Navegando por Palavras-chave "Delivery of health care"
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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 resolutividade e da satisfação da clientela de um serviço de referência secundária em oftalmologia da Universidade Federal de São Paulo (UNIFESP) - UNIFESP(Conselho Brasileiro de Oftalmologia, 2003-01-01) Gentil, Rosana Maura; Leal, Sandra Maria Reis [UNIFESP]; Scarpi, Marinho Jorge [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)In developing countries blindness prevalence could be reduced if access to ophthalmic assistance for the population were not impaired by the lack of organization of the resources. Besides the primary level, organization of ocular care establishes secondary and tertiary care levels, according to the complexity of the diagnosis and treatment of the ocular diseases. The Ophthalmic Secondary Reference Center (CERESO) of the Department of Ophthalmology, Federal University of São Paulo, according to an internal flow model of assistance, selects cases of low complexity to be seen on the same day, the others being referred to the tertiary level. PURPOSE: To evaluate CERESO's resolution and its user's satisfaction. METHODS: By means of applying a questionnaire based on the resolution of the main complaint and for the client's satisfaction, a sample of 238 users was interviewed from February to July, 1998. RESULTS: CERESO's resolution degree was 85.96%; the user's satisfaction was 100%; 6.8% of the users chose CERESO because it was close to their homes; 21.3% because they could be seen on the same day; 13.9% because they were already UNIFESP patients and 58.1% because they like UNIFESP or were indicated by another patient. CONCLUSIONS: The customers were very pleased with the assistance they were given, and their major aims were achieved. The organization of the ophthalmological services, with the secondary care service establishment, would certainly have a positive impact on the solution of ophthalmic problems - especially refractive errors. For this reason, this organization would case an important public health problem.
- ItemAcesso aberto (Open Access)Avaliação das anotações de enfermagem em prontuários de um hospital universitário(Universidade Federal de São Paulo (UNIFESP), 2003) Labbadia, Lilian Lestingi [UNIFESP] ; Adami, Nilce Piva [UNIFESP]; http://lattes.cnpq.br/9462726149672876; http://lattes.cnpq.br/4088009570911927Este estudo teve por objetivos: identificar aspectos quantitativos e qualitativos das anotacoes de enfermagem nos prontuarios de pacientes internados em um hospital universitario; verificar as anotacoes de enfermagem nos prontuarios de pacientes comparando os registros da unidade de treinamento admissional com as de outras unidades de internacao; e avaliar estes dados confrontando-os com o principio orientador do padrao do nivel 1 do Manual Brasileiro de Acreditacao Hospitalar (MBAH) estabelecido para a enfermagem. A pesquisa foi do tipo descritiva e retrospectiva, com abordagem quantitativa. A amostra foi composta por 130 prontuarios de pacientes com saidas (altas e obitos) no mes de junho de 2002 em um hospital universitario da cidade de São Paulo. Apos a aprovacao do projeto de pesquisa pelo Comite de Etica em Pesquisa dessa instituicao, a coleta de dados foi realizada utilizando-se um roteiro que contemplou criterios para avaliacao de aspectos quantitativos e qualitativos das anotacoes de enfermagem. Verificou-se nos prontuarios analisados que as atividades relacionadas a execucao da prescricao medica como terapeutica medicamentosa assim como o controle de sinais vitais e outros controles foram registradas na forma completa na maior parte dos prontuarios avaliados (96,2 por cento, 72,6 por cento e 67,7 por cento, respectivamente). As anotacoes dos procedimentos que exigem observacao e detalhamento das acoes realizadas pela equipe de enfermagem e que independem da prescricao medica alcancaram valores inferiores a 40 por cento. As anotacoes, apesar de adequadas quanto a forma, revelaram-se incompletas em relacao aos conteudos analisados. A identificacao da executora da atividade, um dos itens de observacao do MBAH e exigencia legal do COFEN, estava presente na forma completa em valores inferiores a 30 por cento, impossibilitando a identificacao formal da executora da atividade. O desempenho da equipe de enfermagem da unidade de treinamento foi superior ao das outras unidades apenas em relacao aos registros de saida - alta (p-valor = 0,001). No confronto dos dados com o principio orientador do Nivel 1 do MBAH, verificou-se que os itens relacionados aos controles dos pacientes e a legibilidade das anotacoes foram os unicos que apresentaram valores superiores a 90 por cento. As principais conclusoes foram: as atividades de enfermagem realizadas nesta instituicao estavam voltadas, ainda_ (AU)
- ItemAcesso aberto (Open Access)Construção do conhecimento e do fazer enfermagem e os modelos assistenciais(Universidade de São Paulo, Escola de Enfermagem, 2006-06-01) Lucena, Amália de Fátima; Paskulin, Lisiane Manganelli Girardi; Souza, Mariana Fernandes de [UNIFESP]; Gutiérrez, Maria Gaby Rivero de [UNIFESP]; Universidade Federal do Rio Grande do Sul Escola de Enfermagem; Universidade Federal de São Paulo (UNIFESP)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, the authors propose a re-thinking of Nursing knowledge and practice, pointing out possibilities for expanding the Nursing field, as well as the boundaries and challenges to be overcome by the area professionals.
