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1.
Fortaleza; SMS Fortaleza; 3. rev; Abr. 2022. 168 p. ilus, tab.
Monography in Portuguese | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1366325

ABSTRACT

Trata-se do Volume 1 da coleção "Normas de Conduta Técnica e Gestora para Profissionais do SAMU 192 - Regional Fortaleza" (SAMUFor), que publiciza o Regimento Interno do SAMUFor. Divide-se em três capítulos: 1. Normatização Vigente; 2. Normatização Municipal Vigente; e 3. Regimento Interno SAMUFor. Esse terceiro capítulo divide-se em: Regimento Interno do SAMU 192 ­ Regional Fortaleza; Regimento Interno da Gerência SAMUFor; Regimento Interno dos Órgãos de Assessoria da Gerência do SAMUFor; Regimento Interno do Núcleo Médico; Regimento Interno do Núcleo de Enfermagem; Regimento Interno do Núcleo de Farmácia; Regimento Interno do Núcleo Administrativo; Regimento Interno do Núcleo de Educação Permanente; e Regimento Interno da Central de Regulação das Urgências


Subject(s)
Internal Rules , Delivery of Health Care/organization & administration , Answering Services/organization & administration , Emergency Medical Services/organization & administration , Organization and Administration/standards , Emergencies , Emergency Medical Services/legislation & jurisprudence
3.
Salud bienestar colect ; 5(1): 5-17, ene.-abr. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1352342

ABSTRACT

El propósito de este estudio consistió en revisar el modelo del Balanced Scorecard y analizar su aplicabilidad como instrumento de gestión en los centros de salud. El tipo de investigación fue de tipo documental, con un diseño no experimental. Para alcanzar el objetivo, se revisaron los postulados teóricos de Kaplan y Norton, así como algunas implementaciones prácticas centradas en este paradigma que fueron desarrolladas en Norteamérica, Europa y Sur América. Los resultados demuestran el alto valor agregado que ofrece el Balanced Scorecard como instrumento de gestión en centros de salud.


The purpose of this study was to review the Balanced Scorecard model and analyze its applicability as a management instrument in health centers. The type of research was documentary, with a non-experimental design. To achieve the objective, the theoretical postulates of Kaplan and Norton were reviewed, as well as some practical implementations focused on this paradigm that were developed in North America, Europe and South America. The results demonstrate the high added value that the Balanced Scorecard offers as a management instrument in health centers.


Subject(s)
Organizations/organization & administration , Delivery of Health Care/organization & administration , Organizational Objectives , Health Centers , Organizations/economics , Benchmarking/organization & administration , Delivery of Health Care/economics , Health Resources/organization & administration
4.
Salud bienestar colect ; 5(1): 32-52, ene.-abr. 2021.
Article in Spanish | LILACS | ID: biblio-1352348

ABSTRACT

El presente ensayo es una reflexión de la violencia en, desde, hacia y entre el personal de salud. Para lograr una aproximación, se consideran distintas fuentes de información, desde reportes periodísticos, estudios empíricos y, por supuesto, postulados conceptuales producidos para otras situaciones y campos de conocimiento. El análisis se realiza en diferentes ejes, el primero con referentes para situar el problema en el marco de propuestas enunciativas y conceptos relevantes; el segundo presenta la perspectiva del paciente o usuario; en el tercero se presentan algunos elementos de los profesionales de la salud. Por último, en último eje se delinean situaciones de las instituciones en salud, como espacio donde se desarrolla y vehiculiza la violencia, en tanto generadora y ámbito donde se ejerce tanto para los profesionales de la salud como para los pacientes usuarios. Finalmente se esbozan unas conclusiones que permiten situar el tema en sus implicaciones y consecuencias. Estos ejes nos permiten sugerir que el estudio de la violencia requiere un abordaje complejo, ya que deja un saldo de víctimas y victimarios siendo las propias instituciones en salud las generadoras de violencia alejando a los actores sociales de actos solidarios y humanizados.


This essay is a reflection about violenceexpressed inside and outside health institutions with an impact on health professionals and patients. We considered different sources of information: journalistic reports, empirical studies and conceptual postulates produced for other situations and fields of knowledge. The analysis is carried out in different axes, first, with references to place the problem within the framework of enunciativeproposals and relevant concepts; the second presents the perspective of the patient; the third presents some elements of health professionals. Finally, in the last axis, situations of health institutions are outlined, as a space where violence is developed and conveyed, as a generator and an area where it is exercised both for health professionals and patients. As conclusions we leave sketches that allow us to place the subject in its implications and consequences. These axes allow us to suggest that the study of violence requires a complex approach, since it leaves a balance of victims and perpetrators, the health institutions themselves being the generators of violence, distancing social actors from acts of solidarity and humanization.


