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Atividades educativas de trabalhadores na atenção primária: concepções de educação permanente e de educação continuada em saúde presentes no cotidiano de Unidades Básicas de Saúde em São Paulo; Educational activities for primary healthcare workers: permanent education and inservice healthcare education concepts in the daily life of primary healthcare units in São Paulo; Actividades educativas de trabajadores en la atención primaria: concepciones de educación permanente y de educación continuada en salud presentes en el quehacer cotidiano de Unidades Básicas de Salud en Sao Paulo, Brasil

PEDUZZI, Marina; GUERRA, Débora Antoniazi Del; BRAGA, Carina Pinto; LUCENA, Fabiana Santos; SILVA, Jaqueline Alcântara Marcelino da
Fonte: Revista Interface - Comunicação, Saúde, Educação Publicador: Revista Interface - Comunicação, Saúde, Educação
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
36.66%
Esta pesquisa tem o objetivo de analisar a prática de atividades educativas de trabalhadores da saúde em Unidade Básica de Saúde (UBS) segundo as concepções de educação permanente em saúde (EPS) e de educação continuada (EC), processo de trabalho em saúde e enfermagem, trabalho em equipe e integralidade. Estudo do tipo transversal, realizado em dez UBS do Município de São Paulo, por meio de entrevista dirigida com 110 informantes-chave, representantes de todas as categorias profissionais e equipes das UBS, sobre as atividades educativas desenvolvidas em 2005. As informações foram classificadas segundo categorias operacionais para cada variável de estudo, com base no referencial teórico. Os trabalhadores relataram 396 atividades educativas, que revelam a complementaridade das concepções de EPS e EC. De acordo com a perspectiva do Sistema Único de Saúde (SUS) e da transformação das práticas de saúde, coloca-se a necessidade de ampliação do debate em torno da EPS como política pública.; The objective of this study was to analyze the educational activity practices among healthcare workers in primary healthcare units (PHUs) according to the concepts of permanent healthcare education (EPS) and continuing education (CE)...

Cadeia de valor da saúde: um modelo para o sistema de saúde brasileiro; Healthcare value chain: a model for the Brazilian healthcare system

Pedroso, Marcelo Caldeira; Malik, Ana Maria
Fonte: ABRASCO; RIO DE JANEIRO Publicador: ABRASCO; RIO DE JANEIRO
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
36.68%
Este artigo apresenta um modelo de cadeia de valor da saúde que representa, de maneira esquemática, o sistema de saúde do Brasil. O modelo proposto tem como intuito apresentar uma adequação à realidade brasileira, bem como abrangência e flexibilidade para utilização em atividades acadêmicas e análises do setor de saúde do Brasil. O modelo coloca ênfase em três componentes: principais atividades dessa cadeia, agrupadas em elos verticais e horizontais; missão de cada um desses elos; e principais fluxos da cadeia. A cadeia proposta é formada por seis elos verticais e três horizontais, perfazendo um total de nove: desenvolvimento de conhecimento em saúde; fornecimento de produtos e tecnologias; serviços de saúde; intermediação financeira; financiamento da saúde; consumo de saúde; regulação; distribuição de produtos de saúde; e serviços de apoio e complementares. A análise da cadeia proposta pode ser realizada por meio de quatro fluxos: inovação e conhecimento; produtos e serviços; financeiro; e de informação.; This article presents a model of the healthcare value chain which consists of a schematic representation of the Brazilian healthcare system. The proposed model is adapted for the Brazilian reality and has the scope and flexibility for use in academic activities and analysis of the healthcare sector in Brazil. It places emphasis on three components: the main activities of the value chain...

O processo de trabalho em HIV/Aids: a visão dos profissionais; Work Process of HIV/Aids: perspectives of healthcare professionals.

