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A atenção ao usuário de drogas na atenção básica: elementos do processo de trabalho em unidade básica de saúde; The attention to drug users in Primary Health Care: elements of the work process in Primary Health Centers

Coelho, Heloisa da Veiga
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 17/12/2012 PT
Relevância na Pesquisa
75.83%
O objeto deste estudo são as práticas de Atenção Básica (AB) desenvolvidas nos serviços de saúde voltadas para pessoas e grupos sociais que consomem drogas de forma prejudicial. Este objeto foi recortado a partir do referencial teórico da Saúde Coletiva e se conforma na interface entre as políticas públicas voltadas para a população que faz uso prejudicial de drogas e a realidade concreta dos serviços de saúde. O estudo tem por objetivo geral analisar as práticas voltadas para consumidores problemáticos de drogas na AB, a partir do levantamento dessas práticas junto a trabalhadores de uma UBS da região periférica do município de São Paulo. Trata-se de estudo qualitativo, de natureza descritiva e analítica, que se desenvolveu na perspectiva dialético-crítica. A coleta de dados foi realizada a partir de entrevistas semiestruturadas e individuais com 10 trabalhadores de uma UBS mista, ou seja, que atua com a Estratégia de Saúde da Família (ESF) e com o modelo tradicional de produção dos serviços de saúde. As práticas desenvolvidas pelos trabalhadores e direcionadas aos usuários de drogas são analisadas a partir da categoria analítica processo de trabalho, que permite analisar os modos e as dificuldades de operacionalização das políticas públicas nos espaços concretos de produção dos serviços de saúde. Os resultados mostram que: 1) os trabalhadores desenvolvem o processo de trabalho...

Relacionando os modelos assistenciais e as tendências pedagógicas em saúde : subsídios para a ação educativa da enfermeira; Connecting care models and health pedagogical trends: subsidies to nursing education

Kohlrausch, Eglê Rejane; Rosa, Ninon Girardon da
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
POR
Relevância na Pesquisa
85.87%
A partir das vivências das autoras em atividades de Educação e Saúde no âmbito hospitalar e comunitário e da revisão da literatura, estabelece-se uma relação entre os modelos assistenciais e as tendências pedagógicas com o propósito de contribuir para a (re)construção da ação educativa do enfermeiro. As tendências pedagógicas, bem como os modelos assistenciais adotados pela enfermeira ao exercer a ação educativa, demonstram sua visão de mundo. Assim, considera- se fundamental que a enfermeira saiba discernir o que está por trás de sua prática, pois a enfermagem faz parte de um contexto histórico e político e o seu trabalho pode ser um meio de transformação social ou de manutenção do status quo.; In this article the authors establish a connection between health care models and pedagogical trends considering their education and health care experiences in the hospital and in the communities and also the review of the literature. The pedagogical trends and health care models used by nurses in nursing education demonstrate their world view. Therefore it is important that they understand what is behind their practice so that nursing is in a political and historical context and its practice can foster the social transformation or keep the status quo. The purpose of this study is to contribute to the construction of nursing education.; Partiendo de las experiencias de los autores en actividades de Educación y Salud...

Construção do conhecimento e do fazer enfermagem e os modelos assistenciais; Health care models and the building of nursing knowledge and practice; Construcción del conocimiento y del quehacer en enfermería y los modelos asistenciales

Lucena, Amália de Fátima; Paskulin, Lisiane Manganelli Girardi; Souza, Mariana Fernandes de; Gutierrez, Maria Gaby Rivero de
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
POR
Relevância na Pesquisa
85.8%
Artigo de reflexão que enfoca as origens e as principais características dos modelos clínico e epidemiológico, seus nexos com os modelos assistenciais vigentes no sis- ]tema de saúde brasileiro, e a construção do conhecimento da enfermagem nesse contexto. Nessa perspectiva, as autoras propõem um repensar acerca do saber/fazer da enfermagem, apontando possibilidades de expansão do seu campo de atuação, bem como dos limites e desafios a serem vencidos pelos profissionais da área.; El presente artículo de reflexión enfoca los orígenes y las principales características de los modelos clínico y epidemiológico, sus nexos con los modelos asistenciales vigentes en el sistema de salud brasileño, y la construcción del conocimiento de la enfermería en ese contexto. Bajo esa perspectiva, las autoras proponen un repensar acerca del saber/hacer de la enfermería, apuntando posibilidades de expansión de su campo de actuación, así como de los límites y desafíos a ser vencidos por los profesionales del área.; This is a reflective paper focused on the origins and main characteristics of the epidemiological and clinical models, their connections with the health care models currently adopted in Brazil, and the construction of Nursing knowledge in this context. From this perspective...