Subject(s)
Humans , Professional-Patient Relations , Violence/statistics & numerical data , Delivery of Health Care/organization & administration , Health Facilities/statistics & numerical data , Power, Psychological , Workplace Violence/trends , Health Policy , Health Services
5.
Salud colect ; 17: e3338, 2021.
Article in Spanish | LILACS | ID: biblio-1252146

ABSTRACT

RESUMEN El artículo presenta un análisis basado en diversas fuentes de una encuesta nacional realizada con el equipo de Consultorios en la Calle en Brasil sobre la población en situación de calle y la pandemia de Covid-19. A través de ciertos principios ético-políticos y apuestas metodológicas, dirigimos nuestra mirada al discurso sobre quién vive y trabaja en las calles durante la pandemia, entrecruzando el discurso y la experiencia. De esta manera, buscamos desvelar las relaciones de poder, desde la perspectiva de la gubernamentalidad y la biopolítica, que permiten mostrar los modos de gobierno encarnados en la calle -principalmente a partir de las medidas de aislamiento y distanciamiento social- para tensionar el surgimiento de la noción de población en situación de calle, en este escenario pandémico. Por último, discutimos nociones de precariedad que circunscriben la vida en la calle como condición compartida, en busca de pistas sobre formas de resistencia y el derecho a aparecer.


ABSTRACT Drawing on multiple sources, this article presents an analysis of a national survey implemented by Street Clinic teams in Brazil on the homeless population and the COVID-19 pandemic. Through the lens of certain ethical-political principles and methodological decisions, we focus our analysis on discourses about who lives and works on the streets during the pandemic, connecting discourse with experience. From the perspective of governmentality and biopolitics, we seek to shed light on power relations that reveal modes of government embodied at the street level - mainly related to isolation measures and social distancing - to create tensions surrounding the emergence of the notion of the homeless population in the midst of the pandemic. We conclude with a discussion of the precariousness that circumscribes life on the streets as a shared condition, and search for ways to comprehend forms of resistance and the right to exist.


Subject(s)
Humans , Homeless Persons , Government Regulation , Vulnerable Populations , Safety-net Providers/legislation & jurisprudence , Physical Distancing , COVID-19/prevention & control , Health Policy , Social Justice , Brazil/epidemiology , Health Care Surveys , Delivery of Health Care/legislation & jurisprudence , Delivery of Health Care/organization & administration , Pandemics , Safety-net Providers/organization & administration , COVID-19/epidemiology
6.
Rev. enferm. UERJ ; 28: e45918, jan.-dez. 2020.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1117684

ABSTRACT

Objetivo: analisar a compreensão de estudantes de graduação em enfermagem sobre as Redes de Atenção à Saúde. Método: estudo descritivo e exploratório, qualitativo, realizado com 27 estudantes em Enfermagem de uma universidade federal do sul do Brasil, por meio de entrevistas semiestruturadas realizadas entre agosto e setembro de 2018. Resultados: foi evidenciado o conhecimento dos estudantes em relação ao conceito e objetivo das Redes de Atenção à Saúde, a identificação de fragilidades na comunicação e a falta de conhecimento do usuário como obstáculos na efetivação das mesmas, a dificuldade em ver a atuação do enfermeiro dentro dos variados serviços das redes e a percepção sobre a fragmentação do processo de formação. Conclusão: o estudo contribui para a discussão sobre a inclusão dos estudantes nas Redes de Atenção à Saúde, com intuito de superar as exigências educacionais que buscam favorecer a efetivação do Sistema Único de Saúde e das Redes de Atenção à Saúde.


Objective: to examine undergraduate nursing students' understanding of Health Care Networks (HCNs). Method: in this exploratory, qualitative descriptive study, semi-structured interviews were conducted with 27 Nursing students at a federal University in southern Brazil between August and September 2018. Results: the interviews revealed that the students' knowledge related to the HCNs' concept and purpose, beyond the communication weaknesses and users' lack knowledge as obstacles to effective HCNs, the difficulty in seeing nurses' roles in the various network services, and perceived fragmentation in the training process. Conclusion: the study contributed to discussion of inclusion of students in HCRs, with a view to meeting the educational requirements designed to favor implementation of the national health system (SUS) and the HCNs.


Objetivo: analizar la comprensión de los estudiantes de enfermería de pregrado sobre las redes de atención de la salud (HCN). Método: en este estudio exploratorio, cualitativo descriptivo, se realizaron entrevistas semiestructuradas a 27 estudiantes de Enfermería de una Universidad federal del sur de Brasil entre agosto y septiembre de 2018. Resultados: las entrevistas revelaron que los conocimientos de los estudiantes relacionados con el concepto y propósito, más allá de las debilidades de comunicación y la falta de conocimiento de los usuarios como obstáculos para una HCN eficaz, la dificultad para ver el rol de las enfermeras en los distintos servicios de la red y la fragmentación percibida en el proceso de formación. Conclusión: el estudio contribuyó a la discusión de la inclusión de los estudiantes en las HCR, con miras a cumplir con los requisitos educativos diseñados para favorecer la implementación del Sistema Nacional de Salud (SUS) y las HCN.


