Navegando por Palavras-chave "Health services evaluation"
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- ItemAcesso aberto (Open Access)Auditoria de avaliação dos serviços de saúde no processo de credenciamento(ABRASCO - Associação Brasileira de Saúde Coletiva, 2011-01-01) Paim, Chennyfer da Rosa Paino [UNIFESP]; Zucchi, Paola [UNIFESP]; Centro Universitário Sant Anna; Universidade Federal de São Paulo (UNIFESP)This article shows how many health insurance companies operating in the Greater São Paulo have been performing auditing of the quality of their health care services, professionals, and which criteria are being employed to do so. Because of the legislation decreeing that health insurance companies have legal co-responsibility for the health care services and National Health Agency control the health services National Health Agency, auditing evaluations have been implemented since then. The survey was based on electronic forms e-mailed to all health insurance companies operating in the Greater São Paulo. The sample consisted of 125 health insurance companies; 29 confirmed that had monitoring and evaluation processes; 26 performed auditing of their services regularly; from those, 20 used some type of form or protocol for technical visits; all evaluation physical and administrative structure and 22 included functional structure. Regarding the professionals audited 21 were nurses, 13 administrative assistants; 04 managers and 02 doctors. Regarding criteria for accreditation the following were highlighted: region analysis (96%), localization (88,88%) and cost (36%). We conclude that this type of auditing evaluation is rather innovative and is being gradually implemented by the health insurance companies, but is not a systematic process.
- ItemAcesso aberto (Open Access)Avaliação da implantação da Política Nacional de Humanização da atenção e gestão por meio da construção do Índice de Humanização dos Serviços de Saúde(Universidade Federal de São Paulo (UNIFESP), 2015-03-25) Souza, Delvane Jose de [UNIFESP]; D'Innocenzo, Maria [UNIFESP]; http://lattes.cnpq.br/8539986249567784; http://lattes.cnpq.br/8363020984762239; Universidade Federal de São Paulo (UNIFESP)Propor e desenvolver um Indicador Sintético de Humanização dos Serviços de Saúde, tendo como referência as diretrizes emanadas da Política Nacional de Humanização da Atenção e Gestão (PNH). Métodos: pesquisa de campo aplicada, quantitativa e metodológica, desenvolvida em três etapas: a) levantamento bibliográfico para identificação das variáveis iniciais emanadas da PNH e modelo teórico-lógico; b) construção de um consenso entre os critérios da avaliação dos especialistas da saúde com a técnica Delphi e c) validação de constructo por meio da aplicação do Índice de Humanização dos Serviços em dois serviços de saúde, sendo um serviço de atenção primária e secundária e outro serviço de atenção terciária (hospital). Vinte e cinco especialistas da área de saúde foram convidados a manifestar, individualmente, a sua concordância ou discordância do roteiro de avaliação do programa por meio da técnica Delphi, atribuindo a cada item de zero a cem pontos. Também foram solicitadas sugestões relativas à inclusão, exclusão ou indecisão quanto à variável no indicador proposto. O instrumento foi desenvolvido nos moldes de escalas ordinais tipo Likert. Em seguida, a escala foi aplicada em uma amostra de trabalhadores, gestores e usuários. A elaboração do IHS seguiu os seguintes procedimentos: (a) Cálculo do escore de cada quesito/pergunta; (b) Cálculo do valor do IPH para cada variável da PNH; (c) Cálculo do IPH para cada dimensão. O índice de cada dimensão foi obtido por meio de média aritmética, com base nos valores IHS das variáveis organizacionais a ela correspondentes e validade do constructo através da técnica de análise multivariada. Resultados: a revisão bibliográfica possibilitou identificar 186 estudos, sendo identificadas 42 variáveis, distribuídas nas dimensões trabalho, usuário e gestão. Na etapa Delphi, foram adicionadas 14 novas variáveis que obtiveram entre 78 % a 99% de consenso. O questionário com 56 variáveis foi aplicado em uma amostra de 312 profissionais de saúde, 49 gestores e 211 usuários. O valor de alfa de Cronbach foi de ,881, ,723 e ,827 nas dimensões trabalho, usuário e gestão, respectivamente. A análise fatorial indicou sete fatores relacionados à dimensão trabalho, sete fatores na dimensão usuário e três fatores na dimensão gestão. Conclusão: o desenvolvimento da tese possibilitou mensurar a visão dos trabalhadores, gestores e usuários sobre diferentes aspectos da humanização nos serviços de saúde. O índice proposto ao ser aplicado em diferentes serviços e níveis de atenção à saúde demonstrou robustez e consistência, atendendo aos requisitos da qualidade como método desenvolvido para avaliar os diferentes aspectos da implantação da PNH.
- ItemAcesso aberto (Open Access)Avaliação da qualidade da consulta de enfermagem à criança no Programa de Saúde da Família(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2007-03-01) Saparolli, Eliana Campos Leite [UNIFESP]; Adami, Nilce Piva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: This descriptive study has objectified to evaluate the process developed in the nursing consultations given to the children up to one year of age in Basic Units of Health of the Family Health Program of São Paulo City, considering the application of technical scientific knowledge in the implementation of the basic actions of health proposed for the Ministry of Health. The theoretical reference adopted was based on systemic conception of the evaluation of health services. METHOD: It was carried through systemize comment of 114 nursing consultations given to the children, for 14 nurses, using itself an instrument, contemplating evaluated criterion been valid for 11 specialists. RESULTS: In the observed consultations, nurses had implemented these actions of adjusted form, lacking, however, of complementation. CONCLUSIONS: The care process, even so developed adequately, requires adjustments of easy resolution in some procedures, so as to enclose essential aspects to the children health in the selected Units of the Family Health Program.