Fonseca, Joana Filipa Afonso Monteiro Frateschi 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 26/01/2007 PT
Relevância na Pesquisa
36.66%
A fragmentação do trabalho em saúde, atualmente, tem sido muito estudada. Os estudos apontam que esta além de esvaziar o trabalho de sentido, gerando conseqüências emocionais para os profissionais, trás repercussões na vida dos pacientes, uma vez que, entre outras coisas, prioriza os aspectos técnicos do atendimento em detrimento dos aspectos psicossocias. Considerando que a infecção ao HIV trás desdobramentos psicossociais na vida da pessoa contaminada, a atuação voltada para estes aspectos torna-se primordial. Assim sendo, este estudo tem como objetivo recuperar a síntese do processo de trabalho em HIV/Aids a partir dos profissionais envolvidos neste processo. Dentro da abordagem de pesquisa qualitativa foram realizadas 10 entrevistas com profissionais da Unidade Especial de Tratamento de Doenças Infecciosas do HC de Ribeirão Preto. Estas foram semi-estruturadas e realizadas segundo procedimentos de evocação-enunciação-verificação. As falas dos profissionais foram agrupadas conforme as semelhanças de seus conteúdos temáticos e analisadas à luz do materialismo histórico. Os dados mostraram que três Elementos constituem a síntese do processo de trabalho em HIV/Aids: Elementos de Competência Psicossocial; Elementos de Controle Sócio-Político e Administrativo; Elementos de Competência Técnica. Embora os profissionais estudados tenham privilegiado em suas reflexões os Elementos de Competência Psicossocial...

Gestão do trabalho em saúde: revisão da literatura por meio de scoping review; Work management in healthcare: literature review by scoping review

Viana, Dirce Laplaca
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 26/02/2013 PT
Relevância na Pesquisa
36.66%
No setor saude no Brasil, o termo gestao do trabalho passou a ser utilizado principalmente apos a 12ª Conferencia Nacional de Saude, por haver criticas ao termo gestao de recursos humanos. Entretanto, o que e gestao do trabalho em saude? O que se tem produzido no Brasil a respeito desse tema? Como essa expressao vem sendo utilizada na producao cientifica brasileira? Esta pesquisa busca analisar a producao cientifica publicada em periodicos brasileiros com relacao a incorporacao da expressao gestao do trabalho em saude. Foi realizado um scoping review na base de dados Lilacs, com exclusao de teses, livros, estudos sem resumo, estudos repetidos, monografias e documentos governamentais. Foram encontrados 495 estudos, submetidos a criterios de inclusao e exclusao por tres juizes, 74 artigos foram considerados na integra para mapeamento. Dos artigos mapeados, 34 foram selecionados para pesquisa. Com relacao as caracteristicas dos estudos, os especialistas do Sudeste e Sul brasileiro produziram mais artigos sobre o tema, com abordagem metodologica predominantemente qualitativa publicados nos periodicos Cadernos de Saude Publica e Ciencia & Saude Coletiva. Tais publicacoes apresentaram crescimento numerico principalmente apos 2006, com a 3ª Conferencia Nacional de Gestao do Trabalho e Educacao em Saude. Com relacao a incorporacao...

Proposta de aplicação das ferramentas do lean healthcare à logística hospitalar; Application proposal of lean healthcare tools in hospital logistics

Oliveira, Thomás Silva
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 14/02/2014 PT
Relevância na Pesquisa
36.69%
A logística representa uma importante e complexa função de apoio dentro do hospital, assegurando a correta e ótima movimentação dos fluxos de materiais, informações e pessoas, a fim de que os cuidados médicos (competência essencial) sejam prestados com eficácia aos pacientes. Pode-se perceber, no entanto, que embora as atividades logísticas possuam um caráter estratégico, tanto em relação ao custo que representam para as finanças hospitalares, quanto para o nível de serviço prestado e a consequente percepção do paciente, alguns hospitais não a possuem de maneira bem estruturada e desenvolvida, principalmente dentro do setor público. Dessa forma, considerando a relevância da logística hospitalar, afirma-se que a busca de melhorias na execução de suas atividades pode trazer benefícios diretos ao hospital e aos seus clientes internos (colaboradores) e externos (pacientes e familiares). É nesse contexto que se insere o lean healthcare, abordagem advinda do Sistema Toyota de Produção. Baseado em princípios e ferramentas voltados a eliminação de desperdícios, criação de valor para o cliente e melhoria contínua, a produção enxuta já tem sido aplicada com sucesso para otimizar as atividades no ambiente hospitalar. O objetivo desta pesquisa é...

