Compartir
array:24 [
"pii" => "S0213911102719511"
"issn" => "02139111"
"doi" => "10.1016/S0213-9111(02)71951-1"
"estado" => "S300"
"fechaPublicacion" => "2002-09-01"
"aid" => "71951"
"copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria"
"copyrightAnyo" => "2002"
"documento" => "article"
"crossmark" => 0
"licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
"subdocumento" => "fla"
"cita" => "Gac Sanit. 2002;16:417-24"
"abierto" => array:3 [
"ES" => true
"ES2" => true
"LATM" => true
]
"gratuito" => true
"lecturas" => array:2 [
"total" => 3390
"formatos" => array:3 [
"EPUB" => 124
"HTML" => 2816
"PDF" => 450
]
]
"itemSiguiente" => array:19 [
"pii" => "S0213911102719523"
"issn" => "02139111"
"doi" => "10.1016/S0213-9111(02)71952-3"
"estado" => "S300"
"fechaPublicacion" => "2002-09-01"
"aid" => "71952"
"copyright" => "Sociedad Española de Salud Pública y Administración Sanitaria"
"documento" => "article"
"crossmark" => 0
"licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
"subdocumento" => "rev"
"cita" => "Gac Sanit. 2002;16:425-35"
"abierto" => array:3 [
"ES" => true
"ES2" => true
"LATM" => true
]
"gratuito" => true
"lecturas" => array:2 [
"total" => 3201
"formatos" => array:3 [
"EPUB" => 119
"HTML" => 2494
"PDF" => 588
]
]
"es" => array:9 [
"idiomaDefecto" => true
"titulo" => "Análisis comparado del impacto de las políticas impositivas vía precio en el consumo de tabaco"
"tienePdf" => "es"
"tieneTextoCompleto" => 0
"tieneResumen" => "es"
"paginas" => array:1 [
0 => array:2 [
"paginaInicial" => "425"
"paginaFinal" => "435"
]
]
"contieneResumen" => array:1 [
"es" => true
]
"contienePdf" => array:1 [
"es" => true
]
"autores" => array:1 [
0 => array:2 [
"autoresLista" => "J. Pinilla"
"autores" => array:1 [
0 => array:2 [
"nombre" => "J."
"apellidos" => "Pinilla"
]
]
]
]
]
"idiomaDefecto" => "es"
"EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911102719523?idApp=WGSE"
"url" => "/02139111/0000001600000005/v1_201310251655/S0213911102719523/v1_201310251655/es/main.assets"
]
"itemAnterior" => array:19 [
"pii" => "S021391110271950X"
"issn" => "02139111"
"doi" => "10.1016/S0213-9111(02)71950-X"
"estado" => "S300"
"fechaPublicacion" => "2002-09-01"
"aid" => "71950"
"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. 2002;16:408-16"
"abierto" => array:3 [
"ES" => true
"ES2" => true
"LATM" => true
]
"gratuito" => true
"lecturas" => array:2 [
"total" => 3332
"formatos" => array:3 [
"EPUB" => 122
"HTML" => 2696
"PDF" => 514
]
]
"es" => array:10 [
"idiomaDefecto" => true
"titulo" => "Análisis cualitativo de las innovaciones organizativas en hospitales públicos españoles"
"tienePdf" => "es"
"tieneTextoCompleto" => 0
"tieneResumen" => array:2 [
0 => "es"
1 => "en"
]
"paginas" => array:1 [
0 => array:2 [
"paginaInicial" => "408"
"paginaFinal" => "416"
]
]
"titulosAlternativos" => array:1 [
"en" => array:1 [
"titulo" => "(Qualitative analysis of organizational innovations in Spanish public hospitals)"
]
]
"contieneResumen" => array:2 [
"es" => true
"en" => true
]
"contienePdf" => array:1 [
"es" => true
]
"autores" => array:1 [
0 => array:2 [
"autoresLista" => "J. del Llano, J.F. Martínez-Cantarero, J. Gol, F. Raigada"
"autores" => array:4 [
0 => array:2 [
"nombre" => "J."