Subject(s)
Humans , Male , Female , Primary Health Care/organization & administration , Students, Nursing , Unified Health System/organization & administration , Delivery of Health Care/organization & administration , Comprehension , Brazil , Nurse's Role , Qualitative Research , Education, Nursing, Graduate
7.
Gac. méd. Méx ; 156(4): 330-334, Jul.-Aug. 2020.
Article in English | LILACS | ID: biblio-1249920

ABSTRACT

Abstract COVID-19 arrived to Latin America early in March 2020. Currently, strategies are being developed in Colombia focusing on the quarantine and social and economic capital reactivation, whereby the expected results are not being obtained. In this article, we propose to review scientific evidence-based literature where information on the operation and adaptation of health systems, and social, economic and solidarity sectors of Colombia is presented. The purpose is to identify COVID-19 implications in the network that provides health services, quality of life and health-disease prognosis in the country, which is not prepared to face crises of social nature and of health systems, as well as the economic and solidarity impacts that are brought about by pandemics and crude episodes of disease.


Resumen COVID-19 llegó a Latinoamérica a principios de marzo de 2020. Actualmente, en Colombia se desarrollan estrategias enfocadas en la cuarentena y la reactivación del capital social y económico, con las cuales no se están obteniendo los resultados esperados. En este artículo se propone revisar literatura basada en evidencia científica en la que se exponga información del funcionamiento y adaptación de los sistemas de salud, sectores sociales, económicos y solidarios de Colombia. El objetivo es identificar las implicaciones de COVID-19 en la red prestadora de servicios de salud, calidad de vida, pronóstico de salud-enfermedad en el país, el cual no está preparado para afrontar crisis de orden social, de sistemas de salud e impactos económicos y solidarios que conllevan las pandemias y episodios graves de enfermedad.


Subject(s)
Humans , Pneumonia, Viral/epidemiology , Public Health , Coronavirus Infections/epidemiology , Delivery of Health Care/organization & administration , Quality of Life , Colombia/epidemiology , Pandemics , Betacoronavirus/isolation & purification , SARS-CoV-2 , COVID-19
8.
Gac. méd. Méx ; 156(4): 307-312, Jul.-Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1249916

ABSTRACT

Abstract Medical schools play a central role in the compilation and development of professional knowledge, which is why they have privileges and resources that are justified only to the extent that they use them to serve the community, particularly those who are most in need. Medical schools social accountability focuses on the training, healthcare provision and research services they offer. The principles of medical education and the structure proposed by the Flexner Report are in crisis due to the COVID-19 pandemic, and redefinition of the social contract is required. This document offers a proposal for medical schools social accountability that includes anticipation of the needs of the community, patient-centered inter-professional care, training of people in the area of health and collaboration between institutions. It highlights the need for a conscious institution that finds new training spaces other than hospitals, where each patient is cared for in a personalized way, with inter-professional training models that consider the student as a person who takes care of him/herself in open collaboration with organizations. Leaders must act now because it is their social responsibility and because it is the right thing to do.


Resumen Las escuelas de medicina desempeñan un papel central en la acumulación y desarrollo del conocimiento profesional, por lo cual poseen privilegios y recursos que se justifican solo en la medida en que los retribuyan a la comunidad, en particular a los más necesitados. La responsabilidad social de las escuelas de medicina se centra en los servicios formativos, asistenciales y de investigación que ofrecen. Los principios de la educación médica y la estructura propuesta por el Informe Flexner están en crisis debido a la pandemia de COVID-19 y se requiere la redefinición del contrato social. El presente documento ofrece una propuesta de responsabilidad social de las escuelas de medicina que incluye previsión de las necesidades de la comunidad, atención interprofesional centrada en el paciente, formación de profesionales en el área de salud y colaboración entre instituciones. Resalta la necesidad de una institución consciente que encuentre nuevos espacios de entrenamiento diferentes al hospitalario, donde se atienda a cada paciente de forma personalizada, con modelos formativos interprofesionales que consideren al alumno como persona que cuida de sí misma en colaboración abierta con las organizaciones. Los líderes deben actuar ya porque es su responsabilidad social y porque es lo correcto.


