Résumé
O artigo a seguir propõe-se analisar a política de saúde suplementar nos anos recentes no Brasil e em países europeus. A abordagem proposta é a análise comparativa de políticas de planos e seguros privados no contexto de sistemas públicos de saúde, União Européia e Brasil. Foram comparadas as políticas dos países acima mencionados, o que possibilitou estabelecer parâmetros e categorias de análise capazes de evidenciar as semelhanças e diferenças que tais experiências comportam. Aprofundou-se a discussão destas variáveis/categorias de análise, para o caso de Brasil, utilizando resultados de pesquisa recentes sobre o setor privado da saúde no contexto do SUS. Indagaram-se especialmente: os convênios e contratos do setor público com o privado, as atribuições dos planos privados no sistema de saúde, a produção, capacidade instalada e financiamento dos setores público e privado e, por último, a regulação e ressarcimento dos planos privados ao SUS. Nas conclusões, retomamos a discussão da perspectiva teórico-conceitual na análise de políticas comparadas de sistemas de saúde e os aportes que nosso estudo providenciou.
This paper analyzes the supplementary healthcare policies adopted in recent years in Brazil and in European countries. The proposed approach is a comparative analysis of the private health plan and insurance policies in the context of the European Union and Brazilian public health systems. This comparison allowed establishing parameters and categories capable of showing the differences and similarities between these experiences. These variables served as a basis for analyzing the Brazilian case using recent results of studies on private health insurance in the context of the Unified Health System (SUS), the Brazilian Public Health System. The main topics investigated were: the contracts and agreements between the public and the private sector, the attributions of the private health care services in the public system, the production, available capacity and financing of the public and private health systems and finally, the regulations regarding reimbursement of the SUS in those cases, where users covered by the private sector made use of the public services. We conclude retaking the discussion of the theoretical and conceptual perspective in the comparative analysis of health system policies based on the insights originated by this work.
Sujets)
Prestations des soins de santé/organisation et administration , Politique de santé , Secteur privé , Secteur public , Brésil , Union européenneRésumé
O absenteísmo é um assunto de interesse crescente devido ao atual contexto econômico de competitividade, que faz com que as empresas procurem meios para diminuir sua ocorrência, aumentando a rentabilidade e com isso crescendo de forma sustentada. Procurou-se estudar o absenteísmo por razões odontológicas e médicas, nos serviços público e privado, analisando se a idade, o sexo e a função do trabalhador, além do regime empregatício, interferem na sua ocorrência. Desenvolveu-se o estudo na prefeitura do município de Araçatuba, São Paulo, Brasil, e em uma indústria acrílica. Para a coleta dos dados, analisaram-se todos os atestados odontológicos e médicos, que deram entrada nas empresas no período de janeiro a junho de 2002 e as listagens dos trabalhadores. Verificou-se que a falta por motivos odontológicos tiveram pouco peso sobre o total de faltas por motivo de doença, além de provocarem o afastamento do trabalhador por um período menor. As variáveis idade, sexo, função e regime empregatício influenciaram na ocorrência do absenteísmo ao trabalho. A disponibilidade dessas informações deverá ser muito importante, pois, visto as inúmeras variáveis envolvidas, facilitarão a tomada de decisões das distintas estratégias para sua prevenção.
Absenteeism is a subject of increasing interest. Due to the current economical context based on competition, and in order to profit and grow in a sustainable way, companies have been trying to find ways of decreasing its rates. The purpose of this study was to analyze how much the worker's age, genre, occupation as well as the kind of management he is submitted to, could affect the incidence of absenteeism caused by medical or dentistry problems in public and private services. The research was held at an acrylic industry in Araçatuba, a town in the state of São Paulo, Brazil. Data collecting consisted of analyzing the doctors' and dentists' certificates workers handed in to their employers, to explain their absences from work, from January to June 2002. The results showed that absences caused by dental problems were much rarer and for a shorter period than the absences caused by medical problems. The workers' age, genre, occupation as well as the kind of management they were submitted to, influenced the incidence of their absences from work. Making these information available is of great importance. Their different aspects will help choosing the correct strategy to decrease absenteeism rates.
Résumé
OBJECTIVE: To discover the etiology of birth defects and low birth weight, it is necessary to establish epidemiological birth defects monitoring system in Korea. Our aim was to develop new practical model in Incheon to establish birth defects monitoring system to evaluate the incidence rate and patterns of birth defects in Korea. METHODS: Public health center and private hospitals and clinics participated in this monitoring system. Web based reporting system have been built. Trained nurses actively collected the records obtained from delivery units in the participating hospitals during 2 years (first year: December 1st, 1998-November. 31, 1999; second year: January 1 st, 2000-December 31 th, 2000). RESULTS: Through this monitoring system at 1 st year and 2 nd year, we observed 25 birth defect cases from 2482 births, 28 birth defect cases from 3490 births including live births and stillbirths. The incidence of birth defect per thousand person was 10.1, 8.0 respectively. At 1st year, the highest proportion of birth defects was 28.0% in musculoskeletal system. The proportion of birth defects in gastrointestinal system, cardiovascular system and cleft lip & cleft palate were 20.0%, 12.0%. 12.0%. At 2 nd year, the highest proportion of birth defects was 21.4% in gastrointestinal system The proportion of birth defects in cardiovascular system and musculoskeletal system were 17.9% and 14.3%. CONCLUION: In conclusion, we could build population-based monitoring system for birth defects successfully in Yonsu gu, Incheon. To establish population-based monitoring system for birth defects in Korea, it is necessary to organize the reporters of public health center and private hospitals and clinics, to build an available reporting system, and to extend participating centers for birth defects monitoring systems.