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"Gerência enquanto instrumento para mudanças em um serviço substitutivo de saúde mental no município de Uberaba - estudo de caso" ; Management as a changing instrument in a substitute mental health service in the city of Uberaba – a case study.

Cunha, Maria Thereza Rodrigues da
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 14/02/2003 PT
Relevância na Pesquisa
66.03%
Esta pesquisa caracteriza-se como um estudo de caso, realizado no Núcleo de Atenção Psicossocial - NAPS “Maria Boneca”, um serviço substitutivo de Saúde Mental, na cidade de Uberaba-MG e busca compreender a dinâmica da gerência do referido serviço, enquanto um instrumento capaz de propiciar mudanças nas práticas de atenção ao paciente portador de sofrimento mental. O pressuposto deste estudo é creditar à gerência a potência de dar ao serviço substitutivo de saúde mental uma organização e dinâmica capaz de produzir no portador de sofrimento mental uma vida mais humana, mais digna e cidadã, permitindo-lhe participar do mundo em sociedade, não com o traço da estranheza e periculosidade, como geralmente lhe é atribuído, mas como alguém portador de uma diferença. A pesquisa foi realizada com dez (10) trabalhadores do NAPS, um por categoria profissional, sendo escolhidos pelo critério da antigüidade, com os quais foram realizadas entrevistas semi-estruturadas. O material empírico foi organizado segundo o método do Discurso do Sujeito Coletivo e a análise do material, feita segundo a análise de conteúdo, na vertente da Análise Temática. Do movimento de análise foi possível identificar dois (2) grandes temas: A expressão da subjetividade no trabalho em saúde mental – um trabalho muito especial e O processo de trabalho participativo enquanto um componente da gerência nos serviços substitutivos. É identificado no estudo...

Adaptação e aplicação da técnica HAZOP na identificação de risco na área de serviço de saúde : estudo de caso HEMOCENTRO/UNICAMP; Adaptation and application of HAZOP technique on risk identification in health service area : HEMOCENTRO/UNICAMP case study

Mônica Caldeira Quintella
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 25/02/2011 PT
Relevância na Pesquisa
65.91%
A problemática de segurança do trabalho, que envolve o ser humano e o ambiente de trabalho, tem sido estudada continuamente. A segurança no trabalho nem sempre é tratada com o cuidado e a atenção que merece, e a conseqüência desta falta de atenção pode gerar problemas de perdas graves para o homem e para o meio ambiente. Ferramentas da área de Engenharia de Segurança de Sistemas foram desenvolvidas para atender, principalmente, a indústria química na identificação dos riscos de processos e operações. Estas técnicas estruturadas minimizam e controlam os riscos através do seu gerenciamento, e vêm sendo estudadas para aplicação em outras áreas. Dentre as técnicas de análise de risco, o HAZOP (Hazard and Operability) tem-se apresentado eficiente, visando a minimização dos possíveis incidentes e acidentes, tanto em processos industriais, como em outras áreas. Na área de serviços de saúde, existe uma ausência de trabalhos que apontam o uso de técnicas estruturadas para identificar riscos existentes. Isto se torna um sério problema, pois afeta o gerenciamento de risco em biossegurança, expondo funcionários a condições favoráveis a acidentes de trabalho e doenças ocupacionais crônicas. Este trabalho tem como objetivo adaptar...

Governance in Health Care Delivery : Raising Performance

Lewis, Maureen; Pettersson, Gunilla
Fonte: Banco Mundial Publicador: Banco Mundial
Relevância na Pesquisa
56.14%
The impacts of health care investments in developing and transition countries are typically measured by inputs and general health outcomes. Missing from the health agenda are measures of performance that reflect whether health systems are meeting their objectives; public resources are being used appropriately; and the priorities of governments are being implemented. This paper suggests that good governance is central to raising performance in health care delivery. Crucial to high performance are standards, information, incentives and accountability. This paper provides a definition of good governance in health and a framework for thinking about governance issues as a way of improving performance in the health sector. Performance indicators that offer the potential for tracking relative health performance are proposed, and provide the context for the discussion of good governance in health service delivery in the areas of budget and resource management, individual provider performance, health facility performance, informal payments...

Republic of Burundi : Health Financing Study

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
56.06%
During the conflict, public expenditure on health drastically decreased weakening the health system at a time when needs were growing. With increasing peace and stability in the country, foreign aid and public resources allocated to the sector have started to increase. However, health authorities still face the challenge of mobilizing extra resources to reverse the damage to the health system and to progress towards achieving the Millennium Development Goals (MDGs). Nevertheless, more resources allocated to the sector will not necessarily improve health outcomes, especially for the poor, if weaknesses in public expenditure management and inefficiencies in the allocation of resources for the sector are not reduced. These challenges become more acute in the context of the presidential measure of eliminating user fees for deliveries and for child health service.