"apellidos" => "del Llano"
]
1 => array:2 [
"nombre" => "J.F."
"apellidos" => "Martínez-Cantarero"
]
2 => array:2 [
"nombre" => "J."
"apellidos" => "Gol"
]
3 => array:2 [
"nombre" => "F."
"apellidos" => "Raigada"
]
]
]
]
]
"idiomaDefecto" => "es"
"EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021391110271950X?idApp=WGSE"
"url" => "/02139111/0000001600000005/v1_201310251655/S021391110271950X/v1_201310251655/es/main.assets"
]
"es" => array:14 [
"idiomaDefecto" => true
"titulo" => "Opiniones de los gestores de la atención primaria sobre las fuentes de influencia en la práctica médica. Diferencias con la opinión de los médicos asistenciales"
"tieneTextoCompleto" => 0
"paginas" => array:1 [
0 => array:2 [
"paginaInicial" => "417"
"paginaFinal" => "424"
]
]
"autores" => array:2 [
0 => array:4 [
"autoresLista" => "L.A. López, J.M. Jiménez, O. Solas, J.I. Martínez, E. de Manuel"
"autores" => array:5 [
0 => array:4 [
"nombre" => "L.A."
"apellidos" => "López"
"email" => array:1 [
0 => "luisandres@easp.es"
]
"referencia" => array:1 [
0 => array:2 [
"etiqueta" => "*"
"identificador" => "cor0005"
]
]
]
1 => array:2 [
"nombre" => "J.M."
"apellidos" => "Jiménez"
]
2 => array:2 [
"nombre" => "O."
"apellidos" => "Solas"
]
3 => array:2 [
"nombre" => "J.I."
"apellidos" => "Martínez"
]
4 => array:2 [
"nombre" => "E."
"apellidos" => "de Manuel"
]
]
"afiliaciones" => array:1 [
0 => array:1 [
"entidad" => "Escuela Andaluza de Salud Pública (EASP). Granada"
]
]
"correspondencia" => array:1 [
0 => array:3 [
"identificador" => "cor0005"
"etiqueta" => "*"
"correspondencia" => "Correspondencia: Luis Andrés López Fernández. Escuela Andaluza de Salud Pública. Campus Universitario de Cartuja, s/n. 18080 Granada"
]
]
]
1 => array:3 [
"autoresLista" => "J.D. de Luna"
"autores" => array:1 [
0 => array:3 [
"nombre" => "J.D."
"apellidos" => "de Luna"
"referencia" => array:1 [
0 => array:2 [
"etiqueta" => "<span class="elsevierStyleSup">a</span>"
"identificador" => "aff0005"
]
]
]
]
"afiliaciones" => array:1 [
0 => array:3 [
"entidad" => "Facultad de Medicina. Universidad de Granada"
"etiqueta" => "a"
"identificador" => "aff0005"
]
]
]
]
"titulosAlternativos" => array:1 [
"en" => array:1 [
"titulo" => "(Opinions of primary care managers on sources of influence on medical practice. Differences with physicians' opinions)"
]
]
"pdfFichero" => "main.pdf"
"tienePdf" => true
"fechaRecibido" => "2001-10-02"
"fechaAceptado" => "2002-06-18"
"PalabrasClave" => array:2 [
"es" => array:1 [
0 => array:4 [
"clase" => "keyword"
"titulo" => "Palabras clave"
"identificador" => "xpalclavsec268836"
"palabras" => array:4 [
0 => "Patrones de práctica médica"
1 => "Atención primaria"
2 => "Variaciones en la práctica médica"
3 => "Gestión sanitaria"
]
]
]
"en" => array:1 [
0 => array:4 [
"clase" => "keyword"
"titulo" => "Key words"
"identificador" => "xpalclavsec268837"
"palabras" => array:4 [
0 => "Medical practice patterns"
1 => "Primary healthcare"
2 => "Variations in medical practice"
3 => "Health management"
]
]
]
]
"tieneResumen" => true
"resumen" => array:2 [
"es" => array:2 [
"titulo" => "Resumen"
"resumen" => "<span class="elsevierStyleSectionTitle"><span class="elsevierStyleItalic">Objetivos</span></span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los objetivos del estudio son: conocer la opinión de los gestores de atención primaria acerca de la importancia y legitimidad de distintas fuentes de influencia en la práctica médica, y comparar estos resultados con la opinión de los médicos asistenciales de los equipos de atención primaria.