RESUMO
PURPOSE: Several authors have examined the lean healthcare literature, but besides all efforts made, articles comparing conceptual and analytical studies were not found. Thus, a systematic review is conducted aiming to understand the state of the art of lean healthcare by investigating and comparing how conceptual and analytical articles address tools/methods, application fields, implementation barriers and facilitators and positive and negative impacts. DESIGN/METHODOLOGY/APPROACH: Articles in English about lean healthcare, published in journals in the last ten years (2009-2018) and indexed in Web of Science (WoS) or Scopus were examined and assessed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) protocol. A qualitative content analysis on the eligible articles was conducted, and results from the conceptual and analytical studies were compared. FINDINGS: There is a literature gap regarding tools/methods in both conceptual and analytical approaches once they prioritize for different items. Barriers, facilitators and negative impacts are perceived differently within both categories and might require more extensive analysis. The same items prevail in both conceptual and analytical categories when analyzing healthcare fields and positive impacts. ORIGINALITY/VALUE: There is a lack of articles comparing conceptual and analytical studies concerning lean healthcare. So, this study's relevance is in identifying theoretical and applied research gaps to strengthen the lean healthcare state of the art and to integrate theoretical-applied knowledge. For healthcare professionals, it might provide an overview of the key factors that can promote lean implementation.
Assuntos
Pesquisa sobre Serviços de Saúde/normas , Gestão da Qualidade Total/métodos , Gestão da Qualidade Total/organização & administraçãoRESUMO
As formas de proteção das invenções no setor farmacêutico apontam para estratégias de perpetuação da proteção patentária. Com base em uma revisão bibliográfica mostrou-se as especificidades do patenteamento no setor, perpassando por um breve histórico sobre a concessão de patentes farmacêuticas no Brasil, uma abordagem sobre invenções patenteáveis e não-patenteáveis, e pelas modalidades e aspectos da proteção patentária que visam à extensão do monopólio temporário conferido pela patente. Dentre essas estratégias estão as patentes direcionadas a polimorfos e isômeros ópticos de fármacos; combinações de fármacos e segundo uso médico, cada vez mais presentes nas reivindicações dos pedidos de privilégio de invenção das indústrias farmacêuticas. O objetivo do trabalho é mostrar algumas especificidades dos pedidos de patente farmacêuticas, de modo a contribuir para a formação de expertise na área e para a discussão sobre o impacto da ampliação dos escopos de proteção das patentes. Conclui-se que se por um lado a tendência de escopos de proteção mais permissivos pode desvelar oportunidades para os inventores nacionais, por outro, pode ser danosa para uma política de acesso a medicamentos.
Different forms of protection for inventions in the pharmaceutical industry point to strategies for the perpetuation of patent protection. Based on a literature review showing the specificities of patenting in the industry, the article provides a brief history of drug patents in Brazil, a discussion of patentable and non-patentable inventions, and the modalities and traits of patent protection that aim to extend the temporary monopoly granted under the patent. Such strategies include patents targeting polimorphs and optical isomers of drugs and drug combinations and specific clinical preparations, increasingly present in the drug patent claims filed by pharmaceutical companies. The study's objective is to discuss the specificities of drug patent claims in order to help develop expertise in the area and discuss the impact of expanding the scope of patent protection. In conclusion, while the tendency to expand towards more a permissive protective scope could produce opportunities for Brazilian national inventors, it could also be harmful to a policy for access to medicines.