Brazil - Raising the Quality of Public Spending and Resource Management in the Health Sector

Couttolenc, Bernard; La Forgia, Gerard; Matsuda, Yasuhiko
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Relevância na Pesquisa
56.05%
The report assesses how the processes of allocation, transfer, and utilization of resources are conducted at the different levels of the system. The study provides valuable information regarding the reality of the executing units of the system and how these relate to the central levels. It also seeks to identify problems related to financial flows, analyze how resources are used at the local level, and estimate their impact on the efficiency and quality of health services in general. In this respect, the study provides a basis for improving the entire cycle of public resource management processes (i.e., planning, budgeting, budget execution, input management, and health service production) in the health sector, which together help to bolster good governance in health care delivery. This report referenced in this note assesses resource allocation and management, planning and budgeting functions, and budget execution at different levels of government for public expenditures on health services. The emphasis is on understanding the incentives generated for service providers...

Romania - Functional Review : Health Sector

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
56.09%
This Functional Review was carried by a Bank team upon request by the Government of Romania. As a starting point, it shows that: (i) health outcomes in Romania lag behind those of the EU; (ii) users are not satisfied with its lack of responsiveness - long lines, informal payments, discourteous handling of patients, poor cleanliness, lack of maintenance, and breach of safety measures; (iii) the poor and other vulnerable groups (for example Roma communities) suffer from a significant lack of access to services; and (iv) the fiscal contraction of 2008-2010 exposed the weakness of financial controls in the health sector. The Review examines four health functions in depth: service delivery, financing, stewardship and resources (including pharmaceuticals). Based on our findings, we present recommendations categorized by the three set of challenges that the sector is facing: (i) improving governance and management; (ii) streamlining the health service network and re-launching quality control systems; and (iii) increasing preventive services and equity. For any expansion of the sector to be sustainable...

Improving the Delivery of Health Services : A Guide to Choosing Strategies

Berman, Peter; Pallas, Sarah; Smith, Amy L.; Curry, Leslie; Bradley, Elizabeth H.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
56.08%
Sufficient funding and efficacious technology may be necessary conditions for achieving health gains, but experience in many countries confirms that they are not sufficient. Effective and efficient service delivery is the point at which the potential of the health system to improve lives meets the opportunity to realize health gains. Health service delivery performance means access and use by those in need; adequate quality of care to produce health benefits; efficient use of scarce resources; and organizations that can learn, adapt, and improve for the future. All too often, potential benefits are not realized because service delivery underperforms. Organizations must combine financial, physical, and human resources to deliver health services. However, organizations can be complex, and this complexity must be considered in developing strategies for change. This guide will help planners and policy makers navigate the complexity and make better decisions to improve health services. Users of this Guide will find practical advice about what performance means in service delivery as well as how to measure the performance of service delivery organizations. The Guide discusses reforms to service delivery organizations at the system level and at the individual facility level. It emphasizes the internal workings of the organization as well as the external environment in which an organization functions...

Raising Returns : The Distribution of Health Financing and Outcomes in Yemen

Elgazzar, Heba A.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
56.04%
Given relatively few resources and lagging health outcomes in Yemen, the quest for equitable, cost-effective health care delivery continues as long-term, sustainable development remains a priority. This paper assesses overall value for money of the health system mainly as indicated by an analysis of public expenditure trends from 1997 until 2008 and by the degree to which health care benefits are conferred equitably to the population. Total health expenditure in 2007 accounted for 5.2 percent of Gross Domestic Product (GDP), or only PPP$ 41 per capita, with nearly 70 percent sourced by direct household payments (67 percent). Despite recent improvements in health status, Yemen continues to lag behind countries of similar or lower income and health expenditure levels. Levels of health outcomes in Vietnam, Indonesia and the Kyrgyz Republic are 2 to 6 times better than levels found in Yemen regarding the proportion of infants with low birth weight, the prevalence of malnutrition amongst children, the rate of births delivered by skilled attendants...

