Thực hành kép trong lĩnh vực y tế: tổng quan bằng chứng
Tóm tắt
Bài báo này báo cáo về các hoạt động tạo thu nhập trong số các cán bộ nhà nước trong lĩnh vực y tế, đặc biệt nhấn mạnh đến vấn đề thực hành kép. Đầu tiên, bài báo tiếp cận chủ đề chồng chéo giữa khu vực công và tư. Sau đó, bài viết tập trung vào các chiến lược đối phó nói chung và thực hành kép nói riêng.
Để bù đắp cho mức lương không phản ánh đúng thực tế, nhân viên y tế thường dựa vào các chiến lược đối phó cá nhân. Nhiều lương y kết hợp công việc lâm sàng có lương trong khu vực công với việc nhận lượng bệnh nhân tư trả phí. Thực hành kép này thường là một cách mà nhân viên y tế cố gắng đáp ứng nhu cầu sinh tồn của mình, phản ánh sự thiếu khả năng của các Bộ Y tế trong việc đảm bảo mức lương và điều kiện làm việc đầy đủ.
Thực hành kép có thể được coi là hiện diện ở hầu hết các quốc gia, nếu không muốn nói là tất cả. Tuy nhiên, có một điều đáng ngạc nhiên là có rất ít bằng chứng vững chắc về mức độ mà nhân viên y tế resort đến thực hành kép, về sự cân bằng giữa các động lực kinh tế và những động lực khác liên quan, hoặc về những hậu quả đối với việc sử dụng hợp lý các nguồn lực công khan hiếm dành cho y tế.
Trong bài báo này, thực hành kép được tiếp cận từ sáu góc độ khác nhau: (1) khái niệm, liên quan đến смысл của thực hành kép; (2) mô tả, với nỗ lực xây dựng một kiểu loại thực hành kép; (3) định lượng, nhằm xác định mức độ phổ biến; (4) tác động đến thu nhập cá nhân, hệ thống chăm sóc sức khỏe và tình trạng sức khỏe; (5) định tính, xem xét lý do tại sao những người hành nghề lại thường duy trì thực hành công trong khi cũng làm việc trong khu vực tư và các yếu tố bối cảnh, cuộc sống cá nhân, tổ chức và nghề nghiệp ảnh hưởng đến việc thực hiện thực hành kép; và (6) các can thiệp khả thi nhằm giải quyết vấn đề thực hành kép.
Từ khóa
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