Proadess 2
Sexta-Feira, 24 de Maio de 2013.
- Principal
- Antecedentes
- Matriz Conceitual
- Matriz dos indicadores
- Busca nos indicadores
- Regiões de saúde
- Mapa dos indicadores
- Biblioteca
- Todos
- Busca
- Anais congresso
- Artigos em periódicos
- Periódico (full)
- Livros
- Capítulos de livros
- Relatórios
- Teses/dissertações
- Sites relacionados
- Produtos do PROADESS (Disponível relatório 2012)
- Equipe
- Contato
Biblioteca (Todos)
1. Access as a policy-relevant concept in low- and middle-income countries
AUTOR(ES): Mcintyre DI, Theide M, Birch S
ANO: 2009
RESUMO: Although access to health care is frequently identified as a goal for health care policy, the precise meaning of access to health care often remains unclear. We present a conceptual framework that defines access to health care as the empowerment of an individual to use health care and as a multidimensional concept based on the interaction (or degree of fit) between health care systems and individuals, households, and communities. Three dimensions of access are identified: availability, affordability, and acceptability, through which access can be evaluated directly instead of focusing on utilisation of care as a proxy for access. We present the case for the comprehensive evaluation of health care systems as well as the dimensions of access, and the factors underlying each dimension. Such systemic analyses can inform policy-makers about the ‘fit’ between needs for health care and receipt of care, and provide the basis for developing policies that promote improvements in the empowerment to use care.
FONTE:
REFERENCIA: Health Economics Policy and Law (2009), 4: 179-193
2. The ideal of equal health revisited: definitions and measures of inequity in health should be better integrated with theories of distributive justice
AUTOR(ES): Ole Frithjof Norheim and Yukiko Asada
ANO: 2009
RESUMO: The past decade witnessed great progress in research on health inequities. The most widely cited definition of health inequity is, arguably, the one proposed by Whitehead and Dahlgren: "Health inequalities that are avoidable, unnecessary, and unfair are unjust." We argue that this definition is useful but in need of further clarification because it is not linked to broader theories of justice. We propose an alternative, pluralist notion of fair distribution of health that is compatible with several theories of distributive justice. Our proposed view consists of the weak principle of health equality and the principle of fair trade-offs. The weak principle of health equality offers an alternative definition of health equity to those proposed in the past. It maintains the all-encompassing nature of the popular Whitehead/Dahlgren definition of health equity, and at the same time offers a richer philosophical foundation. This principle states that every person or group should have equal health except when: (a) health equality is only possible by making someone less healthy, or (b) there are technological limitations on further health improvement. In short, health inequalities that are amenable to positive human intervention are unfair. The principle of fair trade-offs states that weak equality of health is morally objectionable if and only if: (c) further reduction of weak inequality leads to unacceptable sacrifices of average or overall health of the population, or (d) further reduction in weak health inequality would result in unacceptable sacrifices of other important goods, such as education, employment, and social security.
FONTE: International Journal for Equity in Health 2009, 8:40
REFERENCIA: Ole Frithjof Norheim and Yukiko Asada. The ideal of equal health revisited: definitions and measures of inequity in health should be better integrated with theories of distributive justice. Canada: International Journal for Equity in Health 2009, 8:40.
3. Conceitos de acesso à saúde
AUTOR(ES): Raquel Maia Sanchez e Rozana Mesquita Ciconelli
ANO: 2012
RESUMO: Esse artigo descreve quatro dimensões de acesso à saúde — disponibilidade, aceitabilidade, capacidade de pagamento e informação, correlacionado-as aos seus indicadores e tecendo considerações sobre a complexidade do conceito de acesso. Para a revisão desses conceitos foram pesquisadas as bases de dados PubMed/MEDLINE, LILACS, SciELO e World Health Organization Library & Information Networks for Knowledge (WHOLIS). Veículos de grande circulação, como a revista The Economist, o jornal The Washington Post e os arquivos da rede BBC também foram pesquisados. O conceito de acesso à saúde modificou-se ao longo do tempo, tomando uma forma mais complexa. As primeiras análises, datadas da década de 1970, sugeriam uma forte relação do acesso com o aspecto geográfico (disponibilidade) e financeiro (capacidade de pagamento). A literatura mais recente procura abordar aspectos menos tangíveis, como os aspectos cultural, educacional e socioeconômico, incorporando o elemento aceitabilidade nas análises. A literatura mostra ainda que ter informação está na base do acesso à saúde, estando essa noção associada aos conceitos de empoderamento e de letramento para a tomada de decisões de saúde. Concluiu-se que a melhoria do acesso à saúde e a garantia de uma maior equidade não serão obtidas com ações cujo foco se limite aos sistemas de saúde. Em vez disso, dependem de ações inter-setoriais e políticas sociais e econômicas que permitam dissipar diferenças de renda e educação.
FONTE: Rev Panam Salud Publica
REFERENCIA: SANCHEZ, Raquel Maia and CICONELLI, Rozana Mesquita. Conceitos de acesso à saúde. Rev Panam Salud Publica [online]. 2012, vol.31, n.3, pp. 260-268.
4. Health system performance management: Quality for better or for worse
AUTOR(ES): Niek Klazinga
ANO: 2010
RESUMO: There is a growing interest in measuring quality of care to help increase the value of health systems. This paper addresses the reasons and difficulties of health system performance measurement. It stresses the need for a thoughtful health system performance framework and illustrates the need of an adequate underlying information infrastructure with respect to mortality data, clinical registries, administrative databases and patient surveys.Various strategies are discussed that can help to turn health system performance measurement into health system performance management.
FONTE: Eurohealth Vol 16 No 3
REFERENCIA: Niek KlazingaHealth system performance management: Quality for better or for worse. London: Eurohealth, Performance 2010;16(3): 26-28.
5. Improving performance in the English National Health Service
AUTOR(ES): Chris Ham
ANO: 2010
RESUMO: Performance improvement in the English NHS since 1997 has resulted mainly from targets and terror. The Coalition Government elected in May 2010 is committed to reducing the use of process oriented targets, and instead will seek to bring about further improvements in performance through patient choice and provider competition. The adversarial political system in Britain contains the risk that newly elected governments will throw the baby out with the bathwater. Health policy makers should resist the temptation to reject policies inherited from their opponents and should seek to provide direction from the top and empower front line teams in taking forward reform.
FONTE: Eurohealth Vol 16 No 3
REFERENCIA: Chris Ham.Improving performance in the English National Health Service. London: Eurohealth, Performance 2010;16(3): 23-25.
6. If neither altruism nor markets have improved NHS performance, what might?
AUTOR(ES): Gwyn Bevan
ANO: 2010
RESUMO: Este artigo considera três modelos comportamentais dos incentivos aos gestores dos prestadores de cuidados de saúde a usar a informação em seu desempenho melhorar, e evidências da eficácia de cada modelo dos Estados Unidos e Reino Unido Reino. Os três modelos são: altruísmo, mercados e reputação. Este artigo esboça a justificativa para os três modelos da Nacional de Saúde Inglês Service (NHS), o evidência de os EUA e o Reino Unido em cada modelo, e conclui com um paradoxo.
FONTE: Eurohealth Vol 16 No 3
REFERENCIA: Gwyn Bevan. If neither altruism nor markets have improved NHS performance, what might?. London: Eurohealth, Performance 2010;16(3): 20-22.
7. Access to health care in the EU Member States
AUTOR(ES): Markus Wö rz, Thomas Foubister and Reinhard Busse
ANO: 2006
RESUMO: Boletim de Política de Saúde do Observatório Europeu dos Sistemas e Políticas de Saúde. O acesso aos cuidados de saúde na UE Estados-Membros
FONTE: The Health Policy Bulletin of the European Observatory on Health Systems and Policies
REFERENCIA: Markus Wörz, Thomas Foubister and Reinhard Bus. Access to health care in the EU Member States. Belgium: Euro Observer: The Health Policy Bulletin of the European Observatory on Health Systems and Policies 2006.
8. Condicionantes socioeconômicos e geográficos do acesso à mamografia no Brasil, 2003-2008
AUTOR(ES): Evangelina Xavier Gouveia de Oliveira; Rejane Sobrino Pinheiro; Enirtes Caetano Praates Melo; Marilia Sá Carvalho
ANO: 2011
RESUMO: Este estudo examinou os efeitos de características da população e geográficas na chance de mamografia, no Brasil em 2003 e 2008. A partir do Suplemento Saúde da Pesquisa Nacional por Amostra de Domicílios, foram analisados os padrões de mamografia em mulheres com 25 anos ou mais, por meio de razão de prevalências, e em mulheres com 40 anos ou mais, por meio de regressão logística multivariada, incluindo o local de residência e a distribuição geográfica da oferta. Entre as mulheres com 50-69 anos, 54,6% relataram ter feito mamografia, em 2003, e 71,5%, em 2008. A chance de realização do exame é maior entre as de 50 a 69 anos, aumenta com a renda familiar e escolaridade, dentre as casadas, para as que consultaram médico e têm plano de saúde. Residir em área metropolitana triplica a chance de mamografia. Comparado com a região Norte, residentes das demais regiões têm chances maiores e a distância influencia negativamente a realização do exame. No período, a cobertura aumentou na faixa etária alvo da política nacional, com redução das desigualdades de renda e de escolaridade. A ampliação do acesso parece mais ligada às políticas de aumento de renda e inclusão social, e à ampliação da oferta de exames na rede pública e conveniada, do que ao aumento do número de mamógrafos.
FONTE: Ciênc. saúde coletiva vol.16 no.9 Rio de Janeiro Sept. 2011
REFERENCIA: Evangelina Xavier Gouveia de Oliveira; Rejane Sobrino Pinheiro; Enirtes Caetano Praates Melo, et al. Condicionantes socioeconômicos e geográficos do acesso à mamografia no Brasil, 2003-2008. Rio de Janeiro: Ciênc. saúde coletiva, 2011. vol.16 no.9.
9. Health systems and the right to health: an assessment of 194 countries
AUTOR(ES): Gunilla Backman, Paul Hunt, Rajat Khosla, Camila Jaramillo-Strouss, Belachew Mekuria Fikre, Caroline Rumble, David Pevalin, David Acurio Pá ez, Mó nica Armijos Pineda, Ariel Frisancho, Duniska Tarco, Mitra Motlagh, Dana Farcasanu, Cristian Vladescu
ANO: 2008
RESUMO: Há 60 anos, a Declaração Universal dos Direitos Humanos lançou as bases para o direito ao mais alto atingível padrão de saúde. Este direito é fundamental para a criação de sistemas de saúde eqüitativos. Identificamos algumas características do direito à saude dos sistemas de saúde, como um Plano Nacional de Saúde Abrangente, e propomos 72 indicadores que refletem algumas destas características. Nós coletamos dados processados ​​globalmente sobre estes indicadores para 194 países e os dados nacionais para Equador, Moçambique, Peru, Romênia e Suécia. Dados globalmente transformados não estavam disponíveis para 18 indicadores para qualquer país, o que sugere que as organizações que obtêm esses dados dão insuficiente atenção para os direito à saúde dos sistemas de saúde. Onde estão disponíveis, os indicadores mostram que os sistemas de saúde precisam ser melhorados para perceber melhor o direito à saúde. Nós fornecemos recomendações para governos, organismos internacionais, sociedade civil organizações, e outras instituições e sugerimos que estes indicadores e dados, embora não sejam perfeito, fornecem uma base para o monitoramento dos sistemas de saúde e para a realização progressiva do direito à saúde. Características do direito à saúde não são apenas boa gestão, justiça, ou humanitarismo, são obrigações sob as leis dos direitos humanos.
FONTE: Lancet 2008; 372: 2047–85
REFERENCIA: Gunilla Backman, Paul Hunt, Rajat Khosla et al ,Lancet 2008; 372: 2047–85
10. Equity, social determinants and public health programmes
AUTOR(ES): Erik Blas e Anand Sivasankara Kurup Eds
ANO: 2010
RESUMO: Este livro foi encomendado pelo Department of Ethics, Equity, Trade and Human Rights, como parte do trabalho realizado pelo Priority Public Health Conditions Knowledge Network of the Commission on Social Determinants of Health, em colaboração com 16 dos principais programas de saúde pública da OMS: questões relacionadas à ingestão de alcool, doenças cardiovasculares, saúde infantil, diabetes, segurança alimentar, HIV / SIDA, saúde materna, malária, saúde mental, doenças tropicais negligenciadas, nutrição, saúde bucal, saúde sexual e reprodutiva, saúde e tabaco, tuberculose e violência e lesões. Além disso, através da colaboração com o Programa Especial de Investigação,Desenvolvimento e Formação em Reprodução Humana, o Programa Especial para Pesquisa e Treinamento em Doenças Tropicais, e da Aliança de Política de Saúde e Pesquisa de Sistemas, 13 estudos de caso foram contratados para examinar os desafios de implementação em abordar os determinantes sociais da saúde em ambientes de baixa e média renda. A Prioridade de Saúde Pública Rede de Conhecimento Condições analisou o impacto dos determinantes sociais sobre as condições de saúde speciic, identiied possíveis pontos de entrada, e explorou as possíveis intervenções para melhorar a saúde
FONTE:
REFERENCIA:
11. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies
AUTOR(ES): WHO
ANO: 2010
RESUMO: Este manual descreve um conjunto de indicadores e estratégias de medição relacionados, estruturado em torno da estrutura da OMS que descreve os sistemas de saúde em termos de seis "blocos de construção": prestação de serviços, profissionais de saúde, informação, medicamentos, financiamento e governança.
FONTE: ISBN 978 92 4 156405 2
REFERENCIA: WHO, 2010
12. Diferenças regionais no acesso a cirurgia cardiovascular no Brasil, 2002 -2010
AUTOR(ES): Viacava, Francisco ; PORTO, SILVIA ; LAGUARDIA, JOSUÉ ; MOREIRA, RODRIGO DA SILVA ; UGÁ , MARIA ALÍ CIA DOMINGUEZ
ANO: 2011
RESUMO: As taxas internação por angioplastia e cirurgia de revascularização vêm sendo usadas como proxies de acesso a serviços de alta complexidade. O objetivo é analisar sua evolução e discutir quais seriam as possíveis causas associadas às desigualdades regionais. Foram calculadas as taxas padronizadas de realização de angioplastia e cirurgia de revascularização por sexo e idade por 100 mil habitantes de 20 anos e mais, no período 2002 a 2010. A comparação com os dados internacionais mostra que o Brasil tem taxas menores que as observadas nos países da OECD. No Brasil, as taxas padronizadas de internação por angioplastia na população de 20 anos ou mais apresentaram uma tendência de crescimento, passando de 27,5 por 100 mil habitantes em 2002 para 39 por 100 mil em 2010. Na comparação das taxas padronizadas por idade e sexo entre as grandes regiões do Brasil, além das diferenças marcantes no eixo Norte - Sul, o que chama atenção é que mantenham um padrão estável e também as diferenças regionais. A constituição de redes assistenciais regionais hierarquizadas para cirurgias cardíacas constitui uma estratégia importante para: garantir a qualidade do cuidado, a optimização dos custos operacionais e reduzir as desigualdades no acesso entre as regiões brasileiras.
FONTE:
REFERENCIA: Viacava, Francisco ; PORTO, SILVIA ; LAGUARDIA, JOSUÉ ; MOREIRA, RODRIGO DA SILVA ; UGÁ, MARIA ALÍCIA DOMINGUEZ . Diferenças regionais no acesso a cirurgia cardiovascular no Brasil, 2002 -2010. Ciência e Saúde Coletiva (Impresso), v. 17, p. 2963-2969, 2012.
13. Health Systems, Health, Wealth and Societal Well-being
AUTOR(ES): Josep Figueras and Martin McKee Eds
ANO: 2011
RESUMO: This book looks at health systems from a new perspective. It argues that they are not, as is often believed, simply a drag on resources but rather are part and parcel of improving health and achieving better economic growth. The relationship between health systems, health and wealth is complex, but the three are inextricably linked so that investing cost-effectively in health systems can contribute to the ultimate goal of societal well-being (Figueras et al. 2009; McKee et al. 2009)
FONTE: World Health Organization 2012 on behalf of the European Observatory on Health Systems and Policies.
REFERENCIA:
14. Health Inequalities - Inequalities in health service access
AUTOR(ES): Tamsma N (RIVM)
ANO: 2009
RESUMO:
FONTE:
REFERENCIA: Bilthoven: RIVM, <http://www.euphix.org> EUphocus\ Health Inequalities, 8 June 2009.
15. Estatísticas e Indicadores Sociais
AUTOR(ES): Nelson Senra
ANO: 2009
RESUMO:
FONTE: HEB, Vol IV, 2009
REFERENCIA: http://www.estantevirtual.com.br/umsebonapracaxv/Nelson-Senra-Historia-Das-Estatisticas-Brasileiras-59676768
16. Indice de Desempenho do Sistema Único de Saúde, IDSUS 2011
AUTOR(ES): MS/DEMAS
ANO: 2011
RESUMO:
FONTE:
REFERENCIA:
17. Inequalities in health, does health care matter? Social inequalities in mortality in Europe, with a special focus on the role of the health care system.
AUTOR(ES): Irina Stirbu
ANO: 2008
RESUMO: The international evidence on socioeconomic inequalities in health is compelling: in all European countries, people who live in disadvantaged circumstances have poorer health, more disability and shorter lives than those who are more affluent. Also, the health of migrants is often poorer compared to the health status of the host population, particularly among some ethnic groups and for some conditions. Poorer access to health services and lower quality of services provided to disadvantaged populations may potentially contribute to the explanation of inequalities in health. Knowledge of these shortcomings can be used by policy makers as potential entry points for improvements in population health and for reductions of socioeconomic and ethnic inequalities in health. The research underlying this thesis aims to contribute to the discussion on the role that the health care system plays in socioeconomic and ethnic inequalities in health. Specifically, we aim to measure the magnitude of socioeconomic and ethnic inequalities related to the functioning of the health care system. We do so by estimating the levels of inequalities in avoidable mortality, utilization and quality of health services. The following specific research questions are addressed: 1) What is the magnitude of socioeconomic and ethnic inequalities in mortality in different European countries? 2) What is the magnitude of socioeconomic and ethnic inequalities in mortality from causes that are related to the functioning of health care in Europe? 3) What is the magnitude of socioeconomic and ethnic inequalities in the utilization and quality of specific health care services?
FONTE: Erasmus MC: University Medical Center Rotterdam
REFERENCIA: Stirbu, Irina. Inequalities in health, does health care matter? Social inequalities in mortality in Europe, with a special focus on the role of the health care system. Erasmus MC: University Medical Center Rotterdam. Doctoral Thesis 2008-12-05.
18. Santa Clara County Public Health Linking social determinants to health outcomes at local level
AUTOR(ES): Aimee Reedy, Rocio Luna, Mandeep Baath, Douglas Schenk, Marcela Vasquez, David Hill, Anandi Sujeer
ANO: 2010
RESUMO: The Santa Clara County Health Equity Data Project is a collaborative project being co-led by the Santa Clara County Public Health Department and The Health Trust (a local charitable foundation). Specific methods for the project include (1) establishing criteria to identify and prioritize social and economic indicators; (2) applying the criteria to select at least five social and economic variables and associated indicators and data sources; (3) accessing public and proprietary databases; (4) analyzing data using GIS mapping, and other analytical techniques; and, (5) enlisting necessary partners to supply the prioritized social and economic data, assist with accessing and using the data, and providing interpretation for the results.
FONTE: Santa Clara County Public Health Linking social determinants to health outcomes at local level
REFERENCIA: Aimee Reedy, Rocio Luna, Mandeep Baath, Douglas Schenk, Marcela Vasquez, David Hill, Anandi Sujeer. Social and Health Inequities in Santa Clara County. EUphocus Health Inequalities, 8 June 2009.
19. Equity in access to health care in Italy: a disease-based approach
AUTOR(ES): Cristina Masseria and Margherita Giannoni
ANO: 2010
RESUMO: Background: Equitable access to health care is a core objective of the Italian health care system. Despite having achieved universal coverage for a fairly comprehensive set of health services for decades, there is still evidence of inequities systematically associated with income. Method: Income-related inequity indices were estimated for the probability of general practitioner (GP), specialist, inpatient care and also emergency care using a variety of need indicators. The data used were the Multiscopo survey, 2000 matched with the European Community Household Panel survey for Italy. The contribution of regional inequality was also estimated. Horizontal inequity indices for health care utilization measures were computed separately for people reporting hypertension, arthritis, tumour and heart disease. Results: Significant pro-rich income related inequity was found for GP, specialist and emergency care, no inequity was found for inpatient care. The disease approach showed statistically significant inequity in the probability of specialist care in three of the four chronic conditions analysed, and pro-poor inequity in GP care for all conditions. Inequity was mainly caused by income and regional variations. Conclusions: By reducing regional variation it would be possible to significantly reduce the pro-rich inequity in GP, specialist and emergency care. For specialist care inequity was found for the overall adult population and also among people with serious chronic conditions, and was caused not only by income and regional variation, but also by educational attainment and insurance.
FONTE: Oxford Journals Medicine European Journal of Public Health Volume 20, Issue 5 Pp. 504-510.
REFERENCIA: Cristina Masseria and Margherita Giannoni. Equity in access to health care in Italy: a disease-based approach. Oxford Journals Medicine European Journal of Public Health Volume 20, Issue 5 Pp. 504-510.
20. Predição de Risco em Cirurgia Cardíaca
AUTOR(ES): Almeida, Fernanda Fuscaldi.
ANO: 2001
RESUMO: A crescente utilização de indicadores de resultados na área da saúde e a necessidade de ajuste dos mesmos pelo risco, vem estimulando, há décadas, o desenvolvimento de sistemas de quantificação de gravidade dos pacientes assistidos, particularmente a nível hospitalar. Uma das áreas em que estes modelos de ajuste de risco mais se desenvolveram foi a cirurgia cardíaca A ausência de critérios padronizados para comparação de resultados, considerando-se as condições pré-operatórias, limitam comparações entre instituições e diferentes práticas terapêuticas. O objetivo deste trabalho é avaliar os vários estudos disponíveis na literatura, procurando identificar os eventos resposta considerados na avaliação de resultados em cirurgia cardíaca, os fatores que afetam estes resultados e os sistemas de predição de risco disponíveis. Foi realizado levantamento bibliográfico dos artigos relacionados à avaliação de risco em cirurgia cardíaca publicados no período de 1985 a 2000, em periódicos indexados. A comparação dos modelos de predição de risco revela mais similaridades que diferenças entre os mesmos. Mortalidade e complicações foram os eventos resposta mais avaliados. Os sistemas de predição desenvolvidos em cirurgia cardíaca, em sua maioria, têm como base grandes populações de pacientes, resultam na maioria dos casos de estudos multicêntricos e utilizam a regressão logística na avaliação estatística. Os achados dos estudos avaliados confirmam a condição clínica pré-operatória do paciente como o principal determinante dos resultados cirúrgicos.
FONTE: Biblioteca Virtual UFMG - Dissertações e Teses - Pós-Graduação em Saúde Pública - Dissertações de Mestrado
REFERENCIA: Almeida, Fernanda Fuscaldi. Predição de risco em cirurgia cardíaca. Faculdade de Medicina da UFMG. Belo Horizonte, 2001. 113p.
21. Qualidade da Informação sobre Cirurgia de Revascularização do Miocárdio em Prontuários: o caso da abrangência.
AUTOR(ES): Oliveira, Thaí s Mendonç a Lips de; Silva, Nelson Albuquerque Souza e; Oliveira, Glá ucia Maria Moraes de; Klein, Carlos Henrique.
ANO: 2008
RESUMO: A abrangência das informações nos prontuários de cirurgia de revascularização do miocárdio (RVM) está relacionada com a qualidade do atendimento. Avaliar a abrangência dos registros de RVM no município do Rio de Janeiro (MRJ), de 1999 a 2003. Selecionaram-se amostras aleatórias de pacientes de RVM em hospitais públicos do MRJ, de 1999 a 2003. Estimaram-se os percentuais de ausência de registro de dados sociodemográficos, fatores de risco, comorbidades, exames complementares e complicações.
FONTE: Rev. SOCERJ;21(6):372-381, nov.-dez. 2008. tab, ilus.
REFERENCIA: Oliveira, Thaís Mendonça Lips de; Silva, Nelson Albuquerque Souza e; Oliveira, Gláucia Maria Moraes de; Klein, Carlos Henrique. Qualidade da Informação sobre Cirurgia de Revascularização do Miocárdio em Prontuários: o caso da abrangência. Rev. SOCERJ;21(6):372-381, nov.-dez. 2008. tab, ilus.
22. Understanding different methodological approaches to measuring inequity in health care.
AUTOR(ES): Asada Y; Kephart G.
ANO: 2011
RESUMO: The objectives of this study were to classify different methodological approaches to measuring inequity in health care, identify the strengths and weaknesses of each approach, and suggest directions for future improvement of each approach. The authors classified three approaches to measuring inequity in health care according to: (1) collective expert judgments (clinical standard approach), (2) average health care use based on need (population standard approach), and (3) assessment of health care users or providers (direct approach). The clinical standard approach has strong face validity and immediate policy implication, while lacking global policy implications. The population standard approach offers a global picture of inequity but has weak face validity. The direct approach can reveal private information of health care users and offer opportunity for managing public expectation. Strengths and limitations of these approaches are complementary, suggesting directions for future improvements of each approach. This study will help researchers make a well-informed choice of measurement approach and assist policymakers in resolving some of the problems caused by the diverse findings of studies, partly due to the measurement approaches taken.
FONTE: Int J Health Serv; 41(2): 195-207, 2011.
REFERENCIA: Asada Y; Kephart G. Understanding different methodological approaches to measuring inequity in health care. Int J Health Serv; 41(2): 195-207, 2011.
23. Using routine data to measure ethnic differentials in Access to coronary revascularization
AUTOR(ES): Mindell J; Klodawski E; Fitzpatrick J
ANO: 2008
RESUMO: Background: Ethnic inequalities in access to health services are difficult to monitor and address because of limited data. Within the health service, ethnicity data have been poor quality, partly because they are not seen as useful. Methods: The analysis related age- and sex-standardized coronary revascularization procedures to defined measures of need, using proportional ratios derived from Hospital Episode Statistics records for London residents admitted to any hospital nationally in 2002-03 or 2003-04. Results: Although 2001 Ethnicity Categories were mandatory for the NHS from April 2001, by 2003-04 >20% of coronary heart disease (CHD) records still had no ethnic category coded. Hospital admission for CHD and revascularization by ethnicity varied widely, following known patterns of CHD incidence and mortality. There is much less variation between ethnic groups when comparing revascularization rate relative with CHD admission rates (whether all or emergencies). However, Bangladeshi patients had only two-thirds [proportional ratio 66.8, 95% confidence interval (CI) 60.7-73.3] and Black Caribbean and Black African patients four-fifths (proportional ratios 80.5, 72.0-89.9 and 80.7, 68.0-95.2, respectively) the revascularization rate in comparison with apparent need as the general population. Conclusion: Even with imperfect data, the analysis of routine data can identify inequalities that warrant further investigation.
FONTE: Journal of Public Health. 30(1):45-53, March 2008.
REFERENCIA: Mindell J; Klodawski E; Fitzpatrick J. Using routine data to measure ethnic differentials in Access to coronary revascularization. Journal of Public Health. 30(1):45-53, March 2008.
24. Population need for coronary revascularisation: are national targets for England credible?
AUTOR(ES): Martin RM, Hemingway H, Gunnell D, Karsch KR, Baumbach A, Frankel S.
ANO: 2002
RESUMO: Objective: To estimate the need for coronary revascularisation, by using an incidence of indications approach, among 45-84 year olds with stable angina, unstable angina, and acute myocardial infarction. Design: Modelling exercise. Six key steps along the pathway of care from initial diagnosis in primary or secondary care to revascularisation were defined and the frequency of indications estimated using routine data from hospital admissions and data from studies in the general population, and primary and secondary care. Setting and patients: Mid-1998 population of England. Intervention: Coronary revascularisation. Main outcome measure: Ability to benefit (need), defined by randomised trials, expert panel ratings from the ACRE (appropriateness of coronary revascularisation) study, or by informal consensus. Results: The need for coronary revascularisation was estimated to be 92 000 procedures, equivalent to a rate of 1861 per million population. Overall, the model of need exceeded current provision by 3.3:1, although among people aged 75 years and over the ratio was 7.7:1. A plausible upper estimate of need--obtained by assuming that 90% of patients with stable angina were referred from primary care and that angiography would be performed in 65% of patients with acute myocardial infarction and 75% of patients with unstable angina--was 2626 per million population. Conclusions: The national target of 1500 revascularisation procedures per million population is credibly related to population need, although upper estimates of need are considerably higher. Better understanding is required of the benefits of referring patients with specific indications from primary care. The greatest relative increase in provision is required for those aged 75 and older, among whom trial evidence of benefit is scant.
FONTE: Heart. 88(6):627-633, December 2002.
REFERENCIA: Martin RM, Hemingway H, Gunnell D, Karsch KR, Baumbach A, Frankel S. Population need for coronary revascularisation: are national targets for England credible? Heart. 88(6):627-633, December 2002.
25. The identification and development of Canadian coronary artery bypass graft surgery quality indicators
AUTOR(ES): Guru V, Anderson GM, Fremes SE, O' Connor GT, Grover FL, Tu JV; Canadian CABG Surgery Quality Indicator Consensus Panel.
ANO: 2005
RESUMO: Objective: The study objective was to develop quality indicators for coronary artery bypass graft surgery that relate to quality of care, associate with preventable death, and could be reported on performance reports. Methods: A comprehensive list of quality indicators was collected from quality improvement organizations including the Society For Thoracic Surgery, Northern New England Cardiovascular Disease Study Group, and Veteran's Affairs System. Indicators were collated from practice guidelines from the American College of Cardiology and the American Heart Association. A MEDLINE search using the keywords "quality indicators" and "coronary bypass" was completed. A 17-member multidisciplinary international expert panel was assembled, who voted using a 2-step Delphi process regarding association with quality of care, risk adjustment, association with preventable death, and inclusion on performance reports. Results: A total of 149 quality indicators were examined. This list was distilled to 33 indicators related to quality of care, 10 indicators that could be adequately risk adjusted, 34 indicators related to preventable death, and 18 indicators to be included on performance reports. These selected indicators consisted of 19 outcome variables, 23 process of care variables, and 4 structure variables. The quality indicators believed to be useful on a Canadian institutional coronary artery bypass graft surgery report card included the following: 30-day mortality, in-hospital mortality, electrocardiographic myocardial infarction, red cell transfusion, allogeneic blood product transfusion, deep sternal wound infection, postoperative stroke, postoperative dialysis, intensive care unit readmission, intensive care unit length of stay, ventilation time, repeat cardiac operation, repeat surgery with cardiopulmonary bypass, repeat revascularization, waiting time to surgery, completion of surgery within a recommended waiting time, use of left internal thoracic artery graft, and institutional volume. Conclusions: This set of consensus quality indicators can be used as a standard list to be monitored by providers of coronary artery bypass graft surgery in an effort to continuously evaluate and improve their performance.
FONTE: J Thorac Cardiovasc Surg; 130(5): 1257, 2005 Nov.
REFERENCIA: Guru V, Anderson GM, Fremes SE, O'Connor GT, Grover FL, Tu JV; Canadian CABG Surgery Quality Indicator Consensus Panel. The identification and development of Canadian coronary artery bypass graft surgery quality indicators. J Thorac Cardiovasc Surg. 2005 Nov;130(5):1257.
26. What is too much variation? The null hypothesis in small-area analysis.
AUTOR(ES): Paula Diehr, Kevin Cain, Frederick Connell, M.D., and Ernest Volinn
ANO: 1990
RESUMO: A small-area analysis (SAA) in health services research often calculates surgery rates for several small areas, compares the largest rate to the smallest, notes that the difference is large, and attempts to explain this discrepancy as a function of service availability, physician practice styles, or other factors. SAAs are often difficult to interpret because there is little theoretical basis for determining how much variation would be expected under the null hypothesis that all of the small areas have similar underlying surgery rates and that the observed variation is due to chance. We developed a computer program to simulate the distribution of several commonly used descriptive statistics under the null hypothesis, and used it to examine the variability in rates among the counties of the state of Washington. The expected variability when the null hypothesis is true is surprisingly large, and becomes worse for procedures with low incidence, for smaller populations, when there is variability among the populations of the counties, and when readmissions are possible. The characteristics of four descriptive statistics were studied and compared. None was uniformly good, but the chi-square statistic had better performance than the others. When we reanalyzed five journal articles that presented sufficient data, the results were usually statistically significant. Since SAA research today is tending to deal with low-incidence events, smaller populations, and measures where readmissions are possible, more research is needed on the distribution of small-area statistics under the null hypothesis. New standards are proposed for the presentation of SAA results.
FONTE: Health Serv Res. 1990 February; 24(6): 741–771.
REFERENCIA: Diehr P; Cain K; Connell F; Volinn E. What is too much variation? The null hypothesis in small-area analysis. Health Serv Res; 24(6): 741-71, 1990 Feb.
27. Evaluación y Mejora del Desempeño de los Sistemas de Salud en la Región de las Américas
AUTOR(ES): Organizació n Panamericana de la Salud; Pan Amé rican Health Organization.
ANO: 2001
RESUMO: El Informe sobre la Salud en el Mundo 2000: Mejorar el Desempeño de los Sistemas de Salud, en el que se presentaron criterios de comparación del desempeño de los sistemas de salud de los 191 Estados Miembros de la OMS, suscitó un interés y debate sin precedentes en los países, en las organizaciones internacionales y en las instituciones de investigación. Las inquietudes expresadas llevaron a la adopción de la Resolución CD42.R5: Informe sobre la Salud en el Mundo 2000 por la 42.a Reunión del Consejo Directivo de la OPS llevada a cabo el 26 de septiembre de 2000. Dicha resolución instaba a los Estados Miembros a movilizar a los sectores de la inteligencia nacional representados por sus respectivos ministerios de salud, universidades, institutos de investigación y organismos afines, para hacer el seguimiento y la evaluación de sus propios sistemas de salud. De igual manera, el 19 de enero de 2001 la sesión 107.a del Consejo Ejecutivo de la OMS adoptó la Resolución EB107.R8: «Evaluación del Desempeño de los Sistemas de Salud». Esta resolución determinó que para ayudar a los Estados Miembros a contribuir regularmente a la evaluación que la OMS realiza del desempeño de sus sistemas de salud se estableciera un proceso de consultas regionales que reúna a funcionarios de los Estados Miembros de las diversas regiones de la OMS y recoja sus puntos de vista. La región de las Américas llevó a cabo la primera de la serie de consultas regionales sobre la evaluación del desempeño de los sistemas de salud. El presente volumen contiene los materiales que se presentaron a y se produjeron en las tres reuniones arriba mencionadas, asi como la relación de asistentes a las dos primeras. También incluye un resumen provisional de los debates habidos en el 43.o Consejo Directivo sobre el particular.
FONTE: Washington, D.C; Organización Panamericana de la Salud;Pan Américan Health Organization; 2001. 67 p.
REFERENCIA: Organización Panamericana de la Salud - Washington, DC, Organización Panamericana de la Salud, 2001. 71 pp - ISBN: 92-75-07387-2
28. Territórios do Sistema Único de Saúde – mapeamento das redes de atenção hospitalar
AUTOR(ES): Evangelina X. G. de Oliveira, Marilia Sá Carvalho, Clá udia Travassos
ANO: 2004
RESUMO: This article presents two types of networks organized according to patient caseload in health services, concerning both primary hospital care (most frequent hospital procedures) and tertiary care (high-cost procedures). Data on inpatient care in Brazil in 2000 obtained from the Hospital Information System of the Unified National Health System were aggregated by place of residence and hospital location at the municipal level. Both the network structure and the node (municipality) hiera rchy were established using the dominant flow approach. In addition, a typology of flows was applied to indicate the degree of connection across the networks. Primary hospital care networks reach most of the country, and few municipalities are not connected to the network . Relatively few cities provide higher- level services, and almost half of the municipalities are unconnected. The Ministry of Health aims to provide access to frequently used health services near the user's place of residence, and this goal appears to be feasible in the short run. On the other hand, much remains to be done to ensure widespread access to tertiary care.
FONTE: Cad. Saúde Pública, Rio de Janeiro, 20(2):386-402, mar- a b r, 2004
REFERENCIA: OLIVEIRA, Evangelina X. G. de; CARVALHO, Marilia Sá and TRAVASSOS, Cláudia. Territórios do Sistema Único de Saúde: mapeamento das redes de atenção hospitalar. Cad. Saúde Pública [online]. 2004, vol.20, n.2, pp. 386-402.
29. Da depressão da crise, para a governação prospectiva da saúde.
AUTOR(ES): Vá rios
ANO: 2011
RESUMO: O Observatório Português dos Sistemas de Saúde (OPSS), neste ano, na sequência das análises essencialmente retrospectivas da governação da saúde em Portugal, desenvolveu e fundamentou um modelo de análise prospectiva, baseado no pressuposto de que uma melhoria substancial da qualidade da governação da saúde no País terá de passar pela introdução de instrumentos fortemente prospectivos e adaptativos. O OPSS cumpre, de novo, o compromisso de apresentar anualmente um documento sobre a governação do sistema de saúde português, o Relatório de Primavera (RP), este ano intitulado Da depressão da crise para a governação prospectiva da saúde.Este trabalho e apresentado num momento muito particular da vida do País. A crise financeira e económica, mais do que um lugar-comum, tornou-se uma realidade na vida de um numero crescente de pessoas, resultante de fenómenos como a diminuição do poder de compra, o desemprego e o consequente risco de pobreza, com tudo o que lhe esta associado. A resposta a crise tornou-se o tema central de todas as discussões, de leigos a especialistas, bem como da agenda do espaço europeu. Neste contexto, Portugal tornou-se um país "intervencionado" através do que se convencionou designar como troika (isto e, Fundo Monetário Internacional, Banco Central Europeu e União Europeia) e, como tal, sujeito a um conjunto de medidas que visam restabelecer a confiança dos mercados e criar as condições para que o país possa honrar os seus compromissos internacionais. As medidas acordadas com os partidos do "arco da governação" foram negociadas em plena crise política, com um governo demissionário e o País em clima de campanha eleitoral. As referidas medidas caracterizam-se, genericamente pela imposição de um calendário muito apertado de reformas que atingem todos os sectores de actividade e, como tal, também a saúde. Esta e afectada de forma directa (através das medidas que incidem sobre o sector da saúde) e de forma indirecta (através de todas as medidas que, de algum modo, interfiram com a capacidade de autocuidado). Apesar disso, muitas das medidas acordadas para a saúde foram bem recebidas por vários sectores e entendidas como úteis e necessárias, tendo inclusivamente sido colocada a questão: sendo tão úteis e necessárias, por que razão nunca ninguém as implementou? Podemos dizer que tudo se ira jogar no modo como as referidas medidas serão concretizadas. É neste contexto que surge o presente RP. E também essa a razão pela qual o intitulamos desta forma. Foi ainda esta a razão que nos levou a introduzir uma alteração substantiva no formato do RP. Até aqui, o RP tinha essencialmente uma postura de análise retrospectiva. A partir do presente, entendemos assumir também uma postura prospectiva. Para o efeito, iniciamos o desenvolvimento de um modelo de análise prospectiva que nos permitirá enquadrar e compreender as propostas para o sector da saúde, quer sejam as da troika quer as do programado Governo, ou as decorrentes da negociação do Orçamento Geral do Estado (OGE). Esta perspectiva coexistirá com a análise retrospectiva, uma vez que entendemos como necessário e útil compreender como tem evoluído as diversas reformas e medidas. Esta alteração de perspectiva assumida neste RP insere-se num conjunto de iniciativas realizadas pelo OPSS visando incrementar a qualidade do trabalho por nós desenvolvido e que só têm sido possíveis pelo apoio dispensado pela Fundação Calouste Gulbenkian.
