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1.
Rio de Janeiro; IEPS; 2024. 36 p.
Monography in Portuguese, French | LILACS, PIE, Inca | ID: biblio-1538001

ABSTRACT

O Guia de Políticas de Saúde - Implementando Sistemas de Melhoria da Qualidade na Atenção Primária em Saúde oferece orientações abrangentes para gestores que desejem criar e implementar Sistemas de Qualidade na Atenção Primária à Saúde (APS) e para sanitaristas, acadêmicos e organizações da área da saúde interessadas no tema. Neste guia, você vai encontrar: O DESAFIO: Promover o acesso e a qualidade da APS é fundamental para garantir um SUS mais igualitário, mas essa não é uma tarefa simples. Fatores como a diversidade do território brasileiro e questões de governança dos dados em Saúde são desafios que precisam ser considerados para garantir um melhor funcionamento da APS. Nesta seção, apresentamos esses e outros desafios e motivos que fazem da APS um modelo eficaz e custo-efetivo. O IEPS TESTOU: A 1ª edição do Guia de Políticas de Saúde foi elaborado a partir da experiência de construção do programa Recife Monitora, que integra o projeto Qualifica Atenção Básica, uma parceria do IEPS com a Prefeitura do Recife e que conta com o apoio da Umane. O programa foi iniciado em 2022 e apresentou resultados expressivos em seu primeiro ano de implementação. Nesta seção, apresentamos um relato de experiência com as lições aprendidas no primeiro ano do projeto e os referenciais teóricos que embasaram a construção dos sistemas avaliativos da qualidade da APS, informações que podem ser valiosas para a implementação de sistemas de qualidade em todo o país. CODIFICANDO A ESTRATÉGIA: Nesta seção, apresentamos elementos-chaves e um passo a passo detalhado para que as gestões municipais de todo o país possam implementar sistemas de melhoria da qualidade da APS. Também apresentamos alguns desafios que podem ser enfrentados, considerando as singularidades de cada território.


Subject(s)
Primary Health Care , Quality of Health Care , Health Policy , Unified Health System , Brazil , Quality Improvement , Health Plan Implementation
2.
San Salvador; MINSAL; mayo. 04, 2023. 70 p. ilus, graf, tab.
Non-conventional in Spanish | BISSAL, LILACS | ID: biblio-1437128

ABSTRACT

Los Juegos Centroamericanos y del Caribe son un evento multideportivo, que se realizan cada 4 años desde 1926 en diferentes países de la región que comprenden América Central y la cuenca del Mar Caribe. Es el evento multidisciplinario regional más antiguo del mundo, son coordinados por la Organización Centro Caribe Sports. Para el año 2023 se estima que la fecha de realización de estos juegos será del 23 de junio al 8 de julio, esperando una afluencia masiva de atletas y delegaciones extrajeras. El Ministerio de Salud, como ente rector del Sistema Nacional Integrado de Salud, emite el presente Plan interinstitucional para la atención en salud en el marco de los XXIV Juegos Centroamericanos y del Caribe, San Salvador 2023, en la vigilancia epidemiológica, prevención y atención de la salud en casos de emergencias. El plan contiene estrategias de atención en casos de emergencias médicas (traumas, fracturas, intoxicaciones alimentarias, reacciones alérgicas, atenciones de primeros auxilios, atenciones masivas de víctimas en casos de desastres naturales y accidentes de tránsito), entre otros. Además, incluye una breve descripción del acceso a los puntos de atención médica y zonas de evacuación asignadas en los diferentes escenarios deportivos


The Central American and Caribbean Games are a multi-sport event, held every 4 years since 1926 in different countries of the region comprising Central America and the Caribbean Sea basin. It is the oldest regional multidisciplinary event in the world, coordinated by the Centro Caribe Sports Organization. For 2023 it is estimated that the date of these games will be from 23 June to 8 July, expecting a massive influx of athletes and foreign delegations. The Ministry of Health, as the governing body of the Integrated National Health System, issues this inter-institutional plan for health care within the framework of the twenty-third Central American and Caribbean Games, San Salvador 2023, in epidemiological surveillance, prevention and health care in emergencies The plan contains strategies for dealing with medical emergencies (traumas, fractures, food poisoning, allergic reactions, first-aid care, mass care of victims in cases of natural disasters and traffic accidents), among others. In addition, it includes a brief description of access to health care points and designated evacuation areas in different sports arenas


Subject(s)
Humans , Sports , Delivery of Health Care , Health Plan Implementation , El Salvador
3.
Santiago; Menssage Producciones; feb. 2022. 196 p.
Monography in Spanish | LILACS | ID: biblio-1425750