Prevenção às drogas nas escolas : uma experiência pensada a partir dos modelos de atenção em saúde; Drug prevention in the school environment : an experience considered through the use of health care models

Müller, Ana Cláudia; Paul, Cátia Lucila; Santos, Nair Iracema Silveira dos
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
POR
Relevância na Pesquisa
75.86%
Ao longo da história da saúde pública, vários modelos de atenção foram construídos para orientar ações nessa área, destacandose o modelo biomédico, o da medicina comunitária e o em defesa da vida. Este artigo trata da análise de um projeto de prevenção às drogas no ambiente escolar realizado em Santa Maria (RS) e discute a relação desta proposta com os modelos de atenção em saúde. A partir da experiência, conclui-se ser necessário romper com o paradigma hegemônico e estruturar as ações de prevenção às drogas conforme modelos alternativos, permitindo que alunos, professores e comunidade assumam o papel de promotores de sua própria saúde.; Throughout the history of the public health system, several care models have been constructed to guide actions in this field, with particular emphasis on the biomedical model, the community medicine model and the “in defense of life” model. This article deals with the analysis of a drug prevention project in the school environment, conducted in Santa Maria (Rio Grande do Sul), and discusses the relationship of this proposal with the models of health care. From this experiment, we were able to observe that it is necessary to break with the hegemonic paradigm and to structure drug prevention activity in accordance with alternative models...

Implications of primary health care models in workloads of health professionals

Trindade,Letícia de Lima; Pires,Denise Elvira Pires de
Fonte: Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Publicador: Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2013 EN
Relevância na Pesquisa
85.9%
This study discusses the influence of two health care models on the workloads of health professionals. This qualitative study was conducted with Family Health teams and traditional teams working in southern Brazil. Focus groups, interviews, and documentary study were used to obtain data, which were analyzed combining Thematic Content Analysis with the features of the AtlasTi software. In both models, it was evident that the problems in the organization and management of health care, excessive demand and innefective problem-solving are the main sources of increased workloads while affinity with the health care model and teamwork were mentioned as sources of workloads reduction. We conclude that the increase in workloads in Family Health model was affected by gaps between what was prescribed and performed, while in the traditional model this was due to fact that the health care model is based on biomedicine.

Patterns of Health Care Utilization in Vietnam : Analysis of 1997-98 Vietnam Living Standards Survey Data

Trivedi, Pravin K.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
65.96%
The author provides an econometric analysis of health care utilization in Vietnam based on individual and household level data from the 1997-98 Vietnam Living Standards Survey. The author focuses on the major features of health care utilization patterns, including the determinants of largely self-prescribed use of pharmaceutical drugs, and the use of government hospitals, commune health centers, and private health facilities. The role of income and health insurance is emphasized. Econometric models are estimated for use probability and frequency of contact for all major categories of care, and for individual and household medical expenditure. Econometric results reveal differential responses to income changes at different levels of income. Commune health centers and self-medication are normal goods at lower income levels but inferior goods at higher income levels. The author discusses the policy implications of these results.

Sustaining Health Care Practice Change: The Experience of Best Practice Spotlight Organizations Implementing and Sustaining RNAO Best Practice Guidelines

Schenck, Tracey
Fonte: Brock University Publicador: Brock University
Tipo: Electronic Thesis or Dissertation
ENG
Relevância na Pesquisa
75.81%
Sustainability of change for improvement initiatives has been widely reported as a global challenge both within and outside health care settings. The purpose of this study was to examine the extent to which factors related to staff training and involvement, staff behaviour, and clinical leaders’ and senior leaders’ engagement and support impact the long term sustainability of practice changes for BPSO health care organizations who have implemented Registered Nursing Association of Ontario’s (RNAO) Best Practice Guidelines. Semi structured interviews with eleven organizational leaders’ from ten health care organizations were conducted to explore the unique experiences, views and perspectives on factors related to staff, clinical leaders and senior leaders and their involvement and impact on the long term sustainability of clinical practice changes within organizations who had implemented Registered Nursing Association of Ontario’s (RNAO) Best Practice Guidelines (BPGs). The interviews were coded and analyzed using thematic content analysis. Further analysis identified patterns and themes in relation to: 1. The National Health Service (NHS) Sustainability Model which was used as the theoretical framework for this research; and 2. Organizations found to have sustained practice changes longer term verses organizations that did not. Six organizations were found to have sustained practice changes while the remaining four were found to have been unsuccessful in their efforts to sustain the changes. Five major findings in relation to sustainability emerged from this study. First is the importance of early and sustained engagement and frontline staff...