FONTE: Relatório de Primavera 2011 - OBSERVATÓRIO PORTUGUÊS DOS SISTEMAS DE SAÚDE OPSS
REFERENCIA: Da Depressão da Crise para a Governação Prospectiva da Saúde Relatório de Primavera 2011 de Vários Edição/reimpressão: 2011 Páginas: 128 Editor: Mar da Palavra ISBN: 9789728910563
30. OECD Study of Cross-National Differences in the Treatment, Costs and Outcomes of Ischaemic Heart Disease. Annex 1: Table and Charts
AUTOR(ES): Pierre Moise, Sté phane Jacobzoneand the ARD-IHD Experts Group
ANO: 2003
RESUMO: The Ageing-Related Diseases study compares treatment trends and health outcomes on a disease-by-disease basis. Most of the day-to-day decisions that determine health care system performance are made in treating specific diseases. Therefore, the ARD’s bottom-up approach to comparing health care system performance at the disease level, rather than the more common top-down approach, goes to the heart of health care system performance. This paper presents such an analysis for ischaemic heart disease. There is considerable variation in treatment trends for the same diseases across countries and much of this variation can be explained by differences in structural characteristics of health care systems. A disease-level analysis begins with an examination of these characteristics: the economic incentives, policies and regulations that affect individual providers’ decisions for treating a specific disease, defining a particular health care system’s approach.
FONTE: OECD HEALTH WORKING PAPERS No. 3. 22-Apr-2003
REFERENCIA: Moïse, P. and S. Jacobzone (2003), "OECD Study of Cross-National Differences in the Treatment, Costs and Outcomes of Ischaemic Heart Disease", OECD Health Working Papers, No. 3, OECD Publishing.
31. Avaliação do gerenciamento de resíduos de serviços de saúde por meio de indicadores de desempenho
AUTOR(ES): Katia Sakihama Ventura, Luisa Fernanda Ribeiro Reis, Angela Maria Magosso Takayanagui
ANO: 2010
RESUMO: O presente trabalho propôs um modelo de avaliação do gerenciamento de RSS em estabelecimentos de saúde, com o uso de indicadores de desempenho. A proposta consistiu em identificar esses indicadores a partir dos dados qualitativos obtidos por entrevistas, cujas respostas foram associadas a escalas numéricas e inseridas no programa Statistica (StatSoft®) para efetuar a análise fatorial (AF). Para isso, foi elaborado um roteiro de entrevista, especialmente preparado com 29 variáveis de observação e aplicado a 98 profissionais da saúde da Santa Casa de Misericórdia de São Carlos (SP). Os indicadores de desempenho foram submetidos ao julgamento de especialistas para a sua classificação em ordem de importância, com o uso da matriz de avaliação do método AHP (Analytic Hierarchy Process). Por fim, foi composto um índice global, que possibilitou a avaliação geral da situação investigada, em uma escala de zero a um, indicando que ações de melhoria para esse gerenciamento devem ser desenvolvidas. Este trabalho foi desenvolvido a fim de estruturar um modelo de avaliação de desempenho por meio da identificação de indicadores qualitativos, auxiliando na eficiência do processo de gerenciamento de resíduos em ambientes de saúde.
FONTE: Eng Sanit Ambient | v.15 n.2 | abr/jun 2010 | 167-176
REFERENCIA: VENTURA, Katia Sakihama; REIS, Luisa Fernanda Ribeiro and TAKAYANAGUI, Angela Maria Magosso. Avaliação do gerenciamento de resíduos de serviços de saúde por meio de indicadores de desempenho. Eng. Sanit. Ambient. [online]. 2010, vol.15, n.2, pp. 167-176. ISSN 1413-4152.
32. Utilização de cirurgias cardíacas de alta complexidade no Estado do Rio de Janeiro numa perspectiva regionalizada: SIH-SUS – 1999 a 2007.
AUTOR(ES): Alessandra Maria Silva Pinto, Rejane Sobrino Pinheiro
ANO: 2010
RESUMO: O presente trabalho analisou a utilização da cirurgia cardíaca de alta complexidade pela população do Estado do Rio de Janeiro, numa perspectiva de regionalização. Foram selecionadas internações para revascularizações miocárdicas e angioplastias no sistema de informações hospitalares (SIH) do Sistema Único de Saúde (SUS), 1999-2007. Denominou-se “mercado dominante” o prestador responsável por 50% ou mais do atendimento de determinada população. Os prestadores aumentaram de quatro para oito no período, e o volume de procedimentos aumentou 80,2% devido, principalmente, às angioplastias, variando amplamente entre os municípios. A taxa média de internação estadual cresceu 54,8%. Adicionalmente houve grande variação nas taxas médias de internação entre as regiões do Estado. O Centro-Sul Fluminense, o Médio Paraíba e a Metropolitana I apresentaram as menores taxas de internação, sendo as maiores observadas no Noroeste Fluminense. Observou-se regionalização do atendimento com limites bem definidos no Norte do Estado. Cabo Frio dominou o atendimento para além dos limites de sua regional. Embora tenha havido expansão do atendimento, vários municípios permaneceram sem atendimento. É importante definir padrões baseados em evidência para nortear a indicação de tratamento e estabelecer fluxos de atendimentos mais regionalizados. Devido à fácil visualização e viabilidade de realização nos serviços, o mapeamento dos fluxos de atendimento pode produzir informação para subsidiar a tomada de decisão no setor saúde.
FONTE: Cad. Saúde Colet., 2010, Rio de Janeiro, 18 (3): 445-55.
REFERENCIA: PINTO, Alessandra Maria Silva e PINHEIRO, Rejane Sobrinho.Utilização de cirurgias cardíacas de alta complexidade no Estado do Rio de Janeiro numa perspectiva regionalizada: SIH-SUS – 1999 a 2007. Cad. Saúde Colet., 2010, Rio de Janeiro, 18 (3): 445-55.
33. Health Systems, Health, Wealth and Societal Well-being: assessing the case for investing in health systems.
AUTOR(ES): Josep Figueras; Martin McKee
ANO: 2012
RESUMO:
FONTE: New York: Mcgraw-hill, 2012. 302 p.
REFERENCIA: FIGUERAS, Josep; MCKEE, Martin. Health Systems, Health, Wealth and Societal Well-being:assessing the case for investing in health systems. New York: Mcgraw-hill, 2012. 302 p.
34. Among nonagenarians, congruence between self-rated and proxy-rated health was low but both predicted mortality.
AUTOR(ES): Merja Vuorisalmi; Tytti Sarkeala; Antti Hervonen; Marja Jylhä
ANO: 2012
RESUMO: OBJECTIVE: The congruence between self-rated global health (SRH) and proxy-rated global health (PRH), the factors associated with congruence between SRH and PRH, and their associations with mortality are examined using data from the Vitality 90+ study. STUDY DESIGN AND SETTING: The data consist of 213 pairs of subjects--aged 90 years and older--and proxies. The relationship between SRH and PRH was analyzed by chi-square test and Cohen's kappa. Logistic regression analysis was used to find out the factors that are associated with the congruence between health ratings. The association between SRH and PRH with mortality was studied using Cox proportional hazard models. RESULTS: The subjects rated their health more negatively than the proxies. Kappa value indicated only slight congruence between SRH and PRH, and they also predicted mortality differently. Good self-reported functional ability was associated with congruence between SRH and PRH. CONCLUSIONS: The results imply that the evaluation processes of SRH and PRH differ, and the measures are not directly interchangeable. Both measures are useful health indicators in very old age but SRH cannot be replaced by PRH in analyses.
FONTE: Journal of Clinical Epidemiology, Oxford, v. 65, n. 5, p.553-559, 2012.
REFERENCIA: VUORISALMI, Merja et al. Among nonagenarians, congruence between self-rated and proxy-rated health was low but both predicted mortality. Journal Of Clinical Epidemiology, Oxford, v. 65, n. 5, p.553-559, 2012.
35. Agreement between Internet-Based Self- and Proxy-Reported Health Care Resource Utilization and Administrative Health Care Claims.
AUTOR(ES): Liisa Palmer; Stephen S. Johnston; Matthew D. Rousculp; Bong-Chul Chu; Kristin L. Nichol; Parthiv J. Mahadevia
ANO: 2012
RESUMO: OBJECTIVES: Although Internet-based surveys are becoming more common, little is known about agreement between administrative claims data and Internet-based survey self- and proxy-reported health care resource utilization (HCRU) data. This analysis evaluated the level of agreement between self- and proxy-reported HCRU data, as recorded through an Internet-based survey, and administrative claims-based HCRU data. METHODS: The Child and Household Influenza-Illness and Employee Function study collected self- and proxy-reported HCRU data monthly between November 2007 and May 2008. Data included the occurrence and number of visits to hospitals, emergency departments, urgent care centers, and outpatient offices for a respondent's and his or her household members' care. Administrative claims data from the MarketScan® Databases were assessed during the same time and evaluated relative to survey-based metrics. Only data for individuals with employer-sponsored health care coverage linkable to claims were included. The Kappa (κ) statistic was used to evaluate visit concordance, and the intraclass correlation coefficient was used to describe frequency consistency. RESULTS: Agreement for presence of a health care visit and the number of visits were similar for self- and proxy-reported HCRU data. There was moderate to substantial agreement related to health care visit occurrence between survey-based and claims-based HCRU data for inpatient, emergency department, and office visits (κ: 0.47-0.77). There was less agreement on health care visit frequencies, with intraclass correlation coefficient values ranging from 0.14 to 0.71. CONCLUSIONS: This study's agreement values suggest that Internet-based surveys are an effective method to collect self- and proxy-reported HCRU data. These results should increase confidence in the use of the Internet for evaluating disease burden.
FONTE: Value In Health, New York, v. 15, n. 3, p.458-465, 2012.
REFERENCIA: PALMER, Liisa et al. Agreement between Internet-Based Self- and Proxy-Reported Health Care Resource Utilization and Administrative Health Care Claims. Value In Health, New York, v. 15, n. 3, p.458-465, 2012.
36. Evidence-Based Public Health Policy and Practice: Promises and Limits.
AUTOR(ES): Laurie M. Anderson; Ross C. Brownson; Mindy T. Fullilove; Steven M. Teutsch; Lloyd F. Novick; Jonathan Fielding; Garland H. Land
ANO: 2005
RESUMO:
FONTE: American Journal of Preventive Medicine, Philadelphia, v. 28, n. 5, p.227-230, 2005.
REFERENCIA: ANDERSON, Laurie M. et al. Evidence-Based Public Health Policy and Practice: promises and limits. American Journal of Preventive Medicine, Philadelphia, v. 28, n. 5, p.227-230, 2005.
37. Access to quality health services.
AUTOR(ES): Healthy People
ANO: 2010
RESUMO:
FONTE: Washington: Healthy People, 2010. 35 p.
REFERENCIA: HEALTHY PEOPLE. Access to quality health services. Washington: Healthy People, 2010. 35 p.
38. Managing performance: An introduction.
AUTOR(ES): Rachel Irwin
ANO: 2010
RESUMO:
FONTE: Eurohealth, London, v. 16, n. 3, p.15-16, 2010.
REFERENCIA: IRWIN, Rachel. Managing performance: an introduction. Eurohealth, London, v. 16, n. 3, p.15-16, 2010.
39. The performance paradigm in the English NHS: Potential, pitfalls, and prospects.
AUTOR(ES): Mark Exworthy
ANO: 2010
RESUMO: Managing the performance of health services has become a dominant paradigm in policy and research in many countries over the past two decades. Attention has been directed to the development and implementation of performance ‘products’ such as management systems and metrics (for example, indicators). Whilst this approach offers some benefits, the limitations of relying solely on this approach are increasingly apparent. It is not always clear how such `products’generate improved performance and whether unintended consequences are apparent elsewhere in the health system. Understandings about performance could benefit from stronger and more explicit conceptual foundations. This article highlights one example of how research could be broadened to elicit a more rounded perspective on performance; namely, a focus on ‘informal’ aspects of performance. The article concludes that continued pressure from government, the public and health service users will demand on-going improvements. However, it is likely that, in an era of constrained budgets, new ways of thinking must be sought to meet rising expectations.
FONTE: Eurohealth, London, v. 16, n. 3, p.16-19, 2010.
REFERENCIA: EXWORTHY, Mark. The performance paradigm in the English NHS: potential, pitfalls, and prospects. Eurohealth, London, v. 16, n. 3, p.16-19, 2010.
40. A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2.
AUTOR(ES): World Health Organization (WHO)
ANO: 2010
RESUMO:
FONTE: Geneva: WHO, 2010. 75 p.
REFERENCIA: WORLD HEALTH ORGANIZATION. A conceptual framework for action on the social determinants of health: social determinants of health discussion paper 2. Geneva: WHO, 2010. 75 p.
41. What's measured is what matters: targets and gaming in the English public health care system.
AUTOR(ES): Gwyn Bevan; Christopher Hood
ANO: 2006
RESUMO: In the 2000s, governments in the UK, particularly in England, developed a system of governance of public services that combined targets with an element of terror. This has obvious parallels with the Soviet regime, which was initially successful but then collapsed. Assumptions underlying governance by targets represent synecdoche (taking a part to stand for a whole); and that problems of measurement and gaming do not matter. We examine the robustness of the regime of targets and terror to these assumptions using evidence from the English public health service on reported successes, problems of measurement, and gaming. Given this account, we consider the adequacy of current audit arrangements and ways of developing governance by targets in order to counter the problems we have identified.
FONTE: Public Administration, Oxford, v. 84, n. 3, p.517-538, 2006.
REFERENCIA: BEVAN, Gwyn; HOOD, Christopher. What's measured is what matters: targets and gaming in the English public health care system. Public Administration, Oxford, v. 84, n. 3, p.517-538, 2006.
42. Performance measurement for health system improvement: Experiences, challenges and prospects. Parte1.
AUTOR(ES): Peter C. Smith ; Elias Mossialos ; Irene Papanicolas
ANO: 2009
RESUMO:
FONTE: Copenhagen: World Health Organization, 2009. 225 p.
REFERENCIA: SMITH, Peter C.; MOSSIALOS, Elias; PAPANICOLAS, Irene. Performance measurement for health system improvement: experiences, challenges and prospects. Copenhagen: World Health Organization, 2009. 225 p.
43. Deprivation indices: their interpretation and use in relation to health.
AUTOR(ES): Vera Carstairs
ANO: 1995
RESUMO: STUDY OBJECTIVE: To examine the use of deprivation indices in relation to health. DESIGN: This paper reviews selected publications which illustrate the diversity of use of deprivation indices in the past decade. Most of this work is based in the major routine databases which exist in this country: the census, population, mortality, cancer register, and health service records all now incorporate a postcode identifier which permits the derivation of data at small area level, and thus the examination of health events in relation to the characteristics of that area - usually ward or postcode sector. The small area approach provides a valuable tool both in deprivation and in other epidemiological studies which examine the influence of the environment on health. SETTING: The setting is various journals and official publications. MAIN RESULTS: The link between deprivation and health has been clearly demonstrated in a number of studies, with populations living in deprived areas exhibiting levels of mortality, particularly below the age of 65, which vastly exceed those in affluent areas. In the decade 1981-91, these differentials increased in Scotland and the Northern Health Region and inequalities in health are shown to have widened. Analysis shows that particular causes of death and sites of cancer are more likely to reflect the influence of socio-economic factors. The work so far mostly shows the associations between these factors and health measures and more investigation is required into the determinants of health, which are likely to reside as much in past as in current circumstances. A measure of deprivation has proved of value in excluding the likely variation in the incidence of disease in studies directed towards determining the influence of the physical environment on populations living in the vicinity of possible harmful industrial processes. A deprivation measure has been adopted by the Department of Health as a basis for making enhanced payments to general practitioners for patients living in these areas, but the resource allocation formula for allocating funds to regional authorities has failed to incorporate such a measure in the formula. CONCLUSIONS: An area measure of deprivation has proved a valuable tool in examining differentials in health and death and is likely to prove of continuing value to health authorities in planning the delivery of health care. Future work should strive to examine the determinants of health as well as the associations, although this is unlikely to be possible through the routine databases which have provided the main basis for analysis so far.
FONTE: Journal of Epidemiology and Community Health, London, v. 45, n. 2, p.S3-S8, 1995.
REFERENCIA: CARSTAIRS, Vera. Deprivation indices: their interpretation and use in relation to health. Journal of Epidemiology and Community Health, London, v. 45, n. 2, p.S3-S8, 1995.
44. Shared Decision Making — The Pinnacle of Patient-Centered Care.
AUTOR(ES): Michael J. Barry; Susan Edgman-Levitan
ANO: 2012
RESUMO:
FONTE: The New England Journal of Medicine, Boston, v. 366, n. 9, p.780-781, 2012.
REFERENCIA: BARRY, Michael J.; EDGMAN-LEVITAN, Susan. Shared Decision Making: Centered Care. The New England Journal of Medicine, Boston, v. 366, n. 9, p.780-781, 2012.
45. Defining “Patient-Centered Medicine".
AUTOR(ES): Charles L. Bardes
ANO: 2012
RESUMO:
FONTE: The New England Journal of Medicine, Boston, v. 366, n. 9, p.782-783, 2012.
REFERENCIA: BARDES, Charles L. Defining “Patient-Centered Medicine”. The New England Journal Of Medicine, Boston, v. 366, n. 9, p.782-783, 2012.
46. Performance Improvement in Health Care — Seizing the Moment.
AUTOR(ES): David Blumenthal
ANO: 2012
RESUMO:
FONTE: The New England Journal of Medicine, Boston, v. 366, n. , p.1-3, 2012.
REFERENCIA: BLUMENTHAL, David. Performance Improvement in Health Care: seizing the moment. The New England Journal of Medicine, Boston, v. 366, n. , p.1-3, 2012.
47. Medicare Advantage — Lessons for Medicare's Future.
AUTOR(ES): Marsha Gold
ANO: 2012
RESUMO:
FONTE: The New England Journal of Medicine, Boston, v. 366, n. , p.1174-1177, 2012.
REFERENCIA: GOLD, Marsha. Medicare Advantage: lessons for medicare's future. The New England Journal of Medicine, Boston, v. 366, n. , p.1174-1177, 2012.
48. Fair Enough? Inviting Inequities in State Health Benefits.
AUTOR(ES): Jennifer Prah Ruger
ANO: 2012
RESUMO:
FONTE: The New England Journal Of Medicine, Boston, v. 366, n. 8, p.681-683, 2012.
REFERENCIA: RUGER, Jennifer Prah. Fair Enough? Inviting Inequities in State Health Benefits. The New England Journal Of Medicine, Boston, v. 366, n. 8, p.681-683, 2012.
49. What We Talk about When We Talk about Health Care Costs.
AUTOR(ES): Peter J. Neumann
ANO: 2012
RESUMO:
FONTE: The New England Journal Of Medicine, Boston, v. 366, n. 7, p.585-586, 2012.
REFERENCIA: NEUMANN, Peter J. What We Talk about When We Talk about Health Care Costs. The New England Journal Of Medicine, Boston, v. 366, n. 7, p.585-586, 2012.
50. Goal-Oriented Patient Care — An Alternative Health Outcomes Paradigm.
AUTOR(ES): David B. Reuben; Mary E. Tinetti
ANO: 2012
RESUMO:
FONTE: The New England Journal Of Medicine, Boston, v. 366, n. 9, p.777-779, 2012.
REFERENCIA: REUBEN, David B.; TINETTI, Mary E.. Goal-Oriented Patient Care: an alternative health outcomes Paradigm. The New England Journal Of Medicine, Boston, v. 366, n. 9, p.777-779, 2012.
51. The Value of Federalism in Defining Essential Health Benefits.
AUTOR(ES): Alan Weil
ANO: 2012
RESUMO:
FONTE: The New England Journal of Medicine, Boston, v. 366, n. 8, p.679-681, 2012.
REFERENCIA: WEIL, Alan. The Value of Federalism in Defining Essential Health Benefits. The New England Journal of Medicine, Boston, v. 366, n. 8, p.679-681, 2012.
52. Staging activity limitation and participation restriction in elderly community-dwelling persons according to difficulties in self-care and domestic life functioning.
AUTOR(ES): Margaret G. Stineman; John T. Henry-Sá nchez; Jibby E. Kurichi; Qiang Pan; Dawei Xie; Debra Saliba; Zi Zhang; Joel E. Streim
ANO: 2012
RESUMO: Objective—This study aimed to describe the conceptual foundation and development of an activity limitation and participation restriction staging system for community-dwelling people 70 yrs or older according to the severity and types of self-care (activities of daily living [ADLs]) and domestic life (instrumental ADLs (IADLs)) limitations experienced. Design—Data from the second Longitudinal Study of Aging (N = 9447) were used to develop IADL stages through the analyses of self- and proxy-reported difficulties in performing IADLs. An analysis of activity limitation profiles identified hierarchical thresholds of difficulty that defined each stage. IADL stages are combined with ADL stages to profile status for independent living. Results—IADL stages define five ordered thresholds of increasing activity limitations and a “not relevant” stage for those who normally have someone else do those activities. Approximately 42% of the population experience IADL limitations. To achieve a stage, a person must meet or exceed stage-specific thresholds of retained functioning defined for each activity. Combined ADL andIADL stages de-fine 29 patterns of activity limitations expressing the individual’s potential for participating in life situations pertinent to self-care and independent community life. Conclusions—ADL and IADL stages can serve to distinguish between groups of people according to both severity and the types of limitations experienced during home or outpatient assessments, in population surveillance, and in research.
FONTE: American Journal Of Physical Medicine & Rehabilitation, Baltimore, v. 91, n. 2, p.126-140, 2012.
REFERENCIA: STINEMAN, Margaret G. et al. Staging activity limitation and participation restriction in elderly community-dwelling persons according to difficulties in self-care and domestic life functioning. American Journal Of Physical Medicine & Rehabilitation, Baltimore, v. 91, n. 2, p.126-140, 2012.
53. Data and statistics.
AUTOR(ES): World Health Organization (WHO)
ANO: 2005
RESUMO:
FONTE:
REFERENCIA: WORLD HEALTH ORGANIZATION (WHO). Data and statistics. Disponível em: <http://www.who.int/research/en/>. Acesso em: 02 out. 2010.
54. Essential Surgical Care: manual.
AUTOR(ES): World Health Organization (WHO)
ANO: 2004
RESUMO:
FONTE:
REFERENCIA: WORLD HEALTH ORGANIZATION (WHO). Essential Surgical Care: manual. Disponível em: <http://www.steinergraphics.com/surgical/index.html>. Acesso em: 02 out. 2010.
55. Fratura do Colo Femoral no Idoso: osteossíntese e artropla.
AUTOR(ES): Sociedade Brasileira de ortopedia e traumatologia.Colé gio Brasileiro de Radiologia.
ANO: 2007
RESUMO:
FONTE: Brasília, DF: Associação Médica Brasileira; Conselho Federal de Medicina, 2007. 11 p.
REFERENCIA: SOCIEDADE BRASILEIRA DE ORTOPEDIA E TRAUMATOLOGIA. COLEGIO BRASILEIRO DE RADIOLOGIA. Fratura do Colo Femoral no Idoso: osteossíntese e artropla. Brasília, DF: Associação Médica Brasileira; Conselho Federal de Medicina, 2007. 11 p. Projeto Diretrizes.
56. Os centros renais no Brasil. Censo 2008.
AUTOR(ES): Sociedade Brasileira de Nefrologia
ANO: 2008
RESUMO:
FONTE:
REFERENCIA: SOCIEDADE BRASILEIRA DE NEFROLOGIA. Os centros renais no Brasil: censo 2008.Disponível em: <http://www.sbn.org.br/index.php?>. Acesso em: 7 dez. 2010.
57. As doenças transmissíveis no Brasil: tendências e desafios para o Sistema Único de Saúde
AUTOR(ES): Jarbas Barbosa da Silva Junior
ANO: 2009
RESUMO:
FONTE: Brasília, DF: Ministério da Saúde, 2009. p. 281-310.
REFERENCIA: SILVA JUNIOR, Jarbas Barbosa da. As doenças transmissíveis no Brasil: tendências e desafios para o Sistema Único de Saúde. In: BRASIL. MINISTÉRIO DA SAÚDE. SECRETARIA DE VIGILANCIA EM SAUDE. DEPARTAMENTO DE ANALISE DE SITUAÇAO DE SAUDE. Saúde Brasil 2008: 20 anos de sistema único de saúde (SUS) no Brasil. Brasília, DF: Ministério da Saúde, 2009. p. 281-310.
58. Management of hip fracture in older people: a national clinical guideline.
AUTOR(ES): Scottish Intercollegiate Guidelines Network
ANO: 2009
RESUMO:
FONTE: Edinburgh: NHS, 2009. 49 p.
REFERENCIA: SCOTTISH INTERCOLLEGIATE GUIDELINES NETWORK. Management of hip fracture in older people: a national clinical guideline. Edinburgh: NHS, 2009. 49 p.
59. The Performance of Local Health Departments: A Review of the Literature.
AUTOR(ES): Paul Campbell Erwin
ANO: 2008
RESUMO: Local health department (LHD) performance measurement provides an opportunity to link inputs, outputs, and outcomes in a manner that should facilitate quality improvement. Since inputs flow from LHDs that vary substantially in size, organization, funding, and other characteristics, it is Reasonable to assume that these variable inputs may affect LHD performance or outcomes. Documenting this is becoming increasingly important as LHD accreditation is being seen as one approach to standardization of inputs. This article provides a literature Review of LHD performance measurement and attempts to identify LHD inputs (or characteristics) that impact performance or outcomes. The literature Review identified 23 articles on LHD performance, published in peer-reviewed journals since the 1988 Report on the Future of Public Health. The most common findings Related to LHD size, jurisdictional size, and funding: LHDs with larger staffs, serving populations of more than 50 000 persons, and with higher funding per capita were more often higher performing. Other notable characteristics of higher-performing LHDs included greater community interaction, having a director with higher academic degrees, and leadership functioning within a management team. Prospective studies that examine the linkages among LHD performance measurement, accreditation, and outcomes will be important in achieving performance improvement over time.
FONTE: Journal Of Public Health Management & Practice, Frederick, v. 14, n. 2, p.E9-E18, 2008.
REFERENCIA: ERWIN, Paul Campbell. The Performance of local health departments: a review of the literature. Journal Of Public Health Management & Practice, Frederick, v. 14, n. 2, p.E9-E18, 2008.
60. Quality of Care in U.S. Hospitals as Reflected by Standardized Measures, 2002–2004.
AUTOR(ES): Scott C. Williams; Stephen P. Schmaltz; David J. Morton; Richard G. Koss; Jerod M. Loeb
ANO: 2005
RESUMO: background: In July 2002, the Joint Commission on Accreditation of Healthcare Organizations implemented standardized performance measures that were designed to track the performance of accredited hospitals and encourage improvement in the quality of health care. methods : We examined hospitals’ performance on 18 standardized indicators of the quality of care for acute myocardial infarction, heart failure, and pneumonia. One measure assessed a clinical outcome (death in the hospital after acute myocardial infarction), and the other 17 measures assessed processes of care. Data were collected over a two-year period in more than 3000 accredited hospitals. All participating hospitals received quarterly feedback in the form of comparative reports throughout the study. results: Descriptive analysis revealed a significant improvement (P<0.01) in the performance of U.S. hospitals on 15 of 18 measures, and no measure showed a significant deterioration. The magnitude of improvement ranged from 3 percent to 33 percent during the eight quarters studied. For 16 of the 17 process-of-care measures, hospitals with a low level of performance at baseline had greater improvements over the subsequent two years than hospitals with a high level of performance at baseline. conclusions: Over a two-year period, we observed consistent improvement in measures reflecting the process of care for acute myocardial infarction, heart failure, and pneumonia. Both quantitative and qualitative research are needed to explore the reasons for these improvements.
FONTE: The New England Journal Of Medicine, Boston, v. 353, n. 3, p.255-264, 2005.
REFERENCIA: WILLIAMS, Scott C. et al. Quality of Care in U.S. Hospitals as Reflected by Standardized Measures, 2002–2004. The New England Journal Of Medicine, Boston, v. 353, n. 3, p.255-264, 2005.
61. Institutional and Economic Determinants of Public Health System Performance.
AUTOR(ES): Glen P. Mays; Megan C. McHugh; Kyumin Shim; Natalie Perry; Dennis Lenaway; Paul K. Halverson; Ramal Moonesinghe
ANO: 2006
RESUMO: Objectives. Although a growing body of evidence demonstrates that availability and quality of essential public health services vary widely across communities, relatively little is known about the factors that give rise to these variations. We examined the association of institutional, financial, and community characteristics of local public health delivery systems and the performance of essential services. Methods. Performance measures were collected from local public health systems in 7 states and combined with secondary data sources. Multivariate, linear, and nonlinear regression models were used to estimate associations between system characteristics and the performance of essential services. Results. Performance varied significantly with the size, financial resources, and organizational structure of local public health systems, with some public health services appearing more sensitive to these characteristics than others. Staffing levels and community characteristics also appeared to be related to the performance of selected services. Conclusions. Reconfiguring the organization and financing of public health systems in some communities—such as through consolidation and enhanced intergovernmental coordination—may hold promise for improving the performance of essential services.
FONTE: American Journal Of Public Health, New York, v. 96, n.3, p.523-531, 2006.
REFERENCIA: MAYS, Glen P. et al. Institutional and Economic Determinants of Public Health System Performance. American Journal Of Public Health, New York, v. 96, n.3, p.523-531, 2006.
62. HIV/Aids no Sistema de Saúde: respostas e desafios à epidemiologia no Brasil.
AUTOR(ES): Maria Cristina Pimenta; Ivo Brito
ANO: 2009
RESUMO:
FONTE: Brasília: Ministério da Saúde, 2009. p. 131-155.
REFERENCIA: PIMENTA, Maria Cristina; BRITO, Ivo. HIV/Aids no Sistema de Saúde: respostas e desafios à epidemiologia no Brasil. In: BRASIL. MINISTÉRIO DA SAÚDE. SECRETARIA DE VIGILÂNCIA EM SAÚDE. Saúde Brasil 2008: 20 anos de sistema unico de saude (SUS) no Brasil. Brasília: Ministério da Saúde, 2009. p. 131-155.
63. Neonatal Tetanus.Elimination: field guide.
AUTOR(ES): Pan American Health Organization
ANO: 2005
RESUMO:
FONTE: Washington: Pan American Health Organization, 2005.
REFERENCIA: PAN AMERICAN HEALTH ORGANIZATION. Neonatal Tetanus.Elimination: field guide. 2. ed. Washington: Pan American Health Organization, 2005. (Scientific and Technical Publication No. 602).
64. Increasing the Same day Care Rate for Hernia Repairs.
AUTOR(ES): NHS (Scotland) Institute for Innovation and Improvement
ANO: 2010
RESUMO:
FONTE:
REFERENCIA: NHS(SCOTLAND). INSTITUTE FOR INNOVATION AND IMPROVEMENT. Increasing the Same day Care Rate for Hernia Repairs. Disponível em: <http://uat.qihub.scot.nhs.uk/quality-healthcare-resources/continuous-improvement-in-healthcare/case-studies/search-results/case-study.aspx?id=51>. Acesso em: 05 maio 2010.
65. What is appropriate care?
AUTOR(ES): C.D. Naylor
ANO: 1998
RESUMO:
FONTE: The New England Journal Of Medicine, Boston, v. 338, n. 26, p.1918-1920, 1998.
REFERENCIA: NAYLOR, C.D.. What is appropriate care? The New England Journal Of Medicine, Boston, v. 338, n. 26, p.1918-1920, 1998.
66. Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher PNDS 2006. Dimensões do Processo Reprodutivo e da Saúde da Criança.
AUTOR(ES): Ministé rio da Saú de. Centro Brasileiro de Aná lise e Planejamento
ANO: 2009
RESUMO:
FONTE: Brasília: Ministério da Saúde, Centro Brasileiro de Análise e Planejamento, 2009. 298 p.
REFERENCIA: BRASIL. MINISTÉRIO DA SAÚDE.CENTRO BRASILEIRO DE ANÁLISE E PLANEJAMENTO. Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher PNDS 2006: Dimensões do Processo Reprodutivo e da Saúde da Criança. Brasília: Ministério da Saúde, Centro Brasileiro de Análise e Planejamento, 2009. 298 p. (Série G. Estatística e Informação em Saúde).
67. Prenatal Care: CDC’S public health surveillance for women, infants, and children.
AUTOR(ES): John L. Kiely; Michael D. Kogan
ANO: 1994
RESUMO:
FONTE: Atlanta: CDC's Maternal & Child Health Monograph, 1994. 14 p.
REFERENCIA: KIELY, John L.; KOGAN, Michael D.. Prenatal Care: CDC’S public health surveillance for women, infants, and children. Atlanta: CDC's Maternal & Child Health Monograph, 1994. 14 p.
68. Epidemiology of Quality.
AUTOR(ES): Vahe Kazandjian
ANO: 1995
RESUMO:
FONTE: Aspen: An Aspen Publication, 1995. 314 p.
REFERENCIA: KAZANDJIAN, Vahe. Epidemiology of Quality. Aspen: An Aspen Publication, 1995. 314 p.
69. IDF Diabetes Atlas.
AUTOR(ES): International Diabetes Federation
ANO: 2010
RESUMO:
FONTE:
REFERENCIA: INTERNATIONAL DIABETES FEDERATION. IDF Diabetes Atlas. Disponível em: <http://www.idf.org/>. Acesso em: 05 maio 2010.
70. Mental Health and Labor Markets Productivity Loss and Restoration.
AUTOR(ES): Richard G. Frank; Catherine Koss
ANO: 2005
RESUMO:
FONTE: Washington: Disease Control Priorities Project, 2005. 35 p. Working Paper No. 38.
REFERENCIA: FRANK, Richard G.; KOSS, Catherine. Mental Health and Labor Markets Productivity Loss and Restoration. Washington: Disease Control Priorities Project, 2005. 35 p. Working Paper No. 38.
71. Teoria De La Justicia.
AUTOR(ES): John Rawls
ANO: 1985
RESUMO: A Teoria da Justiça, de 1971, o alinhou entre os grandes pensadores sociais do século 20. Um legítimo sucessor de uma linhagem ideológica que origina-se em Locke. Os temas que hoje provocam polêmica, tal como o sistema de cotas para os negros nas universidades e nos cargos públicos, deriva diretamente da concepção de sociedade justa estabelecida por Rawls.
FONTE: México: Fondo de Cultura Economica, 1985. 49 p.
REFERENCIA: RAWLS, John. Teoria de la justicia. México: Fondo de Cultura Economica, 1985. 49 p.
72. Russian Federation:Health system review.
AUTOR(ES): Larisa Popovich; Elena Potapchik; Sergey Shishkin; Erica Richardson; Alexandra Vacroux; Benoit Mathivet
ANO: 2011
RESUMO:
FONTE: Copenhagen, v. 13, n. 7, p.1-190, 2011.
REFERENCIA: POPOVICH, Larisa et al. Russian Federation: health system review. European Observatory on Health Systems and Policies, Copenhagen, v. 13, n. 7, p.1-190, 2011.
73. Indicadores de desempenho em serviço de enfermagem hospitalar: revisão integrativa.
AUTOR(ES): Graziela Caldana; Carmen Silvia Gabriel; André a Bernardes; Yolanda Dora Martinez É vora
ANO: 2011
RESUMO: Uma maneira efetiva de avaliação do desempenho dos serviços de enfermagem e de sua gestão é através da utilização de indicadores que demonstrem sua evolução ao longo do tempo, permitindo a comparação com referenciais internos e externos. Este trabalho teve como objetivo destacar e analisar por meio de uma revisão integrativa, indicadores que avaliam qualidade da assistência de enfermagem nos serviços hospitalares. Para a coleta de dados utilizou-se as bases de dados: MEDLINE, LILACS, CINAHL, COCHRANE e BDENF. A amostra deste estudo constituiu-se de 15 artigos publicados no período de 1998 a 2009. Após análise dos artigos incluídos na revisão os resultados dos estudos foram classificados segundo a tríade proposta por Donabedian: Indicadores de processos, estrutura e resultados. Os artigos analisados apresentam uma ampla gama de indicadores que podem subsidiar os enfermeiros na avaliação da qualidade da assistência de enfermagem no âmbito hospitalar.
FONTE: Revista da Rede de Enfermagem do Nordeste, Fortaleza, v. 12, n. 1, p.189-197, 2011.
REFERENCIA: CALDANA, Graziela et al. Indicadores de desempenho em serviço de enfermagem hospitalar: revisão integrativa. Revista da Rede de Enfermagem do Nordeste, Fortaleza, v. 12, n. 1, p.189-197, 2011.
74. Avaliação do gerenciamento de resíduos de serviços de saúde por meio de indicadores de desempenho.
AUTOR(ES): Katia Sakihama Ventura; Luisa Fernanda Ribeiro Reis; Angela Maria Magosso Takayanagui
ANO: 2010
RESUMO: O presente trabalho propôs um modelo de avaliação do gerenciamento de RSS em estabelecimentos de saúde, com o uso de indicadores de desempenho. A proposta consistiu em identificar esses indicadores a partir dos dados qualitativos obtidos por entrevistas, cujas respostas foram associadas a escalas numéricas e inseridas no programa Statistica (StatSoft®) para efetuar a análise fatorial (AF). Para isso, foi elaborado um roteiro de entrevista, especialmente preparado com 29 variáveis de observação e aplicado a 98 profissionais da saúde da Santa Casa de Misericórdia de São Carlos (SP). Os indicadores de desempenho foram submetidos ao julgamento de especialistas para a sua classificação em ordem de importância, com o uso da matriz de avaliação do método AHP (Analytic Hierarchy Process). Por fim, foi composto um índice global, que possibilitou a avaliação geral da situação investigada, em uma escala de zero a um, indicando que ações de melhoria para esse gerenciamento devem ser desenvolvidas. Este trabalho foi desenvolvido a fim de estruturar um modelo de avaliação de desempenho por meio da identificação de indicadores qualitativos, auxiliando na eficiência do processo de gerenciamento de resíduos em ambientes de saúde.
FONTE: Engenharia Sanitária e Ambiental., Rio de Janeiro, v. 12, n. 1, p.167-176, 2010.
REFERENCIA: VENTURA, Katia Sakihama; REIS, Luisa Fernanda Ribeiro; TAKAYANAGUI, Angela Maria Magosso. Avaliação do gerenciamento de resíduos de serviços de saúde por meio de indicadores de desempenho. Engenharia Sanitária e Ambiental, Rio de Janeiro, v. 12, n. 1, p.167-176, 2010.
75. Avaliação de desempenho de serviços de saúde.
AUTOR(ES): Antonio Carlos de Azevedo
ANO: 1991
RESUMO: A partir da literatura recente (até 1988) a respeito da avaliação de serviços de saúde em geral e do desempenho hospitalar em particular, destacam-se os diferentes aspectos conceituais e metodológicos envolvidos, começando pelas primeiras tentativas no seio do Colégio Americano de Cirurgiões, passando pela criação e evolução da Comissão Conjunta de Acreditação de Hospitais americana, até os esforços e elaborações conceituais e metodológicas mais recentes. São destacados a metodologia dos grupos diagnósticos homogêneos ("diagnosis related groups" ou "DRGs") e os indicadores de gravidade ("severity of illness"). É comentada a evolução desse incipiente campo de conhecimento e de prática no ambiente nacional. São comentadas as origens do recente interesse internacional a respeito do problema, ou seja, o aumento generalizado de custos dos serviços de saúde, crescente aumento de demandas judiciais em alguns países e ainda o acentuado incremento de complexidade dos atos em muitas especialidades. Destacam-se as fontes de informação correntemente utilizadas no processo, ou seja, a observação direta (estudos caso/controle), os prontuários médicos e os instrumentos-resumo, freqüentemente utilizados para remuneração do atendimento. Mencionam-se as profundas influências na prática de saúde que o processo de avaliação tem introduzido, particularmente a padronização de procedimentos, o estadiamento de agravos, os estudos de trajetória, os relacionados a situações traçadoras ("tracers") e a alternativa que mais tem influenciado a prática de situações complexas de saúde, que são os protocolos diagnóstico-terapêutico s já amplamente utilizados em algumas áreas como a do tratamento de câncer, inclusive no Brasil
FONTE: Revista de Saúde Pública, São Paulo, v. 25, n. 1, p.64-71, 1991.
REFERENCIA: AZEVEDO, Antonio Carlos de. Avaliação de desempenho de serviços de saúde. Revista de Saúde Pública, São Paulo, v. 25, n. 1, p.64-71, 1991.
76. Programa Nacional de Avaliação de Serviços de Saúde.Resultado do processo avaliativo 2004 -2006
AUTOR(ES): Programa Nacional de Avaliaç ã o de Serviç os de Saú de
ANO: 2007
RESUMO:
FONTE: Brasília: Programa Nacional de Avaliação de Serviços de Saúde(PNASS), 2007. 84 p.