ABSTRACT

La Reforma de Salud del año 2004 (Ley de Autoridad Sanitaria Nº19.937), establece como parte de la función rectora del Ministerio de Salud (MINSAL), la definición de objetivos sanitarios y en torno a ellos, el desarrollo de procesos de planificación sanitaria que han considerado una década para su logro. Los objetivos sanitarios se sitúan en una posición estratégica para el sector, enmarcando su desarrollo a través del Plan Nacional de Salud, instrumento que figura como su carta de navegación y que expone los principales desafíos sanitarios, estableciendo acciones y abordajes para enfrentarlos. Estos expresan la misión que la política pública se propone alcanzar en el mediano y largo plazo, específicamente en lo que respecta a mejorar la salud de la población, haciendo los esfuerzos para prolongar la vida y los años de vida libres de enfermedad y, simultáneamente, actuar sobre la reducción de las desigualdades en salud, mejorando la salud de los grupos más desfavorecidos de la sociedad(1). Cada ciclo de formulación de objetivos guarda coherencia con el periodo que lo antecede, dado que, los resultados alcanzados o no alcanzados modulan y determinan las prioridades y metas que el sector se propondrá para el nuevo decenio. En Chile, la formulación de OS fue impulsada por la ministra de Salud Michelle Bachelet el año 2000 en el marco del proceso de Reforma que empezaba a tomar forma en el sector. La experiencia de países como Estados Unidos, el Reino Unido y Canadá que habían realizado procesos similares, sirvió de referencia para el primer ejercicio de formulación que se realizó en Chile. La evaluación de ese periodo concluyó que más del 50% de las metas propuestas habían sido logradas. No obstante, había muchos aspectos que mejorar como la alineación sectorial con los OS y los instrumentos de gestión, la incorporación de mecanismos de monitoreo, la disponibilidad de instrumentos estandarizados y el fortalecimiento del Plan Nacional de Salud en el sector y el intersector. El decenio 2011 a 2020, convocó al sector salud en torno a la formulación de nuevos OS, así se definieron: Mejorar la salud de la población; Disminuir las inequidades; Aumentar la satisfacción de la población y Asegurar la calidad de las prestaciones de salud. Al finalizar esta década, el balance deja resultados disímiles entre las diferentes temáticas, sin embargo, la experiencia planteó aprendizajes relevantes para la formulación de los nuevos OS tanto en materia de salud poblacional como de gestión institucional, no sólo para el sector sino tambien para el intersector. En contexto del inicio de una nueva década, el Departamento de Estrategia Nacional de Salud (DENS) de la División de Planificación Sanitaria (DIPLAS) desarrolló el proceso de formulación de los Objetivos Sanitarios de la Década 2021-2030 y la construcción de un nuevo Plan Nacional de Salud, abarcando la implementación de cinco etapas sucesivas y considerando el desarrollo de una dimensión estratégica, una operativa y una participativa, a fin de crear una red de intervenciones coordinadas, coherentes y sólidas. Para ello, a lo largo de dicho proceso, se promovió el involucramiento de los distintos actores de la organización y la instalación de diversos escenarios para el desarrollo de una planificación sanitaria integrativa y multinivel, basada en el trabajo intra-intersectorial


Subject(s)
National Health Strategies , Sustainable Development , Health Plan Implementation , Health Promotion/standards , Chile
4.
Rev. argent. salud publica ; 13: 1-8, 5/02/2021.
Article in Spanish | LILACS, ARGMSAL, BINACIS | ID: biblio-1151957

ABSTRACT

INTRODUCCIÓN: La rehabilitación basada en la comunidad (RBC) busca mejorar el acceso a la rehabilitación y la inclusión social de las personas con discapacidad. Los escasos estudios realizados muestran experiencias heterogéneas en su implementación. El objetivo de este estudio fue describir las experiencias y percepciones sobre RBC de profesionales sanitarios, personas con discapacidad y familiares participantes en centros de atención primaria de la Región Metropolitana de Chile. MÉTODOS: Se realizó un estudio cualitativo exploratorio-descriptivo. A través de un muestreo de caso típico se seleccionaron profesionales sanitarios, hombres y mujeres con discapacidad física y familiares. Se desarrollaron 16 entrevistas grupales semiestructuradas, 4 por cada grupo. Se realizó análisis de contenido semántico mediante codificación inductiva y deductiva. RESULTADOS: La RBC es valorada positivamente por las personas con discapacidad y familiares. Sin embargo, los profesionales consideran que es insuficiente para lograr la inclusión social. DISCUSIÓN: Existen barreras y facilitadores para la implementación de la RBC. Su ubicación en la Atención Primaria permite flexibilidad en la atención. No obstante, se centra en intervenciones de rehabilitación física, relegando la salud integral y el trabajo intersectorial a un segundo plano. Se requiere capacitar a los equipos sanitarios para proveer una rehabilitación integral, que contribuya a la inclusión social de las personas con discapacidad


Subject(s)
Primary Health Care , Rehabilitation , Rehabilitation Centers , Disabled Persons , Health Plan Implementation
5.
Philippine Journal of Otolaryngology Head and Neck Surgery ; : 15-23, 2021.
Article in English | WPRIM | ID: wpr-973941

