La realidad de la administración de los hospitales públicos en Ecuador: Una revisión de la evidencia científica reciente.

Abstract

Introduction: the administration of Ecuadorian public hospitals faces structural challenges that affect the efficiency and quality of health services. The covid-19 pandemic worsened these complications, making the quantification and review of administrative processes in the public hospital system non-negotiable. Objective: to evaluate the most recent scientific evidence on the administrative management of Ecuadorian public hospitals, establishing challenges, advances, and opportunities for improvement. Methods: a literature review was carried out, considering works printed between 2019 and 2024, audit reports from the state comptroller general's office, and satisfaction surveys with the quality of health services provided by the agency for quality assurance of health services and prepaid medicine (acess). Results: audits conducted prior to the covid-19 state of health emergency for several public hospitals revealed irregularities in the contracting and procurement processes, highlighting structural flaws in hospital management. A comparative analysis between Ecuador and chile used a 95-indicator model to evaluate hospital performance, where only 37 indicators met the required standards and 29 were not reported by the Ecuadorian hospital. Furthermore, quality of care satisfaction instruments in health services showed a 70.81% satisfaction rate in the comprehensive public health network, compared to 94.32% in the complementary private network. Conclusions: testimony often draws attention to the possibility of strengthening administrative and management dynamics in Ecuadorian public hospitals, establishing evaluation and monitoring systems based on performance indicators, and improving the quality of care received by patients. Furthermore, Freire Heredia, J. A., & Delgado Mosquera, I. M. it is crucial to align hospital practice with the strategic goals outlined in the 2022-2031 ten-year health plan to guarantee the right to health and reduce inequities in the national health system.