- ItemAcesso aberto (Open Access)Consulta de enfermagem ao portador de hanseníase no território da Estratégia da Saúde da Família: percepções de enfermeiro e pacientes(Associação Brasileira de Enfermagem, 2008-11-01) Freitas, Cibelly Aliny Siqueira Lima; Silva Neto, Antonio Vieira Da; Ximenes Neto, Francisco Rosemiro Guimarães; Albuquerque, Izabelle Mont'alverne Napoleão; Cunha, Isabel Cristina Kowal Olm [UNIFESP]; Universidade Estadual do Vale do Acaraú Curso de Enfermagem; Universidade Federal de São Paulo (UNIFESP)The present study aims to identify difficulties for the nurse so that he can reflect and create strategies to improve the quality of the nursing consultation and follow-up for patients with leprosy and to understand the perception of the patient in relation to the attendance structure and nursing follow-up. From the results we note that in the nursing consultation, the creation of a bond of confidence was sought with the client with the objective of receiving information on their treatment as well as on any disabilities. Regarding the difficulties confirmed by the nurses, they are related to the organization conditions of health services which causes a high demand. In relation to the perception of patients regarding the nursing consultation it was shown, in general, quite satisfactory.
- ItemAcesso aberto (Open Access)Impacto de um Centro de Informações Toxicológicas na redução do tempo de internação hospitalar de pacientes intoxicados: coorte retrospectiva(Universidade Federal de São Paulo (UNIFESP), 2010-01-27) Galvão, Tais Freire [UNIFESP]; Atallah, Álvaro Nagib [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Poison Control Centers (PCC) play an essential role in caring for poisoned patients, albeit without secure funding for their activities. Objective: to investigate differences in length of hospital stay among poisoned patients, between those who received remote assistance from a PCC and those who did not. Methods: a retrospective cohort including all poisoned patients hospitalized at an emergency service in Manaus between 2005 and 2007 was set up. Patients presenting a known toxic agent, with less than 12 hours elapsed since exposure and without severe comorbidities, were selected. Their severity of poisoning was evaluated by two independent reviewers and divergence was solved by another reviewer. Agreement was obtained by Kappa index. Results: 198 patients were included. Those who received remote assistance from a PCC stayed in hospital on average for 3.43 days less than those without PCC assistance (95% CI: -6.10 to -0.77). Severity was assessed in the cases of 90 patients: there was no statistical difference in severity between the patient groups (p > 0.5). Agreement between reviewers was substantial. Conclusion: Patients with PCC aid had a lower length of stay then patients without this aid. Severity assessment is likely to be incorporated into Brazilian PCC routine.
- ItemAcesso aberto (Open Access)Psychoactive substances and the provision of specialized care: the case of Espirito Santo(Associação Brasileira de Psiquiatria - ABP, 2007-12-01) Siqueira, Marluce Miguel de; Barbosa, Dulce Aparecida [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Hopkins, Kristine; Universidade Federal do Espírito Santo Núcleo de Estudos sobre o Álcool e outras Drogas; Universidade Federal de São Paulo (UNIFESP); University of Texas Unidade de Pesquisa em Álcool e Drogas Population Research CenterOBJECTIVE: In this study, we conducted a survey of all the institutions that provide treatment for psychoactive substances in the state of Espirito Santo, Brazil during the period 2004-2005. METHOD: We used a snowball sampling technique to include all the treatment facilities in our State in which we employed a semi-structured interview instrument for key informants at each institution. We present descriptive results and test differences between groups using the Chi-square test. RESULTS: In Espirito Santo, 250 institutions provide treatment for psychoactive substances and are distributed as follows: governmental (17.6%), nongovernmental (22.8%), and self-help groups (59.6%). Of these 250 institutions, 85 provide direct care, with the majority found in the Central region (70.6%) and followed by the Northern (15.3%) and Southern (14.1%) regions. The majority of those that provide direct care are private nonprofit centers (16.8%) institutions with ties to religious organizations make up nearly one-third (30.6%) of direct care providers. The drugs most consumed by those seeking care are alcohol (82.4%), tobacco (81.2%) and marijuana (68.2%). The institutions generally give assistance to people in the 26-45 years age group (89.4%); with regard to gender, the institutions take care of: men (31.8%), women (5.9%), and both sexes (56.5%). The treatment models most used are psychosocial (58.8%), therapeutic community (47.1%) and biomedical (43.5%) and the work is evaluated through the team technique (72.9 %). CONCLUSIONS: In the state of Espirito Santo, indirect care services are many times greater than those that offer direct care and the majority of all services are in the Central region. The populations in the mainland have a comparative disadvantage when it comes to treatment options for psychoactive substance use. We observed that a significant number of institutions that provide drug abuse treatment have financial support from religious organizations. The Espirito Santo State survey demonstrates the necessity of a decentralized provision of specialized care for psychoactive substance users, with substantially more services directed to the Northern and Southern regions of the state. Moreover, the emphasis of these new institutions should be on outpatient care.