ABSTRACT

Objective@#To determine the self-reported assessment of initial implementation of the 3 domains of Outcome-Based Education in accredited Otolaryngology - Head and Neck Surgery residency training programs in the Philippines by consultants and residents and explore any associations between their demographic profiles and assessments. @*Methods@#Design: Mixed Method Research Design Setting: Multicenter - 30 accredited ORL-HNS residency training institutions in the Philippines- National Capital Region (NCR) 19, Luzon 7, Visayas 2, and Mindanao 2. Participants: A total of 129 consultants and 82 second to fourth year residents in training were included in the study by convenience sampling. First-year residents who started their residency training in January 2020 were excluded. Respondents answered self-reported questionnaires to assess implementation of the 3 domains of OBE: intended learning outcomes (ILO), teaching and learning activities (TLA) and assessment tasks (AT) using the 4-point scale score from “fully implemented” (4) to “not implemented” (1). Results of questionnaires were confirmed using open-ended questions on the challenges of OBE with a focused group discussion among 4 consultants and 1 resident. @*Results@#The self-reported assessment of respondents on OBE implementation was “fully implemented” in the 3 domains. However, low numerical scores were seen for “managing community health and social need” in the ILO and “laboratory activities and workshops” in the TLA for both consultants and residents, in the assessment task (AT “multisource feedback by nurses and administrative staff” for the consultants, and “direct observation of performance skills for patient encounter” for residents. Among the 7 modules, “research methodology” had the lowest score for both consultants’ and residents’ self-perception. Challenges of OBE revealed included “mastery,” “time” and “data keeping.” Consultants younger than 60 years of age who had been in the department longer than 3 years and residents who attended an OBE workshop / lecture tended to give higher scores. @*Conclusion@#Two years after distribution of the manual on OBE to ORL-HNS residency training institutions, the consultants’ and residents’ self-reported assessment on implementation in all the 3 domains of OBE was “fully implemented.


Subject(s)
Delivery of Health Care , Otolaryngology , Health Plan Implementation , Formative Feedback , Internship and Residency , Teaching
7.
Ciênc. Saúde Colet. (Impr.) ; 25(4): 1181-1188, abr. 2020.
Article in Portuguese | LILACS | ID: biblio-1100986

ABSTRACT

Resumo Em 2019, o governo brasileiro lançou uma nova política para a Atenção Primária à Saúde (APS) no Sistema Único de Saúde (SUS). Chamada de "Previne Brasil", a política modificou o financiamento da APS para municípios. No lugar de habitantes e de equipes de Estratégia Saúde da Família (ESF), as transferências intergovernamentais passaram a ser calculadas a partir do número de pessoas cadastradas em serviços de APS e de resultados alcançados sobre um grupo selecionado de indicadores. As mudanças terão um conjunto de impactos para o SUS e para a saúde da população que precisaram ser identificados e monitorados. Neste artigo, discute-se os possíveis efeitos da nova política a partir de uma breve análise de contexto sobre tendências globais de financiamento de sistemas de saúde e de remuneração por serviços de saúde, bem como dos avanços, desafios e ameaças à APS e ao SUS. Com base na análise realizada, entende-se que a nova política parece ter objetivo restritivo, que deve limitar a universalidade, aumentar as distorções no financiamento e induzir a focalização de ações da APS no SUS, contribuindo para a reversão de conquistas históricas na redução das desigualdades na saúde no Brasil.


Abstract In 2019, the Brazilian government launched a new Primary Health Care (PHC) policy for the Unified Health System (SUS). Called "PrevineBrasil", the policy changed the PHC funding for municipalities. Instead of inhabitants and Family Health Strategy (ESF) teams, intergovernmental transfers are calculated from the number of people registered in PHC services and the results achieved in a selected group of indicators. The changes will have a set of impacts for the SUS and the health of the population, which must be observed and monitored. In this paper, possible effects of the new policy are discussed from a brief context analysis of global trends in health systems financing and health services' remuneration models, as well as on the advances, challenges, and threats to PHC and the SUS. Based on the analysis, the new policy seems to have a restrictive purpose, which should limit universality, increase distortions in financing and induce the focus of PHC actions on the SUS, contributing to the reversal of historic achievements in reducing health inequalities in Brazil.


Subject(s)
Humans , Primary Health Care/economics , Healthcare Financing , National Health Programs/economics , Primary Health Care/statistics & numerical data , Reimbursement, Incentive/economics , Brazil , Capitation Fee , Family Health , Health Expenditures , Health Care Reform/economics , Healthcare Disparities/economics , Health Plan Implementation/economics , Health Policy
8.
Ciênc. Saúde Colet. (Impr.) ; 25(4): 1401-1412, abr. 2020. tab
Article in Portuguese | LILACS | ID: biblio-1089525

ABSTRACT

Resumo A partir da criação de uma Secretaria de Atenção Primária à Saúde (SAPS) no Ministério da Saúde em maio de 2019, cinco novos desafios foram trazidos para a gestão federal do SUS: a) ampliação do acesso da população às unidades de saúde da família, b) definição de um novo modelo de financiamento baseado em resultados em saúde e eficiência, c) definição de um novo modelo de provimento e formação de médicos de família e comunidade para áreas remotas, d) fortalecimento da clínica e do trabalho em equipe multiprofissional, e) ampliação da informatização das unidades de saúde e uso de prontuário eletrônico. Esse ensaio discute esses elementos à luz de um novo modelo avaliativo que, ao mesmo tempo, seja capaz de orientar o novo processo de financiamento da Atenção Primária à Saúde (APS) no Brasil. Este baseia-se na correção de distorções distributivas e também busca orientar maior efetividade e eficiência no investimento público e qualidade do serviço prestado à população. Através de estudos dos melhores exemplos internacionais e discussão com os representantes do Conselho Nacional de Secretários Estaduais de Saúde (CONASS) e do Conselho Nacional dos Secretários Municipais de Saúde (CONASEMS) e com apoio técnico do Banco Mundial, foi elaborada a proposta de novo modelo avaliativo e de financiamento da APS.