REFERENCIA: BRASIL. MINISTÉRIO DA SAÚDE. SECRETARIA DE ATENÇÃO À SAÚDE. Programa Nacional de Avaliação de Serviços de Saúde: resultado do processo avaliativo 2004 -2006. Brasília: Programa Nacional de Avaliação de Serviços de Saúde(PNASS), 2007. 84 p.
77. Pesquisa Nacional de Demografia e Saúde (PNDS).
AUTOR(ES): BEMFAM (Sociedade Civil Bem-Estar Familiar no Brasil)
ANO: 1997
RESUMO:
FONTE: Rio de Janeiro: Programa de Pesquisas de Demografia e Saúde (DHS), 1997. 147 p.
REFERENCIA: BEMFAM (SOCIEDADE CIVIL BEM-ESTAR FAMILIAR NO BRASIL). Pesquisa Nacional de Demografia e Saúde (PNDS). Rio de Janeiro: Programa de Pesquisas de Demografia e Saúde (DHS), 1997. 147 p.
78. A new perspective on the health of Canadians: a working document.
AUTOR(ES): Marc Lalond; Canada Dept. of National Health and Welfare.
ANO: 1974
RESUMO:
FONTE: Ottawa: Ministry Of Supply And Services Canada, 1974. 77 p
REFERENCIA: LALOND, Marc; Canada Dept. Of National Health and Welfare. A new perspective on the health of Canadians: a working document. Ottawa: Ministry Of Supply And Services Canada, 1974. 77 p
79. Population-based evidence of a strong decline in the prevalence of smokers in Brazil (1989–2003).
AUTOR(ES): Carlos Augusto Monteiro; Tania Maria Cavalcanteb; Erly Catarina Moura; Rafael Moreira Claro; Cé lia Landmann Szwarcwaldc
ANO: 2007
RESUMO:
FONTE: Bulletin Of The World Health Organization, Geneva, v. 85, n. 7, p.527-534, 2007.
REFERENCIA: MONTEIRO, Carlos Augusto et al. Population-based evidence of a strong decline in the prevalence of smokers in Brazil (1989–2003). Bulletin Of The World Health Organization, Geneva, v. 85, n. 7, p.527-534, 2007.
80. The concept of prevention: a good idea gone astray?
AUTOR(ES): B. Starfield; J. Hyde; J. Gé rvas, I. Heath
ANO: 2008
RESUMO: Over time, the definition of prevention has expanded so that its meaning in the context of health services is now unclear. As risk factors are increasingly considered to be the equivalent of "diseases" for purposes of intervention, the concept of prevention has lost all practical meaning. This paper reviews the inconsistencies in its utility, and suggests principles that it should follow in the future: a population orientation with explicit consideration of attributable risk, the setting of priorities based on reduction in illness and avoidance of adverse effects, and the imperative to reduce inequities in health.
FONTE: Journal of Epidemiology and Community Health, London, v. 62, n. 7, p.580-583, 2008.
REFERENCIA: STARFIELD, B. et al. The concept of prevention: a good idea gone astray?. Journal of Epidemiology and Community Health, London, v. 62, n. 7, p.580-583, 2008.
81. Defining comorbidity: implications for understanding health and health services.
AUTOR(ES): Jose M. Valderas; Barbara Starfield; Bonnie Sibbald; Chris Salisbury; Martin Roland
ANO: 2009
RESUMO: Comorbidity is associated with worse health outcomes, more complex clinical management, and increased health care costs. There is no agreement, however, on the meaning of the term, and related constructs, such as multimorbidity, morbidity burden, and patient complexity, are not well conceptualized. In this article, we review definitions of comorbidity and their relationship to related constructs. We show that the value of a given construct lies in its ability to explain a particular phenomenon of interest within the domains of (1) clinical care, (2) epidemiology, or (3) health services planning and financing. Mechanisms that may underlie the coexistence of 2 or more conditions in a patient (direct causation, associated risk factors, heterogeneity, independence) are examined, and the implications for clinical care considered. We conclude that the more precise use of constructs, as proposed in this article, would lead to improved research into the phenomenon of ill health in clinical care, epidemiology, and health services.
FONTE: Annals Of Family Medicine, Leawood, v. 7, n. 4, p.357-363, 2009.
REFERENCIA: VALDERAS, Jose M. et al. Defining comorbidity: implications for understanding health and health services. Annals Of Family Medicine, Leawood, v. 7, n. 4, p.357-363, 2009.
82. Revisiting Robinson: The perils of individualistic and ecologic fallacy.
AUTOR(ES): S. V. Subramanian; Kelvyn Jones; Afamia Kaddour; Nancy Krieger
ANO: 2009
RESUMO: Background W S Robinson made a seminal contribution by demonstrating that correlations for the same two variables can be different at the individual and ecologic level. This study reanalyzes and historically situates Robinson's influential study that laid the foundation for the primacy of analyzing data at only the individual level. Methods We applied a binomial multilevel logistic model to analyse variation in illiteracy as enumerated by the 1930 US. Census (the same data as used by Robinson). The outcome was log odds of being illiterate, while predictors were race/nativity (‘native whites’, ‘foreign-born whites’ and ‘negroes’) at the individual-level, and presence of Jim Crow segregation laws for education at the state-level. We conducted historical research to identify the social and scientific context within which Robinson's study was produced and favourably received. Results Empirically, the substantial state variations in illiteracy could not be accounted by the states' race/nativity composition. Different approaches to modelling state-effects yielded considerably attenuated associations at the individual-level between illiteracy and race/nativity. Furthermore, state variation in illiteracy was different across the race/nativity groups, with state variation being largest for whites and least for foreign-born whites. Strong effects of Jim Crow education laws on illiteracy were observed with the effect being strongest for blacks. Historically, Robinson's study was consonant with the post-World War II ascendancy of methodological individualism. Conclusion Applying a historically informed multilevel perspective to Robinson's profoundly influential study, we demonstrate that meaningful analysis of individual-level relationships requires attention to substantial heterogeneity in state characteristics. The implication is that perils are posed by not only ecological fallacy but also individualistic fallacy. Multilevel thinking, grounded in historical and spatiotemporal context, is thus a necessity, not an option.
FONTE: International Journal Of Epidemiology, London, v. 38, n. 2, p.1-19, 2009.
REFERENCIA: SUBRAMANIAN, S. V. et al. Revisiting Robinson: the perils of individualistic and ecologic fallacy. International Journal Of Epidemiology, London, v. 38, n. 2, p.1-19, 2009.
83. Condicionantes socioeconômicos e geográficos do acesso à mamografia no Brasil, 2003-2008.
AUTOR(ES): Evangelina Xavier Gouveia de Oliveira; Rejane Sobrino Pinheiro; Enirtes Caetano Praates Melo; Marilia Sá Carvalho
ANO: 2011
RESUMO: Este estudo examinou os efeitos de características da população e geográficas na chance de mamografia, no Brasil em 2003 e 2008. A partir do Suplemento Saúde da Pesquisa Nacional por Amostra de Domicílios, foram analisados os padrões de mamografia em mulheres com 25 anos ou mais, por meio de razão de prevalências, e em mulheres com 40 anos ou mais, por meio de regressão logística multivariada, incluindo o local de residência e a distribuição geográfica da oferta. Entre as mulheres com 50-69 anos, 54,6% relataram ter feito mamografia, em 2003, e 71,5%, em 2008. A chance de realização do exame é maior entre as de 50 a 69 anos, aumenta com a renda familiar e escolaridade, dentre as casadas, para as que consultaram médico e têm plano de saúde. Residir em área metropolitana triplica a chance de mamografia. Comparado com a região Norte, residentes das demais regiões têm chances maiores e a distância influencia negativamente a realização do exame. No período, a cobertura aumentou na faixa etária alvo da política nacional, com redução das desigualdades de renda e de escolaridade. A ampliação do acesso parece mais ligada às políticas de aumento de renda e inclusão social, e à ampliação da oferta de exames na rede pública e conveniada, do que ao aumento do número de mamógrafos.
FONTE: Ciência & Saúde Coletiva, Rio de Janeiro, v. 16, n. 9, p.3649-3664, 2011.
REFERENCIA: OLIVEIRA, Evangelina Xavier Gouveia de et al. Condicionantes socioeconômicos e geográficos do acesso à mamografia no Brasil, 2003-2008. Ciência & Saúde Coletiva, Rio de Janeiro, v. 16, n. 9, p.3649-3664, 2011.
84. The NHS Performance Framework: implementation guidance 2010/11.
AUTOR(ES): Department of Health
ANO: 2010
RESUMO:
FONTE: United Kingdom: Department Of Health, 2010.
REFERENCIA: DEPARTMENT OF HEALTH. The NHS Performance Framework: implementation guidance 2010/11. United Kingdom: Department Of Health, 2010.
85. Diarrhoea: Why children are still dying and what can be done.
AUTOR(ES): The United Nations Children’s Fund (UNICEF); World Health Organization (WHO)
ANO: 2009
RESUMO:
FONTE: Geneva: World Health Organization, 2009. 68 p.
REFERENCIA: THE UNITED NATIONS CHILDREN’S FUND (UNICEF); WORLD HEALTH ORGANIZATION (WHO). Diarrhoea: Why children are still dying and what can be done. Geneva: World Health Organization, 2009. 68 p.
86. World Health Statistics 2009.
AUTOR(ES): World Health Organization
ANO: 2009
RESUMO:
FONTE: Geneva: World Health Organization, 2009. 149 p.
REFERENCIA: WORLD HEALTH ORGANIZATION. World Health Statistics 2009. Geneva: World Health Organization, 2009. 149 p.
87. Asking about access: challenges for surveys in a changing healthcare environment.
AUTOR(ES): Judith D. Kasper
ANO: 1998
RESUMO:
FONTE: Health Services Research, Chicago, v. 335, n. 3, p.715-766, 1998.
REFERENCIA: KASPER, Judith D.. Asking about access: challenges for surveys in a changing healthcare environment. Health Services Research, Chicago, v. 335, n. 3, p.715-766, 1998.
88. Healthy Canadians: A Federal Report on Comparable Health Indicators 2008.
AUTOR(ES): Health Canada.
ANO: 2008
RESUMO:
FONTE: Ottawa: Health Canada, 2008. 112 p.
REFERENCIA: HEALTH CANADA. Healthy Canadians: a federal report on comparable health indicators 2008. Ottawa: Health Canada, 2008. 112 p.
89. Health Survey for England - 2009: Trend tables.
AUTOR(ES): THE NHS INFORMATION CENTRE.
ANO: 2010
RESUMO:
FONTE: The NHS Information Center For Health and Social, 2010. 14 p.
REFERENCIA: THE NHS INFORMATION CENTRE. Health Survey for England - 2009: trend tables. The NHS Information Center For Health and Social, 2010. 14 p.
90. Summary of Findings. 7 chapter.
AUTOR(ES): Jack V. Tu; S.P. Pinfold; Andreas Laupacis; P. McColgan
ANO: 2005
RESUMO:
FONTE: Toronto: ICES Atlas, 2005. Cap. 7, p. 137-161.
REFERENCIA: TU, Jack V. et al. Summary of Findings. In: TU, Jack V. et al. Access to health services in Ontario. Toronto: ICES Atlas, 2005. Cap. 7, p. 137-161.
91. Cataract Surgery. 4 chapter.
AUTOR(ES): Chaim M. Bell; Wendy V. Hatch; Geta Cernat; Pamela M. Slaughter; Shaun Singer; Jack V. Tu
ANO: 2005
RESUMO:
FONTE: Toronto: ICES Atlas, 2005. Cap. 4, p. 71-90.
REFERENCIA: BELL, Chaim M. et al. Cataract Surgery. In: TU, Jack V.; LAUPACIS, Andreas; McCOLGAN, P.. Access to health services in Ontario. Toronto: ICES Atlas, 2005. Cap. 4, p. 71-90.
92. Overview. 1 chapter.
AUTOR(ES): Jack V. Tu; Andreas Laupacis
ANO: 2005
RESUMO:
FONTE: Toronto: ICES Atlas, 2005. Cap. 1, p. 1-8.
REFERENCIA: TU, Jack V.; LAUPACIS, Andreas. Overview. In: TU, Jack V.; LAUPACIS, Andreas; McCOLGAN, P.. Access to health services in Ontario. Toronto: ICES Atlas, 2005. Cap. 1, p. 1-8.
93. The concept of appropriateness in patient care.
AUTOR(ES): Virginia A. Sharpe; Alan I. Faden
ANO: 1998
RESUMO:
FONTE: New York: Cambridge University Press, 1998. p. 213-229.
REFERENCIA: SHARPE, Virginia Ashby; FADEN, Alan I.. The concept of appropriateness in patient care. In: SHARPE, Virginia Ashby; FADEN, Alan I.. Medical Harm: historical, conceptual and ethical dimensions of iatrogenic illness. New York: Cambridge University Press, 1998. p. 213-229.
94. Access to health care: taking into account health systems complexity.
AUTOR(ES): Dina Balabanova; Justin Parkhurst; Martin McKee; Barbara McPake
ANO: 2006
RESUMO: The paper contributes to the understanding of access to care in low and middle-income settings. It synthesizes findings from a linked series of studies on user and provider beliefs and practices. Existing theoretical frameworks often conceptualize access as a one-stop contact with the health system, obstructed by a range of obstacles. These fail to address the complexities involved in accessing health services; including non-linear relationships, continuums of time and skills needed in care provision, the role of communities in mediating member’s access, and the dynamic interaction between patients and providers. We suggest an approach to conceptualizing access taking uncertainty and complexity into account - addressing the continuous nature of treatment, the diversity of barriers at each stage, and the dynamic provider-patient interaction in context.
FONTE: Health Systems Development Programme, 2006. 36 p.
REFERENCIA: BALABANOVA, Dina et al. Access to health care: taking into account health systems complexity. Health Systems Development Programme, 2006. 36 p.
95. What can health services contribute to the reduction of inequalities in health?
AUTOR(ES): Martin McKee
ANO: 2002
RESUMO: Policies to reduce inequalities in health are needed in many different settings, one of which is the healthcare setting. This paper, drawing on the conclusions of the Copenhagen conference, explores the contribution that such policies can make within the healthcare system. In doing so it examines four themes. It begins by exploring the contribution that healthcare makes to health. It challenges the widely held view that this contribution is small, arguing that there have been major advances in the effectiveness of medical care and the use of evidence-based healthcare, so that interventions of proven effectiveness are increasingly delivered to those who will benefi t. Unfortunately, there is growing evidence that the benefi ts of modern healthcare do not benefi t all groups equally. Thus, there is an unfi nished agenda in many countries to enhance the equitable distribution of access to effective healthcare. Second, it explores the dynamic relationship between illness and poverty and, specifi cally, the impoverishing nature of illness in the absence of effective mechanisms to ensure solidarity and to provide social safety nets. It identifi es how all elements within a healthcare system have a part to play. Those responsible for healthcare fi nancing should ensure that funds are obtained in an equitable manner. Those who provide healthcare can do much to promote access for the disadvantaged and to use their facilities to promote health as well as cure disease. Third, it considers the specifi c needs of disadvantaged populations, and especially those whose needs are least visible, such as illegal migrants. It concludes by reviewing the need for better information to document the scale of inequalities, to evaluate interventions designed to reduce them, and to disseminate evidence of good practice.
FONTE: Scandinavian Journal Of Public Health, Basingstoke, v. 30, n. 59, p.54-58, 2002. Suplemento.
REFERENCIA: MCKEE, Martin. What can health services contribute to the reduction of inequalities in health? Scandinavian Journal Of Public Health, Basingstoke, v. 30, n. 59, p.54-58, 2002. Suplemento.
96. Euro Observer.
AUTOR(ES): Euro Observer.
ANO: 2006
RESUMO:
FONTE: Denmark: The Health Policy Bulletin Of The European Observatory On Health Systems and Policies, v. 8, n. 2, 2006.
REFERENCIA: EURO OBSERVER. Denmark: The Health Policy Bulletin Of The European Observatory On Health Systems and Policies, v. 8, n. 2, 2006.
97. Up the garden path and over the edge: where might health-seeking behaviour take us?
AUTOR(ES): Sara Mackian; Nafisa Bedri; Hermione Lovel
ANO: 2004
RESUMO: The concept of health-seeking behaviour continues to permeate the development literature, and this paper reviews the main approaches. However, it also suggests that health-seeking behaviour is a somewhat over-utilized and under-theorized tool. Although it remains a valid tool for rapid appraisal of a particular issue at a particular time, it is of little use as it stands to explore the wider relationship between populations and health systems development. If we wish to move the debate into new and more fruitful arenas, we need to develop a tool for understanding how populations engage with health systems, rather than using health-seeking behaviour as a tool for describing how individuals engage with services. The paper suggests one way in which we might start to frame the debate, using reflexive communities and social capital as key theoretical and analytical concepts.
FONTE: Health Policy and Planning, Oxford, v. 19, n. 3, p.137-146, 2004.
REFERENCIA: MACKIAN, Sara; BEDRI, Nafisa; LOVEL, Hermione. Up the garden path and over the edge: where might health-seeking behaviour take us?. Health Policy and Planning, Oxford, v. 19, n. 3, p.137-146, 2004.
98. Using health status to measure NHS performance: another step into the dark for the health reform in England.
AUTOR(ES): J. M. Valderas; R. Fitzpatrick; M. Roland
ANO: 2011
RESUMO: The National Health Service in England is moving away from targets based on processes of care and focusing on patient outcomes. This vision is operationalised in the recently published NHS Outcomes Framework, which includes the generalised use of Patient Reported Outcomes (health status and quality of life) as measures of population health at the provider level. This is the first time that such a bold initiative is attempted in the UK and it is not without risks. In this article we elaborate on our experience on the use of Patient Reported Outcomes and identify challenges and likely implications of this approach and suggest less disruptive alternatives.
FONTE:
REFERENCIA: VALDERAS, J. M.; FITZPATRICK, R.; ROLAND, M.. Using health status to measure NHS performance: another step into the dark for the health reform in England. Disponível em: <http://qualitysafety.bmj.com/content/early/2011/09/21/bmjqs-2011-000184.short>. Acesso em: 22 set. 2011.
99. Tracking Chronic Disease and Risk Behavior Prevalence as Survey Participation Declines: Statistics From the Behavioral Risk Factor Surveillance System and Other National Surveys.
AUTOR(ES): Mansour Fahimi; Michael Link; Ali Mokdad; Deborah A. Schwartz; Paul Levy
ANO: 2008
RESUMO:
FONTE: Preventing Chronic Disease, Atlanta, v. 5, n. 3, p.1-15, 2008.
REFERENCIA: FAHIMI, Mansour. Tracking chronic disease and risk behavior prevalence as survey participation declines: statistics from the behavioral risk factor surveillance system and other national surveys. Preventing Chronic Disease, Atlanta, v. 5, n. 3, p.1-15, 2008.
100. Beyond Rational Choice: The Social Dynamics of How People Seek Help.
AUTOR(ES): Bernice A. Pescosolido
ANO: 1992
RESUMO:
FONTE: American Journal Of Sociology, Chicago, v. 97, n. 4, p.1096-1138, 1992.
REFERENCIA: PESCOSOLIDO, Bernice A.. Beyond rational choice: the social dynamics of how people seek help. American Journal Of Sociology, Chicago, v. 97, n. 4, p.1096-1138, 1992.
101. Equity of access to health care services: Theory and evidence from the UK.
AUTOR(ES): Maria Goddard; Peter SmithCorresponding author contact information
ANO: 2010
RESUMO: The pursuit of equity of access to health care is a central objective of many health care systems. This paper first sets out a general theoretical framework within which equity of access can be examined. It then applies the framework by examining the extent to which research evidence has been able to detect systematic inequities of access in UK, where equity of access has been a central focus in the National Health Service since its inception in 1948. Inequity between socio-economic groups is used as an illustrative example, and the extent of inequity of access experienced is explored in each of five service areas: general practitioner consultations; acute hospital care; mental health services; preventative medicine and health promotion; and long-term health care. The paper concludes that there appear to be important inequities in access to some types of health care in the UK, but that the evidence is often methodologically inadequate, making it difficult to draw firm conclusions. In particular, it is difficult to establish the causes of inequities which in turn limits the scope for recommending appropriate policy to reduce inequities of access. The theoretical framework and the lessons learned from the UK are of direct relevance to researchers from other countries seeking to examine equity of access in a wide variety of institutional settings.
FONTE: Social Science & Medicine, Oxford, v. 53, n. 9, p.1149-1162, 2001.
REFERENCIA: GODDARD, Maria; INFORMATION, Peter Smithcorresponding Author Contact. Equity of access to health care services: theory and evidence from the UK. Social Science & Medicine, Oxford, v. 53, n. 9, p.1149-1162, 2001.
102. Ofertas de equipamentos hospitalares e número de médicos aumentam, leitos diminuem e desigualdades regionais permanecem.
AUTOR(ES): Instituto Brasileiro de Geografia e Estatí stica
ANO: 2010
RESUMO:
FONTE:
REFERENCIA: INSTITUTO BRASILEIRO DE GEOGRAFIA E ESTATÍSTICA. Ofertas de equipamentos hospitalares e número de médicos aumentam, leitos diminuem e desigualdades regionais permanecem. Disponível em: <http://www.ibge.gov.br/home/presidencia/noticias/noticia_visualiza.php?id_noticia=1757>. Acesso em: 19 nov. 2010.
103. Confiabilidade das informações obtidas de informante secundário em inquéritos de saúde.
AUTOR(ES): Renata Jardim; Sandhi Maria Barreto; Luana Giatti
ANO: 2010
RESUMO: O uso de informante secundário, recurso utilizado no Brasil, pela Pesquisa Nacional por Amostra de Domicílios, pode ser uma fonte de viés em estudos epidemiológicos. Este estudo objetiva estimar a concordância, confiabilidade, magnitude e direção de vieses, e a influência de algumas co-variáveis na discordância entre informações de 710 pares de informantes primário-secundário. A influência do ponto de vista adotado pelo informante secundário, se própria ou na perspectiva do informante primário, também foi investigada. As variáveis pesquisadas estão relacionadas ao modo de vida, avaliação da saúde, morbidade referida e uso de serviços de saúde. Os resultados mostram, em geral, boa concordância. As características dos informantes secundários associadas estatisticamente à discordância foram: idade mais velha, menores escolaridade e conhecimento sobre a saúde do informante primário. Os adultos discordaram menos sobre a avaliação da saúde dos idosos quando utilizaram a perspectiva dos idosos para responder. Os resultados confirmam a presença de viés ao utilizar o informante secundário para hipertensão e consulta médica.
FONTE: Cadernos de Saúde Pública, Rio de Janeiro, v. 26, n. 8, p.1537-1548, 2010.
REFERENCIA: JARDIM, Renata; BARRETO, Sandhi Maria; GIATTI, Luana. Confiabilidade das informações obtidas de informante secundário em inquéritos de saúde. Cadernos de Saúde Pública, Rio de Janeiro, v. 26, n. 8, p.1537-1548, 2010.
104. Métodos de estimação de variância em amostras provenientes de inquéritos domiciliares.
AUTOR(ES): Maria Cecilia Goi Porto Alves; Nilza Nunes da Silva
ANO: 2007
RESUMO: OBJETIVO: O conhecimento dos erros de amostragem é necessário à correta interpretação dos resultados de inquéritos domiciliares e à avaliação dos seus planos de amostragem. A composição das amostras de domicílios utilizadas em inquéritos caracteriza situação complexa de estimação. Nesse sentido, realizou-se estudo com o objetivo de avaliar o desempenho de estimadores de variância em inquéritos efetuados em populações urbanas brasileiras. MÉTODOS: A população de referência do estudo constituiu-se de amostra sorteada pela Fundação Sistema Estadual de Análise de Dados Estatísticos, para a realização da Pesquisa de Emprego e Desemprego na Região Metropolitana de São Paulo. Para estimar variâncias foram utilizados: o método de linearização de Taylor e as técnicas de replicação Jackknife e BRR. Repetidas amostras foram retiradas da população de referência utilizando amostragem estratificada, por conglomerados, em dois estágios: setor censitário e domicílio. Três delineamentos foram utilizados e 2.000 amostras foram sorteadas sob cada um deles. Para um estimador razão, foi avaliada a acurácia dos estimadores de variância, por meio do erro quadrático médio, e a cobertura dos intervalos de confiança. RESULTADOS: Os resultados relacionados ao erro quadrático médio relativo dos estimadores foram semelhantes. As razões de vício ficaram em torno de 0,10 para as menores amostras. As coberturas dos intervalos de confiança indicaram que os níveis de confiança observados foram menores que os fixados (95%), ficando em torno de 90% para as menores amostras. CONCLUSÕES: Os estimadores de variância mostraram desempenhos semelhantes quanto à acurácia e cobertura dos intervalos de confiança. Os vícios foram irrelevantes frente às dimensões do erro-padrão. Os níveis de confiança reais foram menores que os níveis nominais da distribuição normal, mas as alterações não impedem que estimativas intervalares sejam feitas com razoável confiança.
FONTE: Revista de Saúde Pública, São Paulo, v. 41, n. 6, p.938-946, 2007.
REFERENCIA: ALVES, Maria Cecilia Goi Porto; SILVA, Nilza Nunes da. Métodos de estimação de variância em amostras provenientes de inquéritos domiciliares. Revista de Saúde Pública, São Paulo, v. 41, n. 6, p.938-946, 2007.
105. Production and Analysis of Health Indicators: The Role of Academia.
AUTOR(ES): Christopher J. L. Murray; Alan D. Lopez
ANO: 2010
RESUMO:
FONTE: Plos Medice, San Francisco, v. 7, n. 4, p.1-3, 2010.
REFERENCIA: MURRAY, Christopher J. L.; LOPEZ, Alan D.. Production and analysis of health indicators: the role of academia. Plos Medice, San Francisco, v. 7, n. 4, p.1-3, 2010.
106. Evaluation of Healthcare Services: Asking the Right Questions to Develop New Policy and Program-Relevant Knowledge for Decision-Making.
AUTOR(ES): Marcus J. Hollander; Jo Ann Miller; Helena Kadlec
ANO: 2010
RESUMO: This article presents a framework for thinking about the key questions that need to be answered to develop new policy and program-relevant knowledge that can be used to make more informed decisions. It is a primer for administrators, policy makers and others about how to identify the knowledge they need to make decisions regarding new or existing programs. The article covers three related dimensions in evaluation: types of evaluations, key domains of inquiry and generic research questions. While the questions are generic, they can be readily adapted to any new and/or existing healthcare program evaluation. Examples of how the generic questions can be adapted to primary healthcare clinics and home care are presented. Program evaluation is an extensive topic and it is beyond the scope of this article to outline all relevant aspects. Rather, this article presents a framework for thinking about the key questions which need to be answered to develop new policy and program-relevant knowledge that can be used to make more informed decisions. Thus, this article is essentially a primer for administrators, policy makers and others about how to identify the knowledge they need to make decisions about new or existing programs. It covers three related dimensions in evaluation: types of evaluations, key domains of inquiry and generic research questions. The questions are fairly generic but, as will be shown later, can be readily adapted to the evaluation of any new or existing healthcare program.
FONTE: Healthcare Quarterly, Toronto, v. 13, n. 4, p.40-47, 2010.
REFERENCIA: HOLLANDER, Marcus J.; MILLER, Jo Ann; KADLEC, Helena. Evaluation of Healthcare Services: asking the right questions to develop new policy and program-relevant knowledge for decision-making. Healthcare Quarterly, Toronto, v. 13, n. 4, p.40-47, 2010.
107. The World Health Report 2000: expanding the horizon of health system performance.
AUTOR(ES): Julio Frenk
ANO: 2010
RESUMO:
FONTE: Health Policy And Planning, Oxford, v. 25, n. 5, p.343-345, 2010.
REFERENCIA: FRENK, Julio. The World Health Report 2000: expanding the horizon of health system performance. Health Policy And Planning, Oxford, v. 25, n. 5, p.343-345, 2010.
108. World Health Report 2000: 10 years on.
AUTOR(ES): Martin McKee
ANO: 2010
RESUMO:
FONTE: Health Policy And Planning, Oxford, v. 25, n. 5, p.346-348, 2010.
REFERENCIA: MCKEE, Martin. World Health Report 2000: 10 years on. Health Policy And Planning, Oxford, v. 25, n. 5, p.346-348, 2010.
109. Health disparities across the lifespan: Meaning, methods, and mechanisms.
AUTOR(ES): Nancy E. Adler; Judith Stewart
ANO: 2010
RESUMO: Over the past two decades, exponential growth of empirical research has fueled markedly increased concern about health disparities. In this paper, we show the progression of research on socioeconomic status (SES) and health through several eras. The first era reflected an implicit threshold model of the association of poverty and health. The second era produced evidence for a graded association between SES and health where each improvement in education, income, occupation, or wealth is associated with better health outcomes. Moving from description of the association to exploration of pathways, the third era focused on mechanisms linking SES and health, whereas the fourth era expanded on mechanisms to consider multilevel influences, and a fifth era added a focus on interactions among factors, not just their main effects or contributions as mediators. Questions from earlier eras remain active areas of research, while later eras add depth and complexity.
FONTE: Annals Of The New York Academy Of Sciences, New York, v. 1186, p.5-23, 2010.
REFERENCIA: ADLER, Nancy E.; STEWART, Judith. Health disparities across the lifespan: meaning, methods, and mechanisms. Annals Of The New York Academy Of Sciences, New York, v. 1186, p.5-23, 2010.
110. Future health systems: Why future? Why now?
AUTOR(ES): Gerald Bloom; Hilary Standing
ANO: 2008
RESUMO:
FONTE: Social Science & Medicine, Oxford, v. 66, n. 10, p.2067-2075, 2008.
REFERENCIA: BLOOM, Gerald; STANDING, Hilary. Future health systems: why future? why now?. Social Science & Medicine, Oxford, v. 66, n. 10, p.2067-2075, 2008.
111. Assessing health system performance in developing countries: a review of the literature.
AUTOR(ES): Margaret Elizabeth Kruk, Lynn P. Freedman
ANO: 2008
RESUMO: With the setting of ambitious international health goals and an influx of additional development assistance for health, there is growing interest in assessing the performance of health systems in developing countries. This paper proposes a framework for the assessment of health system performance and reviews the literature on indicators currently in use to measure performance using online medical and public health databases. This was complemented by a review of relevant books and reports in the grey literature. The indicators were organized into three categories: effectiveness, equity, and efficiency. Measures of health system effectiveness were improvement in health status, access to and quality of care and, increasingly, patient satisfaction. Measures of equity included access and quality of care for disadvantaged groups together with fair financing, risk protection and accountability. Measures of efficiency were appropriate levels of funding, the cost-effectiveness of interventions, and effective administration. This framework and review of indicators may be helpful to health policy makers interested in assessing the effects of different policies, expenditures, and organizational structures on health outputs and outcomes in developing countries.
FONTE: Health Policy, Limerick, v. 85, n. 3, p.263-267, 2008.
REFERENCIA: KRUK, Margaret Elizabeth; FREEDMAN, Lynn P.. Assessing health system performance in developing countries: a review of the literature. Health Policy, Limerick, v. 85, n. 3, p.263-267, 2008.
112. Measuring the performance of health care services: a review of international experiences and their application to urban contexts.
AUTOR(ES): Anna Garcí a-Alté sa; Lauriane Zoncob; Carme Borrella; Antoni Plasè nciac; for the Barcelona group on the performance of health care services
ANO: 2006
RESUMO: BACKGROUND: The objective of performance assessment is to provide governments and populations with appropriate information about the state of their health care system. The objective of this paper is to present the most recent developments in performance assessment and their application in urban contexts. METHODS: Literature review in PubMed (1970-2004). We identified additional papers and grey literature from retrieved references. RESULTS: Performance assessment initiatives were identified in Australia, Canada, the United Kingdom, and New Zealand. The World Health Report 2000 is one of the best known examples of a transnational approach to performance assessment. CONCLUSION: The best developed initiatives to date are those that define precise categories, criteria and indicators with which to analyse and assess health care systems, based on a solid conceptual framework. Performance assessment fits perfectly in urban contexts, as it is a useful tool for designing and monitoring policies, assessing the quality of the services provided, and measuring the health status of city dwellers. Barcelona and Montreal are currently collaborating together on a project to assess the performance assessment of their respective health care services.
FONTE: Gaceta Sanitaria, Madrid, v. 20, n. 4, p.316-324, 2006.
REFERENCIA: GARCÍA-ALTÉSA, Anna et al. Measuring the performance of health care services: a review of international experiences and their application to urban contexts. Gaceta Sanitaria, Madrid, v. 20, n. 4, p.316-324, 2006.
113. Os inquéritos de saúde sob a perspectiva do planejamento.
AUTOR(ES): C. E. A. Campos
ANO: 1993
RESUMO: Este trabalho discute a importância dos inquéritos de saúde no acompanhamento do processo de distritalização do sistema de saúde. Os principais conceitos que embasam os inquéritos e a bibliografia acerca dos usos que foram feitos dos inquéritos de saúde são revisados. A despeito dos autores dedicados a este tema afirmarem a importância dos inquéritos para o planejamento dos serviços de saúde, este trabalho encontrou evidências de que, na prática, são muito raros os relatos de sua aplicabilidade. Os principais problemas metodológicos são também discutidos. A proposta da realização de inquéritos de demanda mais ágeis e de menor complexidade metodológica poderia ser, para alguns autores, a saída para a sua utilização no planejamento em saúde.
FONTE: Cadernos de Saúde Pública, Rio de Janeiro, v. 9, n. 2, p.190-200, 1993.
REFERENCIA: CAMPOS, C. E. A.. Os inquéritos de saúde sob a perspectiva do planejamento. Cadernos de Saúde Pública, Rio de Janeiro, v. 9, n. 2, p.190-200, 1993.
114. National health surveys and the behavioral model of health services use.
AUTOR(ES): Ronald M. Andersen
ANO: 2008
RESUMO: National health surveys have played an important role in the development of health services research. They have contributed to the advancement of concepts, methods, and the policy relevance of the field. One product of these surveys was the Behavioral Model of Health Services Use. This article documents a 75-year legacy by reviewing the series of national studies that have given to the form and function of health services research. It further examines the Behavioral Model through 40 years of considerable application and alteration.
FONTE: Medical Care, Philadelphia, v. 46, n. 7, p.647-653, 2008.
REFERENCIA: ANDERSEN, Ronald. National health surveys and the behavioral model of health services use. Medical Care, Philadelphia, v. 46, n. 7, p.647-653, 2008.
115. Measuring population health: a review of indicators.
AUTOR(ES): Vera Etches; John Frank; Erica Di Ruggiero; Doug Manuel
ANO: 2006
RESUMO: This article reviews the historical development of population health indicators. We have long known that environmental, socioeconomic, early life conditions, individual actions, and medical care all interact to affect health. Present quantitative reporting on the impact of these factors on population health grew out of Bills of Mortality published in the 1500s. Since then, regular censuses, civil registration of vital statistics, and international classification systems have improved data quality and comparability. Regular national health interview surveys and application of administrative data contributed information on morbidity, health services use, and some social determinants of health. More recently, traditional health databases and datasets on “nonhealth” sector determinants have been linked. Statistical methods for map-making, risk adjustment, multilevel analysis, calculating population-attributable risks, and summary measures of population health have further helped to integrate information. Reports on the health of populations remain largely confined to focused areas. This paper suggests a conceptual framework for using indicators to report on all the domains of population health. Future ethical development of indicators will incorporate principles of justice, transparency, and effectiveness.
FONTE: Annual Review Of Public Health, Califórnia, v. 27, p.29-55, 2006.
REFERENCIA: ETCHES, Vera et al. Measuring population health: a review of indicators. Annual Review Of Public Health, Califórnia, v. 27, p.29-55, 2006.
116. How Health Insurance Design Affects Access To Care And Costs, By Income, In Eleven Countries.
AUTOR(ES): Cathy Schoen; Robin Osborn; David Squires; Michelle M. Doty; Roz Pierson; Sandra Applebaum
ANO: 2010
RESUMO: This 2010 survey examines the insurance-related experiences of adults in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United States, and the United Kingdom. The countries all have different systems of coverage, ranging from public systems to hybrid systems of public and private insurance, and with varying levels of cost sharing. Overall, the study found significant differences in access, cost burdens, and problems with health insurance that are associated with insurance design. US adults were the most likely to incur high medical expenses, even when insured, and to spend time on insurance paperwork and disputes or to have payments denied. Germans reported spending time on paperwork at rates similar to US rates but were well protected against out-of-pocket spending. Swiss out-of-pocket spending was high, yet few Swiss had access concerns or problems paying bills. For US adults, comprehensive health reforms could lead to improvements in many of these areas, including reducing differences by income observed in the study.
FONTE: Health Affairs, Philadelphia, v. 29, n. 12, p.2323-2334, 2010.
REFERENCIA: SCHOEN, Cathy et al. How health insurance design affects access to care and costs, by income, in eleven countries. Health Affairs, Philadelphia, v. 29, n. 12, p.2323-2334, 2010.
117. Analysing health systems to make them stronger.
AUTOR(ES): Josefien van Olmen; Bart Criel; Wim Van Damme; Bruno Marchal; Sara Van Belle; Monique Van Dormael; Tom Hoeré e; Marjan Pirard; Guy Kegels
ANO: 2010
RESUMO:
FONTE: Antwerp: Studies In Health Services Organisation & Policy, 2010. 98 p.
REFERENCIA: OLMEN, Josefien Van et al. Analysing health systems to make them stronger. Antwerp: Studies In Health Services Organisation & Policy, 2010. 98 p.
118. Prevalence of chronic kidney disease in population-based studies: systematic review.
AUTOR(ES): Qiu-Li Zhang; Dietrich Rothenbacher
ANO: 2008
RESUMO: BACKGROUND: Chronic kidney disease (CKD) is becoming a major public health problem worldwide. This article reviews the published evidence of prevalence of CKD in population-based study samples that used the standardized definition from the Kidney Disease Outcomes Quality Initiative of the National Kidney Foundation (K/DOQI) practice guideline, and particularly focus on performance of serum-creatinine based equations for GFR estimation. We provide a summary of available data about the burden of CKD in various populations. METHODS: We performed a systematic review of available published data in MEDLINE. A combination of various keywords relevant to CKD was used in this research. Related data of included studies were extracted in a systematic way. RESULTS: A total of 26 studies were included in this review. The studies were conducted in different populations, and the number of study participants ranged from 237 to 65181. The median prevalence of CKD was 7.2% in persons aged 30 years or older. In persons aged 64 years or older prevalence of CKD varied from 23.4% to 35.8%. Importantly, the prevalence of CKD strongly depended on which estimating equations were used. The Modification of Diet in Renal Disease Study (MDRD) equation was likely to be preferred in recent epidemiological studies compared to the adjusted Cockcroft-Gault (CG) equation. CONCLUSION: Worldwide, CKD is becoming a common disease in the general population. Accurately detecting CKD in special groups remains inadequate, particularly among elderly persons, females or other ethnic groups such as Asians.
FONTE: BMC Public Health, London, v. 8, n. 117, p.1-13, 2008.
REFERENCIA: ZHANG, Qiu-li; ROTHENBACHER, Dietrich. Prevalence of chronic kidney disease in population-based studies: systematic review. BMC Public Health, London, v. 8, n. 117, p.1-13, 2008.
119. Disparities in hypertension-related mortality among selected Hispanic subgroups and non-Hispanic white women ages 45 years and older.United States, 1995-1996 and 2001-2002.
AUTOR(ES): R.E.Zambrana; C. Ayala; O.C. Pokras; J.Minaya; G.A. Mensah
ANO: 2007
RESUMO: OBJECTIVES: To compare hypertension-related mortality (HRM) age-standardized and age-specific rates for Hispanic subgroup and non-Hispanic White (NHW) women; to identify underlying causes of HRM by Hispanic subgroup and age; and to examine relative percent change in HRM among Hispanic subgroups and NHW women. DESIGN: Secondary data analyses of 1995-1996 and 2001-2002 national vital statistics multiple cause mortality files. SETTING: United States-50 states and District of Columbia. SUBJECTS: Mexican American (MA), Puerto Rican (PR), Cuban (CA) and NHW female decedents ages > or =45 years with hypertension listed as one of up to 20 conditions resulting in death. MAIN OUTCOME MEASURES: Age-standardized death rates (ASDR per 100,000) for HRM and relative percent change to examine trends (2-year intervals). RESULTS: During 1995-1996, the ASDR (per 100,000) for HRM was highest among PR (248.5) followed by NHW (188.7), MA (185.4), and CA women (139.7). During 2001-2002, PR (215.5) and MA (205.5) had higher ASDR for HRM than NHW (171.9) and CA women (104.6). The relative percent increase from 1995-1996 to 2001-2002 was 10.8% (P < .01) among MA, while CA (-25.1%, P < .01), PR (-13.3%, P < .01) and non-Hispanic Whites (-8.5%, P < .01) showed a decrease. CONCLUSIONS: HRM was highest among PR and MA women, increased significantly for MA women between 1995-1996 to 2001-2002, and declined for CA, PR and non-Hispanic White women. Public health efforts should focus on strengthening heart health protection communication and hypertension control programs for PR and MA women and their healthcare providers.