Subject(s)
Humans , Pneumonia, Viral/therapy , Social Responsibility , Coronavirus Infections/therapy , Education, Medical/methods , Pneumonia, Viral/epidemiology , Schools, Medical , Students, Medical , Coronavirus Infections/epidemiology , Patient-Centered Care/methods , Cooperative Behavior , Delivery of Health Care/organization & administration , Pandemics , COVID-19
9.
Medicina (B.Aires) ; 80(supl.3): 37-41, June 2020. tab
Article in Spanish | LILACS | ID: biblio-1135189

ABSTRACT

Para contener la pandemia de COVID-19 se han adoptado medidas nacionales estrictas de aislamiento social y se han reorganizado los sistemas de salud. En este período, se observaron cambios en la atención de enfermedades no infecciosas. El objetivo de este trabajo fue describir las consecuencias de la pandemia de COVID-19 sobre la atención de enfermedades no transmisibles. Se realizó una encuesta estructurada retrospectiva a 31 centros asistenciales de la Asociación de Clínicas, Sanatorios y Hospitales Privados de la República Argentina y Cámara de Entidades de Diagnóstico y Tratamiento. Se compararon indicadores de abril de 2019 versus abril 2020. Se recolectaron datos sobre consultas de emergencia, ingresos hospitalarios, procedimientos invasivos, tratamiento y ocupación de áreas de internación. En ese periodo las consultas a emergencias y las hospitalizaciones disminuyeron en 75% y 48% respectivamente; los ingresos por angina de pecho y síndrome coronario agudo en 62% y los debidos a accidentes cerebrovascular e isquémico transitorio en 46%. Se encontró una disminución de las angioplastias coronarias (59%) e intervenciones percutáneas totales (65%), y un descenso tanto de las cirugías generales (73%) como de las cardíacas centrales (58%). Si bien el aislamiento social obligatorio es una estrategia clave de salud pública para aplanar la curva de propagación de la infección, la marcada disminución porcentual de consultas e intervenciones podría influir negativamente sobre la morbimortalidad cardiovascular, cerebrovascular y oncológica. Se requiere un esfuerzo conjunto para evitar una posible expansión del daño colateral del COVID-19.


To contain the coronavirus pandemic (COVID-19), a strict nationwide lockdown has been enforced and the health systems have been reorganized to deal with this entity. During this period, changes in the care of non-infectious diseases have been observed. Our aim was to describe the impact of the COVID-19 pandemic in the care of non-communicable diseases. A structured retrospective survey was carried out in 31 healthcare centers affiliated with the Asociación de Clínicas, Sanatorios y Hospitales Privados de la República Argentina y Cámara de Entidades de Diagnóstico y Tratamiento. We compared data for April 2019 versus April 2020 regarding emergency room consultations, hospital admissions, invasive procedures and treatments, and bed occupancy. In April 2020, we observed a decrease in emergency room visits (75%) and hospitalizations (48%). A 62% decrease in admissions was noted for angina pectoris and acute coronary syndromes and a 46% decrease in admissions for stroke and transient ischemic attack. A meaningful decrease was found in coronary angioplasties (59%) and total percutaneous interventions (65%), and also a decrease in general surgeries (73%), and cardiac surgeries (58%). Although social distancing measures are a key public health strategy to flatten the infection curve, the observed decrease in medical visits and interventions may impact negatively on cardiovascular, cerebrovascular and cancer related morbidity and mortality. A collective effort is required to avoid the unintended consequences and collateral damage of the COVID-19 pandemic.


Subject(s)
Humans , Pneumonia, Viral , Patient Acceptance of Health Care , Coronavirus Infections , Delivery of Health Care/organization & administration , Pandemics , Noncommunicable Diseases/therapy , Argentina , Social Isolation , Hospitals, Private , Cost of Illness , Betacoronavirus , SARS-CoV-2 , COVID-19
10.
Arch. cardiol. Méx ; 90(2): 124-129, Apr.-Jun. 2020. tab
Article in English | LILACS | ID: biblio-1131020

ABSTRACT

Abstract Introduction: Congenital heart disease represents a public health issue worldwide. Objective: To know the number of patients with heart disease treated in two public hospitals of the State of Jalisco, as well as the mortality and resources available to participating hospitals for the care of these patients in the period from 2015 to 2018; the information was requested to the National Transparency Platform, and the database of pediatric cardiology services and pediatric cardiovascular surgery of the participating hospitals were also reviewed. Results: The second level hospital has human resources, but not the material to attend to these patients; so it is not possible to offer any type of palliative or corrective treatment. A total of 624 patients were evaluated, of which 92.2% corresponded to non-critical heart disease; overall mortality was 12% but in critical heart disease it was 79.5%. The third level hospital has human and material resources to care for these patients. During the study period, 289 operations were performed and the overall mortality was 20.4%. Conclusion: Congenital heart disease in the State of Jalisco is an important cause of mortality, with a high incidence and a very limited resolution capacity since the health services in the State of Jalisco for the care of these patients are insufficient and inadequate. It is essential to strengthen the health system for the care for these patients.


