RESUMO
PURPOSE: This article discusses the evolution of university hospitals, their characteristics, functioning and financing and their role in medical education and research. METHODS: Data come from a workshop organized by the World Health Organization on university hospitals in 22 countries. RESULTS: The main finding is that these institutions are increasingly inadequate to the reality of the health sector in which they operate and to the challenges posed by the profound changes currently taking place in the health system of most countries. CONCLUSION: A reform is needed, and the article presents a few possible strategies for reforming these hospitals.
Assuntos
Educação Médica/tendências , Hospitais Universitários/tendências , Educação Médica/organização & administração , Previsões , Hospitais Universitários/organização & administração , HumanosRESUMO
OBJETIVO: O presente artigo discute a evoluçäo dos hospitais universitários, suas características, funcionamento e financiamento, e seu papel no ensino e pesquisa médicos. MÉTODOS: Baseia-se nas informaçöes e conclusöes de um seminário organizado pela Organizaçäo Mundial da Saúde sobre os hospitais universitários de 22 países. RESULTADOS: O artigo avalia que essas instituiçöes estäo crescentemente inadaptadas à realidade do setor saúde em que se inserem e aos desafios impostos pelas mudanças profundas atualmente em curso no sistema de saúde da maioria dos países. CONCLUSÄO: Conclui-se pela necessidade de reforma dos hospitais universitários, e algumas estratégias para essas reformas säo apresentadas e discutidas
Assuntos
Humanos , Educação Médica , Hospitais Universitários , Educação Médica , Previsões , Hospitais UniversitáriosRESUMO
The private sector is the predominant provider of health care in Brazil, particularly for inpatient services, and financing is a mix of public (through a prospective reimbursement system) and private. Roughly a quarter of the population has private insurance coverage, reflecting rapid growth in the past decade fuelled by the crisis in the public reimbursement system and the perceived deterioration of publicly provided care. Four major forms of insurance exist: (1) prepaid group practice; (2) medical cooperatives, physician owned and operated preferred provider organizations; (3) company health plans where employers ensure employee access to services under various types of arrangements from direct provision to purchasing of private services; and (4) health indemnity insurance. Each type of plan includes a wide variety of subplans from basic individual/family coverage to comprehensive executive coverage. The paper discusses the characteristics, costs and utilization patterns of all types of privately financed care, as well as the major problems associated with private financing: the limited package of benefits and low payout ceilings, inadequate consumer information and virtually no regulation.
Assuntos
Seguro Saúde/classificação , Programas Nacionais de Saúde/economia , Setor Privado/economia , Brasil , Coleta de Dados , Países em Desenvolvimento , Atenção à Saúde/economia , Empreendedorismo , Organização do Financiamento , Custos de Cuidados de Saúde , Pesquisa sobre Serviços de Saúde , Seguro Saúde/estatística & dados numéricos , Seguro Saúde/tendências , Programas Nacionais de Saúde/estatística & dados numéricos , Setor Privado/estatística & dados numéricos , Setor Privado/tendênciasRESUMO
The private sector is the predominant provider of health care in Brazil, particularly for inpatient services, and financing is a mix of public (through a prospective reimbursement system) and private. Roughly a quarter of the population has private insurance coverage, reflecting rapid growth in the past decade fuelled by the crisis in the public reimbursement system and the perceived deterioration of publicly provided care. Four major forms of insurance exist: (1) prepaid group practice; (2) medical cooperatives, physician owned and operated preferred provider organizations; (3) company health plans where employers ensure employee access to services under various types of arrangements from direct provision to purchasing of private services; and (4) health indemnity insurance. Each type of plan includes a wide variety of subplans from basic individual/family coverage to comprehensive executive coverage. The paper discusses the characteristics, costs and utilization patterns of all types of privately financed care, as well as the major problems associated with private financing: the limited package of benefits and low payout ceilings, inadequate consumer information and virtually no regulation.
Assuntos
Seguro Saúde/classificação , Programas Nacionais de Saúde/economia , Setor Privado/economia , Brasil , Coleta de Dados , Atenção à Saúde/economia , Países em Desenvolvimento , Empreendedorismo , Organização do Financiamento , Custos de Cuidados de Saúde , Pesquisa sobre Serviços de Saúde , Seguro Saúde/estatística & dados numéricos , Seguro Saúde/tendências , Programas Nacionais de Saúde/estatística & dados numéricos , Setor Privado/estatística & dados numéricos , Setor Privado/tendênciasRESUMO
"The main purpose of this article is to study the relationship between the Statistical System and Society in Brazil. The analysis of demographic data and information systems [is included].... In general, the question is seen in [a] historical and prospective approach....[The author also discusses] the information demand created by the New Constitution of 1988 in Brazil." (SUMMARY IN ENG)
Assuntos
Demografia , Mudança Social , Classe Social , Estatística como Assunto , América , Brasil , Países em Desenvolvimento , Economia , América Latina , Pesquisa , Fatores Socioeconômicos , América do SulRESUMO
"The [purpose] of this article is to explain the main differences between the concepts and the [collection procedures] of income distribution data used in [the] 1980 demographic census and in [the] 1979 and 1981 household surveys in Brazil. The article also comments [on] some differences about the data information on income distribution produced by census and household surveys." (SUMMARY IN ENG)
Assuntos
Censos , Coleta de Dados , Renda , América , Brasil , Países em Desenvolvimento , Economia , América Latina , Características da População , Pesquisa , Estudos de Amostragem , Fatores Socioeconômicos , América do SulRESUMO
"This paper studies the main changes in the Brazilian labor force from 1976 to 1981. Several aspects concerning... Brazilian labor market dynamics, such as activity levels, employment, income distribution and social security, are examined. The paper takes into account the short-run effects of...economic policy on the Brazilian labor force." (summary in ENG)
Assuntos
Emprego , Mão de Obra em Saúde , Renda , Ocupações , Política Pública , Previdência Social , Fatores Socioeconômicos , América , Brasil , Países Desenvolvidos , Países em Desenvolvimento , Economia , Administração Financeira , Financiamento Governamental , América Latina , Classe Social , América do SulRESUMO
PIP: Changes in income distribution among the economically active population of Brazil during the 1970s are analyzed using data from the 1970 and 1980 censuses. A slight increase in the inequality of income distribution over the decade is noted. The methodology used includes various indicators of income inequality, including the Gini coefficient and the Theil indexes. (summary in ENG)^ieng