Abstract Five new challenges were brought to the federal management of SUS from the establishment of the Primary Health Care Secretariat (SAPS) in May 2019, as follows: a) to expand people's access to health facilities; b) to define a new financing model from health outcomes and efficiency; c) to define a new model of provision and training of family and community doctors for remote areas; d) to strengthen clinic and multi-professional teamwork; e) to expand computerization of health facilities and use of electronic medical records. This essay discusses these elements in light of a new evaluation model that also guides a new process of financing the Brazilian Primary Health Care (PHC). It builds on the correction of distributive distortions, and also seeks to guide greater effectiveness and efficiency in public investment and quality of service provided to the population. The proposal for a new PHC evaluation and financing model was elaborated through studies of the best international examples and discussion with representatives of the National Council of State Health Secretaries (CONASS) and the National Council of Municipal Health Secretaries (CONASEMS), and with technical support from the World Bank.


Subject(s)
Humans , Primary Health Care/economics , Primary Health Care/legislation & jurisprudence , Primary Health Care/organization & administration , Government Programs/economics , Government Programs/legislation & jurisprudence , Health Plan Implementation/economics , Health Plan Implementation/legislation & jurisprudence , Health Services Accessibility/economics , Health Services Accessibility/legislation & jurisprudence , Health Services Accessibility/organization & administration , Reimbursement, Incentive , Brazil , Universal Health Insurance
10.
Epidemiol. serv. saúde ; 29(4): e2020499, 2020. graf
Article in English, Portuguese | LILACS | ID: biblio-1124773

ABSTRACT

Apresenta-se o relato de experiência da integração entre serviços de saúde públicos e privados, gestores e universidade, para a vigilância e controle da epidemia de COVID-19 em Tubarão, SC, Brasil. A cidade, universitária, cenário de grande fluxo de pessoas de diferentes locais do país, foi um dos primeiros municípios do estado catarinense com transmissão comunitária do SARS-CoV-2. São detalhadas as medidas adotadas com a criação do Comitê de Monitoramento da COVID-19, do Centro de Operações de Emergências Municipais em Saúde, e do Plano de Contingência da Doença. Passados 100 dias de pandemia, foram 5.979 casos notificados e 431 (7,2%) confirmados, dos quais 5 (1,2%) foram a óbito. Decisões precoces - suspensão imediata das atividades de comércio e eventos com aglomeração - podem ter limitado a propagação do vírus. As parcerias estabelecidas trazem inovação e subsidiam a gestão pública nas tomadas de decisão pautadas em evidências científicas.


Se presenta la experiencia de la integración entre los servicios de Salud Pública y privados, los administradores y la universidad para la vigilancia y el control de la epidemia de COVID-19 en Tubarão, Santa Catarina, Brasil. La ciudad universitaria, con un gran flujo de personas de diferentes partes del país, fue uno de los primeros municipios del estado con transmisión comunitaria de SARS-CoV-2. Las medidas adoptadas se detallan con la creación del Comité de Monitoreo COVID-19, el Centro de Operaciones Municipales de Emergencia en Salud y un Plan de Contingencia de la Enfermedad. Después de 100 días de pandemia, se reportaron 5,979 casos, 431 (7,2%) confirmados, de los cuales cinco (1,2%) murieron. Las decisiones precoces, la suspensión inmediata de las actividades comerciales y de los eventos con aglomeración han reducido la propagación del virus. Las asociaciones establecidas aportan innovación y subsidian la gestión pública en la toma de decisiones basadas en evidencia científica.


This article presents an experience report about integration between public and private health services, health service managers and the academy, for surveillance and control of the COVID-19 epidemic, in the municipality of Tubarão, Santa Catarina, Brazil. The city is home to a university and has a large flow of people from different parts of the country, as well as being one of the first municipalities in the state of Santa Catarina to report cases of community transmission of SARS-CoV-2. The measures adopted included the implementation of the COVID-19 Monitoring Committee, the Municipal Health Emergency Operations Center, and the COVID-19 Contingency Plan. After 100 days of pandemic, 5,979 cases had been reported, 431 (7.2%) had been confirmed, of which five (1.2%) died. Early decisions, such as the immediate suspension of business activities and crowded events, may have reduced the spread of the virus. The partnerships put into place have provided innovation and supported public service management in decision-making based upon scientific evidence.


Subject(s)
Humans , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Coronavirus Infections/epidemiology , Public-Private Sector Partnerships/organization & administration , Health Plan Implementation , Interinstitutional Relations , Brazil/epidemiology , Advisory Committees , Pandemics , Public Health Surveillance , Epidemiological Monitoring
11.
Article in English | AIM | ID: biblio-1257700

ABSTRACT

Background: Voluntary Medical Male Circumcision (VMMC) is an effective HIV prevention strategy prioritized by the World Health Organisation (WHO) for regions of high HIV prevalence, South Africa (SA) and in particular KwaZulu-Natal (KZN) is one of such regions. Since the roll out of VMMC in 2010 there has been little research conducted on the implementation of this service. Existing studies on the uptake of VMMC have mainly focused on service users resulting in a paucity of data on health care workers perspectives on the intervention. Aim: To analyse health care workers' perceptions and experiences of implementing voluntary medical male circumcision in KZN, SA. Setting: The study took place at six different health districts and their six respective rural clinics in the KZN province of SA. Methods: A qualitative approach using a phenomenographic design was employed. Data were collected from a sample of 18 participants comprising of health care providers (n = 12) and health policy makers (n = 6). Individual, face-to-face interviews were conducted using a semi-structured interview guide. An audiotape was used to record the data, which were transcribed verbatim and then analysed using a step-wise phenomenographic data analysis procedure. Results: Participants reported that VMMC was implemented by the department of health with support from non-governmental organisations and private general practitioners. Negative perceptions and negative experiences regarding VMMC and implementation were reported. Conclusion: The implementation of VMMC is compromised due to poor preparation and training of healthcare workers for implementing the service. Addressing health care workers' needs for training and preparation is crucial for successful implementation of VMMC