</p> <span class="elsevierStyleSectionTitle"><span class="elsevierStyleItalic">Material y métodos</span></span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Diseño de estudio transversal. Población: gestores de atención primaria pertenecientes a la Red del INSALUD (gerentes de área, directores médicos y de enfermería) y al Servicio Andaluz de Salud (directores de distrito, coordinadores de enfermería y coordinadores de epidemiología y programas). La muestra se corresponde con la población total y fue de 302. Como variables dependientes se consideró un conjunto de preguntas que recogían las opiniones de los entrevistados sobre distintas estrategias, instituciones y/o colectivos que ejercen algún tipo de influencia en la práctica médica. El grado de «importancia» de cada una de ellas se sintetizó en un conjunto de 9 ítems que se pedía que se puntuaran desde 1 (el más importante) hasta 9 (el menos importante). Para valorar la «legitimidad» de las mismas se presentaron 16 ítems medidos mediante una escala tipo Likert de 7 puntos (1: nada legítimo; 7: muy legítimo). Se utilizó un cuestionario autoadministrado enviado por correo. Para el análisis estadístico de los datos se emplearon test no paramétricos (Friedman y Kruskall-Wallis).</p> <span class="elsevierStyleSectionTitle"><span class="elsevierStyleItalic">Resultados</span></span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La tasa de respuesta fue del 79,8%. El análisis de los rangos medios de cada ítem, mediante el test de Friedman para una escala ordinal de 9 puntos, puso de manifiesto que entre las fuentes de influencia más importantes para los gestores sanitarios de atención primaria estudiados destacan: la elaboración de protocolos de actuación por los propios médicos; la discusión con los colegas; recibir retroalimentación de los pacientes atendidos, y la asistencia a cur-sos de formación, lectura de artículos e informes científicos. Las instituciones o colectivos con mayor legitimidad para influir en la práctica médica son: los usuarios o ciudadanos, las auditorías internas, los compañeros de trabajo médicos, las organizaciones científicas y los propios gestores.</p> <span class="elsevierStyleSectionTitle"><span class="elsevierStyleItalic">Conclusiones</span></span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las fuentes de influencia que se consideran más importantes y legitimadas para influir en la práctica médica se sitúan en torno al denominado «sistema profesional médico». Respecto a las principales diferencias entre la opinión de los gestores y la de los médicos asistenciales, hay que señalar que entre los primeros cuentan con una mayor aceptación los mecanismos de gestión empresarial y las influencias en la práctica médica procedentes de los distintos actores del contexto social. Este hecho podría expresar la existencia de diferencias en los sistemas de valores entre los profesionales asistenciales y los gestores de la atención primaria.</p>"
]
"en" => array:2 [
"titulo" => "Summary"
"resumen" => "<span class="elsevierStyleSectionTitle"><span class="elsevierStyleItalic">Objectives</span></span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine the opinion of primary healthcare managers on the importance and legitimacy of different sources of influence in medical practice, and to compare the results with the opinions of physicians in healthcare teams.</p> <span class="elsevierStyleSectionTitle"><span class="elsevierStyleItalic">Material and methods</span></span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Design: cross-sectional study. Population: primary healthcare managers in the Spanish public health system (area managers, medical and nursing directors) and in the Andalusian health service (district director, nursing coordinators and epidemiology and program coordinators). The sample comprised the total population of 302. As dependent variables, a series of questions was designed to gather the interviewees’ opinions on different strategies, institutions and/or collectives that exert some kind of influence on medical practice. The degree of «importance» of each factor was summarized into a set of 9 items. The subjects were asked to score each item from 1 (most important) to 9 (least important). To assess the «legitimacy» of these scores, 16 items were presented measured using a Likert-type 7-point scale (1: not at all legitimate; 7: very legitimate). A self-administered questionnaire was used, sent by mail. Non-parametric tests (Friedman and Kruskall-Wallis) were used for statistical analysis of the data.