos" "apellidos" => "Campillo Artero" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108760709?idApp=WGSE" "url" => "/02139111/00000022000000S1/v1_201301221349/S0213911108760709/v1_201301221349/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Capítulo 1. Mejorando la información y el conocimiento para las intervenciones sobre la salud</span>" "titulo" => "¿Cómo mejorar la efectividad (calidad) reduciendo la brecha de la investigación a la acción? Informe SESPAS 2008" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "19" "paginaFinal" => "26" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Enrique Bernal Delgado" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Enrique" "apellidos" => "Bernal Delgado" "email" => array:1 [ 0 => "ebernal.iacs@aragon.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad de Investigación de Servicios Sanitarios, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Enrique Bernal Delgado. Instituto Aragonés de Ciencias de la Salud." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "How can we improve effectiveness [quality] by reducing the gap between research and action?" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec13629" "palabras" => array:4 [ 0 => "Efectividad" 1 => "Calidad" 2 => "Gestión del conocimiento" 3 => "Implementación" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec13630" "palabras" => array:4 [ 0 => "Effectiveness" 1 => "Quality" 2 => "Knowledge management" 3 => "Implementation" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La investigación sobre la efectividad de las tecnologías y la calidad de los cuidados es un elemento primordial en las políticas de generación de conocimiento de los países de nuestro entorno. Al mismo tiempo, hay un amplio consenso sobre la necesidad de reforzar el componente traslacional de este tipo de investigación bajo la hipótesis de que la transferencia de conocimiento a la práctica es una condición necesaria para mejorar los cuidados de salud.</p><p class="elsevierStyleSimplePara elsevierViewall">A lo largo del texto se analizan algunas características de las organizaciones sanitarias que facilitan o dificultan la transferencia de conocimiento. Se muestran, también, algunas experiencias exitosas de las que se puede aprender para reducir la brecha y mejorar la efectividad (calidad) de los cuidados.</p><p class="elsevierStyleSimplePara elsevierViewall">Entre los mecanismos que pueden reducir (o mantener) la brecha se encuentran los siguientes: <span class="elsevierStyleItalic">a)</span> el tipo de organización (tipo de proveedor, estatus académico, mezcla de profesionales, su capacidad para aprender e innovar, etc.); <span class="elsevierStyleItalic">b)</span> su gobierno (liderazgo en la implementación de la evidencia, capacidad en la gestión de los roles profesionales, posibilidad de utilizar incentives económicos, disponer de un entorno rico en información, utilizar la gestión del conocimiento, etc.), y <span class="elsevierStyleItalic">c)</span> la efectividad de las propias estrategias para difundir el conocimiento.</p><p class="elsevierStyleSimplePara elsevierViewall">Por último, se detalla cómo las experiencias exitosas que se describen han centrado sus esfuerzos en la implementación de la evidencia, en investigar aquello que se necesita y en reinventar la organización para convertir la información en conocimiento.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">In our environment, research on health technologies and health care effectiveness is a prominent issue in current knowledge policies. Nevertheless, there is wide consensus on the need for additional efforts to develop the translational component of this kind of research under the hypothesis that taking research into practice is a necessary condition for improving healthcare.</p><p class="elsevierStyleSimplePara elsevierViewall">The characteristics that facilitate or hinder knowledge transfer in healthcare organizations are analyzed throughout the present text. At the same time, we discuss some successful experiences that illustrate how the chasm can be reduced and healthcare effectiveness (i.e. quality) improved.</p><p class="elsevierStyleSimplePara elsevierViewall">Among the mechanisms that might either reduce or maintain the chasm are the following: <span class="elsevierStyleItalic">1)</span> the type of organization (healthcare provider model, teaching status, mix of professionals, the organization's capacity to learn and innovate, etc.); <span class="elsevierStyleItalic">2)</span> the organization's government (leadership in evidence implementation, capacity to manage professional roles, ability to use economic incentives, availability of an information-rich context, the use of knowledge management, etc.), and <span class="elsevierStyleItalic">3)</span> the effectiveness of the strategies themselves in translating evidence into practice.</p><p class="elsevierStyleSimplePara elsevierViewall">Finally, we describe some successful experiences focusing on implementation, on researching the evidence that is needed, and on reinventing the organization to convert information into knowledge.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patient Outcomes Research Teams and the Agency for Health Care Policy and Research" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.E. Salive" 1 => "J.A. Mayfield" 2 => "N.W. Weissman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "HSR" "fecha" => "1990" "volumen" => "25" "paginaInicial" => "697" "paginaFinal" => "708" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2254084" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Guía europea de prevención cardiovascular en la práctica clínica. Madrid: Ministerio de Sanidad y Consumo; 2004." ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recomendaciones preventivas cardiovasculares en atención primaria" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "por el Grupo de Prevención Cardiovascular del PAPPS" "etal" => false "autores" => array:6 [ 0 => "F. Villar" 1 => "A. Maiques" 2 => "C. Brotons" 3 => "J. Torcal" 4 => "J.R. Banegas" 5 => "A. Lorenzo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Aten Primaria" "fecha" => "2005" "volumen" => "36" "numero" => "Suppl 2" "paginaInicial" => "11" "paginaFinal" => "26" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Estrategia en cardiopatía isquémica del Sistema Nacional de Salud. Madrid: Ministerio de Sanidad y Consumo; 2006." ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tratamiento del infarto agudo de miocardio en España en el año 2000. El estudio PRIAMHO II" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "por los investigadores del estudio PRIAHMO II" "etal" => false "autores" => array:6 [ 0 => "F. Arós" 1 => "J. Cuñat" 2 => "A. Loma-Osorio" 3 => "E. Torrdo" 4 => "X. Bosch" 5 => "J.J. Rodríguez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2003" "volumen" => "56" "paginaInicial" => "1165" "paginaFinal" => "1173" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14670268" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La asistencia prehospitalaria en los síndromes coronarios agudos. Experiencia del Grupo ARIAM" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "por el grupo ARIAM" "etal" => false "autores" => array:5 [ 0 => "E. Aguayo" 1 => "A. Reina" 2 => "M. Ruiz" 3 => "M. Colemenero" 4 => "M. García" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Aten Primaria" "fecha" => "2001" "volumen" => "27" "paginaInicial" => "478" "paginaFinal" => "483" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11334594" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recursos hospitalarios y letalidad por infarto de miocardio. Estudio IBERICA" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "por el grupo IBERICA" "etal" => false "autores" => array:6 [ 0 => "E. Álvarez-León" 1 => "R. Elosua" 2 => "A. Zamora" 3 => "E. Aldasoro" 4 => "J. Galcerá" 5 => "H. Vanaclocha" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2004" "volumen" => "57" "paginaInicial" => "514" "paginaFinal" => "523" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15225498" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Variaciones en la hospitalización por problemas y procedimientos cardiovasculares en el Sistema Nacional de Salud" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "por el Grupo de Variaciones en la Práctica Médica en el Sistema Nacional de Salud (Grupo VPM-SNS)" "etal" => false "autores" => array:6 [ 0 => "S. Márquez-Calderón" 1 => "A. Jiménez" 2 => "E. Perea" 3 => "E. Briones" 4 => "E. Aguayo" 5 => "A. Reina" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Atlas Var Prac Med SNS" "fecha" => "2006" "volumen" => "2" "paginaInicial" => "151" "paginaFinal" => "164" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Differences between women's and men's acces to interventional cardiovascualr procedures at public hositals in Andalusia (SPAIN)" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "por el VPMIRySS Andalusia Group" "etal" => false "autores" => array:3 [ 0 => "M.J. Aguado" 1 => "S. Márquez-Calderón" 2 => "M.L. Buzón" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2006" "volumen" => "59" "paginaInicial" => "785" "paginaFinal" => "793" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16938227" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The relationship between organizational characteristics and the effects of clinical guidelines on medical performance in hospitals: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Dijkstra" 1 => "M. Wensing" 2 => "R. Thomas" 3 => "R. Akkermans" 4 => "J. Braspenning" 5 => "J. Grimshaw" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1472-6963-6-53" "Revista" => array:5 [ "tituloSerie" => "BMC Health Services Research" "fecha" => "2006" "volumen" => "6" "paginaInicial" => "53" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16646968" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The impact of Health Plan Delivery System Organization on Clinical Quality and Patient Satisfaction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.R. Gillies" 1 => "K.E. Chenok" 2 => "S.M. Shortell" 3 => "G. Pawlson" 4 => "J.J. Wimbush" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1475-6773.2006.00529.x" "Revista" => array:6 [ "tituloSerie" => "Health Serv Res" "fecha" => "2006" "volumen" => "41" "paginaInicial" => "1181" "paginaFinal" => "1199" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16899002" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Are physician reimbursement strategies associated with processes of care and patient satisfaction for patients with diabetes in managed care?" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "por el TRIAD study" "etal" => false "autores" => array:6 [ 0 => "S.L. Tener" 1 => "T.J. Thompson" 2 => "M.R. Stevens" 3 => "C.M. Mansiones" 4 => "C. Kim" 5 => "W.N. Steers" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1475-6773.2006.00533.x" "Revista" => array:6 [ "tituloSerie" => "Health Serv Res" "fecha" => "2006" "volumen" => "41" "paginaInicial" => "1221" "paginaFinal" => "1241" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16899004" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microsystems in health care (I). Learning from high-performing front-line clinical units" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.C. Nelson" 1 => "P.B. Batalden" 2 => "T.P. Huber" 3 => "J.J. Mohr" 4 => "M.M. Godfrey" 5 => "L.A. Headrick" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Qual Improvement" "fecha" => "2002" "volumen" => "28" "paginaInicial" => "472" "paginaFinal" => "493" "itemHostRev" => array:3 [ "pii" => "S0213911109000922" "estado" => "S300" "issn" => "02139111" ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "effectiveness and efficiency of guideline dissemination and implementation strategies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Grimshaw" 1 => "R.E. Thomas" 2 => "G. MacLennan" 3 => "C. Fraser" 4 => "C.R. Ramsay" 5 => "L. Vale" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Health Technol Assess" "fecha" => "2004" "volumen" => "8" "numero" => "6" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.E. Phelps" 1 => "C. Mooney" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:2 [ "titulo" => "Variations in medical practice use: causes and consequences, in competitive approaches to health care reform" "serieFecha" => "1993" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The economics of iatroepidemics and quakeries: physician learning, informational cascades and geographic variation in medical practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Bikhchandani" 1 => "A. Chandra" 2 => "D.P. Goldman" 3 => "I. Welch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2002" "editorial" => "Department of Economics Working Paper" "editorialLocalizacion" => "Washington, DC" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "¿A qué incentivos responde la utilización hospitalaria en el Sistema Nacional de Salud?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Peiró" 1 => "E. Bernal-Delgado" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Gac Sanit" "fecha" => "2006" "volumen" => "20" "numero" => "Suppl 1" "paginaInicial" => "110" "paginaFinal" => "116" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16539973" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "In pursuit of quality: the National Institute for Clinical Excellence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Rawlins" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(99)02381-8" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1999" "volumen" => "353" "paginaInicial" => "1079" "paginaFinal" => "1082" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10199366" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "How to put NICE guidance into practice. Washington, DC: National Institute for Health and Clinical Excellence; 2005." ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "AHRQ's FY 2005 budget request: new mission, new vision" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C.M. Clancy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Health Serv Res" "fecha" => "2004" "volumen" => "39" "paginaInicial" => "11" "paginaFinal" => "18" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Moving research into practice: lessons form the US Agency for Healthcare Research and Quality's IDSRN Program" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Gold" 1 => "E.F. Taylor" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1748-5908-2-9" "Revista" => array:5 [ "tituloSerie" => "Implementation Science" "fecha" => "2007" "volumen" => "2" "paginaInicial" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17394644" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Received Wisdoms: how health systems are using evidence to inform decision-making. Canadian Health Services Research Foundation [citado Mar 2007]. Disponible en: <a class="elsevierStyleInterRef" href="http://www.chsrf.ca/pdf/received_wisdoms_e.pdf">http://www.chsrf.ca/pdf/received_wisdoms_e.pdf</a>" ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microsystems in health care (II). Creating a rich information environment" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.C. Nelson" 1 => "P.B. Batalden" 2 => "C. Homa" 3 => "M.M. Godfrie" 4 => "C. Campbell" 5 => "L.A. Headrick" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Qual Improvement" "fecha" => "2003" "volumen" => "29" "paginaInicial" => "5" "paginaFinal" => "15" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/02139111/00000022000000S1/v1_201301221349/S0213911108760710/v1_201301221349/es/main.assets" "Apartado" => array:4 [ "identificador" => "714" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Capítulo 1. Mejorando la información y el conocimiento para las intervenciones sobre la salud" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02139111/00000022000000S1/v1_201301221349/S0213911108760710/v1_201301221349/es/main.pdf?idApp=WGSE&text.app=https://gacetasanitaria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911108760710?idApp=WGSE" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 4 | 2 | 6 |
| 2024 Octubre | 50 | 31 | 81 |
| 2024 Septiembre | 43 | 18 | 61 |
| 2024 Agosto | 67 | 29 | 96 |
| 2024 Julio | 40 | 22 | 62 |
| 2024 Junio | 45 | 22 | 67 |
| 2024 Mayo | 46 | 46 | 92 |
| 2024 Abril | 44 | 25 | 69 |
| 2024 Marzo | 36 | 19 | 55 |
| 2024 Febrero | 37 | 30 | 67 |
| 2024 Enero | 30 | 19 | 49 |
| 2023 Diciembre | 35 | 16 | 51 |
| 2023 Noviembre | 36 | 20 | 56 |
| 2023 Octubre | 35 | 21 | 56 |
| 2023 Septiembre | 38 | 21 | 59 |
| 2023 Agosto | 32 | 16 | 48 |
| 2023 Julio | 41 | 23 | 64 |
| 2023 Junio | 35 | 15 | 50 |
| 2023 Mayo | 18 | 7 | 25 |
Mostrar todo