FONTE: Ethnicity & Disease, Atlanta, v. 17, n. 3, p.434-440, 2007.
REFERENCIA: ZAMBRANA, R. E. et al. Disparities in hypertension-related mortality among selected Hispanic subgroups and non-Hispanic white women ages 45 years and older: United States, 1995-1996 and 2001-2002. Ethnicity & Disease, Atlanta, v. 17, n. 3, p.434-440, 2007.
120. Inequalities in access to knee joint replacements for people in need.
AUTOR(ES): P. F. K. Yong; P. C. Milner; J. N. Payne; P. A. Lewis; C. Jennison
ANO: 2004
RESUMO: OBJECTIVES: To quantify the effects of socioeconomic deprivation and rurality on evidence of need for total knee joint replacement and the use of health services, after adjusting for age and sex. METHODS: A random stratified sample of 15 000 people aged > or =65 years taken from central age/sex registers for the geographical areas covered by the previous Sheffield and Wiltshire Health Authorities. A self completion validated questionnaire was then mailed directly to subjects to assess need for knee joint replacement surgery and whether general practice and hospital services were being used. Subjects were followed up for 18 months to evaluate access to surgery. RESULTS: The response rate was 78% after three mailings. In those aged 65 years and over (with and without comorbidity), the proportion with no comorbid factors and in need of knee replacement was 5.1%; the rate of need among subjects without comorbidity was 7.9%. There were inequalities in health and access to health related to age, sex, geography, and deprivation but not rurality. People who were more deprived had greater need. Older and deprived people were less likely to access health services. Only 6.4% of eligible people received knee replacement surgery after 18 months of follow up. CONCLUSIONS: There is an important unmet need in older people, with significant age, sex, geographical, and deprivation inequalities in levels of need and access to services. The use of waiting list numbers as a performance indicator is perverse for this procedure. There is urgent need to expand orthopaedic services and training.
FONTE: Annals Of The Rheumatic Diseases, London, v. 63, n. 11, p.1483-1489, 2004.
REFERENCIA: YONG, P. F. K. et al. Inequalities in access to knee joint replacements for people in need. Annals Of The Rheumatic Diseases, London, v. 63, n. 11, p.1483-1489, 2004.
121. Hysterectomy rates in the United States, 2003.
AUTOR(ES): Jennifer M. Wu; Mary Ellen Wechter; Elizabeth J. Geller; Thao V. Nguyen; Anthony G. Visco
ANO: 2007
RESUMO: OBJECTIVE: To estimate hysterectomy rates by type of hysterectomy and to compare age, length of stay, and regional variation in type of hysterectomy performed for benign indications. METHODS: We conducted a cross-sectional analysis of national discharge data using the 2003 Nationwide Inpatient Sample. These data represent a 20% stratified sample of U.S. hospitals. Women aged 16 years or older who underwent a hysterectomy were identified by International Classification of Diseases, 9th Revision, Clinical Modification procedure codes. We extracted data regarding age, race, diagnoses codes, length of stay, and hospital characteristics. Using 2000 National Census data and weighted data analysis for cluster sampling, we calculated hysterectomy rates. RESULTS: In 2003, 602,457 hysterectomies were performed, for a rate of 5.38 per 1,000 women-years. Of the 538,722 hysterectomies for benign disease (rate 4.81 per 1,000 women-years), the abdominal route was the most common (66.1%), followed by vaginal (21.8%) and laparoscopic (11.8%) routes. Mean ages (+/-standard deviation) differed among hysterectomy types (abdominal 44.5+/-0.1 years, vaginal 48.2+/-0.2 years, and laparoscopic 43.6+/-0.3 years, P<.001). Mean lengths of stay (+/-standard deviation) were also different (3.0+/-0.03 days, 2.0+/-0.03 days, 1.7+/-0.03 days, respectively, P<.001). The hysterectomy rate was highest in the South (5.92 per 1,000 women-years) and lowest in the Northeast (3.33 per 1,000 women-years). CONCLUSION: Despite a shorter length of stay, vaginal and laparoscopic hysterectomies remain far less common than abdominal hysterectomy for benign disease.
FONTE: Obstetrics And Gynecology, New York, v. 110, n. 5, p.1091-1095, 2007.
REFERENCIA: WU, Jennifer M. et al. Hysterectomy rates in the United States, 2003. Obstetrics And Gynecology, New York, v. 110, n. 5, p.1091-1095, 2007.
122. Neuroimaging of stroke: a review.
AUTOR(ES): Andrew R. Xavier; Adnan I. Qureshi; Jawad F. Kirmani; Abutaher M. Yahia; Rohit Bakshi
ANO: 2003
RESUMO: Advances in neuroimaging technology during the past 30 years have resulted in a virtual explosion in the amount of pathologic information that can be obtained in the clinical stroke setting. This neuroimaging revolution has led to a much better understanding of cerebrovascular and tissue pathology, creating a wide array of opportunities for acute treatment and secondary prevention. Advances include early and accurate detection of ischemic and infarcted tissue and the ability to reveal hypoperfused tissue at risk. Clinicians are increasingly able to noninvasively detect embolic and atherothrombotic intravascular lesions. Vascular lesions associated with stroke can be characterized through endovascular neuroimaging techniques and repaired by various means. In this article, we provide an overview and update on the various techniques used in the neuroimaging of stroke and intracranial hemorrhage, including computed tomography, magnetic resonance imaging, ultrasound, and catheter angiography. We outline the specific role of each modality in clinical practice.
FONTE: Southern Medical Journal, Birmingham, v. 96, n. 4, p.367-379, 2003.
REFERENCIA: XAVIER, Andrew R. et al. Neuroimaging of stroke: a review. Southern Medical Journal, Birmingham, v. 96, n. 4, p.367-379, 2003.
123. The contribution of hypertension to mortality in the US: 1968, 1977.
AUTOR(ES): S. Wing; K. G. Manton
ANO: 1983
RESUMO:
FONTE: American Journal Of Public Health, New York, v. 73, n. 2, p.140-144, 1983.
REFERENCIA: WING, S.; MANTON, K. G.. The contribution of hypertension to mortality in the US: 1968, 1977. American Journal Of Public Health, New York, v. 73, n. 2, p.140-144, 1983.
124. Inpatient hysterectomy surveillance in the United States, 2000-2004.
AUTOR(ES): Maura K. Whiteman; Susan D. Hillis; Denise J. Jamieson; Brian Morrow; Michelle N. Podgornik; Kate M. Brett, Polly A. Marchbanks
ANO: 2008
RESUMO: OBJECTIVE: The objective of the study was to examine recent trends in hysterectomy rates and indications in the United States. STUDY DESIGN: Data on hysterectomy hospitalizations during 2000-2004 were obtained from the National Hospital Discharge Survey, an annual nationally representative survey of inpatient hospitalization records. RESULTS: The hysterectomy rate decreased slightly from 5.4 per 1000 in 2000 to 5.1 per 1000 in 2004 (P for trend < .05). The proportion of hysterectomies performed for uterine leiomyoma decreased from 44.2% in 2000 to 38.7% in 2004 (P for trend < .01). Concomitant bilateral oophorectomy accompanied 54% of hysterectomies; this proportion declined from 55.1% in 2000 to 49.5% in 2004 (P for trend < .001). CONCLUSIONS: Continued monitoring is needed to determine whether the observed trends persist and to evaluate impact on women's health. In the future, information on both inpatient and outpatient procedures may be important for hysterectomy surveillance.
FONTE: American Journal Of Obstetrics And Gynecology, New York, v. 198, n. 1, p.34.e1-34.e7, 2008.
REFERENCIA: WHITEMAN, Maura K. et al. Inpatient hysterectomy surveillance in the United States, 2000-2004. American Journal Of Obstetrics And Gynecology, New York, v. 198, n. 1, p.34.e1-34.e7, 2008.
125. Radiology of Stroke.
AUTOR(ES): J. M. Wardlaw
ANO: 2001
RESUMO:
FONTE: Journal Of Neurology, Neurosurgery, And Psychiatry, London, v. 70, n. 1, p.i7-i11, 2001. Suplemento.
REFERENCIA: WARDLAW, J. M.. Radiology of Stroke. Journal Of Neurology, Neurosurgery, And Psychiatry, London, v. 70, n. 1, p.i7-i11, 2001. Suplemento.
126. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America.
AUTOR(ES): José Villar; Eliette Valladares; Daniel Wojdyla; Nelly Zavaleta; Guillermo Carroli; Alejandro Velazco; Archana Shah; Liana Campodó nico; Vicente Bataglia; Anibal Faundes; Ana Langer; Alberto Narvá ez; Allan Donner; Mariana Romero; Sofia Reynoso; Karla Simô nia de Pá dua; Daniel Giordano; Marius Kublickas; Arnaldo Acosta
ANO: 2006
RESUMO: BACKGROUND: Caesarean delivery rates continue to increase worldwide. Our aim was to assess the association between caesarean delivery and pregnancy outcome at the institutional level, adjusting for the pregnant population and institutional characteristics. METHODS: For the 2005 WHO global survey on maternal and perinatal health, we assessed a multistage stratified sample, comprising 24 geographic regions in eight countries in Latin America. We obtained individual data for all women admitted for delivery over 3 months to 120 institutions randomly selected from of 410 identified institutions. We also obtained institutional-level data. FINDINGS: We obtained data for 97,095 of 106,546 deliveries (91% coverage). The median rate of caesarean delivery was 33% (quartile range 24-43), with the highest rates of caesarean delivery noted in private hospitals (51%, 43-57). Institution-specific rates of caesarean delivery were affected by primiparity, previous caesarean delivery, and institutional complexity. Rate of caesarean delivery was positively associated with postpartum antibiotic treatment and severe maternal morbidity and mortality, even after adjustment for risk factors. Increase in the rate of caesarean delivery was associated with an increase in fetal mortality rates and higher numbers of babies admitted to intensive care for 7 days or longer even after adjustment for preterm delivery. Rates of preterm delivery and neonatal mortality both rose at rates of caesarean delivery of between 10% and 20%. INTERPRETATION: High rates of caesarean delivery do not necessarily indicate better perinatal care and can be associated with harm.
FONTE: The Lancet, New York, v. 367, n. 9525, p.1819-1829, 2006.
REFERENCIA: VILLAR, José et al. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. The Lancet, New York, v. 367, n. 9525, p.1819-1829, 2006.
127. Reducing deaths from diarrhoea through oral rehydration therapy.
AUTOR(ES): Cesar G. Victora; Jennifer Bryce; Olivier Fontaine; Roeland Monasch
ANO: 2000
RESUMO: In 1980, diarrhoea was the leading cause of child mortality, accounting for 4.6 million deaths annually. Efforts to control diarrhoea over the past decade have been based on multiple, potentially powerful interventions implemented more or less simultaneously. Oral rehydration therapy (ORT) was introduced in 1979 and rapidly became the cornerstone of programmes for the control of diarrhoeal diseases. We report on the strategy for controlling diarrhoea through case management, with special reference to ORT, and on the relationship between its implementation and reduced mortality. Population-based data on the coverage and quality of facility-based use of ORT are scarce, despite its potential importance in reducing mortality, especially for severe cases. ORT use rates during the 1980s are available for only a few countries. An improvement in the availability of data occurred in the mid-1990s. The study of time trends is hampered by the use of several different definitions of ORT. Nevertheless, the data show positive trends in diarrhoea management in most parts of the world. ORT is now given to the majority of children with diarrhoea. The annual number of deaths attributable to diarrhoea among children aged under 5 years fell from the estimated 4.6 million in 1980 to about 1.5 million today. Case studies in Brazil, Egypt, Mexico, and the Philippines confirm increases in the use of ORT which are concomitant with marked falls in mortality. In some countries, possible alternative explanations for the observed decline in mortality have been fairly confidently ruled out. Experience with ORT can provide useful guidance for child survival programmes. With adequate political will and financial support, cost-effective interventions other than that of immunization can be successfully delivered by national programmes. Furthermore, there are important lessons for evaluators. The population-based data needed to establish trends in health service delivery, outcomes and impact are not available in respect of diarrhoea, as is true for malaria, pneumonia and other major childhood conditions. Standard indicators and measurement methods should be established. Efforts to change existing global indicators should be firmly resisted. Support should be given for the continuing evaluation and documentation activities needed to guide future public health policies and programmes.
FONTE: Bulletin Of The World Health Organization, Geneva, v. 78, n. 10, p.1246-1255, 2000.
REFERENCIA: VICTORA, Cesar G. et al. Reducing deaths from diarrhoea through oral rehydration therapy. Bulletin Of The World Health Organization, Geneva, v. 78, n. 10, p.1246-1255, 2000.
128. Meningites bacterianas na infância.
AUTOR(ES): Helmar Abreu Rocha Verlangieri; Calil Kairalla Farhat
ANO: 2008
RESUMO: Revisão do sempre atual tema das meningites bacterianas na infância, abordando seu conceito e incidência, agentes etiológicos, epidemiologia, fisiopatogenia, quadro clínico, diagnóstico, em especial o etiológico, diagnóstico diferencial e tratamento.Neste particular trata das medidas de suporte, do emprego de corticosteróides e da antibioticoterapia em cada caso, terminando com a análise das possíveis complicações e seqüelas da moléstia e sua profilaxia, vacinal e medicamentosa.Meningites bacterianas são processos agudos que acometem as leptomeninges (pia-máter e aracnóide) que envolvem o cérebro e a medula espinal, podendo acometer a dura-máter e outras estruturas do sistema nervoso central (SNC), provocando reação purulenta detectável no líquido cefalorraquidiano (LCR). Estão associadas a uma elevada incidência de complicações e risco de seqüelas e são causa de alta morbimortalidade, principalmente em crianças menores de cinco anos de idade, com maior risco entre os lactentes de 6 a 12 meses de idade. O advento de novos e potentes antimicrobianos eficazes para seu tratamento fez com que as meningites bacterianas evoluíssem de doenças potencialmente fatais para infecções de evolução favorável na maioria dos casos. Representam, ainda, importante desafio em saúde pública em todo o mundo, com estimativa de 1 milhão de casos por ano e 171.000 mortes. No Brasil ocorrem aproximadamente 30.000 casos por ano (2,4/100.000 habitantes), com uma letalidade geral que se mantém constante no nível de 20%(9,20).
FONTE: Pediatria Moderna, São Paulo, v. 44, n. 6, p.213-228, 2008.
REFERENCIA: VERLANGIERI, Helmar Abreu Rocha; FARHAT, Calil Kairalla. Meningites bacterianas na infância. Pediatria Moderna, São Paulo, v. 44, n. 6, p.213-228, 2008.
129. Boletim epidemiológico AIDS. DST: versão preliminar.
AUTOR(ES): MS/ SVS/ Departamento de DST, Aids e Hepatites Virais
ANO: 2011
RESUMO:
FONTE: Brasília: 2011. 26 p.
REFERENCIA: MS/ SVS/ Departamento de DST, Aids e Hepatites Virais. Boletim epidemiológico AIDS. DST: versão preliminar. Brasília: 2011. 26 p. (ANO VIII). 26ª a 52ª semanas epidemiológicas - julho a dezembro de 2010 01ª a 26ª semanas epidemiológicas - janeiro a junho de 2011.
130. Inequalities in access to medical care by income in developed countries.
AUTOR(ES): Eddy van Doorslaer; Cristina Masseria; Xander Koolman
ANO: 2006
RESUMO: Background: Most of the member countries of the Organization for Economic Cooperation and Development (OECD) aim to ensure equitable access to health care. This is often interpreted as requiring that care be available on the basis of need and not willingness or ability to pay. We sought to examine equity in physician utilization in 21 OECD countries for the year 2000. Methods: Using data from national surveys or from the European Community Household Panel, we extracted the number of visits to a general practitioner or medical specialist over the previous 12 months. Visits were standardized for need differences using age, sex and reported health levels as proxies. We measured inequity in doctor utilization by income using concentration indices of the need-standardized use. Results: We found inequity in physician utilization favouring patients who are better off in about half of the OECD countries studied. The degree of pro-rich inequity in doctor use is highest in the United States and Mexico, followed by Finland, Portugal and Sweden. In most countries, we found no evidence of inequity in the distribution of general practitioner visits across income groups, and where it does occur, it often indicates a pro-poor distribution. However, in all countries for which data are available, after controlling for need differences, people with higher incomes are significantly more likely to see a specialist than people with lower incomes and, in most countries, also more frequently. Pro-rich inequity is especially large in Portugal, Finland and Ireland.
FONTE: Canadian Medical Association Journal, Ottawa, v. 174, n. 2, p.177-183, 2006.
REFERENCIA: DOORSLAER, Eddy Van; MASSERIA, Cristina; KOOLMAN, Xander. Inequalities in access to medical care by income in developed countries. Canadian Medical Association Journal, Ottawa, v. 174, n. 2, p.177-183, 2006.
131. Prevalence and incidence of hypertension from 1995 to 2005: a population-based study.
AUTOR(ES): Karen Tu; Zhongliang Chen; Lorraine L. Lipscombe
ANO: 2008
RESUMO: BACKGROUND: Researchers have predicted that there will be a relative increase of 24% in the prevalence of hypertension in developed countries from 2000 to 2025. Hypertension is a leading risk factor for death, stroke, cardiovascular disease and renal disease. Thus, accurate estimates of the prevalence of hypertension in a population have important implications for public policy. We sought to assess whether the estimated increase in the prevalence of hypertension has been underestimated. METHODS: We performed a population-based cohort study using linked administrative data for adults aged 20 years and older in Ontario, Canada's most populous province with more than 12 million residents. Using a validated case-definition algorithm for hypertension, we examined trends in prevalence from 1995 to 2005 and in incidence from 1997 to 2004. RESULTS: The number of adults with hypertension more than doubled from 1995 to 2005. The age- and sex-adjusted prevalence increased from 153.1 per 1000 adults in 1995 to 244.8 per 1000 in 2005, which was a relative increase of 60.0% (p < 0.001). The age- and sex-adjusted incidence of hypertension increased from 25.5 per 1000 adults in 1997 to 32.1 per 1000 in 2004, which was a relative increase of 25.7% (p < 0.001). INTERPRETATION: Our findings indicate that the rise in hypertension prevalence will likely far exceed the predicted prevalence for 2025. Public health strategies to prevent and manage hypertension and its sequelae are urgently needed.
FONTE: Canadian Medical Association Journal, Ottawa, v. 178, n. 11, p.1429-1435, 2008.
REFERENCIA: TU, Karen; CHEN, Zhongliang; LIPSCOMBE, Lorraine L.. Prevalence and incidence of hypertension from 1995 to 2005: a population-based study. Canadian Medical Association Journal, Ottawa, v. 178, n. 11, p.1429-1435, 2008.
132. Mortality associated with influenza and respiratory syncytial virus in the United States.
AUTOR(ES): William W. Thompson; David K. Shay; Eric Weintraub; Lynnette Brammer; Nancy Cox; Larry J. Anderson; Keiji Fukuda
ANO: 2003
RESUMO: CONTEXT: Influenza and respiratory syncytial virus (RSV) cause substantial morbidity and mortality. Statistical methods used to estimate deaths in the United States attributable to influenza have not accounted for RSV circulation. OBJECTIVE: To develop a statistical model using national mortality and viral surveillance data to estimate annual influenza- and RSV-associated deaths in the United States, by age group, virus, and influenza type and subtype. DESIGN, SETTING, AND POPULATION: Age-specific Poisson regression models using national viral surveillance data for the 1976-1977 through 1998-1999 seasons were used to estimate influenza-associated deaths. Influenza- and RSV-associated deaths were simultaneously estimated for the 1990-1991 through 1998-1999 seasons. MAIN OUTCOME MEASURES: Attributable deaths for 3 categories: underlying pneumonia and influenza, underlying respiratory and circulatory, and all causes. RESULTS: Annual estimates of influenza-associated deaths increased significantly between the 1976-1977 and 1998-1999 seasons for all 3 death categories (P<.001 for each category). For the 1990-1991 through 1998-1999 seasons, the greatest mean numbers of deaths were associated with influenza A(H3N2) viruses, followed by RSV, influenza B, and influenza A(H1N1). Influenza viruses and RSV, respectively, were associated with annual means (SD) of 8097 (3084) and 2707 (196) underlying pneumonia and influenza deaths, 36 155 (11 055) and 11 321 (668) underlying respiratory and circulatory deaths, and 51 203 (15 081) and 17 358 (1086) all-cause deaths. For underlying respiratory and circulatory deaths, 90% of influenza- and 78% of RSV-associated deaths occurred among persons aged 65 years or older. Influenza was associated with more deaths than RSV in all age groups except for children younger than 1 year. On average, influenza was associated with 3 times as many deaths as RSV. CONCLUSIONS: Mortality associated with both influenza and RSV circulation disproportionately affects elderly persons. Influenza deaths have increased substantially in the last 2 decades, in part because of aging of the population, underscoring the need for better prevention measures, including more effective vaccines and vaccination programs for elderly persons.
FONTE: The Journal Of The American Medical Association, Chicago, v. 289, n. 2, p.179-186, 2003.
REFERENCIA: THOMPSON, William W. et al. Mortality associated with influenza and respiratory syncytial virus in the United States. The Journal Of The American Medical Association, Chicago, v. 289, n. 2, p.179-186, 2003.
133. PCI or CABG in coronary artery disease?
AUTOR(ES): David P Taggart
ANO: 2009
RESUMO:
FONTE: The Lancet, New York, v. 373, n. 9670, p.1150-1152, 2009.
REFERENCIA: TAGGART, David P. .PCI or CABG in coronary artery disease? The Lancet, New York, v. 373, n. 9670, p.1150-1152, 2009.
134. A disseminação da epidemia da AIDS no Brasil, no período de 1987-1996: uma análise espacial.
AUTOR(ES): Celia Landmann Szwarcwald; Francisco Iná cio Bastos; Maria Angela Pires Esteves; Carla L. Tavares de Andrade
ANO: 2000
RESUMO: As taxas médias de incidência da AIDS em adultos no Brasil foram estimadas para os períodos 1987-89, 1990-92 e 1993-96, segundo o município de residência dos casos. Nas análises foram utilizadas as variáveis “tamanho da população do município de residência”; “proporção de população que vive em área urbana” e “concentração de pobreza”, estratificando-se por sexo e categoria de exposição. A Região Sudeste apresenta menor ritmo de crescimento em contraste com os aclives acentuados das regiões Norte e Sul, do 2o ao 3o intervalo. Cotejando-se as variações das taxas de incidência de 1990-92 a 1993-96 por região ou tamanho de população, obtém-se maiores aumentos relativos entre as mulheres. Nas cidades grandes, a categoria “homo/bissexuais” prevalece, decrescendo proporcionalmente à medida que cresce o número de casos por transmissão heterossexual. Nos municípios médios predominam os usuários de drogas injetáveis e nos menores há aumento dos casos por transmissão heterossexual. A epidemia – ainda fenômeno urbano – dá sinais de expansão nos municípios rurais, intensificando-se naqueles situados abaixo do limite crítico regional do índice de pobreza. Há disseminação crescente da epidemia nos municípios mais pobres.
FONTE: Cadernos de Saúde Pública, Rio de Janeiro, v. 16, n. 1, p.7-19, 2000. Suplemento.
REFERENCIA: SZWARCWALD, Celia Landmann et al. A disseminação da epidemia da AIDS no Brasil, no período de 1987-1996: uma análise espacial. Cadernos de Saúde Pública, Rio de Janeiro, v. 16, n. 1, p.7-19, 2000. Suplemento.
135. Aplicação de medidas de ajuste de risco para a mortalidade após fratura proximal de fêmur.
AUTOR(ES): Rô mulo Cristovã o de Souza; Rejane Sobrino Pinheiro; Clá udia Medina Coeli; Kenneth Rochel de Camargo Jr.; Tâ nia Z. Guillé n de Torres
ANO: 2007
RESUMO: OBJETIVO: Analisar os fatores associados à mortalidade em pacientes para tratamento da fratura proximal do fêmur e as diferentes formas de ajuste de risco. MÉTODOS: Estudo de coorte não-concorrente com 390 pacientes com 50 anos ou mais. Os pacientes foram identificados no Sistema de Informações Hospitalares do Sistema Único de Saúde, internados para correção cirúrgica da fratura proximal do fêmur em um hospital universitário do município do Rio de Janeiro, entre 1995 e 2000. Foram levantados dados complementares nos prontuários desses pacientes e elaborados modelos de regressão logística para a chance de óbito em 90 dias após a data da admissão, segundo perfil dos pacientes e do tratamento. Foram calculados índices de classificação da gravidade do paciente. RESULTADOS: A taxa de mortalidade foi de 7,4% e os fatores que tiveram efeito sobre o óbito foram: idade (OR=1,06; IC 95%: 1,02;1,11), quantidade de comorbidades (OR=1,44; IC 95%: 1,12;1,69), índice de comorbidade de Charlson acima de 2 (OR=6,67; IC 95%: 2,98;22,16) e intervalo de tempo para a realização da cirurgia (OR=1,04; IC 95%:1,02;1,07). CONCLUSÕES: A quantidade de comorbidades e o índice de comorbidade de Charlson auxiliaram na predição da mortalidade.
FONTE: Revista de Saúde Pública, São Paulo, v. 41, n. 4, p.625-631, 2007.
REFERENCIA: SOUZA, Rômulo Cristovão de et al. Aplicação de medidas de ajuste de risco para a mortalidade após fratura proximal de fêmur. Revista de Saúde Pública, São Paulo, v. 41, n. 4, p.625-631, 2007.
136. Avoidable mortality in Europe 1955-1994: a plea for prevention.
AUTOR(ES): L. Simonato; T. Ballard; P. Bellini; R. Winkelmann
ANO: 1998
RESUMO: OBJECTIVE: To analyse trends of avoidable mortality in Europe, emphasising causes of death amenable to primary prevention through reduction of exposures, secondary prevention through early detection and treatment, and tertiary prevention through improved treatment and medical care. DESIGN: Descriptive study of mortality from avoidable causes for the years 1955 through 1994, for ages 5-64 at time of death. Using the World Health Organisation Mortality Database, five year death rates were standardised to the world population. SETTING: 21 countries of Europe in four regions (northern, central, and southern Europe, Nordic countries). PARTICIPANTS: All causes of deaths for men and women, aged 5-64, at time of death. MAIN RESULTS: Between 1955-59 and 1990-94, the reduction in mortality was somewhat greater for avoidable causes than for all causes: 45.8% v 45.1% (women) and 39.3% v 32.6% among men. Reductions in mortality were greater for causes amenable to improved medical care: 77.9% among women and 76.3% among men. The smallest reduction in mortality was seen in women for causes amenable to secondary prevention (11.0%), and in men for causes amendable to primary prevention including tobacco related conditions (16.6%). From a geographical point of view, there were slight differences in trends between European regions, but overall the patterns were similar. CONCLUSIONS: The greatest reduction of avoidable mortality in Europe from 1955-94 came from causes amenable to improved treatment and medical care for both sexes. Further reductions of avoidable mortality can be achieved through implementation of primary and secondary prevention activities, such as tobacco control, reduction of occupational exposures, and universal access to breast and cervical cancer screening programmes.
FONTE: Journal Of Epidemiology Community Health, London, v. 52, n. 10, p.624-630, 1998.
REFERENCIA: SIMONATO, L. Avoidable mortality in Europe 1955-1994: a plea for prevention. Journal Of Epidemiology Community Health, London, v. 52, n. 10, p.624-630, 1998.
137. Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature.
AUTOR(ES): Bibha Simkhada; Edwin R. van Teijlingen; Maureen Porter; Padam Simkhada
ANO: 2008
RESUMO: AIM: This paper is a report of a systematic review to identify and analyse the main factors affecting the utilization of antenatal care in developing countries. BACKGROUND: Antenatal care is a key strategy for reducing maternal mortality, but millions of women in developing countries do not receive it. DATA SOURCES: A range of electronic databases was searched for studies conducted in developing countries and published between 1990 and 2006. English-language publications were searched using relevant keywords, and reference lists were hand-searched. REVIEW METHODS: A systematic review was carried out and both quantitative and qualitative studies were included. RESULTS: Twenty-eight papers were included in the review. Studies most commonly identified the following factors affecting antenatal care uptake: maternal education, husband's education, marital status, availability, cost, household income, women's employment, media exposure and having a history of obstetric complications. Cultural beliefs and ideas about pregnancy also had an influence on antenatal care use. Parity had a statistically significant negative effect on adequate attendance. Whilst women of higher parity tend to use antenatal care less, there is interaction with women's age and religion. Only one study examined the effect of the quality of antenatal services on utilization. None identified an association between the utilization of such services and satisfaction with them. CONCLUSION: More qualitative research is required to explore the effect of women's satisfaction, autonomy and gender role in the decision-making process. Adequate utilization of antenatal care cannot be achieved merely by establishing health centres; women's overall (social, political and economic) status needs to be considered.
FONTE: Journal Of Advanced Nursing, Oxford, v. 61, n. 3, p.244-260, 2008.
REFERENCIA: SIMKHADA, Bibha et al. Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature. Journal Of Advanced Nursing, Oxford, v. 61, n. 3, p.244-260, 2008.
138. Avoidable hospitalisations: potential for primary and public health initiatives in Canterbury, New Zealand.
AUTOR(ES): Ian Sheerin; Gary Allen; Mark Henare; Kirsty Craig
ANO: 2006
RESUMO: Aim To investigate the extent of potentially “avoidable hospitalisations” in the Canterbury District Health Board area; specifically, to identify the leading causes, recent trends, and estimated costs of avoidable hospitalisations. Methods All hospitalisations in Christchurch Hospital from 2000 to 2004 were analysed and potentially “avoidable admissions” were categorised using ICD10 clinical codes. Costs of these admissions were estimated for the financial year ending 30 June 2003 using diagnostic-related groups (DRGs). Results The leading causes of potentially “avoidable hospitalisations” in Christchurch Hospital were cardiovascular disease, stroke, respiratory, gastrointestinal, and urinary disorders. The total estimated costs of avoidable hospitalisations in 2003 were NZ$96.6 million, accounting for an estimated 94,462 bed days. The estimated costs of cardiovascular admissions (excluding stroke) were $50.6 million, with stroke accounting for an additional $6.2 million. Conclusion Potentially “avoidable admissions” to Christchurch Hospital comprised 31% of all hospital admissions. There is considerable opportunity to invest in public and primary health initiatives aimed at early detection and intervention, with the major opportunities being identified as cardiovascular disease, stroke, respiratory, gastrointestinal, and urinary disorders.
FONTE: Journal Of The New Zealand Medical Association, New Zealand, v. 119, n. 1236, p.1-9, 2006.
REFERENCIA: SHEERIN, Ian et al. Avoidable hospitalisations: potential for primary and public health initiatives in Canterbury, New Zealand. Journal Of The New Zealand Medical Association, New Zealand, v. 119, n. 1236, p.1-9, 2006.
139. O Programa de Humanização no Pré-natal e Nascimento do Ministério da Saúde no Brasil: resultados iniciais.
AUTOR(ES): Suzanne Jacob Serruya; José Guilherme Cecatti; Tania di Giacomo do Lago
ANO: 2004
RESUMO: Avalia-se a experiência da implantação do Programa de Humanização no Pré-natal e Nascimento do Ministério da Saúde, no Brasil, a partir dos dados gerados pelo SISPRENATAL/DATASUS. De sua instituição em junho de 2000 até dezembro de 2002, 3.983 municípios aderiram, e 71% desses (3.183) registraram procedimentos no âmbito do programa, constituindo um banco de dados com 720.871 mulheres. Cerca de 20% das mulheres realizaram seis ou mais consultas de pré-natal, e cerca da metade delas realizou também a consulta puerperal e os exames obrigatórios em 2002, e 41% das mulheres foram imunizadas com a vacina antitetânica. A realização de exames para a detecção de HIV foi o dobro em relação à sífilis, nos dois anos em análise. O conjunto das atividades assistenciais recomendado foi recebido apenas por um pequeno percentual de mulheres, 2% em 2001 e 5% em 2002. Os baixos percentuais registrados ratificam a necessidade de permanentes avaliações com o objetivo de melhorar a qualidade dessa atenção, garantindo, além de melhores resultados maternos e perinatais, o direito inalienável de cada mulher de gestar e parir com segurança e bem-estar.
FONTE: Cadernos de Saúde Pública, Rio de Janeiro, v. 20, n. 5, p.1281-1289, 2004.
REFERENCIA: SERRUYA, Suzanne Jacob; CECATTI, José Guilherme; LAGO, Tania Di Giacomo do. O programa de humanização no pré-natal e nascimento do Ministério da Saúde no Brasil: resultados iniciais. Cadernos de Saúde Pública, Rio de Janeiro, v. 20, n. 5, p.1281-1289, 2004.
140. Measuring and managing performance.
AUTOR(ES): Eurohealth.
ANO: 2010
RESUMO:
FONTE: Eurohealth, v. 3, n. 16, 2010.
REFERENCIA: Eurohealth.Measuring and managing performance. Eurohealth, London, v. 3, n. 16, 2010.
141. Chronic renal diseases as a public health problem: epidemiology, social, and economic implications.
AUTOR(ES): Arrigo Schieppati; Giuseppe Remuzzi
ANO: 2005
RESUMO: The impact of chronic kidney disease (CKD) on the global burden of diseases is probably underestimated by current methods of evaluation. However, CKD are emerging as a major health problem. First, the costs of renal replacement therapy are excedingly high and are consuming a significant proportion of health care budgets of developed countries, while in developing countries are out of reach. Second, complex interaction are clearly emerging between chronic kidney, cardiovascular disease, and diabetes.
FONTE: Kidney International, Malden, v. 68, n. 98, p.7-10, 2005. Suplemento.
REFERENCIA: SCHIEPPATI, Arrigo; REMUZZI, Giuseppe. Chronic renal diseases as a public health problem: epidemiology, social, and economic implications. Kidney International, Malden, v. 68, n. 98, p.7-10, 2005. Suplemento.
142. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis.
AUTOR(ES): Nicole Simunovic; P.J. Devereaux; Sheila Sprague; Gordon H. Guyatt; Emil Schemitsch; Justin DeBeer; Mohit Bhandari
ANO: 2010
RESUMO: Background: Guidelines exist for the surgical treatment of hip fracture, but the effect of early surgery on mortality and other outcomes that are important for patients remains unclear. We conducted a systematic review and meta-analysis to determine the effect of early surgery on the risk of death and common postoperative complications among elderly patients with hip fracture. Methods: We searched electronic databases (including MEDLINE and EMBASE), the archives of meetings of orthopedic associations and the bibliographies of relevant articles and questioned experts to identify prospective studies, published in any language, that evaluated the effects of early surgery in patients undergoing procedures for hip fracture. Two reviewers independently assessed methodologic quality and extracted relevant data. We pooled data by means of the DerSimonian and Laird random-effects model, which is based on the inverse variance method. Results: We identified 1939 citations, of which 16 observational studies met our inclusion criteria. These studies had a total of 13 478 patients for whom mortality data were complete (1764 total deaths). Based on the five studies that reported adjusted risk of death (4208 patients, 721 deaths), irrespective of the cut-off for delay (24, 48 or 72 hours), earlier surgery (i.e., within the cut-off time) was associated with a significant reduction in mortality (relative risk [RR] 0.81, 95% confidence interval [CI] 0.68–0.96, p = 0.01). Unadjusted data indicated that earlier surgery also reduced in-hospital pneumonia (RR 0.59, 95% CI 0.37–0.93, p = 0.02) and pressure sores (RR 0.48, 95% CI 0.34–0.69, p < 0.001).
FONTE: Canadian Medical Association Journal, Ottawa, v. 182, n. 15, p.1609-1616, 2010.
REFERENCIA: SIMUNOVIC, Nicole et al. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. Canadian Medical Association Journal, Ottawa, v. 182, n. 15, p.1609-1616, 2010.
143. The diagnosis and management of acute bacterial meningitis in resource-poor settings.
AUTOR(ES): Matthew Scarborough; Guy E. Thwaites
ANO: 2008
RESUMO: Acute bacterial meningitis is more common in resource-poor than resource-rich settings. Survival is dependent on rapid diagnosis and early treatment, both of which are difficult to achieve when laboratory support and antibiotics are scarce. Diagnostic algorithms that use basic clinic and laboratory features to distinguish bacterial meningitis from other diseases can be useful. Analysis of the CSF is essential, and simple techniques can enhance the yield of diagnostic microbiology. Penicillin-resistant and chloramphenicol-resistant bacteria are a considerable threat in resource-poor settings that go undetected if CSF and blood can not be cultured. Generic formulations of ceftriaxone are becoming more affordable and available, and are effective against meningitis caused by penicillin-resistant or chloramphenicol-resistant bacteria. However, infection with Streptococcus pneumoniae with reduced susceptibility to ceftriaxone is reported increasingly, and alternatives are either too expensive (eg, vancomycin) or can not be widely recommended (eg, rifampicin, which is the key drug to treat tuberculosis) in resource-poor settings. Additionally, improved access to affordable antibiotics will not overcome the problems of poor access to hospitals and the fatal consequences of delayed treatment. The future rests with the provision of effective conjugate vaccines against S pneumoniae, Haemophilus influenzae, and Neisseria meningitides to children in the poorest regions of the world.
FONTE: The Lancet Neurology, London, v. 7, n. 7, p.637-648, 2008.
REFERENCIA: SCARBOROUGH, Matthew; THWAITES, Guy E.. The diagnosis and management of acute bacterial meningitis in resource-poor settings. The Lancet Neurology, London, v. 7, n. 7, p.637-648, 2008.
144. Health at a Glance 2011-OECD Indicators.
AUTOR(ES): OECD.Organisation for Economic Co-operation and Development.
ANO: 2011
RESUMO:
FONTE: Paris: OECD, 2011. 199 p.
REFERENCIA: ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT. Health at a Glance 2011: Health at a Glance 2011. Paris: OECD, 2011. 199 p.
145. The equity dimension in evaluations of the quality and outcomes framework: a systematic review.
AUTOR(ES): Pauline Boeckxstaens; Delphine De Smedt; Jan De Maeseneer; Lieven Annemans; Sara Willems
ANO: 2011
RESUMO: BACKGROUND: Pay-for-performance systems raise concerns regarding inequity in health care because providers might select patients for whom targets can easily be reached. This paper aims to describe the evolution of pre-existing (in)equity in health care in the period after the introduction of the Quality and Outcomes Framework (QOF) in the UK and to describe (in)equities in exception reporting. In this evaluation, a theory-based framework conceptualising equity in terms of equal access, equal treatment and equal treatment outcomes for people in equal need is used to guide the work. METHODS: A systematic MEDLINE and Econlit search identified 317 studies. Of these, 290 were excluded because they were not related to the evaluation of QOF, they lacked an equity dimension in the evaluation, their qualitative research focused on experiences or on the nature of the consultation, or unsuitable methodology was used to pronounce upon equity after the introduction of QOF. RESULTS: None of the publications (n = 27) assessed equity in access to health care. Concerning equity in treatment and (intermediate) treatment outcomes, overall quality scores generally improved. For the majority of the observed indicators, all citizens benefit from this improvement, yet the extent to which different patient groups benefit tends to vary and to be highly dependent on the type and complexity of the indicator(s) under study, the observed patient group(s) and the characteristics of the study. In general, the introduction of QOF was favourable for the aged and for males. Total QOF scores did not seem to vary according to ethnicity. For deprivation, small but significant residual differences were observed after the introduction of QOF favouring less deprived groups. These differences are mainly due to differences at the practice level. The variance in exception reporting according to gender and socio-economic position is low. CONCLUSIONS: Although QOF seems not to be socially selective at first glance, this does not mean QOF does not contribute to the inverse care law. Introducing different targets for specific patient groups and including appropriate, non-disease specific and patient-centred indicators that grasp the complexity of primary care might refine the equity dimension of the evaluation of QOF. Also, information on the actual uptake of care, information at the patient level and monitoring of individuals' health care utilisation tracks could make large contributions to an in-depth evaluation. Finally, evaluating pay-for-quality initiatives in a broader health systems impact assessment strategy with equity as a full assessment criterion is of utmost importance.