Realising opportunities for evidence-based cancer service delivery and research: linking cancer registry and administrative data in Australia

Roder, D.M.; Fong, K.M.; Brown, M.P.; Zalcberg, J.; Wainwright, C.E.
Fonte: John Wiley & Sons Publicador: John Wiley & Sons
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
75.96%
The traditional roles of Australian cancer registries have been incidence, mortality and survival surveillance although increasingly, roles are being broadened to include data support for health-service management and evaluation. In some Australian jurisdictions, cancer stage and other prognostic data are being included in registry databases and this is being facilitated by an increase in structured pathology reporting by pathology and haematology laboratories. Data linkage facilities are being extended across the country at national and jurisdictional level, facilitating data linkage between registry data and data extracts from administrative databases that include treatment, screening and vaccination data, and self-reported data from large population cohorts. Well-established linkage protocols exist to protect privacy. The aim is to gain better data on patterns of care, service outcomes and related performance indicators for health-service management and population health and health-services research, at a time of increasing cost pressures. Barriers include wariness among some data custodians towards releasing data and the need for clearance for data release from large numbers of research ethics committees. Progress is being made though...

"If we can't measure it, we can't do it". The role of health outcomes in community and allied health service accountability

Nancarrow, Susan Alison
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Thesis (PhD); Doctor of Philosophy (PhD)
Relevância na Pesquisa
76.01%
Health outcomes fulfill a number of roles in the health sector. Economists, clinicians, researchers and managers use health outcomes in a range of different contexts for distinct purposes. New management approaches that use contracts as the basis for health service accountability have attempted to take health outcomes from their clinical role into a management setting. In particular, the purchasers and managers of some health services expect that service providers should demonstrate that they improve the health outcomes of their patients to justify their on-going funding. However, a number of organisations have experienced barriers to the application of the outcomes approach to health service management and there has been no systematic evaluation of the approach. Nor has there been an investigation into why purchasing organisations have difficulty introducing health outcomes into purchasing contracts. The result is that managers and purchasers continue to assign resources to the pursuit of health outcomes as an accountability tool. This thesis addresses two research questions around the use of health outcomes in community and allied health service accountability. The first is the barriers to the application of health outcomes to health services accountability. The second question examines the conditions that must be met before health outcomes can be used as an accountability tool in purchasing contracts for allied health. The research questions are addressed through the analysis of case studies that explore systematically the approach taken by two organisations...

A study to guide the design and implementation of a chronic disease management register in a regional health service

Guda, Dominic Robin
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Thesis (PhD); Doctor of Philosophy (PhD)
EN_AU
Relevância na Pesquisa
56.04%
Background. The mounting burden of chronic disease associated with population ageing creates a challenge for health systems. Healthcare organisations are addressing this challenge by exploring new ways to improve patient health outcomes, including through the use of information technologies. Aim. This research aimed to identify key design features of a chronic disease management (CDM) register for the public sector health services provided in the Australian Capital Territory. Methods and setting. ACT Health, a government agency, is the largest health service provider in the ACT. An organisational analysis of ACT Health was conducted using qualitative, quantitative, and participant observation methods. Three index conditions- Chronic Heart Failure, Chronic Obstructive Pulmonary Disease, and Diabetes Mellitus Type 2 defined information according to the 'International Statistical Classification of Diseases and Health Related Problems: lOth Revision, Australian Modification' (ICD-10-AM)­ were chosen for data collection and analysis. Results. ACT Health policies support evidence-based CDM interventions, but their implementation has been slow and disjointed. This research found that support for CDM in ACT Health is within the 'basic support' range as measured by the MacColl Institute's Assessment of Chronic Illness Care (ACIC) survey. The survey revealed continuity of care as a concern. On the positive side...

Private Health Sector Assessment in Ghana

Makinen, Marty; Sealy, Stephanie; Bitrán, Ricardo A.; Adjei, Sam; Muñoz, Rodrigo
Fonte: World Bank Publicador: World Bank
Tipo: Publications & Research :: Publication; Publications & Research :: Publication
ENGLISH
Relevância na Pesquisa
76.09%
Most countries in Sub-Saharan Africa confront serious health challenges; however, Ghana has done beer than many of its neighbors. Ghana's life expectancy at birth is 60 years (versus 53 for all of Sub-Saharan Africa), the infant mortality rate is 73 per thousand (versus 79), and the maternal mortality ratio is 562 per 100,000 (versus 832) (World Bank 2009b). Ghana has worked hard to achieve the gains it has made, and it has benefited from substantial assistance from external development partners. Ghana has separated policy making the Ministry of Health, (MOH) from provision Ghana Health Service (GHS) in the public sector and decentralized health service management to the district level. In 2004, Ghana instituted its National Health Insurance Scheme (NHIS) to ease consumers' need to mobilize payment at the time of illness. The private health sector in Ghana is a large and important factor in the market for health-related goods and services. The size and configuration of private providers and their contribution to health sector outcomes. With beer information about the size...