Subject(s)
Circumcision, Male , Health Plan Implementation , Perception , South Africa
12.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 38: e2018120, 2020. tab, graf
Article in English, Portuguese | LILACS, SES-SP | ID: biblio-1136733

ABSTRACT

ABSTRACT Objective: To evaluate the trend of hospitalization for acute bronchiolitis in infants under one year of age, in the past eight years and after the implementation of the palivizumab immunization program in Brazil. Methods: The study is a retrospective analysis of data on infants younger than one year of age, who were hospitalized with acute bronchiolitis between 2008 and 2015 in Brazil. The Brazilian National Health System database was used. The rates of hospitalization in the pre-implementation (2008-2012) and post-implementation (2014-2015) periods of the palivizumab immunization program were evaluated. The total number of admissions in the same period was used as a comparison. Results: Between January 2008 and December 2015, 263,679 hospitalizations for bronchiolitis were recorded in infants younger than one year of age, 60% represented by boys. The incidence of hospitalization for bronchiolitis increased by 49% over this period (8.5 to 12.7 per 1,000 inhabitants per year). Between 2013 and 2014, the incidence rate of hospitalization for acute bronchiolitis decreased by 8% (12.5 to 11.5 per 1,000 inhabitants per year). However, in the second year of the program, hospitalization rate increased again by 10% (12.7 per 1,000 inhabitants per years). Conclusions: Acute bronchiolitis presented increasing rates of hospitalization over the study period. Hospitalization incidence for acute bronchiolitis declined one year after the implementation of palivizumab but increased again in the second year of the program.


RESUMO Objetivo: Avaliar a tendência de hospitalização por bronquiolite aguda (BA) em lactentes menores de um ano de idade nos últimos oito anos no Brasil e, secundariamente, após a implementação do programa de imunização por palivizumabe. Métodos: Análise retrospectiva dos dados de lactentes menores de um ano de idade, hospitalizados com diagnóstico de BA entre 2008 e 2015 no Brasil, utilizando o banco de dados do Sistema Único de Saúde (SUS). Foram avaliadas as taxas de hospitalização nos períodos pré-implementação (2008-2012) e pós-implementação (2014-2015) do programa de imunização por palivizumabe. O número total de internações no mesmo período foi utilizado como comparação. Resultados: Entre janeiro de 2008 e dezembro 2015 foram registradas 263.679 internações por bronquiolite em lactentes menores de um ano de idade, 60% representado por meninos. A incidência de hospitalização por bronquiolite aumentou em 49% ao longo desse período (8,5 para 12,7 por mil ­habitantes/­ano). Entre 2013 e 2014, a taxa de incidência de hospitalização por BA diminuiu 8% (12,5 para 11,5 por mil habitantes/ano). Porém, no segundo ano do programa, a taxa de internação aumentou novamente em 10% (12,7 por mil habitantes/ano). Conclusões: A BA apresentou taxas de hospitalização crescente ao longo do período estudado. A incidência de hospitalizações de BA apresentou declínio um ano após a implementação de palivizumabe e retornou à tendência crescente no segundo ano do programa.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Antiviral Agents/therapeutic use , Bronchiolitis/drug therapy , Bronchiolitis/epidemiology , Palivizumab/therapeutic use , Hospitalization/trends , Antiviral Agents/administration & dosage , Respiratory Syncytial Viruses/immunology , Time Factors , Brazil/epidemiology , Bronchiolitis/immunology , Bronchiolitis/virology , Acute Disease , Incidence , Retrospective Studies , Respiratory Syncytial Virus Infections/prevention & control , Immunization Programs/methods , Palivizumab/administration & dosage , Health Plan Implementation/methods
13.
Medicina (B.Aires) ; 79(6): 468-476, dic. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1056755

ABSTRACT

Las secuencias integradas de cuidado para ó;ºltimos días de vida proponen estándares de calidad para optimizar la atenció;n de pacientes y familias. Se implementó; el Programa Asistencial Multidisciplinario Pallium (PAMPA©) basado en estándares del International Collaborative for Best Care for the Dying Person en cuatro fases: inducció;n, implementació;n, diseminació;n y sustentabilidad, en cinco centros de salud en Argentina, entre 2008 y 2018. Se incluyeron 1237 pacientes adultos en situació;n de ó;ºltimos días de vida, en seguimiento por equipos de cuidados paliativos entrenados en el PAMPA©. Se efectuó; una auditoría antes y despuó;©s de la ejecució;n del programa, aó;ºn en curso. El rango de medianas de permanencia en los cinco centros desde el inicio de la secuencia hasta el fallecimiento fue de 16 a 178 horas. Se compararon objetivos de cuidado: control de síntomas, comunicació;n, necesidades multidimensionales, hidratació;n y nutrició;n, documentació;n de intervenciones y cuidados post mortem. El análisis conjunto mostró; una mejoría del nó;ºmero de registros (p = 0.001). La comunicació;n del plan de cuidados con el paciente no mostró; diferencias (p = 0.173). Se realizó; capacitació;n y supervisió;n permanente a los equipos profesionales de quienes se registraron percepciones de la implementació;n. Los principales emergentes de este análisis cualitativo fueron: actitudes ante el programa, aportes fundamentales, fortalezas, debilidades y definició;n subjetiva del programa, reconocimiento de las singularidades culturales institucionales y su influencia en el cuidado. El PAMPA© demostró; la factibilidad de un modelo de atenció;n para pacientes y familias en final de vida, basado en estándares de calidad internacionales.