FONTE: BMC Health Services Research, London, v. 11, n. 209, p.1-15, 2011.
REFERENCIA: BOECKXSTAENS, Pauline et al. The equity dimension in evaluations of the quality and outcomes framework: a systematic review. BMC Health Services Research, London, v. 11, n. 209, p.1-15, 2011.
146. Who are the elderly who never receive influenza immunization?
AUTOR(ES): Usha Sambamoorthi; Patricia A. Findley
ANO: 2005
RESUMO: OBJECTIVE: This paper estimates the rates of lifetime nonreceipt of influenza immunization among elderly and examines variations in the lifetime nonreceipt of immunization by gender, race and ethnic group, socioeconomic status, access to health care, and health status. METHODS: Cross-sectional, nationally representative data on 5557 adults older than 50 years of age and living in the community from the 2000 Medical Expenditure Panel Survey are used. Lifetime nonreceipt of influenza immunization was analyzed with bivariate and multivariate statistical techniques. FINDINGS: Thirty-one percent of the elderly reported never receiving influenza immunization and 20% reported irregular immunization. Higher odds of lifetime nonreceipt of vaccination and irregular vaccination were seen among African-Americans, young-old, current smokers, and those with no usual source of care. CONCLUSIONS: Future campaigns to increase immunization rates should be tailored to target this hard-to-reach group of individuals.
FONTE: Preventive Medicine, New York, v. 40, n. 4, p.469-478, 2005.
REFERENCIA: SAMBAMOORTHI, Usha; FINDLEY, Patricia A. Who are the elderly who never receive influenza immunization? Preventive Medicine, New York, v. 40, n. 4, p.469-478, 2005.
147. Evidence-Based Maternity Care: What It Is and What It Can Achieve.
AUTOR(ES): Carol Sakala; Maureen P. Corry
ANO: 2008
RESUMO:
FONTE: New York: The Milbank Memorial Fund, 2008. 118 p.
REFERENCIA: SAKALA, Carol; CORRY, Maureen P. Evidence-based maternity care: what it is and what it can achieve. New York: The Milbank Memorial Fund, 2008. 118 p.
148. Estudo da mortalidade na fratura do fêmur proximal em idosos
AUTOR(ES): Marcos Hideyo Sakaki; Arnó bio Rocha Oliveira; Fabrí cio F. Coelho; Luiz Eugê nio Garcez Leme; Itiro Suzuki; Marco Martins Amatuzzi
ANO: 2004
RESUMO: Foi feito um estudo de revisão sobre a mortalidade na fratura do fêmur proximal em idosos com base nas publicações mais relevantes do período de 1998 a 2002. Foram incluídos 25 artigos relacionados ao assunto, selecionados com base nos bancos de dados Medline e Cochrane, totalizando 24.062 pacientes com mais de 60 anos de idade, que tiveram fratura do fêmur proximal. Quatorze estudos foram prospectivos, oito retrospectivos e três revisões sistemáticas. As taxas médias de mortalidade foram de 5,5% durante a internação hospitalar, 4,7% ao fim de um mês de seguimento, 11,9% com três meses, 10,8% com seis meses, 19,2% com um ano e 24,9% com dois anos. Foram identificados quatro fatores intimamente relacionados com uma maior mortalidade nestes pacientes: idade avançada, grande número de doenças associadas, sexo masculino e presença de deficiências cognitivas. Outros fatores mostraram uma fraca correlação com a mortalidade como capacidade deambulatória prévia, índice de risco anestésico da Sociedade Americana de Anestesia (ASA), anemia, hipoalbuminemia, linfopenia e existência de AVC prévio. Os fatores como tempo prévio à cirurgia, tipo de anestesia utilizada e tipo de osteossíntese empregada não mostraram ter interferência.
FONTE: Acta Ortopédica Brasileira, São Paulo, v. 12, n. 4, p.242-249, 2004.
REFERENCIA: SAKAKI, Marcos Hideyo et al. Estudo da mortalidade na fratura do fêmur proximal em idosos. Acta Ortopédica Brasileira, São Paulo, v. 12, n. 4, p.242-249, 2004.
149. Measuring the quality of medical care. A clinical method.
AUTOR(ES): David D. Rutstein; William Berenberg; Thomas C. Chalmers; Charles G. Child; Alfred P. Fishman; Edward B. Perrin; Jacob J. Feldman; Paul E. Leaverton; J. Michael Lane; David J. Sencer; Carleton C. Evans
ANO: 1976
RESUMO: We outline the implementation of a new method of measuring the quality of medical care that counts cases of unnecessary disease and disability and unnecessary untimely deaths. First of all, conditions are listed in which the occurrence of a single case of disease or disability or a single untimely death would justify asking, "Why did it happen?" Secondly, we have selected conditions in which critical increases in rates of disease, disability, or untimely death could serve as indexes of the quality of care. Finally, broad categories of illness are noted in which redefinition and intensive study might reveal characteristics that could serve as indexes of health. We describe how these inth of the general population and the effects of economic, political, and other environmental factors upon it, and to evaluate the quality of medical care provided both within and without the hospital to maintain health and to prevent and treat disease.
FONTE: The New England Journal Of Medicine, Boston, v. 294, n. 11, p.582-588, 1976.
REFERENCIA: RUTSTEIN, David D. et al. Measuring the quality of medical care. A clinical method. The New England Journal Of Medicine, Boston, v. 294, n. 11, p.582-588, 1976.
150. Maternal and neonatal tetanus.
AUTOR(ES): Martha H. Roper; Jos H. Vandelaer; Franç ois L. Gasse
ANO: 2007
RESUMO: Maternal and neonatal tetanus are important causes of maternal and neonatal mortality, claiming about 180 000 lives worldwide every year, almost exclusively in developing countries. Although easily prevented by maternal immunisation with tetanus toxoid vaccine, and aseptic obstetric and postnatal umbilical-cord care practices, maternal and neonatal tetanus persist as public-health problems in 48 countries, mainly in Asia and Africa. Survival of tetanus patients has improved substantially for those treated in hospitals with modern intensive-care facilities; however, such facilities are often unavailable where the tetanus burden is highest. The Maternal and Neonatal Tetanus Elimination Initiative assists countries in which maternal and neonatal tetanus has not been eliminated to provide immunisation with tetanus toxoid to women of childbearing age. The ultimate goal of this initiative is the worldwide elimination of maternal and neonatal tetanus. Since tetanus spores cannot be removed from the environment, sustaining elimination will require improvements to presently inadequate immunisation and health-service infrastructures, and universal access to those services. The renewed worldwide commitment to the reduction of maternal and child mortality, if translated into effective action, could help to provide the systemic changes needed for long-term elimination of maternal and neonatal tetanus.
FONTE: The Lancet, New York, v. 370, n. 9603, p.1947-1959, 2007.
REFERENCIA: ROPER, Martha H.; VANDELAER, Jos H.; GASSE, François L. Maternal and neonatal tetanus. The Lancet, New York, v. 370, n. 9603, p.1947-1959, 2007.
151. La Vasectomía: Estudio de 300 intervenciones. Revisión de la literatura nacional y de SUS complicaciones.
AUTOR(ES): P. Romero Pé rez; F. J. Merenciano Cortina; W. Rafie Mazketli; M. Amat Cecilia; Mª C. Martí nez Herná ndez
ANO: 2004
RESUMO: OBJETIVOS: Los objetivos que nos hemos marcado en este trabajo son: 1. Estudiar la demanda e indicaciones de vasectomía en el área 12 de la Comunidad Valenciana. 2. Analizar las complicaciones de nuestra serie y los factores de riesgo previsibles. 3. Revisar las complicaciones de las series nacionales. 4. Revisar las complicaciones referidas en las publicaciones internacionales. PACIENTES Y MÉTODOS: Se realiza un estudio retrospectivo de 300 pacientes sometidos a vasectomía durante el periodo de tiempo comprendido entre enero de 1992 y diciembre de 2000. Se revisaron todas las historias clínicas evaluando 10 variables preestablecidas: edad, número de hijos, indicación, método contraceptivo utilizado pre-vasectomía, fecha de intervención, tipo anestesia, anatomía patológica, seminogramas de control, complicaciones, y posibles causas de las complicaciones (factores de riesgo). Se realiza el estudio estadístico básico con ayuda de una base de datos de Microsoft Access y para la interpretación estadística de las distintas variables se utilizó una tabla de Excel. RESULTADOS: La demanda de atención contraceptiva (vasectomía) constituye la 8ª causa de consulta externa urológica y la 4ª de cirugía urológica local ambulatoria en nuestra área. Durante este periodo se realizaron 300 intervenciones de vasectomía. La edad media de los pacientes fue de 37,5 años (rango entre 23-51). El número de hijos osciló entre un mínimo de 1 y un máximo de 7, con un promedio de 2,41 hijos/paciente. Las indicaciones de la vasectomía fueron: planificación familiar voluntaria (86%), enfermedades medicas de la mujer que contraindicaban la gestación (9%), consejo genético (4,33%), y problema socio-sanitario (0,66%). Los métodos contraceptivos utilizados por las parejas previamente a la vasectomía se conocían en el 71,63% de los pacientes. Los más utilizados fueron: el DIU (49,74%) y el preservativo (25,88%). Se presentaron complicaciones en 30 pacientes (10%); de ellas en 29 pacientes fueron leves (9,66%), siendo las más frecuentes: 12 orquiepididimitis (4%), 5 granulomas espermáticos (1,66%), 3 orquialgias crónicas “síndrome del testículo doloroso”, (1%), 2 hematomas escrotales (0,66%) y 2 hemorragias de herida (0,66%). Se presentó una complicación grave por impétigo escrotal estafilocócico con posterior sepsis estafilocócica (0,33%). De todas las complicaciones sólo 1 caso requirió hospitalización (impétigo-sepsis) y 1 caso cirugía debido a granuloma espermático. No hubo embarazos no deseados ni demandas judiciales postvasectomía. La azoospermia definida al principio del estudio con 1 seminograma sin espermatozoides y en la actualidad con 2 seminogramas sin espermatozoides con una diferencia entre ellos de 15 días ó 30 días, se logró en el 81% de pacientes entre los 45 y 60 días post-vasectomía. CONCLUSIONES: La vasectomía es un método seguro y simple para conseguir la esterilidad del varón. Es la intervención urológica más practicada en España. La técnica no está exenta de complicaciones (tasa de 0-18%), y su gravedad varía, desde la simple equimosis, hasta la gangrena genital de Fournier, la endocarditis o la sepsis. En la información pre-vasectomía el facultativo incurre en negligencia si no informa al paciente de la posibilidad, remota pero existente, de recanalización espontánea de los deferentes, con recuperación de la fertilidad (fallo de la vasectomía). La información post-vasectomía, sobre prolongar la utilización del método contraceptivo habitual hasta confirmar la esterilidad y el seguimiento del paciente hasta la azoospermia demostrada con 2 espermiogramas, es fundamental para el urólogo si no quiere verse envuelto en problemas legales.
FONTE: Actas Urológicas Españolas, Madrid, v. 28, n. 3, p.175-214, 2004.
REFERENCIA: ROMERO PEREZ, P. et al. La Vasectomía: Estudio de 300 intervenciones. Revisión de la literatura nacional y de SUS complicaciones.Actas Urológicas Españolas, Madrid, v. 28, n. 3, p.175-214, 2004.
152. Preventable hospitalization and access to primary health care in an area of Southern Italy.
AUTOR(ES): Paolo Rizza; Aida Bianco; Maria Pavia; Italo F. Angelillo
ANO: 2007
RESUMO: BACKGROUND: Ambulatory care-sensitive conditions (ACSC), such as hypertension, diabetes, chronic heart failure, chronic obstructive pulmonary disease and asthma, are conditions that can be managed with timely and effective outpatient care reducing the need of hospitalization. Avoidable hospitalizations for ACSC have been used to assess access, quality and performance of the primary care delivery system. The aims of this study were to quantify the proportion of avoidable hospital admissions for ACSCs, to identify the related patient's socio-demographic profile and health conditions, to assess the relationship between the primary care access characteristics and preventable hospitalizations, and the usefulness of avoidable hospitalizations for ACSCs to monitor the effectiveness of primary health care. METHODS: A random sample of 520 medical records of patients admitted to medical wards (Cardiology, Internal Medicine, Pneumology, Geriatrics) of a non-teaching acute care 717-bed hospital located in Catanzaro (Italy) were reviewed. RESULTS: A total of 31.5% of the hospitalizations in the sample were judged to be preventable. Of these, 40% were for congestive heart failure, 23.2% for chronic obstructive pulmonary disease, 13.5% for angina without procedure, 8.4% for hypertension, and 7.1% for bacterial pneumonia. Preventable hospitalizations were significantly associated to age and sex since they were higher in older patients and in males. The proportion of patients who had a preventable hospitalization significantly increased with regard to the number of hospital admissions in the previous year and to the number of patients for each primary care physician (PCP), with lower number of PCP accesses and PCP medical visits in the previous year, with less satisfaction about PCP health services, and, finally, with worse self-reported health status and shorter length of hospital stay. CONCLUSION: The findings from this study add to the evidence and the urgency of developing and implementing effective interventions to improve delivery of health care at the community level and provided support to the usefulness of avoidable hospitalizations for ACSCs to monitor this process.
FONTE: BMC Health Services Research, London, v. 7, n. 1, p.134-142, 2007. Suplemento.
REFERENCIA: RIZZA, Paolo et al. Preventable hospitalization and access to primary health care in an area of Southern Italy. BMC Health Services Research, London, v. 7, n. 1, p.134-142, 2007. Suplemento.
153. Women's autonomy and scheduled cesarean sections in Brazil: a cautionary tale.
AUTOR(ES): Joseph E. Potter; Kristine Hopkins; Anibal Faú ndes; Ignez Perpé tuo
ANO: 2008
RESUMO: BACKGROUND: In Brazil, one-fourth of all women deliver in the private sector, where the rate of cesarean deliveries is extremely high (70%). Most (64%) private sector cesareans are scheduled, although many women would have preferred a vaginal delivery. The question this study addresses is whether childbearing women were induced to accept the procedure by their physicians, and if so, how? METHODS: Three face-to-face structured interviews were conducted with 1,612 women (519 private sector and 1,093 public sector) early in pregnancy, approximately 1 month before their due date, and approximately 1 month postpartum. For all private sector patients having a scheduled cesarean section, women's self-reported reasons given for programming surgical delivery were classified into three groups according to obstetrical justification. RESULTS: After loss to follow-up (19.2% of private sector and 34.4% of public sector), our final sample included 1,136 women (419 private sector and 717 public sector). Compared with public sector participants in the final sample, on average, private sector participants were older by 3.4 years (28.7 vs 25.3 yr), had 0.4 fewer previous deliveries (0.6 vs 1.0), and had 3.4 more years of education (11.0 vs 7.6 yr). The final samples also differed slightly with respect to preference for vaginal delivery: 72.3 percent among those in the private sector and 79.6 percent in public sector. The cesarean section rate was 72 percent in the private sector and 31 percent in the public sector. Of the women with reports about the timing of the cesarean decision, 64.4 percent had a scheduled cesarean delivery in the private sector compared with 23.7 percent in the public sector. Many cesarean sections were scheduled for an "unjustified" medical reason, especially among women who, during pregnancy, had declared a preference for a vaginal delivery. Among 96 women in this latter group, the reason reported for the procedure was unjustified in 33 cases. On the other hand, more cesarean deliveries were scheduled for "no medical justification," including physician's or the woman's convenience, among women who preferred to deliver by cesarean (35/65). The incidence of real medical reasons for a scheduled cesarean section diagnosed before the onset of labor among private sector patients who had no previous cesarean birth and who wanted a vaginal delivery was 13 percent (31/243). CONCLUSIONS: The data suggest that doctors frequently persuaded their patients to accept a scheduled cesarean section for conditions that either did not exist or did not justify this procedure. The problem identified in this paper may extend well beyond Brazil and should be of concern to those with responsibility for ethical behavior in obstetrics.
FONTE: Birth, Berkeley, v. 35, n. 1, p.33-40, 2008.
REFERENCIA: POTTER, Joseph E. et al. Women's autonomy and scheduled cesarean sections in Brazil: a cautionary tale. Birth, Berkeley, v. 35, n. 1, p.33-40, 2008.
154. Avoidable admissions and repeat admissions: what do they tell us?
AUTOR(ES): Joan Porter; Jeremy Herring; Jeanie Lacroix; Carey Levinton
ANO: 2007
RESUMO: Ready access to primary healthcare is a desire of governments, healthcare providers and the public. One indicator that is recognized as an indirect measure of access to and quality of primary healthcare is the rate of hospitalization for ambulatory care sensitive conditions (ACSCs). An ACSC hospitalization, also known as a potentially preventable hospitalization, is one in which an individual is admitted for a condition that under most circumstances is manageable on an outpatient basis. While not all admissions for these conditions are avoidable, "timely and effective outpatient care can help to reduce the risks of hospitalization by either preventing the onset of an illness or condition, controlling an acute episodic illness or condition, or managing a chronic disease or condition" (Billings et al. 1993: 163). In this context, a disproportionately high rate may reflect problems in obtaining access to primary healthcare, differences in community- or hospital-based practice patterns or other factors. The conditions captured under this definition include angina, asthma, chronic obstructive pulmonary disease (COPD), congestive heart disease, diabetes, epilepsy and hypertension. This list is a subset of a larger selection of conditions developed by Billings et al. (1993) in a consultative process using a diagnostic framework for assessing hospital use. In 2004-2005, ACSC hospitalizations accounted for 5.1% of all acute care in-patient hospitalizations in Canada for persons less than 75 years of age at admission discharged alive, and ranged from 3.3% to 7.2% among the provinces and territories. ACSC hospitalization rates for those under age 75 years and discharged alive vary across the country (see Figure 1). The rates reflect both new cases and subsequent admissions for the same or another ACSC. More males than females were found to have had an ACSC admission (55.2%). Overall rates, as well as those for both genders, by health region, are available at www.cihi.ca/indicators.
FONTE: Healthcare Quarterly, Toronto, v. 10, n. 1, p.26-28, 2007.
REFERENCIA: PORTER, Joan et al. Avoidable admissions and repeat admissions: what do they tell us?. Healthcare Quarterly, Toronto, v. 10, n. 1, p.26-28, 2007.
155. Hysterectomy in the United States, 1965-84.
AUTOR(ES): R. Pokras; V. G. Hufnagel
ANO: 1988
RESUMO:
FONTE: American Journal Of Public Health, New York, v. 78, n. 7, p.852-853, 1988.
REFERENCIA: POKRAS, R.; HUFNAGEL, V.G. .Hysterectomy in the United States, 1965-84. American Journal Of Public Health, New York, v. 78, n. 7, p.852-853, 1988.
156. A influência da assistência profissional em saúde na escolha do tipo de parto: um olhar sócio antropológico na saúde suplementar brasileira.
AUTOR(ES): Denise Pires; Hosanna Pattrig Fertonani; Eleonor Minho Conill; Thaí s Alves Matos; Fernanda Peixoto Cordova; Cí ntia da Silva Mazur
ANO: 2010
RESUMO: OBJETIVOS: este estudo é um recorte de uma pesquisa multicêntrica realizada em três capitais da Região Sul do Brasil que focaliza as experiências de usuárias da rede suplementar, buscando contribuir na compreensão da influência da assistência profissional na escolha do tipo de parto realizado neste segmento. MÉTODOS: estudo de abordagem qualitativa, explo-ratório-descritivo, utilizando dados coletados entre dezembro de 2006 e fevereiro de 2007, através de entrevistas com 33 mulheres com até dezoito meses de pós-parto. RESULTADOS: os resultados mostraram alta incidência de parto cesáreo e entre os fatores que contribuíram para este fenômeno identificou-se a medicalização do processo gravidez-parto, o medo da dor, a conveniência da data marcada e um processo de negociação/orientação que se estabelece entre a gestante e seus familiares e o profissional médico, fortemente influenciado pelo vínculo de confiança dessa relação. Fatores culturais, experiências anteriores, relações familiares e a assistência pré-natal baseada na biomedicina também influenciaram a favor do parto cesáreo. CONCLUSÕES: conclui-se que um conjunto de fatores de ordem cultural e organizacional deva ser considerado no sentido da reorganização da assistência pré-natal, visando à implantação de práticas que favoreçam o parto normal.
FONTE: Revista Brasileira de Saúde Materno Infantil, Recife, v. 10, n. 2, p.191-197, 2010.
REFERENCIA: PIRES, Denise et al. A influência da assistência profissional em saúde na escolha do tipo de parto: um olhar sócio antropológico na saúde suplementar brasileira. Revista Brasileira de Saúde Materno Infantil, Recife, v. 10, n. 2, p.191-197, 2010.
157. Desigualdade no tratamento à fratura proximal de fêmur no Rio de Janeiro.
AUTOR(ES): Rejane Sobrino Pinheiro; Clá udia Travassos; Dani Gamernan
ANO: 2006
RESUMO: OBJETIVO: O objetivo deste trabalho é analisar a existência de variações na indicação terapêutica a pacientes com fratura proximal de fêmur entre os hospitais conveniados com o SUS e entre pacientes socialmente distintos. MÉTODO: Foram analisados os dados do SIH-SUS dos hospitais do município do Rio de Janeiro, 1994-1995. RESULTADO: A análise multivariada mostrou que as chances de cirurgia foram maiores para as mulheres (OR=1,53, IC95%1,18-1,99); menores para os hospitais federais (OR = 0,21, IC95% 0,10-0,41), estaduais (OR =0,07, IC95% 0,04-0,12) e municipais (OR=0,11, IC95% 0,07-0,18), em comparação com o hospital privado contratado pelo SUS; foram menores nas emergências (OR=0,31, IC95% 0,19-0,48); e foram maiores nos hospitais localizados em áreas mais privilegiadas (OR=1,68, IC95% 1,52-1,86). CONCLUSÃO: A configuração dos mercados variou com o perfil dos hospitais e pacientes, e a indicação de cirurgia foi associada a fatores não relacionados com a necessidade, mostrando diferenças no acesso ao tratamento adequado.
FONTE: Revista Brasileira de Epidemiologia, São Paulo, vol.9, n.3, p. 374-383, 2006.
REFERENCIA: PINHEIRO, Rejane Sobrino; TRAVASSOS, Cláudia; GAMERMAN, Dani. Desigualdade no tratamento à fratura proximal de fêmur no Rio de Janeiro. Revista Brasileira de Epidemiologia, São Paulo, vol.9, n.3, p. 374-383, 2006.
158. Breast cancer screening: from science to recommendation.
AUTOR(ES): Diana B. Petitti; Ned Calonge; Michael L. LeFevre; Bernadette Mazurek Melnyk; Timothy J. Wilt; J. Sanford Schwartz
ANO: 2010
RESUMO:
FONTE: Radiology, Easton, v. 26, n. 1, p.8-14, 2010.
REFERENCIA: PETITTI, Diana B. et al. Breast cancer screening: from science to recommendation. Radiology, Easton, v. 26, n. 1, p.8-14, 2010.
159. The global burden of diarrhoeal disease in children.
AUTOR(ES): Umesh D. Parashar; Joseph S. Bresee; Roger I. Glass
ANO: 2003
RESUMO:
FONTE: Bulletin Of The World Health Organization, Geneva, v. 81, n. 4, p.236-236, 2003.
REFERENCIA: PARASHAR, Umesh D.; BRESEE, Joseph S.; GLASS, Roger I. The global burden of diarrhoeal disease in children. Bulletin Of The World Health Organization, Geneva, v. 81, n. 4, p.236-236, 2003.
160. End-stage renal disease in Brazil: epidemiology, prevention, and treatment.
AUTOR(ES): Marí lia Bahiense Oliveira; Joã o Egí dio Romã o Jú nior; Roberto Zatz
ANO: 2005
RESUMO: End-stage renal disease in Brazil: Epidemiology, prevention, and treatment. Brazil is one of the largest and most populous nations in the world, ranking among the 5 largest economies in the Americas and among the 15 largest economies in the world. However, Brazil is still plagued by social problems such as the persistence of poverty and immense deficiencies in its health system. Currently, there are approximately 390 patients on chronic renal replacement therapy (RRT) per million population, about one third the US prevalence, which suggests that end-stage renal disease is either underdiagnosed or undertreated. The epidemiology of renal disease in the small remaining native Brazilian population is largely unknown. However, it is likely that the prevalence of renal disease is low among at least 2 tribes: the Yanomamis in northern Brazil and the Xingu Indians in central Brazil. Sodium intake is very low, physical activity is intense, and the prevalence of hypertension and cardiovascular disease is negligible among these people, which stresses the potential pathogenic importance of so-called civilized habits. There is currently no conclusive evidence that African descendants or any other Brazilian ethnic minorities are especially vulnerable to renal disease. Access to RRT in Brazil is universal. However, because both the end-stage renal disease population and operational RRT costs are steadily increasing, the system may face severe limitations in the near future. Much effort is needed to limit the prevalence of renal disease, to detain or retard the progression of chronic nephropathies, and to ensure that high-quality RRT will remain available to all those who need it.
FONTE: Kidney International, Malden, v. 68, n. 97, p.46-52, 2005. Suplemento.
REFERENCIA: OLIVEIRA, Marília Bahiense; ROMÃO JúNIOR, João Egídio; ZATZ, Roberto. End-stage renal disease in Brazil: epidemiology, prevention, and treatment. Kidney International, Malden, v. 68, n. 97, p.46-52, 2005. Suplemento.
161. Mortalidade feminina por hipertensão: análise por causas múltiplas.
AUTOR(ES): Bruno Zoca de Oliveira; Sabina Lé a Davidson Gotlieb; Ruy Laurenti; Maria Helena Prado de Mello Jorge
ANO: 2009
RESUMO: INTRODUÇÃO: A prevalência da hipertensão arterial vem crescendo no país, constituindo-se em um problema de saúde pública por sua magnitude e dificuldades no controle. OBJETIVO: Avaliar a qualidade dos dados sobre hipertensão como causa de morte e verificar o ganho de informação na mortalidade por hipertensão arterial de mulheres de 10 a 49 anos, por meio da metodologia de análise por causas múltiplas de morte. MATERIAL E MÉTODOS: Foi constituída uma base de dados com 7.332 óbitos ocorridos no primeiro semestre de 2002 pertencentes ao "Estudo da Morbi-Mortalidade de Mulheres de 10 a 49 anos". A metodologia RAMOS (Reproductive Age Mortality Survey) foi aplicada em todas as capitais de Estados brasileiros e Distrito Federal. Com as informações adicionais, foi preenchida uma nova declaração de óbito - DO-NOVA. Foram analisados dois conjuntos de dados (DO-ORIGINAL - antes da investigação - e DO-NOVA - após resgate das informações. Foram realizadas comparações segundo causas básicas e múltiplas por fontes dos dados (DO-O, DO-N). RESULTADOS E CONCLUSÃO: A DO-ORIGINAL apresentou algumas falhas quantitativas e qualitativas. Concluiu-se que a análise por causas múltiplas enriquece a informação, com base nas DO. São necessárias ações contínuas para um melhor preenchimento da DO, pelos médicos, e deve haver mais estudos que adotem a metodologia de causas múltiplas.
FONTE: Revista Brasileira de Epidemiologia, São Paulo, v. 12, n. 4, p.556-565, 2009.
REFERENCIA: OLIVEIRA, Bruno Zoca de et al. Mortalidade feminina por hipertensão: análise por causas múltiplas. Revista Brasileira de Epidemiologia, São Paulo, v. 12, n. 4, p.556-565, 2009.
162. Tendências da internação e da mortalidade infantil por diarréia: Brasil, 1995 a 2005.
AUTOR(ES): Thais Clá udia Roma de Oliveira; Maria do Rosá rio Dias de Oliveira Latorre
ANO: 2010
RESUMO: OBJETIVO: Analisar a tendência das internações e da mortalidade por diarréia em crianças menores de um ano. MÉTODOS: Foi realizado um estudo ecológico de séries temporais entre 1995 e 2005, para o Brasil e para as capitais dos estados. Foram utilizados dados secundários do Ministério da Saúde, obtidos do Sistema de Informação Hospitalar e do Sistema de Informação sobre Mortalidade. Durante o período de estudo foram registradas 1.505.800 internações e 39.421 mortes por diarréia de crianças menores de um ano de idade. Para as análises das tendências da taxa de internação e de mortalidade foram utilizados modelos de regressão polinomial. RESULTADOS: Houve redução tanto nas internações por diarréia quanto na mortalidade infantil por diarréia no País e em 13 capitais. Oito capitais tiveram queda somente na mortalidade por diarréia, enquanto três apresentaram decréscimo somente nas taxas de internação por diarréia. Na análise conjunta dos indicadores de diarréia e dos indicadores gerais, observou-se que houve decréscimo em todas as séries históricas somente no Brasil e em quatro capitais. CONCLUSÕES: A redução nas taxas de internações e mortalidade por diarréia observada pelas séries temporais podem ser resultado das medidas de prevenção e controle empregadas.
FONTE: Revista de Saúde Pública, São Paulo, v. 44, n. 1, p.102-111, 2010.
REFERENCIA: OLIVEIRA, Thais Cláudia Roma de; LATORRE, Maria do Rosário Dias de Oliveira. Tendências da internação e da mortalidade infantil por diarréia: Brasil, 1995 a 2005. Revista de Saúde Pública, São Paulo, v. 44, n. 1, p.102-111, 2010.
163. Programa Saúde da Família e condições sensíveis à atenção primária, Bagé (RS).
AUTOR(ES): Fú lvio Borges Nedel; Luiz Augusto Facchini; Miguel Martí n-Mateo; Lú cia Azambuja Saraiva VieiraIII; Elaine Thumé
ANO: 2008
RESUMO: OBJETIVO: Condições sensíveis à atenção primária (CSAP) são problemas de saúde atendidos por ações do primeiro nível de atenção. A necessidade de hospitalização por essas causas deve ser evitada por uma atenção primária oportuna e efetiva. O objetivo do estudo foi estimar a probabilidade do diagnóstico de CSAP em pacientes hospitalizados pelo Sistema Único de Saúde. MÉTODOS: Estudo transversal com 1.200 pacientes internados entre setembro/2006 e janeiro/2007 em Bagé (RS). Os pacientes responderam a questionário aplicado por entrevistadoras, sendo classificados segundo o modelo de atenção utilizado previamente à hospitalização. As CSAP foram definidas em oficina promovida pelo Ministério da Saúde. Analisaram-se variáveis demográficas, socioeconômicas, de situação de saúde e relativas aos serviços de saúde utilizados. A análise multivariável foi realizada por modelo de Poisson, seguindo modelo teórico hierárquico de determinação da hospitalização segundo sexo e modelo de atenção. RESULTADOS: O total de 42,6% das internações foi por condições sensíveis à atenção primária. A probabilidade de que o diagnóstico principal de internação seja por uma dessas condições aumenta com as características: ser do sexo feminino, ter idade menor de cinco anos, ter escolaridade menor de cinco anos, ter sido hospitalizado no ano anterior à entrevista, ter consulta médica na emergência, estar internado no hospital universitário. Associaram-se à probabilidade de CSAP: (a) mulheres: faixa etária, escolaridade, tempo de funcionamento da unidade de saúde, residir em área de saúde da família, ser usuária do Programa Saúde da Família, consulta médica na emergência no mês anterior à pesquisa e hospital de internação; (b) homens: faixa etária, ter sofrido outra internação no ano anterior à entrevista e o hospital de internação. CONCLUSÕES: As condições sensíveis à atenção primária permitem identificar grupos carentes de atenção à saúde adequada. Embora o estudo não permita inferências sobre o risco de internação, as análises por sexo e modelo de atenção sugerem que o Programa Saúde da Família é mais eqüitativo que a atenção básica tradicional.
FONTE: Revista de Saúde Pública, São Paulo, v. 42, n. 6, p.1041-1052, 2008.
REFERENCIA: NEDEL, Fúlvio Borges et al. Programa Saúde da Família e condições sensíveis à atenção primária, Bagé (RS). Revista de Saúde Pública, São Paulo, v. 42, n. 6, p.1041-1052, 2008.
164. Hospitalizations associated with rotavirus gastroenteritis in the United States, 1993-2002.
AUTOR(ES): Myrna D. Charles; Robert C. Holman; Aaron T. Curns; Umesh D. Parashar; Roger I. Glass; Joseph S. Bresee
ANO: 2006
RESUMO: BACKGROUND: In the United States, rotavirus gastroenteritis remains a common disease of children that results in many hospitalizations, clinic visits and medical costs. It is a common cause of morbidity and is associated with a high economic burden in developing countries. Prevention of hospitalizations is the primary target of rotavirus vaccines. METHODS: To update estimates of rotavirus hospitalization rates in the United States, we conducted a retrospective analysis of 10 years of national hospitalization data associated with gastroenteritis and used both direct and indirect methods to estimate the percentage of cases associated with rotavirus gastroenteritis. RESULTS: During 1993-2002, an average of 18% of all hospitalizations with gastroenteritis among children <5 years old were associated with rotavirus infection as determined by the rotavirus-specific International Classification of Diseases, 9th revision, Clinical Modification code. The annual proportion of rotavirus-associated hospitalizations increased from 15% in 1993-1995 to 21% in 2000-2002. Hospitalizations associated with rotavirus and those associated with nonspecific gastroenteritis had a marked winter-time seasonality and similar age distribution, which peaked among children between 3 and 24 months old. Using indirect estimation methods, 58,000 to 70,000 rotavirus-associated hospitalizations were estimated to occur each year in the United States. CONCLUSIONS: Rotavirus gastroenteritis remains an important cause of hospitalizations in the United States, and the rate has not declined from 1993 through 2002.
FONTE: The Pediatric Infectious Disease Journal, Baltimore, v. 25, n. 6, p.489-493, 2006.
REFERENCIA: CHARLES, Myrna D. et al. Hospitalizations associated with rotavirus gastroenteritis in the United States, 1993-2002. The Pediatric Infectious Disease Journal, Baltimore, v. 25, n. 6, p.489-493, 2006.
165. Monitoramento da doença renal crônica terminal pelo subsistema de Autorização de Procedimentos de Alta Complexidade – Apac – Brasil, 2000 a 2006.
AUTOR(ES): Lenildo de Moura; Maria Inê s Schmidt; Bruce Bartholow Duncan; Roger dos Santos Rosa; Deborah Carvalho Malta; Antony Stevens; Fernando Saldanha Thomé
ANO: 2009
RESUMO: Este estudo descreve dados gerados pelo Subsistema de Autorização de Procedimento de Alta Complexidade de Terapia Renal Substitutiva (Apac-TRS) 2000-2006 e avalia seu potencial para monitoramento da doença renal crônica terminal no Brasil. Após concatenar 2.192 arquivos da Apac-TRS e excluir pacientes repetidos, analisou-se o perfil epidemiológico dos ingressos em TRS segundo idade, sexo, região, tratamento e causa da doença renal. Identificaram-se 148.284 pacientes em tratamento dialítico no período, sendo a incidência estimada em 119,8/1.000.000 habitantes/ano no Brasil, variando de 143,6/1.000.000/ano na Região Sul a 66,3/1.000.000/ano na Região Norte. Hipertensão foi a causa em 32.571 (22,0%), diabetes mellitus em 20.412 (13,8%), glomerulonefrites em 10.654 (7,2%) e causa indeterminada em 66.439 (44.8 %) dos casos. A incidência foi estável no período, exceto para as faixas etárias acima de 65 anos, em que se observou aumento. Apesar das limitações inerentes aos bancos de dados administrativos, a base Apac-TRS tem potencial para ser utilizada no monitoramento da doença renal crônica terminal.
FONTE: Epidemiologia e Serviços de Saúde, Brasília, v. 18, n. 2, p.121-131, 2009.
REFERENCIA: MOURA, Lenildo de et al. Monitoramento da doença renal crônica terminal pelo subsistema de Autorização de Procedimentos de Alta Complexidade – Apac – Brasil, 2000 a 2006. Epidemiologia e Serviços de Saúde, Brasília, v. 18, n. 2, p.121-131, 2009.
166. Day case haemorrhoidectomy.
AUTOR(ES): A. J. G. Miles; A. J. Dunkley
ANO: 2007
RESUMO: OBJECTIVE: Day case haemorrhoidectomy in a District General Hospital. We have investigated the uptake and outcome of day case haemorrhoidectomy in a small district general hospital. METHOD: Case note review with completion of standard proforma for all patients undergoing haemorrhoidectomy as day case (same day admission and discharge) or inpatient over a 4-year period. RESULTS: Sixty patients underwent day case closed haemorrhoidectomy, 2 day case stapled haemorrhoidectomy and 1 day case open haemorrhoidectomy, whilst 18 patients were treated as in-patients. One patient required re-admission within 31 days for reactionary haemorrhage after day case surgery. None suffered acute urinary retention. Concomitant medical disease or emergency admission were the only reasons for exclusion from day case haemorrhoidectomy. Of the 18 patients treated as in-patients haemorrhoidectomy two had unplanned readmission. CONCLUSION: Closed haemorrhoidectomy with same day discharge should be offered to all patients that require surgical treatment of haemorrhoids and do not have other contra-indications to day case surgery.
FONTE: Colorectal Disease, Abingdon, v. 9, n. 6, p.532-35, 2007.
REFERENCIA: MILES, A. J. G.; DUNKLEY, A. J.. Day case haemorrhoidectomy. Colorectal Disease, Abingdon, v. 9, n. 6, p.532-35, 2007.
167. International variation in hip replacement rates.
AUTOR(ES): H. Merx; K. Dreinhofer; P. Schrader; T. Sturmer; W. Puhl; K. Gunther; H. Brenner
ANO: 2003
RESUMO: Objectives: To summarise epidemiological data on the frequency of hip replacements in the countries of the developed world, especially in countries of the Organisation for Economic Cooperation and Development (OECD), and to investigate whether missing consensus criteria for the indication for total hip replacement (THR) result in different replacement rates. Methods: Country-specific hip replacement rates were collected using the available literature, different data sources of national authorities, and estimates of leading hip replacement manufacturers. Results: According to administrative and literature data sources the reported crude primary THR rate varied between 50 and 130 procedures/100 000 inhabitants in OECD countries in the 1990s. The crude overall hip implantation rate, summarising THR, partial hip replacement, and hip revision procedures, was reported to range from 60 to 200 procedures/100 000 inhabitants in the late 1990s. Moreover, large national differences were seen in the relationship between total and partial hip replacement procedures. Conclusion: The reported differences in hip replacement rates in OECD countries are substantial. They may be due to various causes, including different coding systems, country-specific differences in the healthcare system, in total expenditure on health per capita, in the population age structure, and in different indication criteria for THR.
FONTE: Annals Of The Rheumatic Diseases, London, v. 62, n. 3, p.222-226, 2003.
REFERENCIA: MERX, H. et al. International variation in hip replacement rates. Annals Of The Rheumatic Diseases, London, v. 62, n. 3, p.222-226, 2003.
168. Is antenatal care effective in reducing maternal morbidity and mortality?
AUTOR(ES): Marilyn McDonagh
ANO: 1996
RESUMO: Women in developing countries are dying from simple preventable conditions but what impact can the procedures collectively called antenatal care have in reducing maternal mortality and morbidity? More importantly what is antenatal care? This review found that questions have been raised about the impact of antenatal care (specifically on maternal mortality) since its inception in developed countries, and that although the questions continue to be asked there is very little research trying to find answers. Many antenatal procedures are essentially screening tests yet it was found that there were very few results showing sensitivity and specificity, and that they rarely complied with the established criteria for the effectiveness of a screening test. The acknowledged gold standard measurement of effectiveness is the randomized controlled trial, yet the only results available referred to nutritional supplementation. This service of flawed methodology has been exported to developing countries and is being promoted by WHO and other agencies. This paper argues that there is insufficient evidence to reach a firm decision about the effectiveness of antenatal care, yet there is sufficient evidence to cast doubt on the possible effect of antenatal care. Research is urgently required in order to identify those procedures which ought to be included in the antenatal process. In the final analysis the greatest impact will be achieved by developing a domiciliary midwifery service supported by appropriate local efficient obstetric services. That this domiciliary service should provide care for women in pregnancy is not disputed but the specific nature of this care needs considerable clarification
FONTE: Health Policy And Planning, Oxford, v. 11, n. 1, p.1-15, 1996.
