Navegando por Palavras-chave "Referral and consultation"
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- ItemAcesso aberto (Open Access)Análise da viabilidade econômica da unidade móvel de um serviço de referência em oftalmologia(Conselho Brasileiro de Oftalmologia, 2005-10-01) Lima, Luiz Henrique Soares Gonçalves De; Sousa, Luciene Barbosa De [UNIFESP]; Hospital Oftalmológico de Sorocaba; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To analyse the economic viability of a mobile eye clinic of a tertiary referral Ophthalmology Service. METHODS: The amount of money spent with the purchase and construction of the unit in 2000, and the expenses with its maintenance and operation in 2001 were considered, comparing these expenses with the income obtained from appointments, supplementary tests and eye surgeries through the Sistema Único de Saúde (a health care service provided by the government), in 2001. In order to make an economic analysis, an interest rate of 10% per year and a period of depreciation of 10 years were stipulated. RESULTS: The total amount spent to buy and set up a mobile unit of Hospital Oftamológico de Sorocaba was R$ 184,140,00. The amount spent with its maintenance and operation during 2001 was R$ 28,000.00. The unit was used on average during 2 days each week in 2001 and 6492 appointments were made in this period, generating an income of R$ 32,460.00. The appointments generated complementary tests and eye surgeries making up R$ 51,540.00. Therefore, the total amount received directly with the appointments, complementary tests and eye surgeries during 2001 was R$ 84,000.00 paid by the Sistema Único de Saúde, according to values established beforehand. Using these values it is possible to make an economic analysis of this enterprise and this was done with and without money savings for depreciation, taking into account the income and the expenses. CONCLUSION: Besides attending poor communities that are located in distant neighborhoods, a mobile eye clinic can be a source of income for ophthalmologic services.
- 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)Avaliação de um sistema de segunda opinião em radiologia(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2010-06-01) Neira, Ricardo Alfredo Quintano [UNIFESP]; Puchnick, Andrea [UNIFESP]; Cohrs, Frederico Molina [UNIFESP]; Lopes, Paulo Roberto De Lima [UNIFESP]; Lederman, Henrique Manoel [UNIFESP]; Pisa, Ivan Torres [UNIFESP]; Zilics Sistemas de Informação em Saúde; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: A second medical opinion can aid in the investigation of a health problem as well as in the definition of the therapeutic approach. The present study is aimed at demonstrating a process of second medical opinion by means of a web-based multispecialty system adapted for radiology. MATERIALS AND METHODS: The system was utilized by 49 residents at Universidade Federal de São Paulo (UNIFESP), Brazil, who gave their medical opinion on 52 second opinion requests. Questionnaires were utilized as an evaluation tool. RESULTS: A total of 1704 medical second opinions were evaluated and 514 (29.1%) of them were defined as satisfactory. In 64.4% of cases, the answers of the questionnaires indicated that the images quality did not affect the diagnosis. On average, 6 minutes and 26 seconds was the time required to issue a remote second medical opinion. CONCLUSION: A process of second medical opinion by means of a web-based multispecialty system adapted for radiology has shown to be an excellent tool in the management of therapeutic approaches.
- ItemAcesso aberto (Open Access)Clinical and demographic profile of cancer patients in a consultation-liaison psychiatric service(Associação Paulista de Medicina - APM, 2003-01-01) Citero, Vanessa de Albuquerque [UNIFESP]; Nogueira-Martins, Luiz Antonio [UNIFESP]; Lourenço, Maria Teresa; Andreoli, Sergio Baxter [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital do Câncer AC Camargo Treatment and Research CenterABSTRACT CONTEXT: An almost 50% prevalence of psychiatric disorders among cancer patients has prompted a series of studies on consultation-liaison psychiatry. Nonetheless, there are few reports on the epidemiological factors involving comorbidity between cancer and psychiatric disorders. OBJECTIVE: To evaluate the epidemiological profile of cancer inpatients referred to the consultation-liaison psychiatric service in an oncology hospital during its first year of activity. TYPE OF STUDY: Descriptive study. SETTING: Tertiary-care teaching hospital. PARTICIPANTS: 319 patients referred 412 times to the consultation-liaison psychiatry service. PROCEDURES: From August 97 to July 98, an appraisal was made of data on all admissions registered at the Hospital do Câncer, and also all referrals registered at the consultation-liaison psychiatry service. MAIN MEASUREMENTS: The demographics and patients' clinical data, the type and flow of the request, and the evaluation conducted by the service were analyzed and comparisons with the hospital data were made. The distribution of the number of referrals was used to construct a profile of patients who had repeatedly used the service. RESULTS: Psychiatric diagnoses were found in 59% of the cases. Forty-three percent of these required medication, 18.3% needed psychotherapy, 22.1% family intervention and 20.5% guidance from the staff. Over 22.8% of the consultations were reevaluations, mainly involving younger male patients with worst prognoses. These patients required lengthier and more elaborate intervention, and had higher prevalence of depressive and behavioral disorders. CONCLUSION: A younger and mainly male population of non-surgical oncological cases was referred to the consultation-liaison psychiatric service during its first year of activity. The psychiatric disorder prevalence was higher than expected, and consisted predominantly of mood disorders. We detected a priority group, namely the reevaluated patients, who deserved special attention throughout the psychiatric interventions.
- ItemAcesso aberto (Open Access)Construção e avaliação de sistema de segunda opinião médica em radiologia(Universidade Federal de São Paulo (UNIFESP), 2009-06-24) Neira, Ricardo Alfredo Quintano [UNIFESP]; Pisa, Ivan Torres [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION. The second opinion can be defined as the search of advices or medical information between health professionals. OBJECTIVE. The objective of this work is to present the steps of the construction of a second opinion system, as well as the evaluation results of the developed system. METHODS. In this work an observational study with an empirical ethnographic research focus was implemented. A web system was developed based on open-source technologies. For the evaluation, the system was used by 49 residents from the Federal University of São Paulo that informed their opinion to 52 medical second opinion requests. Questionnaires of previous knowledge, request, opinion and satisfaction where employed as evaluation tools. RESULTS. 1.891 second opinion responses were given by the physicians to the 52 requests. Regarding to the user satisfaction evaluation, the system presents a 87,8% mean in the easy utilization item and a 95,6% mean in learning to operate the system. The physicians showed the necessity to add resources to help observing images, as example, magnifying, brightness and contrast, on 38,2% of the responses. 47,3% responses indicated also that clinical information is the most important information for a second opinion emission. Inappropriate language was found on responses for medical second opinion requests which could difficult physicians’ cooperation. CONCLUSION. The results of the development and evaluation of the second opinion system show that the defined process was effective for the achievement of remote radiology second opinion.
- 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.