</p> <span class="elsevierStyleSectionTitle"><span class="elsevierStyleItalic">Results</span></span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The response rate was 79.8%. Using the Friedman test for an ordinal 9-point scale, analysis of the mean ranges for each item revealed that the most important sources of influence for the primary healthcare managers interviewed were: the devising of management protocols by the doctors themselves; discussion with colleagues; feedback from patients, and attending training courses, and reading articles and scientific journals. The institutions or groups with the greatest legitimacy to influence medical practice were: users or citizens; internal audits; peers; scientific associations, and the managers themselves.</p> <span class="elsevierStyleSectionTitle"><span class="elsevierStyleItalic">Conclusions</span></span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The sources of influence considered to have the greatest importance and legitimacy in influencing medical practice concern the «professional medical system» (selfdefined protocols, discussion with colleagues, etc.). Managers accept the use of business managerial tools as well as the influence of social actors to a greater extent than do physicians. This finding could indicate differences in the value systems between primary healthcare physicians and managers.</p>"
]
]
"bibliografia" => array:2 [
"titulo" => "Bibliografía"
"seccion" => array:1 [
0 => array:2 [
"identificador" => "bibs0005"
"bibliografiaReferencia" => array:29 [
0 => array:3 [
"identificador" => "bib1"
"etiqueta" => "1."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Physician utilization. The state of reseach about physicians’ practice patterns"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "J.M. Eisenberg"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:5 [
"tituloSerie" => "Med Care Rev"
"fecha" => "1985"
"volumen" => "23"
"paginaInicial" => "461"
"paginaFinal" => "483"
]
]
]
]
]
]
1 => array:3 [
"identificador" => "bib2"
"etiqueta" => "2."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Variations in physician practice: the role of uncertainty"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "D.M. Eddy"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:5 [
"tituloSerie" => "Health Aff"
"fecha" => "1984"
"volumen" => "4"
"paginaInicial" => "74"
"paginaFinal" => "85"
]
]
]
]
]
]
2 => array:3 [
"identificador" => "bib3"
"etiqueta" => "3."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "International differences in medical care practices. En: Health are systems in transition. The search of efficiency"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "K. McPherson"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"LibroEditado" => array:1 [
"serieFecha" => "1990"
]
]
]
]
]
]
3 => array:3 [
"identificador" => "bib4"
"etiqueta" => "4."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Small area variations in health care delivery in Maryland"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:2 [
0 => "A. Gittelson"
1 => "N.R. Powe"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:6 [
"tituloSerie" => "Health Serv Res"
"fecha" => "1995"
"volumen" => "30"
"paginaInicial" => "295"
"paginaFinal" => "317"
"link" => array:1 [
0 => array:2 [
"url" => "https://www.ncbi.nlm.nih.gov/pubmed/7782218"
"web" => "Medline"
]
]
]
]
]
]
]
]
4 => array:3 [
"identificador" => "bib5"
"etiqueta" => "5."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Variaciones entre zonas pequeñas, estilo de práctica y calidad asistencial"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:2 [
0 => "N.P. Roos"
1 => "L.L. Roos"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"LibroEditado" => array:4 [
"titulo" => "¿Por qué alguna ente está sana y otra no?"