The integrated care pathways for the last days of life propose quality standards optimizing the care of patients and families. The Pallium Multidisciplinary Assistance Program (PAMPA©) was implemented based on standards of the International Collaborative for Best Care for the Dying Person in 4 phases: induction, implementation, dissemination and sustainability, in five health centres in Argentina, between 2008 and 2018. A total of 1237 adult patients in the last days of life were included and cared for by palliative care teams trained in PAMPA©. An audit was conducted before and after the implementation of the Program, which is still going on. The median range of follow up into five centres from the beginning of the pathway until death varied from 16 to 178 hours. Care goals were compared: symptom control, communication, multidimensional needs, hydration and nutrition, documentation of interventions and post-mortem care. The overall analysis showed an improvement in the number of records (p = 0.001). The goal of communication on care plan to the patient showed no difference (p = 0.173). Continuous training, support and permanent teams supervision were carried out and perceptions and impact of the implementation were registered. The main emerging items of the qualitative analysis were: attitudes towards the program, fundamental contributions, strengths, weaknesses and subjective definition of the program, recognition of institutional cultural singularities and its influence on care. PAMPA© demonstrated its feasibility as a model of end of life care for patients and families, based on international quality standards.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Palliative Care/standards , Quality Assurance, Health Care/standards , Terminal Care/standards , Program Evaluation , Palliative Care/methods , Argentina , Terminal Care/methods , Time Factors , Reproducibility of Results , Critical Pathways/standards , Health Plan Implementation/methods , Health Plan Implementation/standards
14.
Guatemala; MSPAS; oct. 2019. 56 p.
Monography in Spanish | LILACS | ID: biblio-1025888

ABSTRACT

Conteo poblacional se comprenderá como la serie de acciones y procedimientos de recolección de datos de personas, identificación de viviendas y familias, comunidades, sectores y territorios con fines eminentemente sanitarios, relacionando las condiciones de vida, los problemas de salud, sus determinantes sociales y factores de riesgo presentes en ellas. Debido a que las características de la población de una comunidad son dinámicas, se hace necesario realizar cada año una actualización de la información que es de uso necesario para las acciones de salud, lo cual lo diferencia del censo de población que es estático, de cohorte, con otro tipo de indicadores dado por el ente rector el Instituto Nacional de Estadística ­INE-. Además permite el contacto directo entre los equipos de salud del Ministerio de Salud y la población a su cargo Este documento además, forma parte de las herramientas para la implementación del Modelo de Atención y Gestión, junto a la "Guía para la elaboración de un croquis" y a la "Guía de acercamiento y negociación", que forman parte de los documentos que hay en esta App. Este documento contiene los lineamientos y ruta a seguir para el desarrollo del conteo poblacional, describe conceptos básicos, sus características, la secuencia de fases y pasos que incluyen preparación y organización de los equipos de trabajo, herramientas y registro de datos, revisión, análisis y certificación de la información recolectada. Los principales usuarios son el personal que conforman los equipos de salud ­ES- responsables de cada sector y territorio de los distritos de salud.


Subject(s)
Humans , Male , Female , Population Characteristics , Population Forecast , Health Evaluation/standards , Population Dynamics , Community Health Planning/organization & administration , Health Services Accessibility/organization & administration , Institutional Management Teams/organization & administration , Epidemiologic Factors , Risk Factors , Population Growth , Population Groups , Allied Health Personnel/education , Health Information Management , Social Determinants of Health , Guatemala , Health Plan Implementation/organization & administration , Health Services Research
15.
Guatemala; MSPAS; [oct. 2019]. 54 p.
Monography in Spanish | LILACS | ID: biblio-1025889

ABSTRACT

(Acuerdo ministerial No. 246-2019) Este documento propone un marco conceptual y operativo para entender las RISS desde la perspectiva y realidad de Guatemala, brinda los lineamientos orientadores y las acciones estratégicas para que los actores y prestadores de salud de un distrito o departamento se articulen en redes, optimicen las capacidades instaladas, garanticen la continuidad de la atención y consoliden vínculos interinstitucionales e intersectoriales que permitan abordajes integrales para mejorar la calidad de vida de las personas, las familias y las comunidades. La Estrategia de RISS se promueve como uno de los mecanismos para reducir la fragmentación de los sistemas de salud y como una de las principales expresiones operativas del enfoque de la APS en el proceso de atención integral, integrada y continua a las personas; contribuyendo a hacer una realidad varios de sus elementos más esenciales, tales como la cobertura y el acceso universal; la atención integral, integrada y continua; el cuidado apropiado, y la organización y gestión de los servicios de salud. El objetivo general del acuerdo ministerial que la avala es lograr acceso y cobertura de la salud, a través de la implementación de la Estrategia de Redes integradas, basada en la atención primaria de la salud, que permita una atención de salud equitativa, integral, integrada, continua y de calidad con en el derecho de la salud. Es de aplicación obligatoria para todas las dependencias que organicen e implementen redes integradas de servicios de salud a nivel de la república y permitirá orientar a los gerentes y los equipos multidisciplinarios, interinstitucionales e intersectoriales de un territorio definido, con lineamientos y acciones para el reordenamiento, articulación, coordinación, fortalecimiento y funcionamiento de los servicios de salud en red, fomentando la planificación, implementación, monitoreo, evaluación y rendición de cuentas.