Developing Strategies for Improving Health Care Delivery : Guide to Concepts, Determinants, Measurement, and Intervention Design

Bradley, Elizabeth H.; Pallas, Sarah; Bashyal, Chhitij; Berman, Peter; Curry, Leslie
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
56.05%
This report is a user's guide for defining, measuring, and improving the performance of health service delivery organizations. The authors define six core performance domains: quality, efficiency, utilization, access, learning, and sustainability and provide a compendium of metrics that have been used to measure organizational performance in each of these six domains. The compendium, which includes 116 distinct categories of metrics, is based on a detailed literature review of peer-reviewed empirical studies of health care organizational performance in World Bank client countries. Based on reading of the literature, the authors define seven major strategy areas potentially useful for improving performance among health care organizations: 1) standards and guidelines, 2) organizational design, 3) education and training, 4) process improvement and technology and tool development, 5) incentives, 6) organizational culture, and 7) leadership and management. The authors provide illustrations of facility-level interventions within each of the strategy areas and highlight the conditions under which certain strategies may be more effective than others. The authors propose that the choice of strategy targeted at organizational level to improve performance should be informed by the identified root causes of the problem...

Ethiopia : Improving Health Service Delivery

El-Saharty, Sameh; Kebede, Sosena; Olango Dubusho, Petros; Siadat, Banafsheh
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
66.08%
This case study aims to identify how Ethiopia has adopted and implemented strategies to improve health services, including the factors that enabled and inhibited success across a meaningful range of health services for the period 1996-2006. Particular emphasis has been given to the impact of utilized strategies on the poor. This case study reviewed one 'primary strategy', decentralization in the form of devolution of authority to the regional level in 1996 and to the district (woreda) level in 2002, and seven 'corollary strategies' in the context of decentralization implemented at the subnational level. The study concludes that decentralization in the health sector is likely to be more effective when it is implemented as part of a broader government decentralization policy across sectors. Sequencing in implementing Ethiopia's decentralization strategy made decentralization more manageable, although decentralization was rolled out prematurely. Moreover, the effectiveness of implementation was found to be driven largely by the institutional and management capacity at the subnational level. At the subnational level...

Islamic Republic of Iran - Health Sector Review : Volume 1. Main Report

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Health Sector Review; Economic & Sector Work
ENGLISH
Relevância na Pesquisa
56.04%
The Government of the Islamic Republic of Iran has stated its commitment to improving the health and nutritional status of the population as articulated in the Interim Country Assistance Strategy (CAS), which lists as priorities addressing nutritional deficiencies, expanding coverage of basic health services, and improving efficiency of the health system and the quality of service at all levels. This health sector review is consistent with this in that it provides the platform and evidence base for such reform. It is also in-line with part three of the current Fourth Five-Year Plan, which includes health development, human security and social justice priority, the reduction of illness from malnutrition, increasing public health service coverage, and increasing access to quality health services while reducing the financial burden on the families. The objective of this study is to provide a comprehensive review and diagnostic of the performance of the health sector in the Islamic Republic of Iran. The government is quite advanced in the type of analysis it already undertakes on various aspects of the sector (e.g....

Lao PDR - Civil Service Pay and Compensation Review : Attracting and Motivating Civil Servants

World Bank
Fonte: World Bank Publicador: World Bank
Tipo: Economic & Sector Work :: Other Poverty Study
ENGLISH
Relevância na Pesquisa
56.05%
Lao PDR is at a point on its development trajectory where strategic attention to administrative performance is crucial. An efficient and high-performing civil service, with the compensation and human resource management systems to attract and motivate qualified personnel, will be essential to Lao PDR's development efforts. The ministerial-level Public Administration and Civil Service Authority (PACSA) is currently spearheading the drafting of a comprehensive new civil service management strategy that will be implemented over the period 2010-2020, with a number of important reforms to strengthen the civil service anticipated to take place within the next five years. Key objectives include improvements in human resource policies and planning, salary reform, and enhanced performance management. In order to present as comprehensive a picture as possible of the Lao civil service pay and compensation system, and its strengths and challenges, this report comprises four chapters. The first characterizes the Lao civil service in perspective. The second examines how civil servants are compensated. The third assesses whether they are compensated adequately. The fourth summarizes civil servants own characterization of their incentives in both compensation- and non-compensation-related terms. A brief conclusion points to a set of principles for civil service reform and outlines three sequenced steps toward achieving a more rational civil service pay and grading system.