Por uma educação que se movimente como maré e inunde os cotidianos de serviços de saúde; Towards an education that moves like the tide and floods the everyday routines of healthcare services; Por una educación que se mueva como las mareas e inunde los cotidianos de los servicios de salud

Meyer, Dagmar Elisabeth Estermann; Félix, Jeane; Vasconcelos, Michele de Freitas Faria 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
36.66%
Propomos refletir sobre práticas de cuidado e de gestão em saúde, entendendo-as como práticas sociais bem datadas. Situando-nos no cruzamento entre as áreas da educação e saúde e, nelas, dos estudos sobre corpo, apontamos práticas de saúde como pedagogias culturais, a partir das quais são prescritos determinados sentidos e condutas, mas, também, por meio das quais são construídos sentidos e fazeres inéditos que deslocam, bifurcam, fazem questionar tais prescrições. Dito de outro modo, entendemos aqui o campo da saúde como um território de ensino (formatações pedagógico-corporais), mas, também, de aprendizagens (experimentação de formas singulares nos fazeres e dizeres em saúde), e o cuidado e a gestão em saúde como uma montagem (corporal) conflituosa entre formas de sujeição e forças de experimentação, a partir das quais as práticas em saúde se tecem.; We proposed to reflect on care and management practices within healthcare, by taking these to be well-dated social practices. Through placing ourselves at the intersection between the fields of education and healthcare, and, within these, in the field of studies on the body, we showed that healthcare practices comprise cultural pedagogies from which certain meanings and behaviors are prescribed...

Lean thinking in healthcare services: learning from case studies

Guimarães, Maria Cristina Geraldes Malheiros Machado
Fonte: Instituto Universitário de Lisboa Publicador: Instituto Universitário de Lisboa
Tipo: Tese de Doutorado
Publicado em //2013 ENG
Relevância na Pesquisa
36.72%
Tese de doutoramento em Gestão Geral, Estratégia Desenvolvimento Organizacional/ JEL: D22, I12; Healthcare organisations, especially in public sector, have been adopting Lean management practices with increasing outcomes’ evidences in several parts of the world, since the beginning of this century. However, Lean deployment in Healthcare services has been addressed in the literature in a surgical way by an array of case reports addressing the “hard” side of Lean deployment, sometimes with no result’s consistency or even follow-up analysis. This thesis seek to add to the operational side of Lean deployment in Healthcare, a complementary understanding of Lean deployment approaches, addressing both “hard” and “soft” sides, identifying the real constraints of Lean in Healthcare sector and the sustainability factors. Supported by two main literature reviews and a multi-case approach, a deep research on the eligible Portuguese cases was conducted answering the questions: (i) What are the different outcomes from Lean deployment in Healthcare?; (ii) What are the barriers to Lean implementation in Healthcare?; (iii) What enables Lean implementation in Healthcare?; (iv) What are the risks of Lean in Healthcare?; (v) How to measure Lean achievements in Healthcare services?; and (vi) How to develop a sustainable Lean culture? This contribution to the academic debate on Lean deployment in Healthcare creates clarity on what can be called Lean practices in Healthcare settings under the light of the concept’s founders; what pattern of a Lean deployment journey was followed by Healthcare organisations; and how different cultural (organisational and national) contexts can influence the pace in pursuing that pattern.; As organizações de saúde...

Assessing equity of healthcare utilization in rural China: results from nationally representative surveys from 1993 to 2008