Utilization of maternal health-care services in Peru: the role of women's education

Elo, Irma T
Fonte: Health Transition Centre, National Centre for Epidemiology and Population Health, The Australian National University Publicador: Health Transition Centre, National Centre for Epidemiology and Population Health, The Australian National University
Tipo: Artigo de Revista Científica Formato: 66206 bytes; application/pdf
EN_AU
Relevância na Pesquisa
75.81%
This article explores the hypothesis that formal education of women influences the use of maternal health-care services in Peru, net of the mother’s childhood place of residence, household socioeconomic status and access to health-care services. The findings are consistent with the hypothesis; both cross-sectional and fixed-effects logit models yield quantitatively important and statistically reliable estimates of the positive effect of maternal schooling on the use of prenatal care and delivery assistance. In addition, large differentials were found in the utilization of maternal health-care services by place of residence, suggesting that much greater efforts on the part of the government are required if modern maternal health-care services are to reach women in rural areas.; yes

Contracting and Providing Basic Health Care Services in Honduras : A Comparison of Traditional and Alternative Service Delivery Models

Garcia Prado, Ariadna; Lao Peña, Christine
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
66%
This study uses data from health facility and patient exit surveys carried out in 2006 in Honduras to examine the characteristics of two basic health care provision models: a traditional Ministry of Health (MOH) public health care one versus a community based one also known as 'alternative' or 'public-social'. The author compare these models based on access, quality, costs, productivity, and management autonomy. While the alternative model has higher unit costs for drugs, it also has higher labor productivity. The fact that alternative providers are held accountable through performance-based contracts and that their personnel are hired on a contractual basis and can be demoted or even fired may account for their stronger performance relative to traditional providers whose personnel are centrally hired civil service staff. The findings support the alternative model as a viable option to expand services to other areas of Honduras that lack health services, compensating for the MOH's insufficient capacity to deliver and manage health care services in poor and remote areas. Some elements of this model such as performance-based agreements and other incentives can be also incorporated in the management and implementation of the traditional MOH health units in order to improve their performance. As the alternative models increase in number...

Organização das ações de atenção à saúde: modelos e práticas; Organization of health care actions: models and practices

AYRES, José Ricardo de Carvalho Mesquita
Fonte: Faculdade de Saúde Pública, Universidade de São Paulo.Associação Paulista de Saúde Pública. Publicador: Faculdade de Saúde Pública, Universidade de São Paulo.Associação Paulista de Saúde Pública.
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
75.91%
O objetivo deste artigo é discutir recentes contribuições conceituais para a construção de modelos de organização das ações de atenção à saúde. Trata-se de um ensaio crítico baseado na Teoria do Processo de Trabalho em Saúde, de Mendes-Gonçalves e colaboradores, relido na perspectiva filosófica da Hermenêutica contemporânea (Gadamer; Ricoeur, Habermas). Em primeiro lugar, define-se modelo como a convergência de horizontes entre os diversos discursos socialmente legitimados acerca dos modos de operar as tecnologias de atenção à saúde de indivíduos e populações. A seguir, são apontados como norteadores da reflexão o princípio da integralidade da atenção no contexto do Sistema Único de Saúde e seus desafios nos planos do conhecimento, das tecnologias e da ética. Os conceitos de vulnerabilidade, cuidado e humanização, como recentes proposições para novas confluências discursivas interessadas na construção de modelos de atenção integral, são, então, tomados para análise, discutindo-se seus principais pressupostos e conteúdos, assim como seus alcances e desafios práticos.; The objective of this paper is to discuss the recent conceptual contributions to the development of health care organization models. This is a critical essay...