Subject(s)
Humans , Male , Female , Intersectoral Collaboration , Community Networks/legislation & jurisprudence , Hospital Care/organization & administration , National Health Systems/organization & administration , Ambulatory Care , Health Services Accessibility/legislation & jurisprudence , Comprehensive Health Care , Allied Health Personnel/organization & administration , Healthcare Financing , Social Determinants of Health/standards , Health Governance/legislation & jurisprudence , Population Health Management , Community Health Status Indicators , Guatemala , Health Plan Implementation/legislation & jurisprudence , Institutional Management Teams/organization & administration
16.
Rev. chil. infectol ; 36(5): 565-575, oct. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058082

ABSTRACT

Resumen Introducción: La resistencia a los antimicrobianos (RAM) es una amenaza para la salud pública mundial. Los programas de optimización del uso de antimicrobianos (PROAs) son programas que promueven su adecuado uso, mejoran los resultados clínicos, económicos y contribuyen a contener la RAM. Objetivos: Evaluar las fases de diagnóstico e implementación temprana de los PROAs en tres hospitales de alta complejidad pertenecientes al Sistema de Seguridad Social del Perú. Materiales y Métodos: Estudio multicéntrico, cuasi experimental. La estructuración de los programas, las líneas de base microbiológicas, el consumo de antimicrobianos y los consensos fueron evaluadas durante los períodos de diagnóstico inicial y durante la implementación temprana de los PROAs. Resultados: Con posterioridad a la implementación, los hospitales duplicaron la puntuación de recursos disponibles para los programas (6,75 vs 13,75). La prevalencia de enterobacterias portadoras de β-lactamasas de espectro extendido era de 50-60%, mientras que la resistencia a carbapenémicos en Pseudomonas aeruginosa promedió el 69%. La dosis diaria definida de ceftriaxona fue de 13,63, de 7,35 para vancomicina y 6,73 para meropenem en promedio. Los hospitales A y C disminuyeron el uso de antimicrobianos en 30 a 50%. Discusión: A través de estrategias diseñadas por equipos multidisciplinarios para implementar los PROAs, se logró disminuir tempranamente el consumo de antimicrobianos de amplio espectro.


Background. Antimicrobial resistance (AMR) is a global threat to public health. Antibiotic stewardship programs (AMSP) promote the proper use of antimicrobials, improve clinical and economic outcomes, and helps containing the AMR. Aim: To evaluate the diagnostic phase of the AMS programs and early implementation of AMS at three high complexity hospitals that belong to the social security system in Peru. Methods: A quasi-experimental multicenter study was implemented. The construction of the AMSP, microbiological baselines, antimicrobial consumption and consensus on AMS activities were evaluated at the diagnosis and early implementation periods of the AMSP. Results: Following implementation, hospitals doubled their score of resources and processes available for the AMS program from 6.75 to 13.75. The prevalence of extended spectrum beta-lactamase producing enterobacteria was 50-60% while Pseudomonas aeruginosa averaged 69% resistance to carbapenems. The defined daily dose (DDD) of ceftriaxone was 13.63, vancomycin 7.35 and meropenem 6.73 in average. Hospitals A and C decreased the use of antimicrobials (30-50%). Discussion: The implementation of the AMSP in the three hospitals was achieved through diverse strategies designed by multidisciplinary teams, which in addition to its articulation, reduce the consumption of broad spectrum antimicrobials at an early stage.


Subject(s)
Humans , Program Evaluation/methods , Antimicrobial Stewardship/methods , Anti-Infective Agents/administration & dosage , Peru , Social Security , Time Factors , Drug Resistance, Microbial , Non-Randomized Controlled Trials as Topic , Health Plan Implementation , Hospitals/statistics & numerical data
17.
Lima; Perú. Ministerio de Salud; 20190900. 18 p. graf, tab.
Monography in Spanish | LILACS, MINSAPERU | ID: biblio-1016361

ABSTRACT

La directiva sanitaria contiene: la finalidad, objetivos, base legal, ámbito de aplicación, disposiciones generales y las responsabilidades que se establece para los procedimientos para la sustentación e implementación de los servicios complementarios en salud y de está manera contribuir a la mejora del acceso a los servicios de salud mediante la prestación de servicios complementarios de salud.