Resumen Introducción: Las cardiopatías congénitas representan un problema de salud pública a nivel mundial. Objetivo: Conocer la cantidad de pacientes cardiópatas atendidos en dos hospitales públicos del estado de Jalisco, así como la mortalidad y los recursos con que cuentan los hospitales participantes para la atención de estos pacientes en el período del 2015 al 2018. Se solicitó la información a la Plataforma Nacional de Transparencia y además se revisaron las bases de datos de los servicios de cardiología pediátrica y cirugía cardiovascular pediátrica de los hospitales participantes. Resultados: El hospital de segundo nivel cuenta con los recursos humanos, pero no con el material para atender a estos pacientes, por lo que no es posible ofrecer ningún tipo de tratamiento paliativo o correctivo (sólo se cierran algunos conductos arteriosos en la etapa neonatal). Se valoró a un total de 624 pacientes, de los cuales el 92.2% correspondió a cardiopatías no críticas; la mortalidad global fue del 12% pero en las cardiopatías críticas fue del 79.5%. El hospital de tercer nivel cuenta con recursos humanos y material para atender a estos pacientes; en el período de estudio se realizaron 289 operaciones y la mortalidad global fue del 20.4%. Conclusión: Las cardiopatías congénitas en el estado de Jalisco son una causa importante de mortalidad, con una incidencia elevada y una capacidad de resolución sumamente limitada, ya que los servicios de salud de Jalisco para la atención de estos pacientes son insuficientes e inadecuados. Es esencial fortalecer el sistema de salud para atender a estos pacientes.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Delivery of Health Care/organization & administration , Health Resources/statistics & numerical data , Heart Defects, Congenital/therapy , Prospective Studies , Heart Defects, Congenital/mortality , Heart Defects, Congenital/epidemiology , Hospitals, Public , Mexico
11.
Hist. ciênc. saúde-Manguinhos ; 27(1): 199-218, jan.-mar. 2020. graf
Article in Portuguese | LILACS | ID: biblio-1090488

ABSTRACT

Resumo Este trabalho analisou um artefato (um livro de saúde) concebido pelo povo maxakali, denominado Hitupmã'ax: curar (2008). Tangenciado o projeto de produção do livro, o objetivo foi entender o processo de negociação da saúde pública no Brasil, dentro de uma perspectiva histórica e intercultural das epistemologias não ocidentais. Constatamos que a construção da obra maxakali representa um esforço para diminuir a distância da percepção e dos cuidados de saúde entre indígenas e não indígenas, e por essa via demonstramos a importância desse projeto intercultural para a efetivação de políticas públicas voltadas para o público indígena em geral e, especificamenete, para a promoção da história, dos saberes e da cultura maxakali.


Abstract This study analyzed an artifact (a book on health) conceived by the Maxakali people, called Hitupmã'ax: curar (2008). Parallel to the project for the production of this book, the aim was to understand the negotiation of public health in Brazil from a historical and intercultural perspective of non-Western epistemologies. It was found that the construction of the Maxakali work represented an effort to bridge the gap in the perception of health and health care between indigenous and non-indigenous people. This was then used to demonstrate the importance of this intercultural project for the shaping of public policies for indigenous people in general and particularly for the promotion of the history, knowledge, and culture of the Maxakali people.


Subject(s)
Humans , History, 20th Century , History, 21st Century , Books/history , Indians, South American/history , Delivery of Health Care/history , Medicine, Traditional/history , Brazil , Indians, South American/legislation & jurisprudence , Delivery of Health Care/ethnology , Delivery of Health Care/organization & administration , Acculturation/history , Language/history
13.
Rev. bras. ter. intensiva ; 32(1): 72-80, jan.-mar. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1138457

ABSTRACT

RESUMO Objetivo: Analisar a distribuição das unidades de terapia intensiva para adultos, segundo a região geográfica e o setor sanitário no Rio de Janeiro, e investigar a mortalidade por infecção respiratória aguda grave no setor público e sua associação com a capacidade de terapia intensiva no setor público. Métodos: Avaliamos a variação da disponibilidade de terapia intensiva e a mortalidade por infecção respiratória aguda grave no setor público em diferentes áreas da cidade em 2014. Utilizamos as bases de dados do Cadastro Nacional de Estabelecimentos de Saúde, do Instituto Brasileiro de Geografia e Estatística, do Sistema de Informações sobre Mortalidade e do Sistema de Informações Hospitalares do SUS. Resultados: Foi ampla a variação na disponibilidade de leitos em unidades de terapia intensiva per capita (desde 4,0 leitos de terapia intensiva por 100 mil habitantes em hospitais públicos na zona oeste até 133,6 leitos em unidades de terapia intensiva por 100 mil habitantes nos hospitais privados na zona central) na cidade do Rio de Janeiro. O setor privado respondeu pelo suprimento de quase 75% dos leitos em unidades de terapia intensiva. Uma análise espacial com base em mapas mostrou falta de leitos em unidades de terapia intensiva em vastas extensões territoriais nas regiões menos desenvolvidas da cidade. Houve correlação inversa (r = -0,829; IC95% -0,946 - -0,675) entre a quantidade de leitos públicos em unidade de terapia intensiva per capita em diferentes áreas de planejamento em saúde na cidade e a mortalidade por infecção respiratória aguda grave em hospitais públicos. Conclusão: Nossos resultados mostram disponibilidade desproporcional de leitos em unidades de terapia intensiva na cidade do Rio de Janeiro e a necessidade de uma distribuição racional da terapia intensiva.