Zhou, Zhongliang; Su, Yanfang; Gao, Jianmin; Campbell, Benjamin; Zhu, Zhengwei; Xu, Ling; Zhang, Yaoguang
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
36.68%
Background: The phenomenon of inequitable healthcare utilization in rural China interests policymakers and researchers; however, the inequity has not been actually measured to present the magnitude and trend using nationally representative data. Methods: Based on the National Health Service Survey (NHSS) in 1993, 1998, 2003, and 2008, the Probit model with the probability of outpatient visit and the probability of inpatient visit as the dependent variables is applied to estimate need-predicted healthcare utilization. Furthermore, need-standardized healthcare utilization is assessed through indirect standardization method. Concentration index is measured to reflect income-related inequity of healthcare utilization. Results: The concentration index of need-standardized outpatient utilization is 0.0486[95% confidence interval (0.0399, 0.0574)], 0.0310[95% confidence interval (0.0229, 0.0390)], 0.0167[95% confidence interval (0.0069, 0.0264)] and −0.0108[95% confidence interval (−0.0213, -0.0004)] in 1993, 1998, 2003 and 2008, respectively. For inpatient service, the concentration index is 0.0529[95% confidence interval (0.0349, 0.0709)], 0.1543[95% confidence interval (0.1356, 0.1730)], 0.2325[95% confidence interval (0.2132, 0.2518)] and 0.1313[95% confidence interval (0.1174...

The International Charter for Human Values in Healthcare: An interprofessional global collaboration to enhance values and communication in healthcare

Rider, Elizabeth Ann; Kurtz, Suzanne; Slade, Diana; Longmaid, H. Esterbrook; Ho, Ming-Jung; Pun, Jack Kwok-hung; Eggins, Suzanne; Branch, William T.
Fonte: Elsevier BV Publicador: Elsevier BV
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
36.68%
Objectives: The human dimensions of healthcare—core values and skilled communication necessary for every healthcare interaction—are fundamental to compassionate, ethical, and safe relationship-centered care. The objectives of this paper are to: describe the development of the International Charter for Human Values in Healthcare which delineates core values, articulate the role of skilled communication in enacting these values, and provide examples showing translation of the Charter’s values into action. Methods: We describe development of the Charter using combined qualitative research methods and the international, interprofessional collaboration of institutions and individuals worldwide. Results: We identified five fundamental categories of human values for every healthcare interaction—Compassion, Respect for Persons, Commitment to Integrity and Ethical Practice, Commitment to Excellence, and Justice in Healthcare—and delineated subvalues within each category. We have disseminated the Charter internationally and incorporated it into education/training. Diverse healthcare partners have joined in this work. Conclusion: We chronicle the development and dissemination of the International Charter for Human Values in Healthcare...

Exploring Healthcare Experiences of Transgender Individuals

Ross, Katie
Fonte: Brock University Publicador: Brock University
Tipo: Electronic Thesis or Dissertation
ENG
Relevância na Pesquisa
36.66%
The purpose of this study was to explore how transgender individuals were supported to navigate the healthcare system to achieve positive healthcare experiences. A single case study was conducted in Southern Ontario, which included ten individual interviews. Data was analyzed through thematic analysis, allowing for seven themes to emerge within macro (large-scale system), meso (local/interpersonal), and micro (individual/internal) levels of healthcare system support. Themes that emerged within the levels of system support included: 1) existing deficits with hope for change; 2) significant external supports; 3) importance of informal networking; 4) support from local area family physicians and walk-in clinics; 5) navigating the healthcare system alone; 6) personality traits for successful healthcare experiences; and 7) the development of strategies to achieve positive healthcare experiences. This study outlined factors that contributed to positive healthcare experiences for transgender individuals, showing that meso and micro level support are compensating for large-scale healthcare system deficits.

Sustainability of Healthcare Financing in the Western Balkans : An Overview of Progress and Challenges

Bredenkamp, Caryn; Gragnolati, Michele
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Relevância na Pesquisa
36.7%
This paper explores the major challenges to the sustainability of health sector financing in the countries of the Western Balkans - Albania, Bosnia and Herzegovina, the Former Yugoslav Republic of Macedonia, Montenegro, Serbia and the province of Kosovo. It focuses on how the incentives created by the different elements of the healthcare financing system affect the behavior of healthcare providers and individuals, and the resulting inefficiencies in revenue collection and expenditure containment. The paper analyzes patterns of healthcare expenditure, finding that there is some evidence of cost containment, but that current expenditure levels - while similar to that in EU countries as a share of GDP - are low in per capita terms and the fiscal space to increase expenditures is extremely limited. It also examines the key drivers of current healthcare expenditure and the most significant barriers to revenue generation, identifying some key health reforms that countries in the sub-region could consider in order to enhance the efficiency and sustainability of their health systems. Data are drawn from international databases...