"paginaInicial" => "253"
"paginaFinal" => "275"
"serieFecha" => "1996"
]
]
]
]
]
]
5 => array:3 [
"identificador" => "bib6"
"etiqueta" => "6."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "El poder en la organización"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "H. Mintzberg"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"LibroEditado" => array:1 [
"serieFecha" => "1992"
]
]
]
]
]
]
6 => array:3 [
"identificador" => "bib7"
"etiqueta" => "7."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Characteristic of physicians practicing in alternative primary care settings: a Quebec study of local community service center physicians"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:5 [
0 => "R. Pineault"
1 => "B. Maheux"
2 => "J. Lambert"
3 => "F. Béland"
4 => "A. Lévesque"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:6 [
"tituloSerie" => "Int J Health Serv"
"fecha" => "1991"
"volumen" => "21"
"paginaInicial" => "49"
"paginaFinal" => "58"
"link" => array:1 [
0 => array:2 [
"url" => "https://www.ncbi.nlm.nih.gov/pubmed/2004872"
"web" => "Medline"
]
]
]
]
]
]
]
]
7 => array:3 [
"identificador" => "bib8"
"etiqueta" => "8."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Stocking, B. Ways of influencing the behaviour of general practitioners"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:2 [
0 => "J. Horder"
1 => "N. Bonsaquet"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:6 [
"tituloSerie" => "J R Coll Gen Pract"
"fecha" => "1986"
"volumen" => "36"
"paginaInicial" => "517"
"paginaFinal" => "521"
"link" => array:1 [
0 => array:2 [
"url" => "https://www.ncbi.nlm.nih.gov/pubmed/3309276"
"web" => "Medline"
]
]
]
]
]
]
]
]
8 => array:3 [
"identificador" => "bib9"
"etiqueta" => "9."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Preventive medicine: physician practices, beliefs, and perceived barriers to implementation"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:3 [
0 => "R.C. Henry"
1 => "K.S. Ogle"
2 => "L.A. Snellman"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:6 [
"tituloSerie" => "Fam Med"
"fecha" => "1987"
"volumen" => "19"
"paginaInicial" => "110"
"paginaFinal" => "113"
"link" => array:1 [
0 => array:2 [
"url" => "https://www.ncbi.nlm.nih.gov/pubmed/3596091"
"web" => "Medline"
]
]
]
]
]
]
]
]
9 => array:3 [
"identificador" => "bib10"
"etiqueta" => "10."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Factors affecting laboratory test use and prices"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:3 [
0 => "P.M. Danzon"
1 => "W.G. Manning"
2 => "M.S. Marquis"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:5 [
"tituloSerie" => "Health Care Financing Rev"
"fecha" => "1984"
"volumen" => "5"
"paginaInicial" => "23"
"paginaFinal" => "32"
]
]
]
]
]
]
10 => array:3 [
"identificador" => "bib11"
"etiqueta" => "11."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Inpatient length of stay in Twin Cities health plans"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:3 [
0 => "B.E. Dowd"
1 => "A.N. Johnson"
2 => "R.A. Madson"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:5 [
"tituloSerie" => "Med Car"
"fecha" => "1986"
"volumen" => "24"
"paginaInicial" => "694"
"paginaFinal" => "710"
]
]
]
]
]
]
11 => array:3 [
"identificador" => "bib12"
"etiqueta" => "12."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Professional reimbursement and management of time in general practice. An international comparison"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:3 [
0 => "M. Calnan"
1 => "P. Groenewegen"
2 => "J. Hutten"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:6 [
"tituloSerie" => "Soc Sci Med"
"fecha" => "1992"
"volumen" => "35"
"paginaInicial" => "209"
"paginaFinal" => "216"
"link" => array:1 [
0 => array:2 [
"url" => "https://www.ncbi.nlm.nih.gov/pubmed/1509309"
"web" => "Medline"
]
]
]
]
]
]
]
]
12 => array:3 [
"identificador" => "bib13"
"etiqueta" => "13."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Introducing fees for services with professional uncertainty"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:2 [
0 => "H.A. Flierman"
1 => "P.P. Groenewegen"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:5 [
"tituloSerie" => "Health Care Financing Rev"
"fecha" => "1992"
"volumen" => "14"
"paginaInicial" => "107"
"paginaFinal" => "115"
]
]
]
]
]
]
13 => array:3 [