ABSTRACT Objective: To analyze the distribution of adult intensive care units according to geographic region and health sector in Rio de Janeiro and to investigate severe acute respiratory infection mortality in the public sector and its association with critical care capacity in the public sector. Methods: We evaluated the variation in intensive care availability and severe acute respiratory infection mortality in the public sector across different areas of the city in 2014. We utilized databases from the National Registry of Health Establishments, the Brazilian Institute of Geography and Statistics, the National Mortality Information System and the Hospital Admission Information System. Results: There is a wide range of intensive care unit beds per capita (from 4.0 intensive care unit beds per 100,000 people in public hospitals in the West Zone to 133.6 intensive care unit beds per 100,000 people in private hospitals in the Center Zone) in the city of Rio de Janeiro. The private sector accounts for almost 75% of the intensive care unit bed supply. The more developed areas of the city concentrate most of the intensive care unit services. Map-based spatial analysis shows a lack of intensive care unit beds in vast territorial extensions in the less developed regions of the city. There is an inverse correlation (r = -0.829; 95%CI -0.946 to -0.675) between public intensive care unit beds per capita in different health planning areas of the city and severe acute respiratory infection mortality in public hospitals. Conclusion: Our results show a disproportionate intensive care unit bed provision across the city of Rio de Janeiro and the need for a rational distribution of intensive care.


Subject(s)
Humans , Adult , Respiratory Tract Infections/therapy , Critical Care/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Intensive Care Units/statistics & numerical data , Severity of Illness Index , Brazil , Urban Health , Delivery of Health Care/organization & administration , Spatial Analysis
14.
Ciênc. Saúde Colet ; 25(3): 859-868, mar. 2020. tab
Article in Portuguese | LILACS | ID: biblio-1089478

ABSTRACT

Resumo Este artigo objetiva i) descrever e analisar a expansão do provimento de dentistas no Sistema Único de Saúde (SUS); ii) identificar e analisar as características do vínculo trabalhista dos dentistas com o serviço; iii) caracterizar as vagas em concurso público, no que se refere aos requisitos, atribuições e remuneração. Neste estudo de caso, descritivo, foram consultados bancos de dados do Ministério da Saúde e editais de concurso público. Os achados apontam que 48% dos dentistas cadastrados no Cadastro Nacional dos Estabelecimentos de Saúde (CNES) realizam atendimento no SUS, em 13 anos observou-se um aumento de 118% dos municípios com equipes de saúde bucal (eSB) implantadas. A cobertura populacional estimada pelas eSB aumentou 10,46% entre os anos de 2007 e 2015. O principal mecanismo de ingresso nos Centros de Especialidades Odontológicas (CEO) foi o concurso público. O salário na atenção primária variou de 1,05 a 12,67 salários mínimos, para cargos de 40 horas semanais e nos CEOs de 3,35 a 7,05. Conclui-se que é necessário, entre outras medidas, o planejamento de estratégias voltadas aos recursos humanos em saúde. A continuidade dos êxitos alcançados demanda que medidas regulatórias dos contratos de trabalho e apoio aos gestores entrem na agenda das ações da política em saúde bucal.


Abstract This article aims at: i) describing and analyzing the expansion of dental care in the Unified Health System (SUS); ii) Identifying and analyzing the characteristics of hiring dentists' in the public service; iii) characterizing public vacancies, their duties and remuneration. In this descriptive case study, databases of the Ministry of Health were consulted and public tender notices. The findings indicate that 48% of the dentists enrolled in the National Registry of Health Establishments (CNES) perform care in the SUS, in 13 years there was an increase of 118% of the municipalities with oral health teams (eSB) implanted. The population coverage estimated by eSB increased by 10.46% between the years 2007 and 2015. The main mechanism for joining the Dental Specialties Centers (CEO) was the public tender. Primary care salaries ranged from 1.05 to 12.67 Brazilian minimum wages, to 40-hour weekly jobs, and to CEOs from 3.35 to 7.05. It is concluded that, among other measures, the planning of HRH strategies is necessary. The continuity of successes regulatory measures of labor contracts and support to local managers enter the agenda of priority actions of oral health policy.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Dental Health Services , Universal Health Care , Government Programs/organization & administration , Brazil
16.
Ciênc. Saúde Colet ; 25(2): 395-405, Feb. 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1055806