Healthcare costs associated with language difficulties up to 9 years of age: Australian population-based study

Sciberras, Emma; Westrupp, Elizabeth M.; Wake, Melissa; Nicholson, Jan M.; Lucas, Nina; Mensah, Fiona; Gold, Lisa; Reilly, Sheena
Fonte: Informa Healthcare Publicador: Informa Healthcare
Tipo: Artigo de Revista Científica Formato: 12 pages
Relevância na Pesquisa
46.68%
PURPOSE This study aimed to quantify the non-hospital healthcare costs associated with language difficulties within two nationally representative samples of children. METHOD Data were from three biennial waves (2004-2008) of the Longitudinal Study of Australian Children (B cohort: 0-5 years; K cohort: 4-9 years). Language difficulties were defined as scores ≤ 1.25 SD below the mean on measures of parent-reported communication (0-3 years) and directly assessed vocabulary (4-9 years). Participant data were linked to administrative data on non-hospital healthcare attendances and prescription medications from the universal Australian Medicare subsidized healthcare scheme. RESULT It was found that healthcare costs over each 2-year age band were higher for children with than without language difficulties at 0-1, 2-3, and 4-5 years, notably 36% higher (mean difference = $AU206, 95% CI = $90, $321) at 4-5 years (B cohort). The slightly higher 2-year healthcare costs for children with language difficulties at 6-7 and 8-9 years were not statistically different from those without language difficulties. Modelled to the corresponding Australian child population, 2-year government costs ranged from $AU1.2-$AU12.1 million (depending on age examined). Six-year healthcare costs increased with the persistence of language difficulties in the K cohort...

Análise do processo de uma farmácia de medicamentos especializados e aplicação do lean healthcare; Process analysis of a specialized medicines pharmacy and application of lean healthcare

Silva, Ulisses Rezende
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 03/07/2015 PT
Relevância na Pesquisa
36.69%
O Sistema Único de Saúde (SUS), sistema público de saúde brasileiro, tem evoluído continuamente para se adaptar aos novos desafios da área de saúde e as novas necessidades da população. Entre os aprimoramentos para atender a esses desafios está a oferta de medicamentos de alto custo à população por meio de farmácias de medicamentos especializados como a de Ribeirão Preto, que atende aos residentes no município e também as pessoas das cidades englobadas pela DRS XIII. Com o objetivo de analisar o processo de uma farmácia de medicamentos especializados, identificando os problemas e propondo melhorias foi aplicada a metodologia lean healthcare. Inicialmente foi realizada uma pesquisa juntamente aos usuários desse serviço em busca de uma definição do valor no serviço prestado pela farmácia. Os resultados encontrados mostram que receber todos os medicamentos solicitados, a correta orientação em relação as dúvidas, pouco tempo de espera na fila e o bom atendimento são os itens mais valorizados por eles. A partir dessa definição de valor, de entrevistas com funcionários da farmácia e de observações no local, foram criados mapas do fluxo de valor do processo de trabalho da farmácia, identificando os desperdícios praticados e apontando sugestões de melhorias através da aplicação da metodologia lean healthcare. Após a finalização dessa etapa foram criadas propostas para a melhoria do fluxo contínuo...

Horizontal inequity in access to healthcare services and educational level in Spain

Montero Granados, Roberto; Mart??n-Mart??n, Jos?? Jes??s; Jim??nez Aguilera, Juan de Dios
Fonte: Universidad de Granada. Facultad de Ciencias Econ??micas y Empresariales Publicador: Universidad de Granada. Facultad de Ciencias Econ??micas y Empresariales
Tipo: Relatório
ENG
Relevância na Pesquisa
36.66%
The aim of this study is to measure horizontal equity in the use of healthcare services in Spain, proposing two methodological innovations. First by defending it as equality of access for equal need, irrespective of educational level, unlike the prevailing methodological approach to horizontal equity which relates it to income. Second, by estimating it by means of the slope index of the inequality of characteristics, analagous to the inequity index proposed by Kakwani, Wagstaff and van Doorslaer (1997; HIWV) but presenting some methodological advantages, the greater robustness of the data available on educational level than of those on income, and the possibility of isolating the net effect of the educational level on the use of healthcare by controlling for other variables. The methodology is designed in three parts: (1) estimation of the relationship between the educational level and the use of healthcare services by means of a model of the likelihood of demand for healthcare services, commonly used in the literature; (2) estimation of the relationship between educational level and health by approximating a production function of individuals' health according to their personal characteristics and other factors conditioning health; and (3) estimation of the slope index of inequality as a measure of horizontal inequity...