Children's health care assistance according to their families: a comparison between models of Primary Care

Oliveira,Vanessa Bertoglio Comassetto Antunes de; Veríssimo,Maria de La Ó Ramallo
Fonte: Universidade de São Paulo, Escola de Enfermagem Publicador: Universidade de São Paulo, Escola de Enfermagem
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2015 EN
Relevância na Pesquisa
65.93%
OBJECTIVE To compare the health assistance models of Basic Traditional Units (UBS) with the Family Health Strategy (ESF) units for presence and extent of attributes of Primary Health Care (APS), specifically in the care of children. METHOD A cross-sectional study of a quantitative approach with families of children attended by the Public Health Service of Colombo, Paraná. The Primary Care Assessment Tool (PCA-Tool) was applied to parents of 482 children, 235 ESF units and 247 UBS units covering all primary care units of the municipality, between June and July 2012. The results were analyzed according to the PCA-Tool manual. RESULTS ESF units reached a borderline overall score for primary health care standards. However, they fared better in their attributes of Affiliation, Integration of care coordination, Comprehensiveness, Family Centeredness and Accessibility of use, while the attributes of Community Guidance/Orientation, Coordination of Information Systems, Longitudinality and Access attributes were rated as insufficient for APS. UBS units had low scores on all attributes. CONCLUSION The ESF units are closer to the principles of APS (Primary Health Care), but there is need to review actions of child care aimed at the attributes of APS in both care models...

Oral health in Brazil: the challenges for dental health care models

Chaves,Sônia Cristina Lima
Fonte: Sociedade Brasileira de Pesquisa Odontológica - SBPqO Publicador: Sociedade Brasileira de Pesquisa Odontológica - SBPqO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 EN
Relevância na Pesquisa
75.93%
This paper discusses adult oral health in Brazil according to three perspectives: 1) the available epidemiological evidence about the population's oral-health-related epidemiological situation, especially adults and the elderly population, in relation to two high prevalence oral injuries (dental caries and tooth loss), 2) the main health care models for dealing with this situation, by analyzing the related historical processes in order to reveal the likely social, political and epidemiological implications of the different models, and 3) lastly, the possible challenges to Brazilian dentistry or collective oral health in overcoming these obstacles. The main results of the study indicate that, from an epidemiological point of view, Brazil is undergoing a transition in dental caries and tooth loss, which is not yet reflected in the profile of the elderly, but which is tentatively evidenced in young adults. Tooth loss remains high. Certain aspects of society's economic and political superstructure have an important impact on oral health indicators and existing inequalities. Oral health care models have a relative importance and must not be neglected. Vestiges of ideological movements, like preventive medicine, may explain the current impasse in collective oral health practices...

Who Cares About Health Care? Sociodemographics and Attitudes Toward Government’s Role in Health Care Across Germany, Great Britain, and the United States

Tang, Jessie
Fonte: Universidade Duke Publicador: Universidade Duke
Publicado em 10/12/2010 EN_US
Relevância na Pesquisa
75.85%
This paper investigates comparative public attitudes as a mechanism to explain American welfare state “exceptionalism” in health care. The countries of Germany, Great Britain, and the United States were chosen as three distinct cases that exemplify different health care models. Using data collected from the 2006 International Social Survey Program (ISSP), this study 1) analyzed the influence of individual-level indicators on public attitudes toward government’s role in health care in the three countries and 2) looked at how these relationships differed cross nationally. Based upon past research regarding path-dependency research and demographics, 11 individual-level indicators were chosen. Findings revealed that although significant differences exist across the nations, majority of participants from Germany, Great Britain, and the United States felt that their governments have a responsibility to provide health care and that the government should be spending more on health care. This goes against conventional wisdom regarding public opinion and health care reform. Overall, Americans wanted to see more government responsibility and spending in health care, but did not feel that the government was successful in delivering health care. Political affiliation in the United States was the only individual-level indicator to predict greater odds of attitudes in government spending...

Constituição cidadã e representações sociais: uma reflexão sobre modelos de assistência à saúde; Constitución ciudadana y representaciones sociales: una reflexión sobre modelos de atención de la salud; Citizen constitution and social representations: reflecting about health care models

Silva, Sílvio Éder Dias da; Ramos, Flávia Regina Souza; Martins, Cleusa Rios; Padilha, Maria Itayra; Vasconcelos, Esleane Vilela
Fonte: Universidade de São Paulo. Escola de Enfermagem Publicador: Universidade de São Paulo. Escola de Enfermagem
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Artigo Avaliado pelos Pares Formato: application/pdf; application/pdf
Publicado em 01/12/2010 POR; ENG
Relevância na Pesquisa
75.84%
Este artigo apresenta uma reflexão sobre o significado dos termos cidadania e saúde, abordando a Teoria das Representações Sociais como estratégia para implementação e avaliação dos modelos de assistência a saúde no Brasil. Na primeira parte, traçamos um breve histórico sobre a concepção de cidadania; na segunda, tratamos dos princípios de liberdade e igualdade pautados no pensamento de Kant; na terceira, evidenciamos a saúde como um direito do cidadão e um dever do estado; por fim, destacamos a Teoria das Representações Sociais como estratégia para avaliar e implementar os serviços de saúde prestados ao cidadão pelos modelos assistenciais de saúde em vigor no Brasil.; Este artículo expone una reflexión sobre el significado del término ciudadanía, salud y la Teoría de las Representaciones Sociales como una estrategia para la implementación y evaluación de los modelos de atención a la salud en Brasil. En la primera parte, trazamos un breve resumen histórico sobre la concepción de ciudadanía; en la segunda parte, abordamos los principios de libertad e igualdad pautados en el pensamiento de Kant; en la tercera, dejamos evidenciado que la salud es un derecho del ciudadano y un deber del estado y, por fin...