REFERENCIA: MCDONAGH, Marilyn. Is antenatal care effective in reducing maternal morbidity and mortality? Health Policy And Planning, Oxford, v. 11, n. 1, p.1-15, 1996.
169. Oportunidades perdidas de imunização antitetânica de gestantes de Juiz de Fora, Minas Gerais, Brasil.
AUTOR(ES): Laura Maria Braga Borges de Mattos; Waleska Teixeira Caiaffa; Ronaldo Rocha Bastos; Edward Tonelli
ANO: 2003
RESUMO: OBJETIVOS: Estimar as oportunidades perdidas de vacinação antitetânica e a cobertura vacinal ao final da gravidez em gestantes de Juiz de Fora, Estado de Minas Gerais, Brasil. MÉTODOS: Entre 1o de janeiro e 31 de agosto de 1996, realizou-se um estudo transversal com 430 mulheres selecionadas aleatoriamente entre todas as gestantes de Juiz de Fora. As participantes foram entrevistadas a respeito do controle pré-natal, conhecimento sobre o tétano e vacinação antitetânica. RESULTADOS: A idade das gestantes variou de 14 a 45 anos (média de 26,4 ± 6,9 anos); 420 eram de zona urbana e 10 de zona rural. O controle pré-natal foi feito pelo Sistema Único de Saúde em 69,5% (299) das mulheres; 27,6% (119) utilizaram outros convênios; e 2,8% (12) não fizeram controle pré-natal. Trezentas e cinqüenta e duas mulheres (81,8%) portavam o cartão de controle pré-natal e 85,6% (368) tiveram quatro ou mais consultas pré-natais. Com relação ao conhecimento do tétano, 92,1% (396) demonstraram conhecer a doença e sua gravidade. Dentre 430 gestantes, 359 (83,5%) iniciaram a gestação não imunizadas contra o tétano: 104 foram imunizadas durante a gravidez em estudo e 255 permaneceram sem vacina até o puerpério, apesar do aumento significativo na chance de imunização com o aumento do número de visitas de pré-natal (OR = 2,7 para quatro ou mais visitas; P < 0,001). Foram de 70% as oportunidades perdidas de imunização antitetânica na gestação e de 40,6% a cobertura vacinal das gestantes. CONCLUSÃO: A baixa cobertura vacinal, inferior aos níveis recomendados pela Organização Mundial da Saúde, e o índice elevado de oportunidades perdidas de imunização antitetânica apontam para a necessidade de se instituir uma estratégia de incentivo à vacinação, direcionada aos profissionais de saúde em geral e especialmente àqueles responsáveis pelo atendimento das gestantes, tanto em postos de saúde quanto em clínicas privadas. Além disso, a rotina de vacinação em Juiz de Fora deve ser intensificada.
FONTE: Revista Panamericana de Salud Pública, Washington, v. 14, n. 5, p.350-354, 2003.
REFERENCIA: MATTOS, Laura Maria Braga Borges de et al. Oportunidades perdidas de imunização antitetânica de gestantes de Juiz de Fora, Minas Gerais, Brasil. Revista Panamericana de Salud Pública, Washington, v. 14, n. 5, p.350-354, 2003.
170. Desempenho hospitalar: avaliação do tempo de permanência e mortalidade entre prestadores no estado do Rio de Janeiro.
AUTOR(ES): Mô nica Martins; Margareth Crisó stomo Portella; Marina Ferreira de Noronha
ANO: 2010
RESUMO:
FONTE: Rio de Janeiro: Fiocruz, 2010. p. 241-278.
REFERENCIA: MARTINS, Mônica et al. Desempenho hospitalar: avaliação do tempo de permanência e mortalidade entre prestadores no estado do Rio de Janeiro. In: UGÁ, Maria Alicia Domínguez et al.(org). Gestão do SUS no âmbito estadual: o caso do Rio de Janeiro. Rio de Janeiro: Fiocruz, 2010. p. 241-278.
171. Mortalidade hospitalar e tempo de permanência: comparação entre hospitais públicos e privados na região de Ribeirão Preto, São Paulo, Brasil.
AUTOR(ES): Mô nica Martins; Ré gis Blais; Iú ri da Costa Leite
ANO: 2004
RESUMO: A avaliação de desempenho dos serviços de saúde é essencial. A comparação de indicadores de desempenho requer o uso de estratégias de ajuste de risco. O objetivo deste artigo é avaliar variações no desempenho clínico, mensurado pela mortalidade e pelo tempo de permanência, entre hospitais públicos e privados, levando em conta diferenças nas características dos pacientes tratados. Este estudo é limitado à região de Ribeirão Preto, São Paulo, Brasil. Entre os anos de 1996 e 1998, 32.906 pacientes admitidos com diagnósticos cardiovasculares e respiratórios foram estudados. As variáveis usadas para o ajuste de risco dos indicadores de desempenho foram: sexo, idade, diagnóstico principal e medidas de gravidade baseada em comorbidade. Os resultados mostraram que o desempenho clínico dos hospitais públicos, mensurado pela mortalidade hospitalar ajustada (razão de chance = 0,41), é superior ao dos privados. Os hospitais públicos e privados não foram estatisticamente diferentes com relação ao tempo de permanência dos pacientes. Ainda que problemas conceituais e metodológicos devam ser resolvidos, taxa de mortalidade e outros indicadores de desempenho ajustados devem ser considerados como instrumentos úteis para identificar problemas de desempenho dos serviços de saúde.
FONTE: Cadernos de Saúde Pública, Rio de Janeiro, v. 20, n. 2, p.268-282, 2004. Suplemento.
REFERENCIA: MARTINS, Mônica; BLAIS, Régis; LEITE, Iúri da Costa. Mortalidade hospitalar e tempo de permanência: comparação entre hospitais públicos e privados na região de Ribeirão Preto, São Paulo, Brasil. Cadernos de Saúde Pública, Rio de Janeiro, v. 20, n. 2, p.268-282, 2004. Suplemento.
172. Perfil etiológico das meningites bacterianas em crianças.
AUTOR(ES): Orlando C. Mantese; Jorge Hirano; Irenize C. Santos; Elí sio Castro; Valé ria M. Silva
ANO: 2002
RESUMO: Objetivo:analisar o perfil etiológico e alguns aspectos epidemiológicos das crianças com meningite bacteriana, internadas em um hospital público universitário. Métodos: foram seguidas, prospectivamente, as crianças internadas com meningite bacteriana, diagnosticada segundo os critérios clínicos e laboratoriais habituais. Foram excluídos os casos de meningite pós-trauma, de meningite na vigência de derivação liquórica, ou de defeitos congênitos do tubo neural, e de meningite tuberculosa. Resultados: foram analisadas 415 crianças internadas com diagnóstico de meningite bacteriana, no Hospital de Clínicas da Universidade Federal de Uberlândia, no período de 01/01/1987 a 31/01/2001. O agente etiológico foi identificado em 315 pacientes (75,9%), sendo de modo definitivo em 289 (69,3%) e presuntivo, por intermédio da bacterioscopia, em outros 26 (6,6%). Os agentes mais comumente identificados foram o Haemophilus influenzae b (54,2%), o meningococo (20,6%) e o pneumococo (18,1% dos 315 pacientes). O tratamento antimicrobiano prévio, detectado em 47,2% dos casos, causou uma diminuição significante no rendimento das culturas de sangue (de 50,8% para 38,7%) e de liquor (71,7% para 57,6%). Houve um predomínio do acometimento de crianças com idade até 48 meses pelo Haemophilus influenzae b, particularmente em relação ao meningococo. A letalidade geral foi de 10,1%, com diferença significante entre a letalidade do pneumococo, de 17,5%, e a do meningococo, de 4,6%. Conclusões: as crianças afetadas por Haemophilus influenzae b e por pneumococo foram mais jovens que aquelas com meningite por meningococo. A hemocultura e a cultura de liquor continuam sendo importantes recursos laboratoriais para o diagnóstico etiológico da meningite bacteriana, apesar do impacto negativo causado em seu rendimento pelo tratamento antibiótico prévio. Os agentes mais comumente isolados foram o Haemophilus influenzae b, o meningococo e o pneumococo. A meningite bacteriana continua tendo uma importante mortalidade entre as crianças, principalmente quando causada pelo pneumococo.
FONTE: Jornal de Pediatria, Rio de Janeiro, v. 78, n. 6, p.467-474, 2002.
REFERENCIA: MANTESE, Orlando C. et al. Perfil etiológico das meningites bacterianas em crianças. Jornal de Pediatria, Rio de Janeiro, v. 78, n. 6, p.467-474, 2002.
173. The elusive goal of maintaining population cancer screening: it is time for a new paradigm.
AUTOR(ES): Jeanne Mandelblatt; Diana Buist
ANO: 2010
RESUMO:
FONTE: Journal Of The National Cancer Institute, Bethesda, v. 102, n. 14, p.998-999, 2010.
REFERENCIA: MANDELBLATT, Jeanne; BUIST, Diana. The elusive goal of maintaining population cancer screening: it is time for a new paradigm. Journal Of The National Cancer Institute, Bethesda, v. 102, n. 14, p.998-999, 2010.
174. Effect of hysterectomy on incidence trends of endometrial and cervical cancer in Finland 1953–2010.
AUTOR(ES): R. Luoto; J. Raitanen; E. Pukkala; A. Anttila
ANO: 2004
RESUMO: The hysterectomy-corrected age-adjusted incidence rate of endometrial cancer was 29%, and for cervical cancer 11% higher than the uncorrected rate. Correction factors for such cancer sites are recommended for regular use. The levelling-off of the incidence of endometrial cancer appears to be an artefact caused by the increasing prevalence of hysterectomy.
FONTE: British Journal Of Cancer, London, v. 90, n. 9, p.1756-1759, 2004.
REFERENCIA: LUOTO, R. et al. Effect of hysterectomy on incidence trends of endometrial and cervical cancer in Finland 1953–2010. British Journal Of Cancer, London, v. 90, n. 9, p.1756-1759, 2004.
175. Epidemiologia da hipertensão arterial sistêmica e da insuficiência cardíaca no Brasil.
AUTOR(ES): Í nes Lessa
ANO: 2001
RESUMO: A hipertensão arterial (HA) é a morbidade mais comum na população adulta e freqüente nos serviços de emergência no Brasil; a insuficiência cardíaca (IC) é a primeira causa cardiovascular de hospitalização no país. Em revisão da literatura nacional sobre a epidemiologia da HA, a maioria dos estudos continua procedendo das regiões Sul e Sudeste, e a Norte continua sem nenhuma informação de base populacional. As prevalências da HA são, na maioria, acima dos 25%, predominando no sexo masculino, e os principais fatores de risco não diferem dos de outros países. A epidemiologia da IC é desconhecida no Brasil. Dados oficiais sobre hospitalizações refletem parte da morbidade e referem-se aos 2/3 da população atendida pelo SUS (70%), estimando-se que 58 milhões dela sejam adultos ≥ 20 anos. As hospitalizações pela IC predominam nos homens, sendo maior 1,8 vez do que por doenças cerebrovasculares, 2,5 do que para doença arterial coronária e 3,3 vezes mais do que para doenças hipertensivas. Para as mulheres, seguindo a mesma ordem, os valores são: 1,9, 3,3 e 2,0. Para uma média de 5,9 dias de hospitalização, a taxa de letalidade intra-hospitalar pela IC é de 10% para os homens (variação entre 8,1% e 16,3%) e para mulheres de 6,0%, para o mesmo tempo médio de hospitalização. As informações sobre IC sugerem que a doença é de elevada prevalência no Brasil, tendo em vista que os dados referem-se às formas mais graves da doença. Por analogia com as doenças cerebrovasculares, a hipertensão deve ser o mais importante dos seus fatores de risco, desde quando a doença arterial coronária é a menos freqüente das hospitalizações cardiovasculares no SUS. Recomenda-se que estudos epidemiológicos de base populacional sobre IC sejam realizados a curto prazo.
FONTE: Revista Brasileira de Hipertensão, Rio de Janeiro, v. 8, n. 4, p.383-392, 2001.
REFERENCIA: LESSA, Ínes. Epidemiologia da hipertensão arterial sistêmica e da insuficiência cardíaca no Brasil. Revista Brasileira de Hipertensão, Rio de Janeiro, v. 8, n. 4, p.383-392, 2001.
176. Variation in caesarean delivery rates.
AUTOR(ES): Marian Knight; Elizabeth A Sullivan
ANO: 2010
RESUMO:
FONTE: British Medical Journal, London, v. 341, n. 7777, p.789-790, 2010.
REFERENCIA: KNIGHT, Marian; A SULLIVAN, Elizabeth. Variation in caesarean delivery rates: a systematic review. British Medical Journal, London, v. 341, n. 7777, p.789-790, 2010.
177. International variations in hip fracture probabilities: implications for risk assessment.
AUTOR(ES): John A. Kanis; Olof Johnell; Chris De Laet; Bengt Jonsson; Anders Oden; Alan K. Ogelsby
ANO: 2002
RESUMO: It is recommended that intervention thresholds should be based on absolute fracture risk, but there is a large variation in hip fracture incidence from different regions of the world. The aim of this study was to examine heterogeneity of hip fracture probability in different regions from recent estimates of hip fracture incidence and mortality to adjust intervention thresholds. Ten-year probabilities of hip fracture were computed in men and women at 10-year intervals from the age of 50 years and lifetime risks at the age of 50 years from the hazard functions of hip fracture and death. Lifetime risk at the age of 50 years varied from 1% in women from Turkey to 28.5% in women from Sweden. High lifetime risks in women were associated with high lifetime risks in men (r = 0.83). There also were significant correlations of 10-year risk at any age between men and women. Ten-year probability was standardized to that of men and women from Sweden (set at 1.0). There was a 15-fold range in 10-year probability from 1.24 in Norway to 0.08 in Chile. Countries were categorized by 10-year probabilities comprising very high risk (Norway, Iceland, Sweden, Denmark, and the United States), high risk (China [Taiwan [TW]], Germany, Switzerland, Finland, Greece, Canada, The Netherlands, Hungary, Singapore, Italy, United Kingdom, Kuwait, Australia, and Portugal), medium risk (China [Hong Kong [HK]], France, Japan, Spain, Argentina, and China), and low risk (Turkey, Korea, Venezuela, and Chile). The categorization of hip fracture probabilities can be used to adjust intervention thresholds based on age, sex, and relative risk from a reference population such as Sweden.
FONTE: Journal Of Bone and Mineral Research, New York, v. 17, n. 7, p.1237-1244, 2002.
REFERENCIA: KANIS, John A. et al. International variations in hip fracture probabilities: implications for risk assessment. Journal Of Bone and Mineral Research, New York, v. 17, n. 7, p.1237-1244, 2002.
178. Efficacy and effectiveness of influenza vaccines in elderly people: a systematic review.
AUTOR(ES): T. Jefferson; D. Rivetti; A. Rivetti; M. Rudin; C. Di Pietrantonj; V. Demicheli
ANO: 2005
RESUMO: BACKGROUND: Influenza vaccination of elderly individuals is recommended worldwide. Our aim was to review the evidence of efficacy and effectiveness of influenza vaccines in individuals aged 65 years or older. METHODS: We searched five electronic databases to December, 2004, in any language, for randomised (n=5), cohort (n=49), and case-control (n=10) studies, assessing efficacy against influenza (reduction in laboratory-confirmed cases) or effectiveness against influenza-like illness (reduction in symptomatic cases). We expressed vaccine efficacy or effectiveness as a proportion, using the formula VE=1-relative risk (RR) or VE*=1-odds ratio (OR). We analysed the following outcomes: influenza, influenza-like illness, hospital admissions, complications, and deaths. FINDINGS: In homes for elderly individuals (with good vaccine match and high viral circulation) the effectiveness of vaccines against influenza-like illness was 23% (95% CI 6-36) and non-significant against influenza (RR 1.04, 0.43-2.51). Well matched vaccines prevented pneumonia (VE 46%, 30-58) and hospital admission (VE 45%, 16-64) for and deaths from influenza or pneumonia (VE 42%, 17-59), and reduced all-cause mortality (VE 60%, 23-79). In elderly individuals living in the community, vaccines were not significantly effective against influenza (RR 0.19, 0.02-2.01), influenza-like illness (RR 1.05, 0.58-1.89), or pneumonia (RR 0.88, 0.64-1.20). Well matched vaccines prevented hospital admission for influenza and pneumonia (VE 26%, 12-38) and all-cause mortality (VE 42%, 24-55). After adjustment for confounders, vaccine performance was improved for admissions to hospital for influenza or pneumonia (VE* 27%, 21-33), respiratory diseases (VE* 22%, 15-28), and cardiac disease (VE* 24%, 18-30), and for all-cause mortality (VE* 47%, 39-54). INTERPRETATION: In long-term care facilities, where vaccination is most effective against complications, the aims of the vaccination campaign are fulfilled, at least in part. However, according to reliable evidence the usefulness of vaccines in the community is modest.
FONTE: The Lancet, New York, v. 366, n. 9492, p.1165-1174, 2005.
REFERENCIA: JEFFERSON, T. et al. Efficacy and effectiveness of influenza vaccines in elderly people: a systematic review. The Lancet, New York, v. 366, n. 9492, p.1165-1174, 2005.
179. Day case paediatric tonsillectomy: a review of three years experience in a dedicated day case unit.
AUTOR(ES): W. P. L. Hellier; J. Knight; J. Hern; T. Waddell
ANO: 1999
RESUMO: Tonsillectomy is one of the most common surgical procedures performed in children. Day case tonsillectomy is common in many parts of the USA but remains controversial in the UK. Day case tonsillectomy in children has been performed in a dedicated paediatric day care unit at the May day Hospital since 1994. The results for the years 1995-1997 were reviewed. In these years 928 true day case tonsillectomies were performed. Reactionary haemorrhage occurred in 0.97% (nine children) but only three children required a return to theatre. All bleeding occurred within the standard observation period. There were no deaths. The overall effective day case rate was 95.7%, only 31 children needing unplanned admission, mainly for postoperative vomiting. The results suggest that day case tonsillectomy can be safely and successfully performed, with a dedicated paediatric day case unit and a favourable population geography.
FONTE: Clinical Otolaryngology And Allied Sciences, Oxford, v. 24, n. 3, p.208-212, 1999.
REFERENCIA: HELLIER, W. P. L. et al. Day case paediatric tonsillectomy: a review of three years experience in a dedicated day case unit. Clinical Otolaryngology And Allied Sciences, Oxford, v. 24, n. 3, p.208-212, 1999.
180. Laboratory diagnosis of bacterial meningitis.
AUTOR(ES): L. D. Gray; D. P. Fedorko
ANO: 1992
RESUMO: Bacterial meningitis is relatively common, can progress rapidly, and can result in death or permanent debilitation. This infection justifiably elicits strong emotional reactions and, hopefully, immediate medical intervention. This review is a brief presentation of the pathogenesis of bacterial meningitis and a review of current knowledge, literature, and recommendations on the subject of laboratory diagnosis of bacterial meningitis. Those who work in clinical microbiology laboratories should be familiar with the tests used in detecting bacteria and bacterial antigens in cerebrospinal fluid (CSF) and should always have the utmost appreciation for the fact that results of such tests must always be reported immediately. Academic and practical aspects of the laboratory diagnosis of bacterial meningitis presented in this review include the following: anatomy of the meninges; pathogenesis; changes in the composition of CSF; etiological agents; processing CSF; microscopic examination of CSF; culturing CSF; methods of detecting bacterial antigens and bacterial components in CSF (counter-immunoelectrophoresis, coagglutination, latex agglutination, enzyme-linked immunosorbent assay, Limulus amebocyte lysate assay, and gas-liquid chromatography); use of the polymerase chain reaction; and practical considerations for testing CSF for bacterial antigens.
FONTE: Clinical Microbiology Reviews, Washington, v. 5, n. 2, p.130-145, 1992.
REFERENCIA: GRAY, L. D.; FEDORKO, D. P.Laboratory diagnosis of bacterial meningitis. Clinical Microbiology Reviews, Washington, v. 5, n. 2, p.130-145, 1992.
181. Commentary: benefits of influenza vaccine in US elderly-new studies raise questions.
AUTOR(ES): W. Paul Glezen; Lone Simonsen
ANO: 2006
RESUMO:
FONTE: International Journal Of Epidemiology, London, v. 35, n. 2, p.352-353, 2006.
REFERENCIA: GLEZEN, W. Paul; SIMONSEN, Lone. Commentary: benefits of influenza vaccine in US elderly--new studies raise questions. International Journal Of Epidemiology, London, v. 35, n. 2, p.352-353, 2006.
182. The impact of nonclinical factors on practice variations: the case of hysterectomies.
AUTOR(ES): S. E. Geller; L. R. Burns; D. J. Brailer
ANO: 1996
RESUMO: OBJECTIVE: This study investigates the role of nonclinical factors (physician characteristics) in explaining variations in hysterectomy practice patterns. DATA SOURCES AND STUDY SETTING: Patient discharge data are obtained from the Arizona state discharge database for the years 1989-1991. Physician data are obtained from the Arizona State Medical Association. The analyses are based on 36,104 cases performed by 339 physicians in 43 hospitals. STUDY DESIGN: This article measures the impact of physician factors on the decision to perform a hysterectomy, controlling for a host of patient and hospital characteristics. Physician factors include background characteristics and training, medical experience, and physician's practice style. Physician effects are evaluated in terms of their overall contribution to the explanatory power of regression models, as well as in terms of specific hypotheses to be tested. DATA COLLECTION: The sources of data were linked to produce one record per patient. PRINCIPAL FINDINGS: As a set, physician factors account for a statistically significant increase in the explanatory power of the model after addition of patient and hospital effects. Parameter estimates provide further support for the hypothesized effects of physicians' background, experience, and practice characteristics. CONCLUSIONS: Overall, the results confirm that nonclinical (physician) factors play a statistically significant role in the hysterectomy decision. Substantively, however, these factors play a smaller, secondary role compared to that of clinical and patient factors in explaining practice variations in hysterectomies. The results suggest that efforts to reduce unnecessary hysterectomies should be directed at identifying the appropriate clinical indications for hysterectomy and disseminating this information to physicians and patients. This may require such intervention strategies as continuing clinical education, promulgation of explicit practice guidelines, peer review, public education, and greater understanding and inclusion of patient preference in the decision process.
FONTE: Health Services Research, Chicago, v. 30, n. 6, p.729-750, 1996.
REFERENCIA: GELLER, S. E.; BURNS, L. R.; BRAILER, D. J.. The impact of nonclinical factors on practice variations: the case of hysterectomies. Health Services Research, Chicago, v. 30, n. 6, p.729-750, 1996.
183. The magnitude of mortality from acute respiratory infections in children under 5 years in developing countries.
AUTOR(ES): M. Garenne; C. Ronsmans; H. Campbell
ANO: 1992
RESUMO: This article reviews the available evidence of mortality from acute respiratory infections (ARI) among children aged under 5 years in contemporary developing countries and compares the findings with European populations before 1965. In European populations before 1965, the level of mortality was found to be a determinant of the proportion of deaths due to ARI. There were marked differences according to regional patterns of mortality. Deaths from ARI played a smaller role after 1950, when the use of antibiotics became generalized. In developing countries, the role of ARI mortality seems to be similar to the European experience. The age pattern is very marked. In absolute values, ARI mortality is highest in the neonatal period and decreases with age. In relative values, ARI mortality is highest in the postneonatal period. ARI, mainly pneumonia, accounts for about 18% of underlying causes of death in developing countries. Pneumonia and other ARI are frequent complications of measles and pertussis; ARI is also commonly found after other infections and in association with severe malnutrition. Virtually no data are available in developing countries to provide final estimates of the role of ARI in mortality of children aged under 5 years. However, the WHO figure of 1 out of 3 deaths due to--or associated with--ARI may be close to the real range of the ARI-proportional mortality in children of developing countries. Results are discussed in light of the definitions of ARI used in various studies, the difficulties in ascertaining and coding multiple causes of death and the quality of data from some sources. PIP: The available evidence of mortality from acute respiratory infections (ARI) among children less than 5 years old in contemporary developing countries is reviewed and the findings are compared with European populations before 1965. The proportion of ARI deaths in European populations prior to 1965 declined with the level of mortality; the proportion of ARI deaths was slightly higher among children 1-4 than among infants; and there was no difference by sex outside of infancy. The log-linear regression analysis of ARI deaths for children 1 and 1-4 in the European populations prior to 1965 indicated high significance for age 0-11 months and age 12-59 months. In absolute values, ARI mortality was highest in the neonatal period decreasing with age. A multivariate analysis indicated that the proportion of ARI deaths was significantly lower after 1950 among children 1-4 years old, interpreted as the effect of antibiotics on ARI mortality. The ARI deaths were significantly lower in the more developed countries at ages 1-4, but not in infancy. The data from community studies and from vital registrations were compared to the European experience by combining the 2 age groups: 1 and 1-4 years. The consistency of the data from developing countries with the experience of developed countries was striking.
FONTE: World Health Statistics Quarterly, Genève, v. 45, n. 2-3, p.180-191, 1992.
REFERENCIA: GARENNE, M.; RONSMANS, C.; CAMPBELL, H. The magnitude of mortality from acute respiratory infections in children under 5 years in developing countries. World Health Statistics Quarterly, Genève, v. 45, n. 2-3, p.180-191, 1992.
184. Hospitalizations Involving Gastroenteritis in the United States, 1985: The Special Burden of the Disease among the Elderly.
AUTOR(ES): Raymond E. Gangarosa; Roger I. Glass; Judy F. Lew; John R. Boring
ANO: 1991
RESUMO: While diarrheal disease is a well-recognized problem in children, its impact in the elderly has not been adequately assessed. Among the 4.06 million hospitalizations in 1985 in the McDonnell-Douglas Health Information System database, 98,185 hospitalizations, including 1,130 deaths, had gastroenteritis recorded as a discharge diagnosis. The authors analyzed the 87,181 hospitalizations and 514 deaths for which gastroenteritis was one of the top three diagnoses. Gastroenteritis was among the top three diagnoses in 9% of all hospitalizations of children 1–4 years of age, compared with 1.5– of hospitalizations throughout adulthood (≥20 years). Only 0.05% of hospitalizations involving gastroenteritis were fatal for children younger than 5 years, compared with 3% in individuals 80 years or older. While children aged less than 5 years and adults aged 60 years or more each comprised one-fourth of hospitalizations involving gastroenteritis, the older group represented 85% of diarrheal deaths. Age was the most important risk factor for death subsequent to a hospitalization involving gastroenteritis (odds ratio = 52.6, 95% confidence interval 37.0–76.9 for age ≥70 years vs. <5 years).
FONTE: American Journal Of Epidemiology, Baltimore, v. 135, n. 3, p.281-290, 1991.
REFERENCIA: GANGAROSA, Raymond E. et al. Hospitalizations involving gastroenteritis in the United States, 1985: the special burden of the disease among the elderly. American Journal Of Epidemiology, Baltimore, v. 135, n. 3, p.281-290, 1991.
185. Impacto da vacinação contra influenza na mortalidade por doenças respiratórias em idosos.
AUTOR(ES): Priscila Maria Stolses Bergamo Francisco; Maria Rita de Camargo Donalisio; Maria do Rosá rio Dias de Oliveira Lattorre
ANO: 2005
RESUMO: OBJETIVO: As doenças respiratórias, particularmente as infecciosas, vêm se tornando cada vez mais representativas na morbi-mortalidade da população idosa. O objetivo do estudo foi analisar a tendência de mortalidade por doenças respiratórias e observar o impacto da vacinação contra influenza nos coeficientes de mortalidade. MÉTODOS: O estudo foi realizado no período de 1980 a 2000 em idosos residentes no Estado de São Paulo, utilizando-se dados de mortalidade do Sistema de Informações de Mortalidade do Ministério da Saúde. Trata-se de estudo ecológico de séries temporais. Foram analisadas as tendências das taxas padronizadas de mortalidade por doenças respiratórias infecciosas, segundo faixas etárias (60 a 64, 65 a 69, 70 a 74, 75 a 79 e 80 ou mais anos) e sexo, por meio de modelos de regressão polinomial. Foram calculados intervalos de confiança para a resposta média esperada nos anos subseqüentes à intervenção. RESULTADOS: Os coeficientes aumentaram para ambos os sexos na população idosa. Após a intervenção nota-se tendência ao declínio dos indicadores de mortalidade. Para a população idosa masculina, o coeficiente médio no período de 1980 a 1998 foi de 5,08 óbitos por mil homens com aumento linear não constante de 0,13 ao ano; em 2000, o coeficiente observado foi de 4,72 óbitos por mil homens. Já para as mulheres de 60 anos e mais, o coeficiente anual médio foi de 3,18 óbitos por mil mulheres com incremento não constante de 0,08 ao ano; no ano de 2000 o coeficiente observado foi 2,99 óbitos por mil mulheres, além da redução significativa dos mesmos em todas as faixas etárias. CONCLUSÕES: Os dados indicam a importância das doenças respiratórias entre os idosos e sugerem que a proteção específica contra influenza tem se refletido positivamente na prevenção da mortalidade por essas doenças.
FONTE: Revista de Saúde Pública, São Paulo, v. 39, n. 1, p.75-81, 2005.
REFERENCIA: FRANCISCO, Priscila Maria Stolses Bergamo; DONALISIO, Maria Rita de Camargo; LATTORRE, Maria do Rosário Dias de Oliveira. Impacto da vacinação contra influenza na mortalidade por doenças respiratórias em idosos. Revista de Saúde Pública, São Paulo, v. 39, n. 1, p.75-81, 2005.
186. Vacinação contra influenza.
AUTOR(ES): Marilisa Berti de Azevedo Barros; Chester Luiz Galvã o Cesar; Luana Carandina; Moises Golbaum
ANO: 2008
RESUMO: Este livro destina-se à análise das diversas facetas das condições de saúde da população de um município que podem ser apreendidas em inquéritos de base populacional. Os temas desta publicação incluem os eixos centrais da análise de situação de saúde: o estado de saúde da população, apreendido em múltiplas dimensões, os comportamentos relacionados à saúde que constituem, no perfil atual de morbidade, os principais responsáveis pelas incapacidades e mortes prematuras e o componente de uso de serviços de saúde. O estudo procura situar a história e destacar a relevância e as aplicações dos inquéritos de saúde, apresentar em detalhe os métodos utilizados na presente pesquisa e ressaltar os achados mais significativos para as propostas de vigilância da saúde de município baseada em inquéritos.
FONTE: São Paulo: Hucitec, 2008. p. 208-217.
REFERENCIA: FRANCISCO, P.M.S.B.; DONALISIO, M.R.; BARROS, Marilisa B.Azevedo.Vacinação contra influenza. In: BARROS, Marilisa Berti de Azevedo et al. As dimensões da saúde: inquérito populacional em Campinas.São Paulo: Hucitec, 2008. p. 208-217.
187. Vacinação contra influenza em idosos por área de residência: prevalência e fatores associados.
AUTOR(ES): Priscila Maria S. Bergamo Francisco; Maria Rita Donalisio; Marilisa Berti de Azevedo Barros; Chester Luis Galvã o Cesar; Luana Carandina; Moisé s Goldbaum
ANO: 2006
RESUMO: A vacinação contra influenza é a principal forma de prevenir e reduzir a morbidade e mortalidade associadas à doença entre os idosos e grupos de risco. O objetivo deste estudo é determinar fatores demográficos, socioeconômicos, comportamentais e de saúde associados à vacinação, entre idosos residentes em diferentes áreas do Estado de São Paulo, no período de 2001 a 2002. Trata-se de um delineamento transversal de base populacional que considerou os idosos residentes em duas áreas do Estado: uma composta pelo município de Campinas e distrito do Butantã, na cidade de São Paulo, e outra pelos municípios de Taboão da Serra, Embu e Itapecerica da Serra (região metropolitana do município de São Paulo). A amostra foi composta por 849 e 641 indivíduos com 60 anos ou mais, residentes em tais localidades, respectivamente. Na análise bruta foram utilizadas razões de prevalência e intervalos de confiança de 95% e a análise multivariada foi realizada pela regressão de Poisson. A prevalência de vacinação auto-referida foi de 66,9% entre os residentes em Campinas e no distrito do Butantã e 67,6% naqueles das demais localidades. Após análise ajustada, para os idosos de Campinas e Butantã, apenas menor escolaridade (RP = 1,25; IC 95%: 1,02-1,54) esteve associada à vacinação. Já na área composta pelos municípios menos populosos, idade mais avançada (RP = 1,15; IC 95%: 1,02-1,31), hipertensão arterial (RP = 1,21; IC 95%: 1,02-1,45), diabetes (RP = 1,16; IC 95%: 1,01-1,33) e doença crônica de pulmão (RP = 1,30; IC 95%: 1,03-1,64) referidas, estiveram também associadas. Apesar de a prevalência de vacinação contra influenza entre os idosos das diversas localidades ser praticamente a mesma, pôde-se observar diferenças no perfil do idoso quanto à referência desse procedimento preventivo.
FONTE: Revista Brasileira de Epidemiologia, São Paulo, v. 9, n. 2, p.162-171, 2006.
REFERENCIA: FRANCISCO, Priscila Maria S. Bergamo et al. Vacinação contra influenza em idosos por área de residência: prevalência e fatores associados. Revista Brasileira de Epidemiologia, São Paulo, v. 9, n. 2, p.162-171, 2006.
188. Fractures of the proximal femur.
AUTOR(ES): Paul J. Evans; Brian J. McGrory
ANO: 2002
RESUMO:
FONTE: Hospital Physician, Oradell, v. 38, n. 4, p.30-38, 2002.
REFERENCIA: EVANS, Paul J.; MCGRORY, Brian J.Fractures of the proximal femur. Hospital Physician, Oradell, v. 38, n. 4, p.30-38, 2002.
189. A Atenção Primária à Saúde no sul de Santa Catarina: uma análise das internações por condições sensíveis à atenção ambulatorial, no período de 1999 a 2004.
AUTOR(ES): Evelyn Elias; Flá vio Magajewski
ANO: 2008
RESUMO: INTRODUÇÃO: A reorientação do modelo de atenção à saúde brasileira tem como principal estratégia a estruturação de uma rede de atenção primária que dê cobertura às necessidades de saúde da população através do acesso a equipes de saúde da família. A avaliação do impacto da atenção primária sobre a saúde da população pode ser feito a partir do monitoramento das internações hospitalares por condições sensíveis à atenção ambulatorial, iniciativa que vem se desenvolvendo nos últimos anos em vários países e também no Brasil. OBJETIVO: analisar o comportamento das internações hospitalares por algumas condições sensíveis à atenção ambulatorial na região da Associação de Municípios do Extremo Sul de Santa Catarina - AMESC, associando-o com a qualidade da atenção oferecida pelo Programa de Saúde da Família (PSF) MÉTODO: Pesquisa exploratória com características de estudo ecológico que qualificou a atenção primária oferecida a partir de questionário dirigido aos profissionais do PSF e informações colhidas através dos bancos nacionais de informação, definindo dois grupos de população: uma atendida por serviços de atenção básica com padrão adequado e outra servida por serviços abaixo desse padrão. As internações hospitalares por algumas causas selecionadas destas duas populações foram comparadas no período 1999-2004, analisando-se a sua tendência e associação estatística. RESULTADOS: A análise estatística sugeriu que houve tendência ao declínio das taxas de internações por pneumonia em menores de 5 anos e pneumonia em maiores de 60 anos na população com atenção ambulatorial básica adequada e não adequada. As internações por Diabetes Mellitus tiveram tendência ao declínio na população com atenção ambulatorial básica adequada. As taxas por diarréia apresentaram tendência à estabilidade nos dois grupos populacionais, mas nos municípios com atenção adequada a sua magnitude foi muito menor. As taxas de internação por Acidente Vascular Cerebral foram crescentes em município com atenção adequada, com tênue queda linear para a população atendida de forma não adequada. Em relação às internações por Infarto Agudo do Miocárdio, tanto nos municípios com atenção adequada quanto naqueles com atenção não adequada, as taxas apresentaram tendência ao aumento, com tendência um pouco menor nos municípios com PSF adequado. CONCLUSÃO: É possível perceber algumas mudanças positivas na evolução de algumas taxas de internações por condições sensíveis à atenção ambulatorial, que podem estar associadas a maior cobertura e a melhor atenção recebida pelo PSF.
FONTE: Revista Brasileira de Epidemiologia, São Paulo, v. 11, n. 4, p.633-647, 2008.
REFERENCIA: ELIAS, Evelyn; MAGAJEWSKI, Flávio. A Atenção Primária à Saúde no sul de Santa Catarina: uma análise das internações por condições sensíveis à atenção ambulatorial, no período de 1999 a 2004. Revista Brasileira de Epidemiologia, São Paulo, v. 11, n. 4, p.633-647, 2008.
190. Alternative versus standard packages of antenatal care for low-risk pregnancy.
AUTOR(ES): T. Dowswell; G.Carroli; L. Duley; S. Gates; A.M.Gü lmezoglu; D.Khan-Neelofur; G.G.P. Piaggio
ANO: 2010
RESUMO: BACKGROUND: The number of visits for antenatal (prenatal) care developed without evidence of how many visits are necessary. The content of each visit also needs evaluation. OBJECTIVES: To compare the effects of antenatal care programmes with reduced visits for low-risk women with standard care. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2010), reference lists of articles and contacted researchers in the field. SELECTION CRITERIA: Randomised trials comparing a reduced number of antenatal visits, with or without goal-oriented care, with standard care. DATA COLLECTION AND ANALYSIS: Two authors assessed trial quality and extracted data independently. MAIN RESULTS: We included seven trials (more than 60,000 women): four in high-income countries with individual randomisation; three in low- and middle-income countries with cluster randomisation (clinics as the unit of randomisation). The number of visits for standard care varied, with fewer visits in low- and middle- income country trials. In studies in high-income countries, women in the reduced visits groups, on average, attended between 8.2 and 12 times. In low- and middle- income country trials, many women in the reduced visits group attended on fewer than five occasions, although in these trials the content as well as the number of visits was changed, so as to be more 'goal oriented'.Perinatal mortality was increased for those randomised to reduced visits rather than standard care, and this difference was borderline for statistical significance (five trials; risk ratio (RR) 1.14; 95% confidence interval (CI) 1.00 to 1.31). In the subgroup analysis, for high-income countries the number of deaths was small (32/5108), and there was no clear difference between the groups (2 trials; RR 0.90; 95% CI 0.45 to 1.80); for low- and middle-income countries perinatal mortality was significantly higher in the reduced visits group (3 trials RR 1.15; 95% CI 1.01 to 1.32). Reduced visits were associated with a reduction in admission to neonatal intensive care that was borderline for significance (RR 0.89; 95% CI 0.79 to 1.02). There were no clear differences between the groups for the other reported clinical outcomes.Women in all settings were less satisfied with the reduced visits schedule and perceived the gap between visits as too long. Reduced visits may be associated with lower costs. AUTHORS' CONCLUSIONS: In settings with limited resources where the number of visits is already low, reduced visits programmes of antenatal care are associated with an increase in perinatal mortality compared to standard care, although admission to neonatal intensive care may be reduced. Women prefer the standard visits schedule. Where the standard number of visits is low, visits should not be reduced without close monitoring of fetal and neonatal outcome.
FONTE: The Cochrane Database Of Systematic Reviews, Oxford, v. 10, n. 6, p.1-68, 2010.
REFERENCIA: DOWSWELL, T. et al. Alternative versus standard packages of antenatal care for low-risk pregnancy. The Cochrane Database Of Systematic Reviews, Oxford, v. 10, n. 6, p.1-68, 2010.
191. Trajetória das mulheres na definição pelo parto cesáreo: estudo de caso em duas unidades do sistema de saúde suplementar do estado do Rio de Janeiro.
