ABSTRACT
Autonomy in financial management is an advantage in public administration. A 2009 National Healthcare Facility Survey showed that 3.9% of Brazil's 52,055 public healthcare facilities had some degree of financial autonomy. Such autonomy was more common in inpatient facilities (17.8%), those managed by State governments (26.3%), and in Southern Brazil (6.6%). Autonomy was mainly partial (for resources in specific areas, relating to small outlays, consumables and capital goods, and outsourced services or personnel). 74.3% of 2,264 public facilities with any financial autonomy were under direct government administration. Financial autonomy in public healthcare facilities appears to be linked to local political decisions and not necessarily to the facility's specific legal and administrative status. However, legal status displays distinct scopes of autonomy - those under direct government administration tend to be less autonomous, and those under private businesses more autonomous; 85.8% of the 45,394 private healthcare facilities reported that they were financially autonomous.
Subject(s)
Health Facilities/economics , Private Sector/economics , Public Sector/economics , Brazil , Health Care Surveys/economics , Health Facilities/classification , Health Facilities/legislation & jurisprudence , Health Facility Administration , Humans , Private Sector/legislation & jurisprudence , Public Sector/legislation & jurisprudenceABSTRACT
Road traffic injuries are the cause of an expressive number of deaths and hospitalizations among young people in the world. In Brazil, it is responsible for 17.1% of all deaths among adolescents aged 10 to 14 years. This article presents the results of the National Adolescent School-based Health Survey (PeNSE), using a probabilistic sample of students in the 9th grade of high schools (public and private) of the Brazilian capitals in 2009. The prevalence (and 95%CI) of risk factors for road traffic injury among adolescents were estimated. Main results from the 60,973 interviews were: in the last 30 days, 26.3% (25.5% to 27.0% 95%CI) reported no use of seat-belts while riding in a moving vehicle; 18.5% (18.0% to 19.1% 95%CI) of youths younger than 18 years reported driving a motor vehicle (>or= once); 18.7% (18.1% a 19.2% 95%CI) reported a history of being driven by a driver who had been drinking (>or= once); and 35.0% (33.8% to 36.2% 95%CI) reported no use of helmets while riding a motorcycle (>or= once). The results are in accordance with the high rates of morbidity and mortality from traffic injury among youths, reinforcing the need of integrated intersectoral actions, specific legal measures and strict control.
Subject(s)
Accidents, Traffic/statistics & numerical data , Adolescent , Brazil , Female , Health Surveys , Humans , Male , Risk FactorsABSTRACT
Os acidentes de transporte terrestre (ATT) causam expressivo número de mortes e hospitalizações entre jovens no mundo, sendo no Brasil responsável por 17,1 por cento dos óbitos entre 10 e 14 anos. Este artigo apresenta resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE), inquérito realizado em uma amostra probabilística de escolares do 9º ano do ensino fundamental de escolas públicas e privadas das capitais brasileiras, em 2009. Foram estimadas as prevalências (e IC95 por cento) das situações de risco para acidentes de transporte. Os 60.973 entrevistados indicam que (nos últimos trinta dias): 26,3 por cento (IC95 por cento 25,5 por cento-27,0 por cento) referiram nunca ter usado cinto de segurança; 18,5 por cento (IC95 por cento 18,0 por cento-19,1 por cento) dos menores de 18 anos referiram ter dirigido veículo motorizado (>1 vez); 18,7 por cento (IC95 por cento 18,1 por cento-19,2 por cento) referiram ter sido transportados em veículo conduzido por alguém que consumiu bebida alcoólica (>1 vez) e 35 por cento (IC95 por cento 33,8 por cento-36,2 por cento) referiram não ter usado capacete pelo menos uma vez quando andava de motocicleta. Os resultados estão de acordo com as elevadas taxas de morbimortalidade de jovens no país por ATT, o que reforça a importância de ações educativas para adolescentes e a necessidade de ações intersetoriais integradas, além de legislação específica e fiscalização rigorosa.
Road traffic injuries are the cause of an expressive number of deaths and hospitalizations among young people in the world. In Brazil, it is responsible for 17.1 percent of all deaths among adolescents aged 10 to 14 years. This article presents the results of the National Adolescent School-based Health Survey (PeNSE), using a probabilistic sample of students in the 9th grade of high schools (public and private) of the Brazilian capitals in 2009. The prevalence (and 95 percentCI) of risk factors for road traffic injury among adolescents were estimated. Main results from the 60,973 interviews were: in the last 30 days, 26.3 percent (25.5 percent to 27.0 percent 95 percentCI) reported no use of seat-belts while riding in a moving vehicle; 18.5 percent (18.0 percent to 19.1 percent 95 percentCI) of youths younger than 18 years reported driving a motor vehicle (> once); 18.7 percent (18.1 percent a 19.2 percent 95 percentCI) reported a history of being driven by a driver who had been drinking (> once); and 35.0 percent (33.8 percent to 36.2 percent 95 percentCI) reported no use of helmets while riding a motorcycle (> once). The results are in accordance with the high rates of morbidity and mortality from traffic injury among youths, reinforcing the need of integrated intersectoral actions, specific legal measures and strict control.