Indonesia's Doctors, Midwives and Nurses : Current Stock, Increasing Needs, Future Challenges and Options

World Bank
Fonte: World Bank Publicador: World Bank
Tipo: Economic & Sector Work :: Other Health Study
ENGLISH
Relevância na Pesquisa
56.09%
This paper is one of several inputs prepared for a comprehensive Health Sector Review that the Government of Indonesia is currently conducting. It compiles, analyzes and interprets available information on Indonesia's health service providers; doctors, midwives and nurses. Within the limitations imposed by questions about the accuracy and timeliness of current workforce data, the paper describes the stock and distribution of health workers. The paper draws attention to weaknesses in the workforce planning methods in use, and then reviews the human resource policies, including governance structures and the regulatory framework, that affect health workers. It concludes by describing future challenges and some suggested ways of addressing these challenges. In brief, this paper identifies a number of main challenges in the health workforce in Indonesia. These are: (i) there is a shortage and inequitable distribution of medical doctors and specialists; (ii) the education of health professionals is of poor quality and the accreditation and certification system is weak; (iii) health workforce policy development and planning are not based on evidence or demand...

Health Service Delivery in China : A Literature Review

Eggleston, Karen; Ling, Li; Qingyue, Meng; Lindelow, Magnus; Wagstaff, Adam
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
ENGLISH
Relevância na Pesquisa
56.06%
The authors report the results of a review of the Chinese-language and English-language literatures on service delivery in China, asking how well China's health care providers perform, what determines their performance, and how the government can improve it. They find current performance leaves room for improvement in terms of quality, responsiveness to patients, efficiency, cost escalation, and equity. The literature suggests that these problems will not be solved by simply shifting ownership to the private sector, or by simply encouraging providers-public and private-to compete with one another for individual patients. In contrast, substantial improvements could be (and in some places have already been) made by changing the way providers are paid-shifting away from fee-for-service and the distorted price schedule toward prospective payments. Active purchasing by insurers could further improve outcomes.

Epidemiology's contribution to health service management and planning in developing countries: a missing link.

Unger, J. P.; Dujardin, B.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica
Publicado em //1992 EN
Relevância na Pesquisa
65.84%
Two hypotheses are examined in the light of experience and the literature: (1) health service planning requires little epidemiological information, and (2) health services rarely get useful answers to relevant epidemiological questions. In the first hypothesis, the theoretical robustness of the concept of a minimum package of activities common to all facilities belonging to the same level of the system and the extent to which it is unaffected by variations in the frequencies of most diseases are examined. Semi-quantitative analyses and analysis of routine entries and participation suffice to adapt this package to the local context. Some of the methods which give a fundamental role to epidemiological information are criticized. With regard to the second hypothesis, the pertinent contributions epidemiology may make to health service organization are reviewed. These include identification of diseases that justify special activities (health maps and interepidemic surveillance), determination of the activities that should be added to the health centres, the political usefulness of rare impact assessments, and the relevant demographic elements. Finally an epidemiological agenda is proposed for specialized centres, districts, universities...

Production and Management of Solid Health Service Waste in the Veterinary Hospital at UFPR; PRODUÇÃO E MANEJO DE RESÍDUOS SÓLIDOS DE SAÚDE NO HOSPITAL VETERINÁRIO DA UFPR

Roeder-Ferrari, L D; Andriguetto Filho, J M; Ferrari, M V
Fonte: UFPR Publicador: UFPR
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Artigo Avaliado pelos Pares Formato: application/pdf
Publicado em 15/07/2008 POR
Relevância na Pesquisa
65.91%
Health service wastes (RSS) meansany waste which is generated in the diagnosis,treatment, or immunization of human beings oranimals, in research, or in the production of testingbiological, including veterinary clinics and hospitals.In this study, an evaluation of heath service wastegeneration and management was carried out at theVeterinary Hospital of Federal University of Parana(UFPR). According to the results, it has beenverified that the steps in the internal managementof the RSS did not agree with the valid legislativeguidelines, and the handlers of these wastes hadnot the knowledge of the minimal guidance tomanage it. If the hospital adopted the protocol of theAgencia Nacional de Vigilancia Sanitaria (ANVISA)for classification and segregation of RSS, 58% of his RSS may be handled as general solid waste anddid not require special handling or treatment.; Os resíduos de serviços de saúde(RSS) são aqueles gerados em todos os serviçosrelacionados com o atendimento à saúde humanaou animal, e podem ser provenientes de laboratóriosde análises clínicas e patológicas, drogarias efarmácias, estabelecimentos de ensino e pesquisana área da saúde...