"identificador" => "bib14"
"etiqueta" => "14."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Gobierno de la sanidad y práctica clínica: ¿las instituciones olvidadas?"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "V. Ortún Rubio"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:6 [
"tituloSerie" => "Gac Sanit"
"fecha" => "1997"
"volumen" => "11"
"paginaInicial" => "111"
"paginaFinal" => "113"
"link" => array:1 [
0 => array:2 [
"url" => "https://www.ncbi.nlm.nih.gov/pubmed/9340316"
"web" => "Medline"
]
]
]
]
]
]
]
]
14 => array:3 [
"identificador" => "bib15"
"etiqueta" => "15."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "La profesión médica: un estudio de sociología del conocimiento aplicado"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "E. Freidson"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"LibroEditado" => array:1 [
"serieFecha" => "1978"
]
]
]
]
]
]
15 => array:3 [
"identificador" => "bib16"
"etiqueta" => "16."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Salud y poder"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:2 [
0 => "J.A. Rodríguez"
1 => "J. De Miguel"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"LibroEditado" => array:1 [
"serieFecha" => "1990"
]
]
]
]
]
]
16 => array:3 [
"identificador" => "bib17"
"etiqueta" => "17."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Jiménez Martín JM. Diferencias entre los sistemas de valores de los gestores sanitarios y los profesionales asistenciales"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "L.A. López Fernández"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:5 [
"tituloSerie" => "Gestión Hospitalaria"
"fecha" => "1997"
"volumen" => "1"
"paginaInicial" => "34"
"paginaFinal" => "39"
]
]
]
]
]
]
17 => array:3 [
"identificador" => "bib18"
"etiqueta" => "18."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Sources of influence on medical practice"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:6 [
0 => "L.A. López Fernández"
1 => "J.M. Jiménez Martín"
2 => "J.D. Luna del Castillo"
3 => "O. Solas Gaspar"
4 => "J. Martínez Millan"
5 => "E. De Manuel Keenoy"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:6 [
"tituloSerie" => "J Epidemiol Community Health"
"fecha" => "2000"
"volumen" => "54"
"paginaInicial" => "623"
"paginaFinal" => "630"
"link" => array:1 [
0 => array:2 [
"url" => "https://www.ncbi.nlm.nih.gov/pubmed/10890875"
"web" => "Medline"
]
]
]
]
]
]
]
]
18 => array:3 [
"identificador" => "bib19"
"etiqueta" => "19."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Measuring outpatient resource use and case mix in ophthalmology in north east England"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:5 [
0 => "P. McNamee"
1 => "D. Parkin"
2 => "D. Allen"
3 => "N. Steen"
4 => "A. Hutchinson"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:6 [
"tituloSerie" => "J Epidemiol Community Health"
"fecha" => "1998"
"volumen" => "52"
"paginaInicial" => "247"
"paginaFinal" => "252"
"link" => array:1 [
0 => array:2 [
"url" => "https://www.ncbi.nlm.nih.gov/pubmed/9616412"
"web" => "Medline"
]
]
]
]
]
]
]
]
19 => array:3 [
"identificador" => "bib20"
"etiqueta" => "20."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Guillén M. Organizaciones y profesiones en la sociedad contemporánea"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "J.A. Rodríguez"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:5 [
"tituloSerie" => "REIS Madrid"
"fecha" => "1992"
"volumen" => "59"
"paginaInicial" => "9"
"paginaFinal" => "18"
]
]
]
]
]
]
20 => array:3 [
"identificador" => "bib21"
"etiqueta" => "21."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "La crisis del sistema sanitario en España: una interpretación sociológica"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "J. Irigoyen"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"LibroEditado" => array:1 [
"serieFecha" => "1997"
]
]
]
]
]
]
21 => array:3 [
"identificador" => "bib22"
"etiqueta" => "22."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Sociología industrial y de los recursos humanos"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:2 [
0 => "J.A. Garmendia"
1 => "F. Parra Luna"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"LibroEditado" => array:1 [
"serieFecha" => "1993"
]
]
]
]
]
]
22 => array:3 [
"identificador" => "bib23"
"etiqueta" => "23."