ABSTRACT

Resumo Esta revisão narrativa tem por objetivo analisar a produção científica sobre as Práticas Integrativas e Complementares (PIC) no Sistema Único de Saúde (SUS) visando compreender as potencialidades e fragilidades do processo de implantação da Política Nacional de Práticas Integrativas e Complementares (PNPIC). Após busca nas bases de dados, 25 artigos foram selecionados e os seus resultados analisados criticamente. Da análise do material emergiram cinco temas principais que explicitaram potencialidades e fragilidades de implantação da política: 1) Formação profissional em PIC para o SUS; 2) Estruturação da oferta em PIC, acesso e promoção da saúde; 3) Conhecimento, acesso e aceitação de usuários em relação às PIC; 4) Conhecimento de profissionais e gestores em relação à PNPIC; e 5) Escopo, monitoramento e avaliação da PNPIC. Os resultados se alinham aos relatórios de gestão da PNPIC aprofundando o conhecimento acerca da implantação da política e reforçando a necessidade de empoderamento dos atores do SUS para o enfrentamento de seus desafios.


Abstract This narrative review examines the literature on complementary and integrative practices (CIPs) and their incorporation into Brazil's national health system (Sistema Único de Saúde - SUS) in an attempt to understand the strengths and weaknesses of the implementation of the National Policy on Complementary and Integrative Practices in the SUS (PNPIC, acronym in Portuguese). A search was conducted of the MEDLINE, LILACS, and SciELO databases, resulting in final sample of 25 articles. Our analysis identified five key themes in the literature related to the strengths and weaknesses of policy implementation: 1) Professional training in CIPs in the SUS; 2) structuring the provision of CIPs, access, and health promotion; 3) knowledge, access, and acceptance of service users in relation to CIPs; 4) knowledge of SUS professional staff and managers in relation to the PNPIC; and 5) scope and monitoring and evaluation of the PNPIC. In consonance with the conclusions of the PNPIC management reports, the findings provide a deeper insight into policy implementation problems and reinforce the need to empower the actors involved in this process to tackle these challenges.


Subject(s)
Humans , Delivery of Health Care/organization & administration , Health Policy , National Health Programs , Complementary Therapies/organization & administration , Brazil , Health Knowledge, Attitudes, Practice , Delivery of Health Care/legislation & jurisprudence , Integrative Medicine/organization & administration , Health Promotion/organization & administration , Health Services Accessibility , National Health Programs/legislation & jurisprudence
17.
Ciênc. Saúde Colet ; 25(1): 261-272, jan. 2020. graf
Article in Portuguese | LILACS | ID: biblio-1055801

ABSTRACT

Resumo O artigo discorre sobre o Sistema de Saúde em Portugal que possui o modelo de Beverigde, baseado no financiamento dos serviços de saúde pelas receitas, obtidas por impostos sobre o rendimento dos contribuintes, alicerçado num sistema público, em que o direito à saúde é independente do trabalho e do emprego. O ensino de Enfermagem está estruturado em: Formação Pré-Graduada - Licenciatura; Mestrado e Doutorado em Ciências de Enfermagem e Enfermagem. A competência do enfermeiro de cuidados gerais refere-se ao desempenho profissional demonstrador da aplicação efetiva do conhecimento e das capacidades, que lhe permitem o juízo clínico e a tomada de decisão. O exercício das competências baseia-se na relação interpessoal entre o enfermeiro e o cliente individual e/ou grupo; tomada de decisão baseada em evidência científica, juízo clínico fundamentado nas necessidades de cuidados individuais ou do grupo, intervenções de Enfermagem prescritas considerando a segurança dos cuidados e do cliente, detecção precoce dos reais ou potenciais diagnósticos buscando resolução ou minimização das consequências, pelos valores dos clientes, além do respeito e regulamentação profissional que estabelecem a boa prática.


Abstract The paper discusses the Portuguese Health System that has adopted the Beveridge model, which is based on the financing of health services by taxpayers' income, based on a public system, where the right to health is independent of work and employment. Nursing education is structured in Pre-Graduate Education - Degree; Master and Doctorate in Nursing Sciences and Nursing. The competency of the generalist nurses refers to the professional performance showing the effective application of knowledge and skills, which allows them to make a clinical judgment and decide. The exercise of competencies is based on the interpersonal relationship between the nurse and the individual client or group; decision-making based on scientific evidence, clinical judgment based on the needs of individual or group care, prescribed nursing interventions considering the safety of care and the client, early detection of the real or diagnostic potentials seeking resolution or minimization of consequences, by the values of the patients, as well as respect and professional regulation that establish good practice.