Subject(s)
Primary Health Care , Health Services , Health Services Accessibility , Health Plan Implementation
18.
Guatemala; MSPAS; sept. 2019. 46 p.
Monography in Spanish | LILACS | ID: biblio-1025886

ABSTRACT

Este modelo: "de atención y gestión basado en la estrategia atención primaria en salud renovada", tiene como prioridad las intervenciones en el marco de la prevención de la enfermedad, promoción de la salud y vigilancia epidemiológica, con el objetivo de incidir en determinantes de la salud, contribuyendo con el desarrollo de las comunidades y promoviendo la reducción de daños a la población. Fundamentalmente el modelo de acciones extramuros, considera la implementación de acciones fuera de los establecimientos de salud, que permitan identificar las necesidades de la comunidad y establecer medidas preventivas que contribuyan a mejorar la salud de la población de manera oportuna. Por lo que, el personal de salud debe facilitar el acceso a los servicios a la población de acuerdo a los riesgos de la salud identificados en el análisis de situación de salud, a la demanda y oferta para establecer acciones oportunas.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Child, Preschool , Adolescent , Health Services Administration , Population Health Management , Community Health Status Indicators/organization & administration , Health Planning/organization & administration , Health Services Accessibility/organization & administration , Health Services Needs and Demand/organization & administration , Preventive Health Services , Health Infrastructure/standards , Allied Health Personnel/organization & administration , Disease Prevention , Epidemiologic Surveillance Services , Health Information Management , Culturally Competent Care/organization & administration , Noncommunicable Diseases/prevention & control , Guatemala , Health Plan Implementation/organization & administration , Health Promotion , Health Services Research , House Calls/trends , Institutional Management Teams/organization & administration
19.
Salud pública Méx ; 61(4): 436-447, Jul.-Aug. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1099319

ABSTRACT

Resumen: Objetivos: Revisar la aplicación del Convenio Marco de la OMS para el Control del Tabaco en las Américas, describir dos estudios de caso nacionales y analizar la evidencia sobre los cigarrillos electrónicos desde la perspectiva de salud pública. Material y métodos: Revisión de la legislación de control de tabaco y la evidencia científica sobre los cigarrillos electrónicos. Resultados: La aplicación de políticas no es homogénea, con avances importantes en ambientes libres de humo, advertencias sanitarias gráficas y vigilancia epidemiológica, pero desafíos pendientes en la prohibición total de la publicidad, incremento de impuestos y cesación tabáquica. La interferencia de la industria tabacalera es uno de los principales obstáculos para avanzar y los nuevos productos crean incertidumbre sobre su regulación. Conclusiones: Se necesita revitalizar la voluntad política para aplicar integralmente el Convenio, tomando decisiones basadas en evidencia ante los nuevos desafíos y defendiendo los logros de la interferencia de la industria.


Abstract: Objectives: To review the implementation of the WHO Framework Convention on Tobacco Control in the Americas, describe two national case studies and analyze the evidence on electronic cigarettes from a public health perspective. Materials and methods: Revision of the tobacco control legislation and the scientific evidence regarding electronic cigarettes. Results: Implementation of tobacco control policies is not homogeneous, with important advances in smoke-free environments, pictorial health warnings, and epidemiological surveillance, but challenges that remain for the implementation of a total ban of tobacco advertising, increases in tobacco taxes, and tobacco cessation programs. Tobacco industry interference is one of the main obstacles for advancing and novel products create uncertainty about their regulation. Conclusion: There is a need for political will for a comprehensive implementation of the Convention, with evidence-based decisions to confront challenges and to defend the achievements from tobacco industry interference.


Subject(s)
Humans , Tobacco Products/legislation & jurisprudence , Electronic Nicotine Delivery Systems , Smoking Prevention/legislation & jurisprudence , Panama , Taxes , Tobacco Smoke Pollution/prevention & control , World Health Organization , Advertising , Evidence-Based Practice , Smoke-Free Policy , Smoking Prevention/trends , Health Plan Implementation , Health Promotion/methods , International Cooperation , Lobbying , Mexico
20.
Rev. méd. Chile ; 147(6): 776-786, jun. 2019. graf
Article in Spanish | LILACS | ID: biblio-1020726

ABSTRACT

Invasive meningococcal disease is challenging for public health, mainly when it manifests with sudden changes in incidence, serogroups and hypervirulent clones that spread in the population, causing great alarm due to its sequelae and often fatal course, a situation that occurred in Chile, starting at week 26 of the year 2012. To face this scenario, an organization of multidisciplinary teams was required, called W-135 Action Plan in Chile, which included sanitary alerts, education, reinforcement of the epidemiological surveillance of suspicious cases, immediate diagnosis through state-of-the-art techniques, blocking of contacts, communication plans, and, from the 42nd week, ON the vaccination campaign was started for children aged from 9-months-old to less than 5 years of age. The vaccination strategy had a great impact on the decrease in incidence (1.3 to 0.1/100,000) and case fatality rate in the vaccinated population (23% to 0%), with a high safety profile, leading to its subsequent inclusion in the national immunization program. The ability to develop molecular, clinical and epidemiological studies allowed us to better understand the situation, supporting public health policy decisions for its control. The W-135 Action Plan implemented by the Ministry of Health in Chile, to manage the outbreak of meningococcal disease by Neisseria meningitidis serogroup W, demonstrated that the coordination of these efforts, through an organized Action Plan, allows the implementation of campaigns at the national level achieving high coverage of risk populations in short periods of time, generating a positive impact on the health of the population.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Mass Vaccination/methods , Health Plan Implementation/methods , Meningococcal Infections/prevention & control , Meningococcal Infections/epidemiology , Seasons , Chile/epidemiology , Incidence , Disease Outbreaks/prevention & control , Age Distribution , Neisseria meningitidis, Serogroup W-135 , Vaccination Coverage
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