Construção do conhecimento e do fazer enfermagem e os modelos assistenciais; Construcción del conocimiento y del quehacer en enfermería y los modelos asistenciales; Health care models and the building of nursing knowledge and practice

Lucena, Amália de Fátima; Paskulin, Lisiane Manganelli Girardi; Souza, Mariana Fernandes de; Gutiérrez, Maria Gaby Rivero de
Fonte: Universidade de São Paulo. Escola de Enfermagem Publicador: Universidade de São Paulo. Escola de Enfermagem
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Artigo Avaliado pelos Pares Formato: application/pdf
Publicado em 01/06/2006 POR
Relevância na Pesquisa
85.8%
Artigo de reflexão que enfoca as origens e as principais caracterís-ticas dos modelos clínico e epide-miológico, seus nexos com os mo-delos assistenciais vigentes no sis-]tema de saúde brasileiro, e a cons-trução do conhecimento da enfer-magem nesse contexto. Nessa perspectiva, as autoras propõem um repensar acerca do saber/fazer da enfermagem, apontando possibilidades de expansão do seu campo de atuação, bem como dos limites e desafios a serem venci-dos pelos profissionais da área.; El presente artículo de reflexión enfoca los orígenes y las prin-cipales características de los mo-delos clínico y epidemiológico, sus nexos con los modelos asis-tenciales vigentes en el sistema de salud brasileño, y la cons-trucción del conocimiento de la enfermería en ese contexto. Bajo esa perspectiva, las autoras pro-ponen un repensar acerca del saber/hacer de la enfermería, apuntando posibilidades de expansión de su campo de actua-ción, así como de los límites y desafíos a ser vencidos por los profesionales del área.; This is a reflective paper focused on the origins and main characte-ristics of the epidemiological and clinical models, their connections with the health care models currently adopted in Brazil, and the construction of Nursing knowledge in this context. From this perspective...

Population surveys as management tools and health care models; Encuestas poblacionales como instrumentos de gestion y los modelos de atencion a la salud; Inqueritos populacionais como instrumentos de gestao e os modelos de atencao a saude

Andrade, Flavia Reis de; Narvai, Paulo Capel
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf; application/pdf
Publicado em 01/12/2013 POR; ENG
Relevância na Pesquisa
65.93%
O artigo faz uma breve sistematização dos modelos de atenção em saúde, enfatiza o papel do inquérito populacional como instrumento de gestão e analisa o caso específico da Pesquisa Nacional de Saúde Bucal (SBBrasil 2010), ressaltando a sua contribuição no processo de consolidação de modelos de atenção compatíveis com os princípios do Sistema Único de Saúde. Ainda que no plano legal o Sistema Único de Saúde corresponda a um modelo de atenção em saúde, no plano concreto das políticas públicas e das ações, o sistema dá origem a um modelo que resulta não de textos jurídicos nem de formulações teóricas, mas da práxis dos agentes envolvidos. Considerando que a gestão do cotidiano em saúde é um espaço privilegiado e prioritário para a produção e consolidação dos modelos de atenção à saúde, é necessário estimular e apoiar o desenvolvimento de competências técnicas e operacionais diferentes daquelas necessárias à gerência dos cuidados relacionados às demandas individuais.; The article briefly systematizes health care models, emphasizes the role of population surveys as a management tool and analyzes the specific case of the Brazilian Oral Health Survey (SBBrasil 2010) and its contribution to the consolidation process of health care models consistent with the principles of the Sistema Único de Saúde (SUS...