Subject(s)
Nursing , Clinical Competence/legislation & jurisprudence , Delivery of Health Care/legislation & jurisprudence , Delivery of Health Care/organization & administration , Portugal , Legislation, Nursing
18.
Ciênc. Saúde Colet ; 25(1): 303-314, jan. 2020. tab
Article in English | LILACS | ID: biblio-1055796

ABSTRACT

Abstract The primary health care in the Spanish National Health System is organised in health centres with multi-professional teams, composed of doctors and nurses specialised in family and community health, in addition to other professionals. This article analyses the role of primary health care nurses in the Spanish National Health System. In the last decade, new concepts of task sharing between doctors and nurses as well as advanced nursing roles have been evolved in the health centres that focus on improving care for chronically ill patients and access to primary care. With shared responsibility, nurses are responsible for chronic patients in stable conditions, health prevention and promotion. The scaling up of advanced nursing tasks is limited by uncertainties of roles, disparities between states, and legislations that do not cover the full extent of advanced nursing tasks. The case study of Spain indicates that a strong multi-professional model of primary health care teams is a crucial basis for the evolvement of advanced nursing practice and its acceptance in daily routines. However, advantageous education structures and legislations are needed to allow nurses to develop their contribution in the full potential.


Resumo A atenção primária no Sistema Nacional de Saúde espanhol é prestada em centros de saúde públicos, com equipe composta de médicos e enfermeiros especialistas em família e comunidade, além de outros profissionais. Neste artigo, se analisa a atuação do enfermeiro na atenção primária no Serviço Nacional de Saúde espanhol. Na última década, buscando efetividade no manejo de condições crônicas e melhor acesso à atenção, novos modelos de ações compartilhadas entre médicos e enfermeiros, bem como práticas avançadas de enfermagem foram desenvolvidas. Atualmente, com responsabilidades compartilhadas, enfermeiros são responsáveis por pacientes com condições crônicas estáveis, além de ações de prevenção e promoção. Não obstante, a prática avançada em enfermagem é limitada por indefinição de funções, disparidade de atuação entre Estados e legislação insuficiente, que não abarca o potencial desta prática. O caso da Espanha indica que um modelo de atenção multiprofissional forte na atenção primária é crucial para o desenvolvimento da enfermagem de prática avançada. Entretanto, promover formação e legislação adequada à essa prática é necessário, para que os enfermeiros contribuam com todo o seu potencial na atenção primária à saúde.


Subject(s)
Humans , Primary Health Care/methods , Nurse's Role , Delivery of Health Care/organization & administration , Advanced Practice Nursing , Primary Care Nursing , Spain
19.
Ciênc. Saúde Colet ; 25(1): 7-13, jan. 2020. tab
Article in Portuguese | LILACS | ID: biblio-1055771

ABSTRACT

Resumo O artigo debate a importância da Enfermagem para o Sistema Único de Saúde, considerando a mesma estar presente em todas as estruturas organizacionais de saúde, nas 27 unidades da Federação e em todos os municípios do país, essencial, portanto, para a prestação de uma assistência de qualidade. Apesar disso, a profissão enfrenta muitos desafios, quer no campo da formação e do mercado de trabalho, que necessitam ser enfrentados, visando a valorização desses profissionais que apesar de todas as dificuldades a que estão submetidos, são comprometidos com a saúde da população brasileira.


Abstract This paper discusses the importance of the Nursing to the Unified Health System, considering its presence in all organizational health structures, in the 27 units of the Federation and all municipalities of the country, essential, therefore, for the provision of high-quality health care. Nevertheless, the profession faces many challenges, both in the field of education and in the job market, that must be addressed, aiming at the valorization of these professionals who, despite all the difficulties they are subjected to, are committed to the health of the Brazilian population.


Subject(s)
Brazil , Nursing , Employment/organization & administration , Delivery of Health Care/organization & administration
20.
Ciênc. Saúde Colet ; 25(1): 211-222, jan. 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1055768

ABSTRACT

Resumo Este artigo tem como objetivo analisar o perfil e as percepções dos secretários municipais de saúde sobre as agendas e os desafios para o SUS para o ciclo 2017-2020, com ênfase na participação dos enfermeiros na gestão. Os dados foram coletados por meio de questionário eletrônico aplicado via web, contendo questões fechadas, respondido por gestores municipais, no âmbito da Pesquisa Nacional dos Secretários Municipais de Saúde, um estudo de abrangência nacional, realizado em 26 estados nos anos de 2017 e 2018. Pode-se compreender em que medida, no processo de gestão, os enfermeiros gestores percebem os principais desafios, a atuação de atores estratégicos, a dinâmica dos espaços intergestores e as agendas federativas que são necessárias ao fortalecimento da gestão do SUS.


Abstract This paper aims to analyze the profile and perceptions of the municipal health secretaries on the agendas and challenges for the SUS in the 2017-2020 cycle, with emphasis on the participation of nurses in management. The data were collected through an online electronic questionnaire, containing closed-ended questions, answered by municipal managers, within the National Survey of Municipal Health Secretaries, a national study carried out in 26 states in 2017 and 2018. We could understand to what extent nurse managers perceive the main challenges, the performance of strategic actors, the dynamics of interagency spaces, and federative agendas necessary to strengthen SUS management in the management process.


Subject(s)
Humans , Male , Female , Adult , Attitude of Health Personnel , Delivery of Health Care/organization & administration , Nurse Administrators , Time Factors , Brazil , Middle Aged
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