- ItemSomente MetadadadosTendências do tratamento das lesões do ligamento cruzado anterior do joelho nos sistemas de saúde pública e suplementar do Brasil(Universidade Federal de São Paulo (UNIFESP), 2014-02-26) Batista, Rodrigo Martins Borges Ferreira [UNIFESP]; Cohen, Moises [UNIFESP]; http://lattes.cnpq.br/6174355233304675; Universidade Federal de São Paulo (UNIFESP)CONTEXT AND OBJECTIVE: Orthopedic surgery implies high costs for both public and private healthcare. The aim of this study was to better understand the differences between the public and private sectors regarding the treatment of a damaged anterior cruciate ligament (ACL), which is a common knee injury. DESIGN AND SETTING: Descriptive cross-sectional study conducted during the Brazilian Orthopedics Congress in Brasília. METHODS: We applied questionnaires during the 2010 Brazilian Orthopedics Congress, with participation by 241 knee surgeons from 24 Brazilian states. This was followed by statistical analysis on the data that were obtained. RESULTS: The orthopedic surgeons who were evaluated used different approaches and treatment options in different Brazilian states, comparing between the public and private systems. DISCUSSION: Patients with ACL injuries are sometimes dealt with differently in the public and private systems in Brazil. In some situations, the results are not so disparate, but in others, the harm done both to patients and to surgeons themselves may become irreparable. This may be due either to the restrictions of healthcare operators or to the limited or poorly distributed budget of the Brazilian National Health System (Sistema Único de Saúde, SUS). In fact, what is done in practice does not always follow what the literature suggests as the most appropriate treatment. CONCLUSIONS: Both in the public and in the private systems in Brazil, because of nonmedical issues surrounding the treatment, the best medical decision is not always made. This may be harmful both to patients and to physicians.
- ItemAcesso aberto (Open Access)Trends in treatment of anterior cruciate ligament injuries of the knee in the public and private healthcare systems of Brazil(Associação Paulista de Medicina - APM, 2013-01-01) Astur, Diego Costa; Batista, Rodrigo Ferreira; Arliani, Gustavo Goncalves; Cohen, Moises [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)CONTEXT AND OBJECTIVE Orthopedic surgery implies high costs for both public and private healthcare. The aim of this study was to better understand the differences between the public and private sectors regarding treatment of a damaged anterior cruciate ligament, which is a common knee injury. DESIGN AND SETTING Descriptive cross-sectional study conducted during the Brazilian Orthopedics Congress in Brasília. METHODS We applied questionnaires during the 2010 Brazilian Orthopedics Congress, with participation by 241 knee surgeons from 24 Brazilian states. This was followed by statistical analysis on the data that were obtained. RESULTS The orthopedic surgeons who were evaluated used different approaches and treatment options in different Brazilian states, comparing between the public and private systems. CONCLUSION Both in the public and in the private systems in Brazil, because of non-medical issues surrounding the treatment, the best medical decision is not always made. This may be harmful both to patients and to physicians.