Organização das ações de atenção à saúde: modelos e práticas; Organization of health care actions: models and practices

Ayres, José Ricardo de Carvalho Mesquita
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/06/2009 POR
Relevância na Pesquisa
75.91%
O objetivo deste artigo é discutir recentes contribuições conceituais para a construção de modelos de organização das ações de atenção à saúde. Trata-se de um ensaio crítico baseado na Teoria do Processo de Trabalho em Saúde, de Mendes-Gonçalves e colaboradores, relido na perspectiva filosófica da Hermenêutica contemporânea (Gadamer; Ricoeur, Habermas). Em primeiro lugar, define-se modelo como a convergência de horizontes entre os diversos discursos socialmente legitimados acerca dos modos de operar as tecnologias de atenção à saúde de indivíduos e populações. A seguir, são apontados como norteadores da reflexão o princípio da integralidade da atenção no contexto do Sistema Único de Saúde e seus desafios nos planos do conhecimento, das tecnologias e da ética. Os conceitos de vulnerabilidade, cuidado e humanização, como recentes proposições para novas confluências discursivas interessadas na construção de modelos de atenção integral, são, então, tomados para análise, discutindo-se seus principais pressupostos e conteúdos, assim como seus alcances e desafios práticos.; The objective of this paper is to discuss the recent conceptual contributions to the development of health care organization models. This is a critical essay...

International comparison of health care systems using resource profiles

Anell,Anders; Willis,Michael
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2000 EN
Relevância na Pesquisa
75.82%
The most frequently used bases for comparing international health care resources are health care expenditures, measured either as a fraction of gross domestic product (GDP) or per capita. There are several possible reasons for this, including the widespread availability of historic expenditure figures; the attractiveness of collapsing resource data into a common unit of measurement; and the present focus among OECD member countries and other governments on containing health care costs. Despite important criticisms of this method, relatively few alternatives have been used in practice. A simple framework for comparing data underlying health care systems is presented in this article. It distinguishes measures of real resources, for example human resources, medicines and medical equipment, from measures of financial resources such as expenditures. Measures of real resources are further subdivided according to whether their factor prices are determined primarily in national or global markets. The approach is illustrated using a simple analysis of health care resource profiles for Denmark, France, Germany, Sweden, the United Kingdom, and the USA. Comparisons based on measures of both real resources and expenditures can be more useful than conventional comparisons of expenditures alone and can lead to important insights for the future management of health care systems.

Make or buy" decisions in the production of health care goods and services: new insights from institutional economics and organizational theory

Preker,Alexander S; Harding,April; Travis,Phyllida
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2000 EN
Relevância na Pesquisa
75.87%
A central theme of recent health care reforms has been a redefinition of the roles of the state and private providers. With a view to helping governments to arrive at more rational "make or buy" decisions on health care goods and services, we propose a conceptual framework in which a combination of institutional economics and organizational theory is used to examine the core production activities in the health sector. Empirical evidence from actual production modalities is also taken into consideration. We conclude that most inputs for the health sector, with the exception of human resources and knowledge, can be efficiently produced by and bought from the private sector. In the health services of low-income countries most dispersed production forms, e.g. ambulatory care, are already provided by the private sector (non-profit and for-profit). These valuable resources are often ignored by the public sector. The problems of measurability and contestability associated with expensive, complex and concentrated production forms such as hospital care require a stronger regulatory environment and skilled contracting mechanisms before governments can rely on obtaining these services from the private sector. Subsidiary activities within the production process can often be unbundled and outsourced.

The impact of a clinical training unit on integrated child health care in Mexico

Guiscafré,Héctor; Martínez,Homero; Palafox,Miguel; Villa,Sofía; Espinosa,Patricia; Bojalil,Rossana; Gutiérrez,Gonzalo
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 EN
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This study had two aims: to describe the activities of a clinical training unit set up for the integrated management of sick children, and to evaluate the impact of the unit after its first four years of operation. The training unit was set up in the outpatient ward of a government hospital and was staffed by a paediatrician, a family medicine physician, two nurses and a nutritionist. The staff kept a computerized database for all patients seen and they were supervised once a month. During the first three years, the demand for first-time medical consultation increased by 477% for acute respiratory infections (ARI) and 134% for acute diarrhoea (AD), with an average annual increase of demand for medical care of 125%. Eighty-nine per cent of mothers who took their child for consultation and 85% of mothers who lived in the catchment area and had a deceased child received training on how to recognize alarming signs in a sick child. Fifty-eight per cent of these mothers were evaluated as being properly trained. Eighty-five per cent of primary care physicians who worked for government institutions (n = 350) and 45% of private physicians (n = 90) were also trained in the recognition and proper management of AD and ARI. ARI mortality in children under 1 year of age in the catchment area (which included about 25 000 children under 5 years of age) decreased by 43.2% in three years...