Equity in access to healthcare in Brunei Darussalam: Results from the Brunei Darussalam Health System Survey (HSS)

Tant, Elizabeth Michelle
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Tese de Doutorado
Publicado em //2014
Relevância na Pesquisa
36.78%

Background: Universal healthcare has been promoted by organizations including the World Health Organization and United Nations as a means of ensuring healthcare access for vulnerable populations. Despite momentum towards universal healthcare, especially among Southeast Asian nations, little research has been conducted to understand healthcare equity in nations that have already implemented universal healthcare. This paper assesses equity in healthcare access in Brunei Darussalam using results from the Brunei Darussalam Health System Survey (HSS).

Methods: Data were gathered using a nationally-representative survey of 1,197 households across four districts in Brunei Darussalam. The Health System Survey aimed to measure individual's expectations and utilization of the Brunei national healthcare system. Data were analyzed using descriptive statistics and multinomial logistic regression to identify respondent- and household-level characteristics that affect healthcare utilization and expenditures.

Results: HSS data suggest that healthcare utilization in Brunei varies by ethnicity, district of residence, health status, and income. When compared to other ethnic groups, Chinese households were significantly less likely to utilize public healthcare and significantly more likely to utilize private healthcare services. Indigenous groups also demonstrated significantly lower rates of private healthcare utilization compared to other ethnicities. Temburong district had the lowest rates of both private and public healthcare utilization and was associated with a 2.67 decreased likelihood of using public healthcare in the past six months. When stratifying for health status...

Price Transparency in American Healthcare: Public Policies to Support Market-Based Solutions

Mortimer, Laura
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Masters' project
Publicado em 04/05/2014 EN
Relevância na Pesquisa
36.72%
The United States has the most expensive healthcare system in the world. We pay more money per capita for care than any other country – around three times the OECD average. Healthcare accounts for nearly a quarter of our federal budget, and the average family of four in America pays over $20,000 out-of-pocket each year for care. And yet, our health outcomes are no better than those of countries that spend far less money on care; we receive considerably less bang for our buck. As prices rise and we spend both more public and private dollars on healthcare, policy makers and other stakeholders must find ways to build more rational economic decision-making into the system. Unfortunately, the fee-for-service model makes this change difficult because it fundamentally misaligns incentives between patients, payers, and providers. Absent a complete overhaul of fee-for-service, several regulatory reforms and market innovations are essential to bending the healthcare cost curve. Health policy experts agree that lack of price transparency is a major part of the problem. Patients often do not know the amount they will pay for care until they receive a bill, weeks or even months later. As consumer-driven healthcare becomes more the norm and patients pay more out-of-pocket for care...

Insider threat mitigation and access control in healthcare systems

Alshehri, Suhair; Mishra, Sumita; Raj, Rajendra
Fonte: Rochester Instituto de Tecnologia Publicador: Rochester Instituto de Tecnologia
Tipo: Relatório
EN_US
Relevância na Pesquisa
36.68%
Rapid and reliable information sharing of patient healthcare information has become critical for achieving better care with lower costs. However, such healthcare information sharing requires to be done securely with privacy guarantees, as required by law. Among its other requirements, the Health Insurance Portability and Accountability Act (HIPAA) requires the use of appropriate access control mechanisms to protect healthcare information. Despite these legal requirements, currently implemented access control models in the healthcare domain are typically inadequate as demonstrated by the large and increasing numbers of successful attacks on healthcare systems. In particular, current access control models do not provide sufficient protection for healthcare systems from attacks by insiders, i.e., authorized healthcare personnel. This paper examines how healthcare information can be protected from unauthorized or improper use, disclosure, alteration, and destruction by health- care providers. Using a holistic approach toward modeling access control, the authors construct a threat model for access control in healthcare systems. The constructed model is then used to assess the effectiveness of current access control mechanisms such as Role-Based Access Control (RBAC) and Attribute-Based Access Control (ABAC)...