AUTOR(ES): Marcos Augusto Bastos Dias; Rosa Maria Soares Madeira Domingues; Ana Paula Esteves Pereira; Sandra Costa Fonseca; Silvana Granado Nogueira da Gama; Mariza Miranda Theme Filha; Sonia Duarte Azevedo Bittencourt; Penha Maria Mendes da Rocha; Arthur Orlando Correa Schilithz; Maria do Carmo Leal
ANO: 2008
RESUMO: No Brasil, as taxas de cesariana são bastante elevadas, principalmente nos serviços privados, estando provavelmente associadas a fatores socioeconômicos e culturais. O objetivo deste estudo foi descrever as características socioeconômicas, demográficas, culturais e reprodutivas de puérperas e os determinantes da decisão por parto cesáreo em duas unidades do sistema de saúde suplementar do Estado do Rio de Janeiro. A população foi composta por 437 puérperas que tiverem partos vaginais ou cesarianos nas duas unidades selecionadas. Os dados foram coletados por meio de entrevistas com as mães e consulta aos prontuários. Através de regressão logística não condicional, avaliaram-se os fatores associados à decisão por cesariana como via de parto, seguindo os modelos hierárquicos estabelecidos em três momentos definidos: no início, ao longo da gestação e no momento do parto. Observou-se que, embora 70% das entrevistadas não relatassem preferência inicial pela cesariana, 90% apresentaram esse tipo de parto. Verificou-se que, independente do desejo inicial da gestante, a interação com o serviço de saúde resultou na cesariana como via final de parto. Trabalhos educativos direcionados às gestantes e à população geral e mudanças no modelo de assistência ao parto podem ser estratégias promissoras para a reversão desse quadro.
FONTE: Ciência & Saúde Coletiva, Rio de Janeiro, v. 13, n. 5, p.1521-1534, 2008.
REFERENCIA: DIAS, Marcos Augusto Bastos et al. Trajetória das mulheres na definição pelo parto cesáreo: estudo de caso em duas unidades do sistema de saúde suplementar do estado do Rio de Janeiro. Ciência & Saúde Coletiva, Rio de Janeiro, v. 13, n. 5, p.1521-1534, 2008.
192. Geographic variation in osteoporotic hip fracture incidence: the growing importance of asian influences in coming decades.
AUTOR(ES): D. K. Dhanwal; C. Cooper; E. M. Dennison
ANO: 2010
RESUMO: Studies over the last few decades have demonstrated geographic variation in the incidence of hip fracture across continents and among different parts of the same region. This paper studies the epidemiology of hip fracture worldwide, with special emphasis on the geographic variation among Asian countries. Using the Pubmed database, keywords that were employed included hip fracture, incidence rate, geographic variation, osteoporosis, and epidemiology. Articles were chosen based on the basis of (1) focus: studies that were said to specifically focus on geographic variation in hip fracture from different continents with a focus on Asia; (2) language: studies that were in English; (3) methods: studies that used statistical tests to examine hip fracture incidence rates. The highest hip fracture rates are seen in Scandinavian countries and the US and the lowest in African countries. Fracture rates are intermediate in Asian populations. Among different ethnic populations, the highest fracture rates are seen in Caucasians and the lowest in blacks. There is also a north-south gradient, particularly in Europe, where more hip fractures occur in North Europe compared to the South.
FONTE: Journal Of Osteoporosis, New York, v. 2010, n. 757102, p.1-5, 2010.
REFERENCIA: DHANWAL, D. K.; COOPER, C.; DENNISON, E. M.. Geographic variation in osteoporotic hip fracture incidence: the growing importance of asian influences in coming decades. Journal Of Osteoporosis, New York, v. 2010, n. 757102, p.1-5, 2010.
193. Day case tonsillectomy - The Salisbury experience.
AUTOR(ES): S. Dennis; M. Georgallou; L. Elcock; M. Brockbank
ANO: 2004
RESUMO:
FONTE: The Journal Of One-day Surgery, Derbyshire, v. 14, n. 2, p.17-22, 2004.
REFERENCIA: DENNIS, S. et al. Day case tonsillectomy: the Salisbury experience. The Journal Of One-day Surgery, Derbyshire, v. 14, n. 2, p.17-22, 2004.
194. Cerebrovascular Disease .
AUTOR(ES): Robert L. DeLaPaz
ANO: 2007
RESUMO:
FONTE: Americam Journal Of Neuroradiology, Baltimore, v. 28, n. 6, p.1197-1199, 2007.
REFERENCIA: DELAPAZ, Robert L.. Cerebrovascular Disease. Americam Journal Of Neuroradiology, Baltimore, v. 28, n. 6, p.1197-1199, 2007.
195. The Latin American Dialysis and Renal Transplantation Registry Annual Report 2002.
AUTOR(ES): Ana Maria Cusumano; Cristina Di Gioia; Osvaldo Hermida; Carlos Lavorato
ANO: 2005
RESUMO: Latin America is a conglomerate of adjacent countries having in common a Latin extraction and language (Spanish or Portuguese) and exhibiting extreme variations in socioeconomic status. The Latin American Society of Nephrology and Hypertension Dialysis and Renal Transplantation Registry was created in 1991. Annual data are sent by local societies in 3 forms: patient, center, and country. The prevalence of renal replacement therapy (RRT) (all modalities) increased from 119 patients per million population (pmp) in 1991 to 349 pmp in 2001; the acceptance rate was 91.7 pmp in 2001. Dialysis prevalence was 277 pmp; hemodialysis was the predominant modality, except in Mexico (86% on peritoneal dialysis). The highest dialysis prevalence and acceptance rates were reported by Puerto Rico, Uruguay, and Chile. Among incident patients, diabetic nephropathy (33%) and nephroangioesclerosis (32%) were the primary causes; 38% were older than 65 years old. Renal transplants increased from 3.7 pmp in 1987 to 13.7 pmp in 2001. In 2003, 6357 transplants were performed (55% living donor); the cumulative number performed since 1987 reached 55,947. Prevalence and incidence are low because not all patients with end-stage renal disease have access to RRT because of restricted availability, difficulties in referral, and inequities in coverage. The annual increase in the number of patients on RRT (8%-10%) is higher, proportionally, than the annual growth of the Latin American population in general (1.5%). Efforts must be focused on prevention and treatment of chronic kidney disease, especially in diabetic and older patients, and in implementing better organ donation programs to improve the pool of cadaveric donors.
FONTE: Kidney International, Malden, v. 68, n. 97, p.46-2, 2005. Suplemento.
REFERENCIA: CUSUMANO, Ana Maria et al. The Latin American dialysis and renal transplantation registry annual report 2002. Kidney International, Malden, v. 68, n. 97, p.46-2, 2005. Suplemento.
196. Vigilância das meningites na região metropolitana de Belo Horizonte, MG, 1999: o uso dos sistemas de informação em saúde e o método da captura-recaptura na estimação da incidência e da subnotificação
AUTOR(ES): Maria da Conceiç ã o Juste Werneck Cô rtes
ANO: 2002
RESUMO: Estudo sobre a vigilância das meningites na Região Metropolitana de Belo Horizonte, MG -1999, utilizando-se os dados do SINAN, do SIH-SUS e do SIM, na descrição dos casos, na verificação da validade e da confiabilidade da informação disponível e nos cálculos da incidência e da subnotificação da doença após estimativas do total de casos pela metodologia de captura-recaptura. Foram identificados 1.320 casos de meningite, sendo 716 (54,2 por cento) registrados no SINAN [587 confirmados (82 por cento), 76 descartados (10,6 por cento) e 53 sem informação (7,4 por cento); 551 (41,8) no SHI-SUS e 53 no SIM(4 por cento). Correspondiam a 918 casos distintos, com 17(1,9 por cento) comuns as 3 fontes, 346(37,7 por cento) ao SIH-SUS e SINAN, 14(1,5 por cento ) ao SINAN e SIM; 8(0,9 por cento ) ao SIH-SUS e SIM; 339 casos (36,9 por cento) apenas no SINAN, 180(19,6 por cento) no SIH-SUS e 14 (1,0 por cento) no SIM. No SINAN, entre os confirmados 254 casos (43,9 por cento) eram de meningites bacteriana [97(16,6 por cento)meningocócicas, 37(6,3 por cento) pneumocócicas, 24(4,1 por cento) por hemofólio]; 87 (14,7 por cento), bacterianas não especificadas; 209 (35,7 por cento) virais; 59(10,1) não especificadas (...) Através dos modelos probabilísticos de captura-recaptura, estimou-se em 1.087 os casos de meningite (IC 95 por cento: 1033;1166) considerando-se 2 fontes (SINAN e SIH-SUS) û estimador de Lincoln e Petersen û 1.085 casos (IC 95 por cento: 1046;1137) û modelo Mt û e 1.100 (IC 95 por cento: 1.061;1.150) usando-se 3 fontes û modelo Mt. As sensibilidades do SINAN e do SIH-SUS foram de 66 por cento e 51 por cento (...) para 2 fontes, e de 65 por cento e 50 por cento para 3 fontes.A incidência de meningite foi de 17,7 por 100.000 (...) O coeficiente de incidência dos casos estimados pela captura-recaptura foi de 27 por 100.000 habitantes (...) Conclusão: apesar da incomplenitude de dados referentes ao perfil clínico, epidemiológico e diagnóstico, eles foram suficientes para descrever um quadro das meningites consistente com a literatura; o SIH-SUS pode contribuir com a vigilância epidemiológica (...) o uso de fontes complementares melhora a sensibilidade do sistema de vigilância tradicional; a metodologia de captura-recaptura representa uma alternativa de referência do total de casos; 1/3 dos pacientes e seus contatos não foram registrados (...) o que pode ter limitado as ações de prevenção e tratamento, importantes para a diminuição de seqüelas e da letalidade
FONTE: Faculdade de Medicina da UFMG, Belo Horizonte, 2002.
REFERENCIA: CÔRTES, Maria da Conceição Juste Werneck. Vigilância das meningites na região metropolitana de Belo Horizonte, MG, 1999: o uso dos sistemas de informação em saúde e o método da captura-recaptura na estimação da incidência e da subnotificação. 2002. 219 f. Tese (Doutorado) - Faculdade de Medicina da UFMG, Belo Horizonte, 2002.
197. Mortalidade em idosos por diabetes mellitus como causa básica e associada.
AUTOR(ES): Clá udia Medina Coeli; Luis Guilherme Francisco Duarte Ferreira; Mô nica de Miranda Drbal; Renato Peixoto Veras; Kenneth Rochel de Camargo Jr.; Â ngela Maria Cascã o
ANO: 2002
RESUMO: OBJETIVO: Analisar a mortalidade por diabetes mellitus em idosos e a subenumeração do diabetes como causa do óbito de acordo com estatísticas baseadas unicamente em causa básica de óbito. MÉTODOS: Foram revisadas todas as 2.974 declarações de óbito ocorridas em 1994 de idosos residentes em um núcleo habitacional localizado na cidade do Rio de Janeiro, RJ. Destas, foram estudados 291 óbitos, tendo o diabetes mellitus como causa básica (150) e associada (141). A proporção de óbitos em que a diabetes aparece como causa básica em relação ao total de óbitos por diabetes foi calculada de forma global e segundo sexo e faixa etária. RESULTADOS: Dos 291 óbitos estudados, 138 (47,4%) ocorreram em homens, e 153, em mulheres (52,6%). As taxas de mortalidade apresentaram crescimento contínuo com o avançar da idade, sendo superiores no sexo masculino, embora a diferença entre sexos tenha sido menor para a análise baseada unicamente na causa básica. Observou-se proporção elevada de óbitos domiciliares (22%). A proporção de óbitos por diabetes como causa básica foi de 51,5%, sendo maior nas mulheres do que nos homens. CONCLUSÕES: A análise das estatísticas de mortalidade baseadas unicamente na causa básica do óbito pode levar a perfis distorcidos, em função da subenumeração não ocorrer aleatoriamente. Estudos adicionais em coortes de idosos brasileiros diabéticos são necessários para permitir uma avaliação mais acurada da mortalidade nesse grupo.
FONTE: Revista de Saúde Pública, São Paulo, v. 36, n. 2, p.135-140, 2002.
REFERENCIA: COELI, Cláudia Medina et al. Mortalidade em idosos por diabetes mellitus como causa básica e associada. Revista de Saúde Pública, São Paulo, v. 36, n. 2, p.135-140, 2002.
198. Alternatives to hospital care: what are they and who should decide?
AUTOR(ES): J. Coast; A. Inglis; S. Frankel
ANO: 1996
RESUMO: OBJECTIVE--To examine potential for alternatives to care in hospitals for acute admissions, and to compare the decisions about these alternatives made by clinicians with different backgrounds. DESIGN--Standardised tool was used to identify patients who could potentially be treated in an alternative form of care. Information about such patients was assessed by three panels of clinicians: general practitioners without experience of general practitioner beds, general practitioners with experience of general practitioner beds, and consultants. SETTING--One hospital for acute admissions in a rural area of the South and West region of England. SUBJECTS--Of 620 patients admitted to specialties of general medicine and care of the elderly, details of 112 were assessed by panels. MAIN OUTCOME MEASURES--Proportion of hospitalised patients who could have received alternative care and identification of most appropriate alternative form of care. RESULTS--Both general practitioner panels estimated that between 51 and 89 of the hospitalised patients could have received alternative care (equivalent to 8-14% of all admissions). Consultants estimated that between 25 and 55 patients could have had alternative care (5.5-9% of all admissions). General practitioner bed and urgent outpatient appointment were the main alternatives chosen by all three panels. CONCLUSION--About 10% of admissions to general hospital might be suitable for alternative forms of care. Doctors with different backgrounds made similar overall assessments of most appropriate forms of care.
FONTE: British Medical Journal, London, v. 312, n. 7024, p.162-166, 1996.
REFERENCIA: COAST, J.; INGLIS, A.; FRANKEL, S.. Alternatives to hospital care: what are they and who should decide?. British Medical Journal, London, v. 312, n. 7024, p.162-166, 1996.
199. Perfil epidemiológico dos pacientes em terapia renal substitutiva no Brasil, 2000-2004.
AUTOR(ES): Mariangela Leal Cherchiglia; Elaine Leandro Machado; Daniele Araú jo Campo Szuster; Eli Iola Gurgel Andrade; Francisco de Assis Acú rcio; Waleska Teixeira Caiaffa; Ricardo Sesso; Augusto A .Guerra Junior; Odilon Vanni de Queiroz; Isabel Cristina Gomes
ANO: 2010
RESUMO: OBJETIVO: Descrever o perfil epidemiológico e clínico de pacientes em terapia renal substitutiva, identificando fatores associados ao risco de morte. MÉTODOS: Estudo observacional, prospectivo não concorrente, a partir de dados de 90.356 pacientes da Base Nacional em Terapias Renais Substitutivas, no Brasil. Foi realizado relacionamento determinístico-probabilístico do Sistema de Autorização de Procedimentos de Alta Complexidade/Custo e do Sistema de Informação de Mortalidade. Foram incluídos todos os pacientes incidentes que iniciaram diálise entre 1/1/2000 e 31/12/2004, acompanhados até a morte ou final de 2004. Idade, sexo, região de residência, doença renal primária, causa do óbito foram analisados. Ajustou-se um modelo de riscos proporcionais para identificar fatores associados ao risco de morte. RESULTADOS: Ocorreu um aumento médio de 5,5% na prevalência de pacientes em terapia enquanto a incidência manteve-se estável no período. Hemodiálise foi a modalidade inicial predominante (89%). A maioria dos pacientes era do sexo masculino, com idade média de 53 anos, residente na região Sudeste, e apresentava causa indeterminada como principal causa básica da doença renal crônica, seguida da hipertensão, diabetes e glomerulonefrites. Desses pacientes, 7% realizou transplante renal e 42% evoluiu para o óbito. Os pacientes em diálise peritoneal eram mais idosos e apresentavam maior prevalência de diabetes. Entre os não transplantados, 45% foi a óbito e, entre os transplantados, 7%. No modelo final de riscos proporcionais de Cox, o risco de mortalidade foi associado com o aumento da idade, sexo feminino, ter diabetes, residir nas regiões Norte e Nordeste, diálise peritoneal como modalidade de entrada e não ter realizado transplante renal. CONCLUSÕES: Houve aumento da prevalência de pacientes em terapia renal no Brasil. Pacientes com idade avançada, diabetes, do sexo feminino, residentes nas regiões Norte e Nordeste e sem transplante renal apresentam maior risco de morte.
FONTE: Revista de Saúde Pública, São Paulo, v. 44, n. 4, p.639-649, 2010.
REFERENCIA: CHERCHIGLIA, Mariangela Leal et al. Perfil epidemiológico dos pacientes em terapia renal substitutiva no Brasil, 2000-2004. Revista de Saúde Pública, São Paulo, v. 44, n. 4, p.639-649, 2010.
200. Acidente vascular encefálico: conceituação e fatores de risco.
AUTOR(ES): Má rcia L. F. Chaves
ANO: 2000
RESUMO: Pressão arterial e fumo são fatores de risco independentes para AVE, em ambos os sexos. A associação entre níveis pressóricos e risco de AVE não é linear e a pressão sistólica prediz mais AVE que pressão diastólica. Diabetes melito confere um risco relativo para AVE em torno de quatro a seis vezes. A incidência de primeiro AVE é duas vezes maior e mais precoce nos negros que brancos e não é, aparentemente, explicado por classe social. Risco de AVE é maior com anticoncepcional hormonal (ACO) de alta dosagem que os de baixa. História pessoal de migrânea associa-se com maior risco de AVE isquêmico. Mulheres migranosas que usam ACO e fumo apresentaram razão de chance de 34,4 para AVE isquêmico. Até 40 por cento dos AVEs nas mulheres migranosas decorrem diretamente de um episódio de enxaqueca. Mudança do tipo ou freqüência de migrânea com uso de ACO, não prediz AVE. Manejo dos fatores de risco (hipertensão, fumo e hiperglicemia) reduz o risco de AVE. Mudanças nos fatores de risco explicam 71 por cento da queda nos homens e 54 por cento, nas mulheres da mortalidade por AVE. Ênfase continuada na promoção de estilos de vida mais saudáveis e no tratamento efetivo da hipertensão e demais fatores de risco, são essenciais para manter essa queda da mortalidade do AVE.
FONTE: Revista Brasileira de Hipertensão, Rio de Janeiro, v. 7, n. 4, p.372-382, 2000.
REFERENCIA: CHAVES, Márcia L. F.. Acidente vascular encefálico: conceituação e fatores de risco. Revista Brasileira de Hipertensão, Rio de Janeiro, v. 7, n. 4, p.372-382, 2000.
201. Apport des examens biologiques dans le diagnostic positif, la détermination de l’étiologie et le suivi d’une méningite suspectée bactérienne.
AUTOR(ES): E. Carbonnelle
ANO: 2009
RESUMO: Malgré les progrès réalisés dans le diagnostic et le traitement des infections, les méningites restent une cause importante de mortalité et de morbidité. Un diagnostic rapide et précis de l’agent étiologique est capital pour la prise en charge et l’évolution des méningites bactériennes. L’examen essentiel est l’analyse du liquide céphalorachidien (LCR). La coloration de Gram met en évidence des bactéries dans 50 à 80 % des cas et la culture est positive dans au mieux 80 % des LCR. Cependant, en cas de traitement précoce, la sensibilité de ces deux tests est inférieure à 50 %. L’analyse biochimique et cytologique du LCR manque aussi de spécificité et de sensibilité. Afin d’augmenter les preuves diagnostiques, d’autres tests biologiques sont disponibles. L’agglutination des particules de latex est adaptée à la détection des antigènes bactériens présents dans le LCR de patients suspects de méningites d’origine bactérienne. Ces tests permettent de détecter la plupart des germes responsables d’infection du système nerveux central mais ils manquent de sensibilité. De plus, dans les stades précoces des méningites aiguës, les signes cliniques et les perturbations du LCR sont très souvent non spécifiques ne permettant pas le diagnostic différentiel entre méningites bactériennes et méningites virales. Certains marqueurs comme la CRP, la procalcitonine (PCT) ou encore sTREM-1 peuvent être très utiles non seulement pour le diagnostic mais aussi pour différencier entre méningite bactérienne et méningite virale. Plus que jamais, le diagnostic des méningites bactériennes et leur prise en charge nécessitent différents tests biologiques ainsi qu’une approche multidisciplinaire.
FONTE: Médecine Et Maladies Infectieuses, Paris, v. 39, n. 7, p.581-605, 2009.
REFERENCIA: CARBONNELLE, E. Apport des examens biologiques dans le diagnostic positif, la détermination de l’étiologie et le suivi d’une méningite suspectée bactérienne. Médecine Et Maladies Infectieuses, Paris, v. 39, n. 7, p.581-605, 2009.
202. The role of primary care in preventing ambulatory care sensitive conditions.
AUTOR(ES): Josefina Caminal; Barbara Starfield; Emí lia Sá nchez; Carmen Casanova; Marianela Morales
ANO: 2004
RESUMO: BACKGROUND: To examine the postulated relationship between Ambulatory Care Sensitive Conditions (ACSC) and Primary Health Care (PHC) in the US context for the European context, in order to develop an ACSC list as markers of PHC effectiveness and to specify which PHC activities are primarily responsible for reducing hospitalization rates. METHODS: To apply the criteria proposed by Solberg and Weissman to obtain a list of codes of ACSC and to consider the PHC intervention according to a panel of experts. Five selection criteria: i) existence of prior studies; ii) hospitalization rate at least 1/10,000 or 'risky health problem'; iii) clarity in definition and coding; iv) potentially avoidable hospitalization through PHC; v) hospitalization necessary when health problem occurs. Fulfilment of all criteria was required for developing the final ACSC list. A sample of 248,050 discharges corresponding to 2,248,976 inhabitants of Catalonia in 1996 provided hospitalization rate data. A Delphi survey was performed with a group of 44 experts reviewing 113 ICD diagnostic codes (International Classification of Diseases, 9th Revision, Clinical Modification), previously considered to be ACSC. RESULTS: The five criteria selected 61 ICD as a core list of ACSC codes and 90 ICD for an expanded list. CONCLUSIONS: A core list of ACSC as markers of PHC effectiveness identifies health conditions amenable to specific aspects of PHC and minimizes the limitations attributable to variations in hospital admission policies. An expanded list should be useful to evaluate global PHC performance and to analyse market responsibility for ACSC by PHC and Specialist Care.
FONTE: European Journal Of Public Health, Oxford, v. 14, n. 3, p.246-251, 2004.
REFERENCIA: CAMINAL, Josefina et al. The role of primary care in preventing ambulatory care sensitive conditions. European Journal Of Public Health, Oxford, v. 14, n. 3, p.246-251, 2004.
203. Hysterectomy in the 21st century: different approaches, different challenges.
AUTOR(ES): Andrew I. Brill
ANO: 2006
RESUMO: The final decision to perform a certain method of hysterectomy customarily mirrors experience and level of comfort with a particular surgical approach in the context of the patient's condition and indication for surgery. Given the morbidity and recovery associated with a laparotomic incision, every effort should be made to avoid abdominal hysterectomy. The best available evidence points to the advantage of the vaginal approach over other methods of hysterectomy for benign conditions. Regrettably, the state of education in residency programs is not providing a level of surgical competency to meet this charge. Whenever vaginal surgery is not an option, laparoscopically assisted hysterectomy offers the best alternative. Although the promises of supracervical hysterectomy have yet to be demonstrated, laparoscopic supracervical hysterectomy may offer the least morbid alternative to vaginal hysterectomy.
FONTE: Clinical Obstetrics and Gynecology, Hagerstown, v. 49, n. 4, p.722-735, 2006.
REFERENCIA: BRILL, Andrew I.. Hysterectomy in the 21st century: different approaches, different challenges. Clinical Obstetrics and Gynecology, Hagerstown, v. 49, n. 4, p.722-735, 2006.
204. Portaria N° 221/SAS/MS de 17 de Abril de 2008.
AUTOR(ES): Ministé rio da Saú de. Secretaria de Atenç ã o à Saú de.
ANO: 2008
RESUMO:
FONTE: Brasília: Ministério da Saúde, 2008.
REFERENCIA: BRASIL. MINISTÉRIO DA SAÚDE. SECRETARIA DE ATENÇÃO À SAÚDE. Portaria N° 221/SAS/MS de 17 de Abril de 2008. Brasília: Ministério da Saúde, 2008.
205. Guia de Vigilância Epidemiológica.
AUTOR(ES): Ministé rio da Saú de; Secretaria de Vigilâ ncia em Saú de; Departamento de Vigilâ ncia Epidemioló gica.
ANO: 2009
RESUMO:
FONTE: Brasília: Ministério da Saúde, 2009. 816 p.
REFERENCIA: BRASIL. MINISTÉRIO DA SAÚDE. SECRETARIA DE VIGILÂNCIA EM SAÚDE. DEPARTAMENTO DE VIGILÂNCIA EPIDEMIOLÓGICA. Guia de vigilância epidemiológica. 7. ed. Brasília: Ministério da Saúde, 2009. 816 p. (Série A.Normas e manuais técnicos).
206. Instrutivo para preenchimento da programação das ações de vigilância em saúde nas unidades federadas 2010-2011.
AUTOR(ES): Ministé rio da Saú de. Secretaria de Vigilâ ncia em Saú de.
ANO: 2009
RESUMO:
FONTE: Brasília: Secretaria de Vigilância em Saúde, 2009. 141 p.
REFERENCIA: BRASIL. MINISTÉRIO DA SAÚDE. Instrutivo para preenchimento da programação das ações de vigilância em saúde nas unidades federadas.2010-2011. Brasília: Secretaria de Vigilância em Saúde, 2009. 141 p.
207. Portaria Nº 279/GM/MS de 07 de Abril de 1999.
AUTOR(ES): Ministé rio da Saú de. Departamento Nacional de Auditoria do SUS.
ANO: 1999
RESUMO:
FONTE: Brasília: 1999. 1 p.
REFERENCIA: BRASIL. Ministério da Saúde. Portaria Nº 279/GM/MS de 07 de Abril de 1999. Brasília: 1999. 1 p.
208. Viral Gastroenteritis.
AUTOR(ES): N.R. Blacklow; H.B. Greenberg
ANO: 1991
RESUMO:
FONTE: The New England Journal Of Medice, Boston, v. 325, n. 4, p.252-264, 1991.
REFERENCIA: BLACKLOW, N.R.; GREENBERG, H.B. Viral Gastroenteritis. The New England Journal Of Medice, Boston, v. 325, n. 4, p.252-264, 1991.
209. Clinical inquiries. Which imaging modality is best for suspected stroke?
AUTOR(ES): Holly Biola; Karen Crowell
ANO: 2005
RESUMO:
FONTE: The Journal Of Family Practice, New York, v. 54, n. 6, p.536-539, 2005.
REFERENCIA: BIOLA, Holly; CROWELL, Karen. Clinical inquiries: Which imaging modality is best for suspected stroke?. The Journal Of Family Practice, New York, v. 54, n. 6, p.536-539, 2005.
210. Impact of socioeconomic status on hospital use in New York City.
AUTOR(ES): J. Billings; L. Zeitel; J. Lukomnik; T. S. Carey; A. E. Blank; L. Newman
ANO: 1993
RESUMO: This DataWatch examines the potential impact of socioeconomic differences on rates of hospitalization, based on patterns of hospital use in New York City in 1988. The research suggests that lack of timely and effective outpatient care may lead to higher hospitalization rates in low-income areas. For certain conditions identified as ambulatory care sensitive, hospitalization rates were higher in low-income areas than they were in higher-income areas where appropriate outpatient care was more readily available. Further study is needed to determine the relative impact of various economic, structural, and cultural factors that affect access to care.
FONTE: Health Affairs (Project Hope), Millwood, v. 12, n. 1, p.162-173, 2003.
REFERENCIA: BILLINGS, J. et al. Impact of socioeconomic status on hospital use in New York City. Health Affairs (Project Hope), Millwood, v. 12, n. 1, p.162-173, 2003.
211. Rates of caesarean section: analysis of global, regional and national estimates.
AUTOR(ES): Ana P. Betrá n; Mario Merialdi; Jeremy A. Lauer; Wang Bing-Shun; Jane Thomas; Paul Van Look; Marsden Wagner
ANO: 2007
RESUMO: Rates of caesarean section are of concern in both developed and developing countries. We set out to estimate the proportion of births by caesarean section (CS) at national, regional and global levels, describe regional and subregional patterns and correlate rates with other reproductive health indicators. We analysed nationally representative data available from surveys or vital registration systems on the proportion of births by CS. We used local non-parametric regression techniques to correlate CS with maternal mortality ratio, infant and neonatal mortality rates, and the proportion of births attended by skilled health personnel. Although very unevenly distributed, 15% of births worldwide occur by CS. Latin America and the Caribbean show the highest rate (29.2%), and Africa shows the lowest (3.5%). In developed countries, the proportion of caesarean births is 21.1% whereas in least developed countries only 2% of deliveries are by CS. The analysis suggests a strong inverse association between CS rates and maternal, infant and neonatal mortality in countries with high mortality levels. There is some suggestion of a direct positive association at lower levels of mortality. CS levels may respond primarily to economic determinants.
FONTE: Paediatric And Perinatal Epidemiology, Oxford, v. 21, n. 2, p.98-113, 2007.
REFERENCIA: BETRÁN, Ana P. et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatric And Perinatal Epidemiology, Oxford, v. 21, n. 2, p.98-113, 2007.
212. As infecções respiratórias agudas na infância como problema de saúde pública.
AUTOR(ES): Yehuda Benguigui
ANO: 2002
RESUMO: As infecções respiratórias agudas (IRA) na infância continuam sendo um importante problema de saúde pública. Em fins da década de 90, as estimativas disponíveis indicavam que mais de 80.000 crianças com menos de cinco anos de idade morriam anualmente, nos países das Américas, em decorrência dessas doenças. Embora essa cifra tivesse sido cerca de 41% mais baixa que aquela estimada em fins dos anos 90, essas doenças continuaram sendo responsáveis por 15% do total de mortes de crianças com menos de cinco anos. Além disso, a distribuição dessas mortes nos diferentes países que compõem a Região, não foi homogênea: enquanto se estima que nos países da área andina ocorra quase uma terça parte do total de mortes de crianças com menos de cinco anos em decorrência da IRA, na América do Norte somente 1% de todas as mortes ocorre por esta causa. Nos países da área andina, essas doenças representam 19% das mortes de crianças de 0 a 5 anos, enquanto que na América do Norte só são responsáveis por 2,5%. As infecções respiratórias agudas também são uma causa importante de enfermidade infantil, e são reconhecidas como sendo a causa mais frequente pela qual uma criança perde sua saúde. Isto é um problema, não só pelo dano direto para a saúde infantil, mas por necessitar um esforço adicional de parte da família quanto ao cuidado e a atenção da criança, que nem sempre são prestados da forma adequada. A falta de reconhecimento dos sinais precoces de alarma, assim como a utilização de tratamentos desnecessários, e inclusive, prejudiciais para criança, já foram descritos como fatores importantes para a deterioração da qualidade do atendimento à infância e põem em maior risco a saúde das crianças com menos de cinco anos. Por todas as razões acima, o controle das IRA na infância representou e continua a representar uma prioridade para a saúde pública. A existência de estratégias e intervenções bem-sucedidas para reduzir os danos causados pelas IRA à no grupo de crianças de cinco anos, em termos de mortalidade e de morbidade grave, bem como para melhorar as práticas de assistência e cuidado das crianças que sofrem dessas doenças, abriu, há alguns anos, uma perspectiva mais favorável para o controle desse problema. Por isso, aumentar a população que possa usufruir desses beneficios aparece como sendo a principal prioridade para o adequado controle do problema e reduzir a mortalidade associada com as IRA na infância. A OPS/OMS juntamente com as Agencias Internacionais e bilaterais apoia a implementação de estratégia AIDPI- Atenção Integrada às Doenças Prevalentes da Infância, que neste momento é considerada a intervenção mais abrangente para conseguir-se a redução da mortalidade em crianças menores de cinco anos pelas doenças mais prevalentes neste grupo de idade, pelo que as organizações internacionais, em conjunto com os Ministérios da Saúde dos países da Região das Américas, lançam a iniciativa "Crianças Saudáveis: a Meta de 2002", que prevê reduzir pelo menos 100.000 mortes adicionais, em crianças menores de cinco anos nos países da Região.
FONTE: Boletim de Pneumologia Sanitária, Rio de Janeiro, v. 10, n. 1, p.13-22, 2002.
REFERENCIA: BENGUIGUI, Yehuda. As infecções respiratórias agudas na infância como problema de saúde pública. Boletim de Pneumologia Sanitária, Rio de Janeiro, v. 10, n. 1, p.13-22, 2002.
213. The increase of diabetes mortality burden among Brazilian adults.
AUTOR(ES): Sandhi Maria Barreto; Valeria Maria Azeredo Passos; Suzanne Kelly Ferreira Almeida; Tiago Duarte Assis
ANO: 2007
RESUMO: OBJECTIVE: To estimate diabetes-related deaths among Brazilian adults between 1999 and 2003 and to investigate demographic factors associated with reporting diabetes as an associated cause of death. METHODS: All deaths with diabetes as the underlying or associated cause were identified using the Brazilian Mortality Data System. Analysis was performed by sex, age, year, state of residence, and place of death. Mortality rates were age standardized by the 2000 Brazilian population. FINDINGS: A total of 237 946 deaths (8.8%) were related to diabetes; in 4.2% of deaths it was the underlying cause and in 4.6% it was an associated cause. Between 1999 and 2003, age-standardized mortality rates for diabetes as the underlying cause increased 14% among males and 9% among females, while mortality with diabetes as an associated cause increased 22% and 28%, respectively. Diabetes appeared more often as an associated cause in death certificates among older individuals and in those residing in São Paulo State; it appeared less often as an associated cause among women, brown- and black-skinned populations, and in deaths occurring outside hospitals. Cardiovascular diseases accounted for 54.5% of the underlying causes of death when diabetes was an associated cause. CONCLUSION: Diabetes was related to almost 9% of the deaths in the South and Southeast regions of Brazil. Mortality from diabetes is increasing, especially deaths with diabetes as an associated cause. The probability of having diabetes as the underlying cause of death is greater among women and nonwhite individuals. Our results reinforce the importance of using multiple causes of death to monitor diabetes, because half the individuals with the disease will die of another cause, especially cardiovascular diseases.
FONTE: Revista Panamericana de Salud Pública, Washington, v. 22, n. 4, p.239-245, 2007.
REFERENCIA: BARRETO, Sandhi Maria et al. The increase of diabetes mortality burden among Brazilian adults. Revista Panamericana de Salud Pública, Washington, v. 22, n. 4, p.239-245, 2007.
214. Parto cesáreo: quem o deseja? Em quais circunstâncias?
AUTOR(ES): Gisele Peixoto Barbosa; Karen Giffin; Antonia Angulo-Tuesta; Andrea de Souza Gama; Dó ra Cho; Eleonora Dorsi; Ana Cristina Gonç alves Vaz dos Reis
ANO: 2003
RESUMO: O Brasil apresenta altos índices de cesáreas. Este estudo investigou a existência de uma "cultura de cesárea", ou preferência por este tipo de parto, através de uma amostra de 909 puérperas (454 vaginais e 455 cesáreos) em duas maternidades do Município do Rio de Janeiro, onde entrevistas e revisão de prontuários foram realizados entre setembro de 1998 e março de 1999. Perguntou-se às mulheres se queriam que seu parto fosse cesáreo e a maioria absoluta (75,5%) respondeu "não", as razões principais sendo: "recuperação mais difícil e lenta no parto cesáreo" (39,2%) e "dor e sofrimento maior depois da cesárea" (26,8%). Apenas 17% das mulheres solicitaram cesárea e, destas, cerca de 75% o fizeram durante o trabalho de parto/parto. Análise mostrou que quanto maior o intervalo de tempo entre a admissão no hospital e o parto, mais freqüente é a solicitação. A maioria das mulheres, nas maternidades estudadas, não quer e não pede cesárea; ou seja, não existe uma ‘cultura’ feminina que valorize a cesárea como preferência. Além do desejo da laqueadura, as circunstâncias concretas da assistência no pré-parto/parto parecem influenciar no pedido da mulher.
FONTE: Cadernos de Saúde Pública, Rio de Janeiro, v. 19, n. 6, p.1611-1620, 2003.
REFERENCIA: BARBOSA, Gisele Peixoto et al. Parto cesáreo: quem o deseja? Em quais circunstâncias? Cadernos de Saúde Pública, Rio de Janeiro, v. 19, n. 6, p.1611-1620, 2003.
215. Day Case Stapled Haemorrhoidectomy.
AUTOR(ES): D. Bandyopadhyay; C. R. Kapadia
ANO: 2004
RESUMO: Purpose: Surgical haemorrhoidectomy is traditionally performed as an inpatient procedure mainly because of associated postoperative pain. Randomised controlled studies of Milligan-Morgan versus stapled haemorrhoidectomy have shown the stapling procedure to be less painful. We studied stapled haemorrhoidectomy to assess the feasibility and safety of this procedure as a day case. Scope: One hundred consecutive cases of stapled haemorrhoidectomy were included in the study. The anaesthetic technique and postoperative care were standardised. Indications for the operation, age and sex distribution, operating time, hospital stay and postoperative complications were noted. All patients were reviewed in the outpatient clinic at 6–8 weeks. Conclusions: Ambulatory stapled haemorrhoidectomy should be the gold standard surgical operation for 3rd degree haemorrhoids and rectal mucosal prolapse.
FONTE: The Journal Of One-day Surgery, Derbyshire, v. 14, n. 3, p.71-73, 2004.
REFERENCIA: BANDYOPADHYAY, D.; KAPADIA, C. R.Day case stapled haemorrhoidectomy. The Journal Of One-day Surgery, Derbyshire, v. 14, n. 3, p.71-73, 2004.
216. Measuring equity of access to health care.
AUTOR(ES): Sara Allin; Cristina Herná ndez-Quevedo; Cristina Masseria
ANO: 2009
RESUMO:
FONTE: Cambridge: Health Economics, Policy And Management. Cambridge University Press, 2009. p. 187-221.
REFERENCIA: ALLIN, Sara; HERNÁNDEZ-QUEVEDO, Cristina; MASSERIA, Cristina. Measuring equity of access to health care. In: SMITH, Peter C. et al. Performance measurement for health system improvement: experiences, challenges and prospects. Cambridge: Health Economics, Policy And Management. Cambridge University Press, 2009. p. 187-221.
217. Internações por condições sensíveis à atenção primária: a construção da lista brasileira como ferramenta para medir o desempenho do sistema de saúde (Projeto ICSAP - Brasil).
AUTOR(ES): Maria Elmira Alfradique; Palmira de Fá tima Bonolo; Inê s Dourado; Maria Fernanda Lima-Costa; James Macinko; Claunara Schilling Mendonç a; Veneza Berenice Oliveira; Luí s Fernando Rolim Sampaio; Carmen De Simoni; Maria Aparecida Turci
ANO: 2009
RESUMO: As internações por condições sensíveis à atenção primária representam condições de saúde que podem ter o risco de hospitalização desnecessária diminuído, por meio de ações efetivas da atenção primária. Essas internações vêm sendo usadas como indicador do acesso e qualidade da atenção básica, mas não existe consenso quanto às doenças que devem fazer parte desse indicador. Apresenta-se uma descrição das etapas seguidas para a construção da lista brasileira de internações por condições sensíveis à atenção primária. A lista final é composta por vinte grupos de diagnósticos, que representavam 28,3% das hospitalizações realizadas pelo Sistema Único de Saúde em 2006, em um total de cerca de 2,8 milhões de internações. Gastroenterites e complicações, insuficiência cardíaca e asma corresponderam a 44,1%. De 2000 a 2006, as internações por condições sensíveis à atenção primária caíram 15,8% no país, e o declínio dessas hospitalizações foi maior do que as internações não-internações por condições sensíveis à atenção primária. São discutidas as aplicações e limites da lista nacional de internações por condições sensíveis à atenção primária.
FONTE: Cadernos de Saúde Pública, Rio de Janeiro, v. 25, n. 6, p.1337-1349, 2009.
REFERENCIA: ALFRADIQUE, Maria Elmira et al. Internações por condições sensíveis à atenção primária: a construção da lista brasileira como ferramenta para medir o desempenho do sistema de saúde. Cadernos de Saúde Pública, Rio de Janeiro, v. 25, n. 6, p.1337-1349, 2009.
218. A qualidade da saúde.
AUTOR(ES): Hannu Vuori
ANO: 1991
RESUMO: Aborda aspectos para definiçäo de uma estratégia para a melhoria da qualidade da saúde. Quem toma as decisöes precisa, no mínimo, ter consciência das alternativas que se apresentam. O maior segredo de uma boa escolha é estar informado dos detalhes. E é exatamente nos detalhes que se pretende aprofundar.