"referencia" => array:1 [
0 => array:1 [
"host" => array:1 [
0 => array:1 [
"LibroEditado" => array:2 [
"titulo" => "Sociología para la empresa"
"serieFecha" => "1994"
]
]
]
]
]
]
23 => array:3 [
"identificador" => "bib24"
"etiqueta" => "24."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Why do variations occur?"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "K. McPherson"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"LibroEditado" => array:4 [
"titulo" => "The challenges of medical practice variations"
"paginaInicial" => "16"
"paginaFinal" => "34"
"serieFecha" => "1990"
]
]
]
]
]
]
24 => array:3 [
"identificador" => "bib25"
"etiqueta" => "25."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Instrumental and affective aspects of physician behavior"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:2 [
0 => "J.M. Bensing"
1 => "J. Dronkers"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:5 [
"tituloSerie" => "Med Car"
"fecha" => "1992"
"volumen" => "30"
"paginaInicial" => "283"
"paginaFinal" => "298"
]
]
]
]
]
]
25 => array:3 [
"identificador" => "bib26"
"etiqueta" => "26."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "How physicians view the process of change in their practice behavior"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:3 [
0 => "R.H. Geertsma"
1 => "R.C. Parker"
2 => "S. Krauss"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:6 [
"tituloSerie" => "J Med Educ"
"fecha" => "1982"
"volumen" => "57"
"paginaInicial" => "752"
"paginaFinal" => "761"
"link" => array:1 [
0 => array:2 [
"url" => "https://www.ncbi.nlm.nih.gov/pubmed/7120330"
"web" => "Medline"
]
]
]
]
]
]
]
]
26 => array:3 [
"identificador" => "bib27"
"etiqueta" => "27."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Images of general practice: the perceptions of the doctor"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "M. Calnan"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:6 [
"tituloSerie" => "Soc Sci Med"
"fecha" => "1988"
"volumen" => "27"
"paginaInicial" => "579"
"paginaFinal" => "586"
"link" => array:1 [
0 => array:2 [
"url" => "https://www.ncbi.nlm.nih.gov/pubmed/3227365"
"web" => "Medline"
]
]
]
]
]
]
]
]
27 => array:3 [
"identificador" => "bib28"
"etiqueta" => "28."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "Assessing the culture of medical groups practice"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:3 [
0 => "J.E. Kralewski"
1 => "T.D. Wingert"
2 => "M.H. Barbouche"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"Revista" => array:5 [
"tituloSerie" => "Med Car Rev"
"fecha" => "1996"
"volumen" => "34"
"paginaInicial" => "377"
"paginaFinal" => "388"
]
]
]
]
]
]
28 => array:3 [
"identificador" => "bib29"
"etiqueta" => "29."
"referencia" => array:1 [
0 => array:2 [
"contribucion" => array:1 [
0 => array:2 [
"titulo" => "El cambio cultural en las sociedades industriales avanzadas"
"autores" => array:1 [
0 => array:2 [
"etal" => false
"autores" => array:1 [
0 => "R. Inglehart"
]
]
]
]
]
"host" => array:1 [
0 => array:1 [
"LibroEditado" => array:1 [
"serieFecha" => "1991"
]
]
]
]
]
]
]
]
]
]
]
"idiomaDefecto" => "es"
"url" => "/02139111/0000001600000005/v1_201310251655/S0213911102719511/v1_201310251655/es/main.assets"
"Apartado" => array:4 [
"identificador" => "18705"
"tipo" => "SECCION"
"es" => array:2 [
"titulo" => "Originales"
"idiomaDefecto" => true
]
"idiomaDefecto" => "es"
]
"PDF" => "https://static.elsevier.es/multimedia/02139111/0000001600000005/v1_201310251655/S0213911102719511/v1_201310251655/es/main.pdf?idApp=WGSE&text.app=https://gacetasanitaria.org/"
"EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213911102719511?idApp=WGSE"
]