Awareness of the healthcare system and rights to healthcare in the Colombian population

Delgado Gallego,María Eugenia; Vázquez-Navarrete,María Luisa
Fonte: Gaceta Sanitaria Publicador: Gaceta Sanitaria
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/10/2013 ENG
Relevância na Pesquisa
36.68%
Objectives: To analyze changes in users' awareness of the healthcare system and of their rights to healthcare in Colombia in the last 10 years, as well as the factors that influence users' awareness. Methods: We carried out a descriptive study to compare the results of two cross-sectional studies based on two surveys of users of the Colombian healthcare system. The first survey was performed in 2000 and the second in 2010. The municipalities of Tuluá (urban area) and Palmira (rural area) were surveyed. In both surveys, a stratified, multistage probability sample was selected. There were 1497 users in the first sample and 1405 in the second. Changes in awareness of the healthcare system and associated factors in each year were assessed through multivariate logistic regressions. Results: Users' awareness of the healthcare system was limited in 2000 and was significantly lower in 2010, except for that relating to health insurers and providers. In contrast, more than 90% of users in both surveys perceived themselves as having healthcare rights. The factors consistently associated with greater awareness were belonging to a high socioeconomic stratum and having higher education. Conclusions: The most underprivileged users were less likely to be aware of the healthcare system...

Ethical issues in healthcare financing

Maharaj,SR; Paul,TJ
Fonte: West Indian Medical Journal Publicador: West Indian Medical Journal
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2011 EN
Relevância na Pesquisa
36.68%
The four goals of good healthcare are to relieve symptoms, cure disease, prolong life and improve quality of life. Access to healthcare has been a perpetual challenge to healthcare providers who must take into account important factors such as equity, efficiency and effectiveness in designing healthcare systems to meet the four goals of good healthcare. The underlying philosophy may designate health as being a basic human right, an investment, a commodity to be bought and sold, a political demand or an expenditure. The design, policies and operational arrangements will usually reflect which of the above philosophies underpin the healthcare system, and consequently, access. Mechanisms for funding include fee-for-service, cost sharing (insurance, either private or government sponsored) free-of-fee at point of delivery (payments being made through general taxes, health levies, etc) or cost-recovery. For each of these methods of financial access to healthcare services, there are ethical issues which can compromise the four principles of ethical practices in healthcare, viz beneficence, non-maleficence, autonomy and justice (1, 2). In times of economic recession, providing adequate healthcare will require governments, with support from external agencies...

Awareness of the healthcare system and rights to healthcare in the Colombian population

Gallego,María Eugenia Delgado; Vázquez-Navarrete,María Luisa
Fonte: Ediciones Doyma, S.L. Publicador: Ediciones Doyma, S.L.
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2013 EN
Relevância na Pesquisa
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Objectives: To analyze changes in users' awareness of the healthcare system and of their rights to healthcare in Colombia in the last 10 years, as well as the factors that influence users' awareness. Methods: We carried out a descriptive study to compare the results of two cross-sectional studies based on two surveys of users of the Colombian healthcare system. The first survey was performed in 2000 and the second in 2010. The municipalities of Tuluá (urban area) and Palmira (rural area) were surveyed. In both surveys, a stratified, multistage probability sample was selected. There were 1497 users in the first sample and 1405 in the second. Changes in awareness of the healthcare system and associated factors in each year were assessed through multivariate logistic regressions. Results: Users' awareness of the healthcare system was limited in 2000 and was significantly lower in 2010, except for that relating to health insurers and providers. In contrast, more than 90% of users in both surveys perceived themselves as having healthcare rights. The factors consistently associated with greater awareness were belonging to a high socioeconomic stratum and having higher education. Conclusions: The most underprivileged users were less likely to be aware of the healthcare system...