FONTE: Divulgação em Saúde Para Debate, Londrina, n. 3, p.17-24, 1991.
REFERENCIA: VUORI, Hannu. A qualidade da saúde. Divulgação em Saúde Para Debate, Londrina, n. 3, p.17-24, 1991.
219. Uma revisão sobre os conceitos de acesso e utilização de serviços de saúde.
AUTOR(ES): Claudia Travassos; Mô nica Martins
ANO: 2004
RESUMO: O objetivo deste artigo é rever os conceitos de acesso e de utilização de serviços de saúde, identificando pontos de distinção e articulação existentes entre ambos. Acesso é um conceito complexo, geralmente empregado de forma imprecisa e que muda ao longo do tempo e de acordo com o contexto. A utilização dos serviços de saúde representa o centro do funcionamento dos sistemas de saúde. Apesar das divergências, predomina a visão de que o acesso relaciona-se a características da oferta de serviços. O uso de serviços é uma expressão do acesso, mas não se explica apenas por ele. Fatores individuais predisponentes e contextuais também influenciam o uso. Observa-se uma tendência de ampliação do escopo do conceito de acesso, com deslocamento do seu eixo da entrada nos serviços (uso) para os resultados dos cuidados recebidos. O acesso é visto pelo seu impacto na saúde e dependerá também da adequação do cuidado prestado. Finalmente, destaca-se que determinantes da saúde diferem daqueles do uso de serviços e que a utilização de serviços impacta diretamente a doença, mas apenas indiretamente a saúde.
FONTE: Cadernos de Saúde Pública, Rio de Janeiro, v. 20, n. 2, p.190-198, 2004. suplemento.
REFERENCIA: TRAVASSOS, Claudia; MARTINS, Mônica. Uma revisão sobre os conceitos de acesso e utilização de serviços de saúde. Cadernos de Saúde Pública, Rio de Janeiro, v. 20, n. 2, p.190-198, 2004. suplemento.
220. Factors affecting attitudes toward colorectal cancer screening in the primary care population.
AUTOR(ES): T. Taskila; S. Wilson; S. Damery; A. Roalfe; V. Redman; T. Ismail; R. Hobbs
ANO: 2009
RESUMO: BACKGROUND: Colorectal cancer (CRC) is a major cause of death in the United Kingdom. Regular screening could significantly reduce CRC-related morbidity and mortality. However, screening programmes in the United Kingdom have to date seen uptake rates of less than 60%. Attitudes towards screening are the primary factors determining patient uptake. METHODS: A questionnaire was sent to people aged 50-69 years who were registered with general practices in the West Midlands. A total of 11 355 people (53%) completed the questionnaire. Multivariable logistic regression analyses were performed to identify those factors (gender, age, ethnicity, deprivation, number of symptoms, and their duration) that most strongly contributed to negative/positive attitudes in the primary care population. RESULTS: Fourteen percent of respondents had a negative attitude towards screening. Men, older people, and those with Indian ethnic backgrounds were more likely to have negative attitudes toward screening, whereas people with Black-Caribbean ethnic background, people with multiple symptoms and those reporting abdominal pain, bleeding, and tiredness were more likely to have a positive attitude. CONCLUSION: Culturally relevant screening strategies should aim to increase knowledge of the symptoms and signs related to bowel cancer among South Asian ethnic groups in the United Kingdom. It is also important to find ways to increase the acceptability of screening among asymptomatic patients.
FONTE: British Journal Of Cancer, London, v. 101, n. 2, p.250-255, 2009.
REFERENCIA: TASKILA, T. et al. Factors affecting attitudes toward colorectal cancer screening in the primary care population. British Journal Of Cancer, London, v. 101, n. 2, p.250-255, 2009.
221. Patient acceptance of CT colonography and conventional colonoscopy: prospective comparative study in patients with or suspected of having colorectal disease.
AUTOR(ES): Maria H. Svensson; Elisabeth Svensson; Anders Lasson; Mikael Hellströ m
ANO: 2002
RESUMO: PURPOSE: To prospectively evaluate, by means of self-assessed questionnaires, patient acceptance of computed tomographic (CT) colonography compared with that of conventional colonoscopy, when performed in patients with or suspected of having colorectal disease. MATERIALS AND METHODS: One hundred eleven patients underwent CT colonography followed immediately by conventional colonoscopy. Patient acceptance was evaluated with questionnaires, and the proportions of patients who favored one examination were compared. The main variables were overall impression, discomfort during air filling or instrumentation, and perceived pain, evaluated by using ordered verbal descriptor scales after each examination. The preference for either examination was evaluated after completion of both examinations. RESULTS: Of the 68 patients who favored one examination, 56 (82%) preferred CT colonography (P <.00001). Concerning overall impression of problems or discomfort in connection with the examination, 49 (69%) of 71 with a preference considered colonoscopy to be more difficult (P =.002). CT colonography was regarded as "not painful" by 62 (57%) of 108 patients compared with 28 (26%) for colonoscopy, and a larger proportion of patients rated pain as higher during colonoscopy than during CT colonography (95% CI: 30%, 56%). Discomfort from air filling of the colon was the major complaint about CT colonography. CONCLUSION: CT colonography was considered less painful and less difficult overall than colonoscopy and was the preferred examination.
FONTE: Radiology, Easton, v. 222, n. 2, p.337-345, 2002.
REFERENCIA: SVENSSON, Maria H. et al. Patient acceptance of CT colonography and conventional colonoscopy: prospective comparative study in patients with or suspected of having colorectal disease. Radiology, Easton, v. 222, n. 2, p.337-345, 2002.
222. Overcoming barriers to health service access and influencing the demandside through purchasing.
AUTOR(ES): Tim Ensor; Stephanie Cooper
ANO: 2004
RESUMO: This paper investigates the role of demand-side barriers in impeding access to the use of health services. Demand-side barriers are defined as determinants of use of health care that are not dependent on service delivery or price or direct price of those services. They include distance, education, opportunity cost, and cultural and social barriers. There is some evidence that these barriers are at least as important in determining access to services as the quality, volume, and price of services delivered by health care providers. The paper is divided into two sections. In the first section literature on demand barriers to accessing services is reviewed. Since the literature on these barriers is so substantial, the review is restricted to an illustrative survey of the main barriers in low-, middle-, and high-income countries. The second section surveys studies that report and evaluate methods for overcoming these barriers. The literature here is substantially less voluminous even when gray and unpublished sources are included in the survey. Many of the studies relate to access to obstetrical and family planning care. In most cases evaluation is not rigorous, and it is often hard to separate the impact of the intervention itself from other confounding factors. Few of the studies reported have an explicit poverty focus, although many of the interventions are conducted in poor areas. There is a clear need for further work to examine the most cost-effective ways of reducing barriers to accessing services and in particular to investigate what methods are most effective in expanding access to essential care among the poor.
FONTE: Washington: Health, Nutrition & Population, 2004. 78 p.
REFERENCIA: ENSOR, Tim; COOPER, Stephanie. Overcoming barriers to health service access and influencing the demandside through purchasing. Washington: Health, Nutrition & Population, 2004. 78 p.
223. Does healthcare save lives? Avoidable mortality revisisted.
AUTOR(ES): Ellen Nolte; Martin McKee
ANO: 2004
RESUMO:
FONTE: London: Nuffield Trust, 2004. 139 p.
REFERENCIA: NOLTE, Ellen; MCKEE, Martin. Does healthcare save lives?:avoidable mortality revisisted. London: Nuffield Trust, 2004. 139 p.
224. Atenção primária: equilíbrio entre necessidades de saúde, serviços e tecnologia.
AUTOR(ES): Barbara Starfield
ANO: 2002
RESUMO:
FONTE: Brasília: Unesco, Ministério da Saúde, 2002. 726 p.
REFERENCIA: STARFIELD, Barbara. Atenção primária: equilíbrio entre necessidades de saúde, serviços e tecnologia. Brasília: Unesco, Ministério da Saúde, 2002. 726 p.
225. Performance measurement for health system improvement: Experiences, challenges and prospects. Parte 2.
AUTOR(ES): Peter C. Smith; Elias Mossialos; Irene Papanicolas
ANO: 2009
RESUMO:
FONTE: Copenhagen: World Health Organization, 2009. 225 p.
REFERENCIA: SMITH, Peter C.; MOSSIALOS, Elias; PAPANICOLAS, Irene. Performance measurement for health system improvement: experiences, challenges and prospects. Copenhagen: World Health Organization, 2009. 225 p.
226. Appropriateness in Patient Care: A New Conceptual Framework.
AUTOR(ES): Virginia A. Sharpe; Alan I. Faden
ANO: 1996
RESUMO: In recent years the focus for the evaluation of health services has shifted from unnecessary treatment--specifically, unnecessary surgery--to appropriateness research. This new emphasis constitutes a shift in the burden of proof, indicating increased attention to the evidentiary basis of medical and surgical practice. The evaluation of the appropriateness of health services is also seen as integral to the reforming drive to contain health care costs and improve quality. Because of its pivotal role as a criterion in health care decision-making, the concept of appropriateness requires clarification. Three sources of value are defined that give meaning to "appropriateness" in patient care: the clinical point of view, the point of view of the individual patient, and the societal point of view. This framework is also used to shed light on the issue of medical futility.
FONTE: The Milbank Quarterly, New York, v. 74, n. 1, p.115-138, 1996.
REFERENCIA: SHARPE, Virginia A.; FADEN, Alan I. Appropriateness in Patient care: a new conceptual framework. The Milbank Quarterly, New York, v. 74, n. 1, p.115-138, 1996.
227. Determinantes e efeitos da continuidade na Atenção à Saúde: Estudo de base populacional em Pelotas, RS.
AUTOR(ES): Luiz Artur
ANO: 2007
RESUMO: Fatores associados à continuidade interpessoal na atenção à saúde: estudo de base populacional Objetivo: Estudar a prevalência de Continuidade Interpessoal na Atenção à Saúde (CIAS) e seus determinantes socioeconômicos, demográficos, assistenciais e relacionados às necessidades de saúde dos indivíduos. Metodologia: Foi realizado um estudo transversal de base populacional com 3133 indivíduos, moradores da zona urbana de Pelotas, RS. A amostra incluiu adultos com 20 anos ou mais e, foi selecionada em múltiplos estágios. A análise multivariável foi realizada através de regressão de Poisson, tendo no primeiro nível variáveis socioeconômicas e demográficas e no nível proximal, variáveis assistenciais e de necessidades em saúde. Resultados: A prevalência de CIAS foi de 43,7% IC95%(42,0-45,5). Indivíduos do sexo feminino, mais velhos, com maior renda, que consultaram no último ano, com relato de doença crônica e que não consultaram no sistema público de saúde apresentaram maior CIAS. Entre os que consultam em Unidades Básicas de Saúde(UBS), sexo feminino, aumento da idade e o Programa de Saúde da Família(PSF) estiveram associadas com CIAS. Discussão: A CIAS é mais prevalente em idosos e aqueles com doenças crônicas. Entretanto, outros grupos vulneráveis, como aqueles de baixa renda e usuários do sistema público de saúde, apresentaram menores prevalências de CIAS, o que mostra importante iniqüidade em saúde. O PSF parece ter um impacto positivo na CIAS. Descritores: Continuidade na Atenção à Saúde, atenção básica em saúde, epidemiologia, relação médico-paciente, estudo de base populacional.
FONTE: Departamento de Centro de Pesquisas Epidemiológicas, Universidade Federal de Pelotas, Pelotas, 2006.
REFERENCIA: ROSA FILHO, Luiz Artur. Determinantes e efeitos da continuidade na Atenção à Saúde: estudo de base populacional em Pelotas, RS. 2007. Tese (Mestrado) - Departamento de Centro de Pesquisas Epidemiológicas, Universidade Federal de Pelotas, Pelotas, 2006.
228. Defusing the Confusion: Concepts and Measures of Continuity of Healthcare, Final Report.
AUTOR(ES): R.J. Reid RJ; J. Haggerty; R. McKendry
ANO: 2002
RESUMO: When patients receive care from a variety of sources, connecting that care into a smooth trajectory becomes increasingly difficult. Policy reports worldwide urge a concerted effort to avoid fragmentation and enhance continuity of care. But efforts to describe the problem or formulate solutions are hampered because continuity has been defined and measured in myriad ways. This report was commissioned by the Canadian Health Services Research Foundation, the Canadian Institute for Health Information and the Conference of Deputy Ministers of Health's Federal/Provincial/ Territorial Advisory Committee on Health Services. The mandate was to survey how continuity has been used and measured in order to develop a common understanding of the concept and to recommend measures for health system monitoring. We did a systematic survey of how the phrase "continuity of care" was used in the literature, and then presented the results to 59 researchers and decision-makers in a discussion paper and two-day workshop in June 2001.
FONTE: Ottawa: Canadian Health Services Research Foundation, 2002. 50 p.
REFERENCIA: REID, R.J.; MCKENDRY, J. Haggerty R; MCKENDRY, R.Defusing the confusion: concepts and measures of continuity of healthcare, final report. Ottawa: Canadian Health Services Research Foundation, 2002. 50 p.
229. Finns defined patients' rights before Dutch.
AUTOR(ES): Marja-Liisa Partanen; Tyyne Martikainen
ANO: 1994
RESUMO:
FONTE: British Medical Journal, London, v. 309, n. 6947, p.130-131, 1994.
REFERENCIA: PARTANEN, Marja-liisa; MARTIKAINEN, Tyyne. Finns defined patients' rights before Dutch. British Medical Journal, London, v. 309, n. 6947, p.130-131, 1994.
230. Health at a glance 2009 – OECD Indicators.
AUTOR(ES): Organisation for Economic Co-operation and Development.
ANO: 2009
RESUMO: This fifth edition of Health at a Glance provides the latest comparable data on different aspects of the performance of health systems in OECD countries. It provides striking evidence of large variations across countries in the costs, activities and results of health systems. Key indicators provide information on health status, the determinants of health, health care activities and health expenditure and financing in OECD countries. This edition also contains new chapters on the health workforce and on access to care, an important policy objective in all OECD countries. The chapter on quality of care has been extended to include a set of indicators on the quality of care for chronic conditions.
FONTE: Paris: OECD, 2009. 200 p.
REFERENCIA: ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT.Health at a Glance 2009: OECD Indicators. Paris: OECD, 2009. 200 p.
231. A healthier future for all Australians - Final Report June 2009.
AUTOR(ES): National Health and Hospitals Reform Commission
ANO: 2009
RESUMO:
FONTE: Australia: NHHRC,2009. 285 p.
REFERENCIA: NATIONAL HEALTH AND HOSPITALS REFORM COMMISSION. A healthier future for all Australians: final report june 2009. Australia: NHHRC,2009. 285 p.
232. Aceitabilidade e Funcionalidade de Uma Nova Caneta para Administração de Insulina (Humapen): Experiência Clínica em Pacientes Brasileiros.
AUTOR(ES): José E.P. Oliveira; Adolpho Milech; Mariangé lica O. Silva; Leã o Zagury; Ivan S. Ferraz; Ana Lú cia C. Correia; Edgard D. Niclewicz; Rosangela S. Ataide; Fadlo F. Filho; Paula Pascalli; Eucy Falcã o; Marcia J. Kayath
ANO: 2000
RESUMO: administração de insulina geralmente é realizada com seringa e agulha. Porém, a injeção é freqüentemente considerada dolorosa e traumática, causando problemas psicossociais em muitos pacientes com diabetes. Reconhece-se que as canetas de injeção de insulina são mais convenientes, causam menos dor à injeção e melhoram a qualidade de vida dos pacientes. Este estudo examinou a aceitabilidade e funcionalidade de uma nova caneta de administração de insulina reutilizável, Humapen®, em 94 pacientes diabéticos tipo 1 e 2, os quais usavam insulina por um tempo mediano de 7,8 anos com 2,7+3,0 aplicações por dia. Quarenta e dois porcento deles usava outras canetas, e os 58% restantes usava seringas. Os pacientes fizeram uso de Humapen® por 8 semanas, mantendo o esquema de insulinização prévio. Todos os pacientes completaram o estudo. Os resultados em pacientes em uso prévio de seringa ou canetas foram semelhantes. As características mais mencionadas como superiores em relação ao método de administração anterior foram a facilidade de ajustar/usar (89%), medição/correção/leitura da dose (88%) e troca do cartucho (80%). Noventa e oito porcento dos usuários prévios de seringa preferiu Humapen® à seringa, e cerca de 80% dos pacientes preferiu Humapen®, à caneta anterior. Nenhum paciente abandonou o uso da caneta e, ao final do estudo, 92% dos pacientes respondeu que continuaria usando Humapen®. Treze porcento mencionou alguma dificuldade com a caneta, e as razões mais freqüentes foram o tamanho da caneta e a adaptação inicial. Não houve relato de evento adverso ou problemas técnicos com a caneta. Os profissionais de saúde não referiram dificuldades na instrução da caneta ou na leitura/ ajuste de dose, e ao final do estudo, 100% deles referiu que continuaria recomendando Humapen®. O uso de caneta de insulina deve ser considerado em pacientes diabéticos, tanto naqueles com esquema de mistura fixa, de insulina basal intermediária, como naqueles em esquema de injeções múltiplas.
FONTE: Arquivos Brasileiros de Endocrinologia & Metabologia, São Paulo, v. 44, n. 6, p.519-522, 2000.
REFERENCIA: OLIVEIRA, José E.P et al. Aceitabilidade e funcionalidade de uma nova caneta para administração de insulina (Humapen): experiência clínica em pacientes brasileiros. Arquivos Brasileiros de Endocrinologia & Metabologia, São Paulo, v. 44, n. 6, p.519-522, 2000.
233. Efficacy, safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction.
AUTOR(ES): Chris G. McMahon; Ramin Samali; Helen Johnson
ANO: 2000
RESUMO: PURPOSE: We assessed the efficacy and safety of sildenafil citrate as treatment for erectile dysfunction. MATERIALS AND METHODS: A total of 433 completely evaluated men with chronic erectile dysfunction were treated with sildenafil citrate. Response was assessed prospectively by baseline and followup physician interviews, and by a patient self-administered 15-item questionnaire on the domains of patient treatment response and satisfaction, partner treatment satisfaction, comparative previous treatment satisfaction, adverse effects, and patient and partner quality of life. RESULTS: Of the 304 men (70.2%) who completed the questionnaire 278 received sildenafil, including 186 who previously had undergone treatment for erectile dysfunction, principally involving intracavernous injection therapy. A response was elicited by a median dose of 100 mg. in 188 patients (67.6%) who achieved erection suitable for sexual intercourse. Those with psychogenic erectile dysfunction responded significantly better than those with organic dysfunction (p <0.001). Erection suitable for intercourse was attained by 30.8% of patients with erectile dysfunction after radical prostatectomy and 80% with cavernous veno-occlusive dysfunction. Of previous intracavernous injection responders 29.9% were refractory to sildenafil, while 33. 3% of previous intracavernous injection nonresponders responded to sildenafil. The sildenafil response was considered inferior to the intracavernous injection response by 43.6% of the men who previously responded to intracavernous injection, of whom 51.5% continued to receive intracavernous injection as the only treatment (19.5%) or as an alternative to sildenafil (32%). Adverse effects in 53.6% of cases were assessed as mild in 56.4%, moderate in 38.3% and severe in 5.3%. Multiple adverse effects were reported by 62.4% of patients, while 17 (6.1%) discontinued sildenafil as a direct result of intolerable adverse effects. The most common adverse effects were facial flushing in 33.5% of cases, headaches in 23.4%, nasal congestion in 12.6%, dyspepsia in 10.1% and dizziness in 10.8%. Baseline patient and partner quality of life scores significantly improved after sildenafil treatment (p <0.001), while significantly improved quality of life was noticed by 51.5% and 43.1%, respectively. CONCLUSIONS: Sildenafil citrate is effective oral first line treatment for erectile dysfunction. Although more than 50% of men reported adverse effects, most were considered mild and rarely resulted in treatment cessation. There was a trend in those on intracavernous injection who responded to sildenafil to continue intracavernous injection as the only therapy or as an alternative to sildenafil. Also, we noted that some cases refractory to sildenafil responded to intracavernous injection. These findings imply that intracavernous injection remains an effective erectile dysfunction treatment option.
FONTE: The Journal Of Urology, Baltimore, v. 164, n. 4, p.1192-1196, 2000.
REFERENCIA: MCMAHON, Chris G.; SAMALI, Ramin; JOHNSON, Helen. Efficacy, safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction. The Journal Of Urology, Baltimore, v. 164, n. 4, p.1192-1196, 2000.
234. Patient Acceptance of the Implantable Cardioverter Defibrillator in Ventricular Tachyarrhythmias.
AUTOR(ES): Berndt Luderitz; Werner Jung; Arno Deister; Andreas Marneros; Matthias Manz
ANO: 1993
RESUMO: Besides surgical problems, recipierifs of implantable cardioverter defibrillators (ICDs) are faced with psychological and social adjustments. Successful ICD therapy is influenced by the patients’ perceived concerns regarding device, discharge, changes in life style, and complications. In order to assess patients’ acceptance of the ICD, the psychological profile of 57 consecutive patients was evaluated using a specifically designed questionnaire and the State Trait Anxiety Inventory (STAI). The results showed that 20 patients staled fear of ICD discharge, 12 patients revealed physical discomfort due to the device, and limited quality-of-life occurred in 8 patients. Fifty-five of 57 patients answered that it was worth having an ICD device implanted, 30 (53%) patients returned to active life, and 56 (98%) would advise another patient to undergo implantation if necessary. Overall, there was only a slight, but insignificant, decrease in the level of anxiety within the total patient population after ICD implantation. However, a comparison of two subgroups indicated that the state of anxiety was significantly higher in patients < 50 years of age as well as in patients having received > 5 shocks versus those > 50 years of age and having experienced < 5 shocks. In general, the acceptance of the ICD as a tool in managing life-threatening ventricular tachyarrhythmias is high. Besides the increased survival rate, quality-of-life and patient acceptance are important criteria for successful ICD therapy.
FONTE: Pacing and Clinical Electrophysiology, United States, v. 16, n. 9, p.1815-1821, 1993.
REFERENCIA: LUDERITZ, Berndt et al. Patient acceptance of the implantable cardioverter defibrillator in ventricular tachyarrhythmias. Pacing and Clinical Electrophysiology, United States, v. 16, n. 9, p.1815-1821, 1993.
235. Health services performance : effectiveness and efficiency.
AUTOR(ES): Andrew F. Long; Stephen Harrison
ANO: 1985
RESUMO:
FONTE: London: Croom Helm, 1985. 269 p.
REFERENCIA: LONG, Andrew F.; HARRISON, Stephen. Health services performance: effectiveness and efficiency. London: Croom Helm, 1985. 269 p.
236. Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance.
AUTOR(ES): Philippe A. Lefere; Stefaan S. Gryspeerdt; Jef Dewyspelaere; Marc Baekelandt; Bartel G. Van Holsbeeck
ANO: 2002
RESUMO: PURPOSE: To compare reduced colonic cleansing based on dietary fecal tagging (FT) with standard (non-FT) colonic cleansing with regard to patient acceptance, sensitivity, and specificity. MATERIALS AND METHODS: In 50 patients (FT group), FT was performed by means of diet, magnesium citrate, and a barium suspension. In another 50 patients (non-FT group), preparation was based on polyethylene glycol administration. All patients underwent conventional colonoscopy after computed tomographic (CT) colonography. Sensitivity and specificity for polyp detection were calculated by using conventional colonography as the reference standard. At CT colonography, fecal residue was evaluated. Patients were interviewed to determine discomfort, side effects, sleep quality, final opinion on examination comfort, and whether they would be reluctant to undergo the same examination again. RESULTS: FT left more fecal residue but improved differentiation from polyps (FT specificity, 88% [30 of 34 patients]; non-FT, 77% [23 of 30 patients]). Sensitivities were comparable: FT, 88% (14 of 16 patients); non-FT, 85% (17 of 20 patients). FT significantly reduced discomfort, side effects, and sleep disturbance, and resulted in an improved final opinion of how comfortable the examination was (P <.05). Although FT improved patient willingness to repeat the examination, this improvement was not statistically significant (P >.05). CONCLUSION: FT offers the patient a well-tolerated preparation and improves specificity, with improved differentiation of polyps from residual stool.
FONTE: Radiology, Easton, v. 224, n. 2, p.393-403, 2002.
REFERENCIA: LEFERE, Philippe A. et al. Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. Radiology, Easton, v. 224, n. 2, p.393-403, 2002.
237. Performance measurement and improvement frameworks in health, education and social services systems: a systematic review.
AUTOR(ES): Anne Klassen; Anton Miller; Nancy Anderson; Jane Shen; Veronica Schiariti; Maureen O' Donnell
ANO: 2010
RESUMO: PURPOSE: To perform a systematic review, supplemented by a targeted grey literature scan, for performance measurement and improvement frameworks within and across the health, education and social service systems. The intended outcome was the creation of a foundation of evidence to inform the development of cross-sectoral quality improvement frameworks. DATA SOURCES: MEDLINE, CINAHL, PsycINFO, ERIC, EMBASE, Social Services Abstracts, Social Work Abstracts and Education Index Full Text were searched up to April/May 2007. In addition, 26 governmental and 27 organizational websites were searched. STUDY SELECTION: English language material with a publication date of 1986 or more recent that described a health, education or social services multidimensional framework for performance measurement and improvement. Data extraction The framework name; administrative sector; level of application; setting; population of interest; categories of quality described within the framework; country of application; and citations to other performance measurement and improvement frameworks were extracted from each article. RESULTS: In total, 111 frameworks were identified. Most frameworks (n = 97) were developed in or for the health sector. A concept sorting exercise identified 16 quality concepts applicable across many settings, sectors and levels of application. CONCLUSION: This systematic review of quality domains will be relevant and useful to those who are developing and using performance measurement and improvement frameworks for adult and child populations within or across the health, social service or education sectors.
FONTE: International Journal for Quality In Health Care, Oxford, v. 22, n. 1, p.44-69, 2010.
REFERENCIA: KLASSEN, Anne et al. Performance measurement and improvement frameworks in health, education and social services systems: a systematic review. International Journal for Quality In Health Care, Oxford, v. 22, n. 1, p.44-69, 2010.
238. Health Care Quality Indicators Project: Conceptual Framework Paper.
AUTOR(ES): Edward Kelley; Jeremy Hurst
ANO: 2006
RESUMO:
FONTE: Paris: OECD Health Working Paper, 2006. 36 p. N° 23.
REFERENCIA: KELLEY, Edward; HURST, Jeremy. Health care quality indicators project: conceptual framework paper. Paris: OECD Health Working Paper, 2006. 36 p. N° 23.
239. National Library of Healthcare Indicators. Health Plan Network Edition.
AUTOR(ES): Joint Commission on Accreditation of Healthcare Organizations
ANO: 1997
RESUMO:
FONTE: Oakbrook: Joint Commission Resources, 1997. 440 p.
REFERENCIA: JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. National library of healthcare indicators: health plan and network edition. Oakbrook: Joint Commission Resources, 1997. 440 p.
240. The Measurement mandate : on the road to performance improvement in health care.
AUTOR(ES): Joint Commission on Accreditation of Healthcare Organizations
ANO: 1993
RESUMO:
FONTE: Oakbrook: The Commission, 1993. 294 p.
REFERENCIA: JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. The Measurement mandate: on the road to performance improvement in health care. Oakbrook: The Commission, 1993. 294 p.
241. Revisão sistemática sobre o conceito de acesso nos serviços de saúde: contribuições do planejamento.
AUTOR(ES): Washington Luiz Abreu de Jesus; Marluce Maria Araú jo Assis
ANO: 2010
RESUMO: Neste artigo, procura-se discutir a categoria acesso aos serviços de saúde e as contribuições do planejamento para sua construção no âmbito do SUS. O eixo central discursivo refere-se à conexão entre teoria e prática do planejamento no campo da saúde coletiva relacionado às diferentes dimensões de análise do acesso: econômica, técnico-assistencial, política e simbólica, retratadas por teóricos da área. As dimensões evidenciam a contribuição dos sujeitos/autores na busca de uma maior aproximação com a realidade de saúde do país; tanto na compreensão dos elementos simbólicos que determinam as intervenções sobre o processo saúde-doença, quanto nas diferentes formas de organização do sistema de saúde e das políticas, percebidas em seus componentes políticos, econômicos e técnico-assistenciais.
FONTE: Ciência & Saúde Coletiva, Rio de Janeiro, v. 15, n. 1, p.161-170, 2010.
REFERENCIA: JESUS, Washington Luiz Abreu de; ASSIS, Marluce Maria Araújo. Revisão sistemática sobre o conceito de acesso nos serviços de saúde: contribuições do planejamento. Ciência & Saúde Coletiva, Rio de Janeiro, v. 15, n. 1, p.161-170, 2010.
242. A systematic review of health care efficiency measures.
AUTOR(ES): Peter S. Hussey; Han de Vries; John Romley; Margaret C. Wang; Susan S. Chen; Paul G. Shekelle; Elizabeth A. McGlynn
ANO: 2009
RESUMO: OBJECTIVE: To review and characterize existing health care efficiency measures in order to facilitate a common understanding about the adequacy of these methods. DATA SOURCES: Review of the MedLine and EconLit databases for articles published from 1990 to 2008, as well as search of the "gray" literature for additional measures developed by private organizations. STUDY DESIGN: We performed a systematic review for existing efficiency measures. We classified the efficiency measures by perspective, outputs, inputs, methods used, and reporting of scientific soundness. PRINCIPAL FINDINGS: We identified 265 measures in the peer-reviewed literature and eight measures in the gray literature, with little overlap between the two sets of measures. Almost all of the measures did not explicitly consider the quality of care. Thus, if quality varies substantially across groups, which is likely in some cases, the measures reflect only the costs of care, not efficiency. Evidence on the measures' scientific soundness was mostly lacking: evidence on reliability or validity was reported for six measures (2.3 percent) and sensitivity analyses were reported for 67 measures (25.3 percent). CONCLUSIONS: Efficiency measures have been subjected to few rigorous evaluations of reliability and validity, and methods of accounting for quality of care in efficiency measurement are not well developed at this time. Use of these measures without greater understanding of these issues is likely to engender resistance from providers and could lead to unintended consequences.
FONTE: Health Services Research, Chicago, v. 44, n. 3, p.784-805, 2009.
REFERENCIA: HUSSEY, Peter S. et al. A systematic review of health care efficiency measures. Health Services Research, Chicago, v. 44, n. 3, p.784-805, 2009.
243. Continuity of care: a multidisciplinary review.
AUTOR(ES): Jeannie L. Haggerty; Robert J. Reid; George K. Freeman; Barbara H. Starfield; Carol E. Adair; Rachael McKendry
ANO: 2003
RESUMO:
FONTE: British Medical Journal, London, v. 7425, n. 327, p.1219-1221, nov. 2003.
REFERENCIA: HAGGERTY, Jeannie L et al. Continuity of care: a multidisciplinary review. British Medical Journal, London, v. 7425, n. 327, p.1219-1221, nov. 2003.
244. What does "access to health care" mean?
AUTOR(ES): Martin Gulliford; Jose Figueroa-Munoz; Myfanwy Morgan; David Hughes; Barry Gibson; Roger Beech; Meryl Hudson
ANO: 2002
RESUMO: Facilitating access is concerned with helping people to command appropriate health care resources in order to preserve or improve their health. Access is a complex concept and at least four aspects require evaluation. If services are available and there is an adequate supply of services, then the opportunity to obtain health care exists, and a population may 'have access' to services. The extent to which a population 'gains access' also depends on financial, organisational and social or cultural barriers that limit the utilisation of services. Thus access measured in terms of utilisation is dependent on the affordability, physical accessibility and acceptability of services and not merely adequacy of supply. Services available must be relevant and effective if the population is to 'gain access to satisfactory health outcomes'. The availability of services, and barriers to access, have to be considered in the context of the differing perspectives, health needs and material and cultural settings of diverse groups in society. Equity of access may be measured in terms of the availability, utilisation or outcomes of services. Both horizontal and vertical dimensions of equity require consideration.
FONTE: Journal Of Health Services Research & Policy, Edinburgh, v. 7, n. 3, p.186-188, jul. 2002.
REFERENCIA: GULLIFORD, Martin et al. What does 'access to health care' mean? Journal Of Health Services Research & Policy, Edinburgh, v. 7, n. 3, p.186-188, jul. 2002.
245. The concepts and measurement of accessibility.
AUTOR(ES): Julio Frenk; Kerr L. White
ANO: 1992
RESUMO:
FONTE: Washington: Pan American Health Organization, 1992. p. 842-855. (PAHO. Scientific Publication, 534).
REFERENCIA: FRENK, J.; WHITE, Kerr L.The concepts and measurement of accessibility.In: WHITE, Kerr et al. Health services research: An anthology.Washington: Pan American Health Organization, 1992. p. 842-855. (PAHO. Scientific Publication, 534).
246. Continuity of Care.
AUTOR(ES): George Freeman; Sasha Shepperd; Ian Robinson; Kathryn Ehrich; Sally Richards
ANO: 2001
RESUMO:
FONTE: Southampton: National Co-ordinating Centre For NHS Service Delivery And Organisation R & D, 2001. 7 p.
REFERENCIA: FREEMAN, George et al. Continuity of care. Southampton: National Co-ordinating Centre For NHS Service Delivery And Organisation R & D, 2001. 7 p.
247. Avaliação de efetividade da Atenção Básica à Saúde em municípios das regiões Sul e Nordeste do Brasil: contribuições metodológicas.
AUTOR(ES): Luiz Augusto Facchini; Roberto Xavier Piccini; Elaine Tomasi; Elaine Thumé ; Vanessa Andina Teixeira; Denise Silva da Silveira; Maria de Fá tima Santos Maia; Fernando Vinholes Siqueira; Maria Aparecida Rodrigues; Vera Vieira Paniz; Alessander Osó rio
ANO: 2008
RESUMO: O artigo apresenta a metodologia de Estudo de Linha de Base (ELB), que avaliou a efetividade da Estratégia Saúde da Família em comparação às unidades básicas de saúde tradicionais. A base do estudo foi composta por 41 municípios acima de 100 mil habitantes, 21 da Região Sul e vinte do Nordeste. Principal variável dependente e pressuposto da base amostral do ELB, a efetividade das ações programáticas das unidades básicas de saúde foi examinada na população de sua área de abrangência, por meio de inquérito epidemiológico. O modelo de atenção das unidades básicas de saúde foi a principal variável independente. Seu efeito sobre as ações programáticas foi controlado por região geopolítica, região metropolitana e porte populacional dos municípios. A cobertura das ações foi caracterizada segundo aspectos sócio-econômicos, demográficos e de saúde. A utilização de grupos de comparação, amostras por múltiplos estágios, medidas padronizadas, controle de características geográficas e sócio-demográficas da população e critérios bem definidos para julgar os achados são contribuições da metodologia utilizada para o delineamento de futuros estudos de avaliação da Atenção Básica à Saúde.
FONTE: Caderno de Saúde Pública, Rio de Janeiro, v. 24, n. 1, p.159-172, 2008.
REFERENCIA: FACCHINI, Luiz Augusto et al. Avaliação de efetividade da atenção básica à saúde em municípios das regiões Sul e Nordeste do Brasil. Caderno de Saúde Pública, Rio de Janeiro, v. 24, n. 1, p.159-172, 2008.
248. An introduction to quality assurance in health care.
AUTOR(ES): Avedis Donabedian
ANO: 2003
RESUMO: Avedis Donabedian's name is synonymous with quality of medical care. He unraveled the mystery behind the concept by defining it in clear operational terms and provided detailed blueprints for both its measurement(known as quality assessment) and its improvement(known as quality assurance). Many before him claimed that quality couldn't be defined in concrete objective terms. He demonstrated that quality is an attribte of a system which he called structure, a set of organized activities whihc he called process, and an outcome which results from both. In this book Donabedian tells the full story of quality assessment and assurance in simple, clear terms. He defines the meaning of quality, explicates its components, and provides clear and systematic guides to its assessment and enhancement. His style is lucid, succinct, systematic and yet personal, almost conversational.
FONTE: New York: Oxford University Press, 2003. 200 p
REFERENCIA: DONABEDIAN, Avedis. An introduction to quality assurance in health care. New York: Oxford University Press, 2003. 200 p.
249. The seven pillars of quality.
AUTOR(ES): A. Donabedian
ANO: 1990
RESUMO: Seven attributes of health care define its quality: (1) efficacy: the ability of care, at its best, to improve health; (2) effectiveness: the degree to which attainable health improvements are realized; (3) efficiency: the ability to obtain the greatest health improvement at the lowest cost; (4) optimality: the most advantageous balancing of costs and benefits; (5) acceptability: conformity to patient preferences regarding accessibility, the patient-practitioner relation, the amenities, the effects of care, and the cost of care; (6) legitimacy: conformity to social preferences concerning all of the above; and (7) equity: fairness in the distribution of care and its effects on health. Consequently, health care professionals must take into account patient preferences as well as social preferences in assessing and assuring quality. When the two sets of preference disagree the physician faces the challenge of reconciling them.
FONTE: Archives Of Pathology & Laboratory Medicine, Chicago, v. 114, n. 11, p.1115-1118, 1990.
REFERENCIA: DONABEDIAN, A.. The seven pillars of quality. Archives Of Pathology & Laboratory Medicine, Chicago, v. 114, n. 11, p.1115-1118, 1990.
250. Aspects of Medical Care Administration: Specifying Requirements for Health Care.
AUTOR(ES): Avedis Donabedian
ANO: 1973
RESUMO:
FONTE: Boston: Harvard University Press, 1973. 800 p.
REFERENCIA: DONABEDIAN, Avedis. Aspects of medical care administration: specifying requirements for health care. Boston: Harvard University Press, 1973. 800 p.
251. A Framework for Measuring Responsiveness.
AUTOR(ES): Amala de Silva
ANO: 1999
RESUMO:
FONTE: Geneva: WHO, Global Programme on Evicence Of Health Policy, 1999. 42 p. N° 32.
REFERENCIA: SILVA, Amala de. A Framework for Measuring Responsiveness. Geneva: WHO, Global Programme on Evicence Of Health Policy, 1999. 42 p. N° 32.
252. A avaliação na área da saúde: conceitos e métodos.
AUTOR(ES): André -Pierre Contandriopoulos; Franç ois Champagne; Jean-Louis Denis; Raynaldi Pineault
ANO: 1997
RESUMO:
FONTE: Rio de Janeiro: Editora Fiocruz, 1997. p. 29-47.
REFERENCIA: CONTANDRIOUPOULOS, A.P. et al. A avaliação na área da saúde: conceitos e métodos. In: HARTZ, Zulmira Maria de Araújo et al. Avaliação em saúde: dos modelos conceituais à prática na análise da implantação de programas. Rio de Janeiro: Editora Fiocruz, 1997. p. 29-47.
253. Crossing the Quality Chasm: A New Health System for the 21st Century.
AUTOR(ES): Committee on Quality of Health Care in America; Institute of Medicine.
ANO: 2001
RESUMO: This report from the committee on the Quality of Health Care in America makes an urgent call for fundamental change to close the quality gap, recommends a redesign of the American health care system, and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. It offers a set of performance expectations for the 21st century health care system, a set of 10 new rules to guide patient-clinician relationships, a suggested organizing framework to better align incentives inherent in payment and accountability with improvement in quality, and key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, this report also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
FONTE: Washington: The National Acdemies Press, 2001. 360 p.
REFERENCIA: COMMITTEE ON QUALITY OF HEALTH CARE IN AMERICA; INSTITUTE OF MEDICE. Crossing the quality chasm: a new health system for the 21st century. Washington: The National Acdemies Press, 2001. 360 p.
254. A enfermagem frente aos direitos de pacientes hospitalizados.
AUTOR(ES): Patrí cia Lemos Chaves; Veridiana Tavares Costa; Valé ria Lerch Lunardi
ANO: 2005
RESUMO: Todo paciente tem direito a ser reconhecido e respeitado como cidadão, o que implica participar das decisões relacionadas ao seu cuidado e tratamento. Visando conhecer como vem ocorrendo o respeito da enfermagem aos direitos de pacientes hospitalizados, pelo Sistema Único de Saúde (SUS) e por convênios privados, foi utilizado como método de coleta a entrevista semi-estruturada com pacientes cirúrgicos hospitalizados e com enfermeiras atuantes em uma Unidade de Clínica Cirúrgica (UCC) e numa Unidade de Convênios Privados (UC), além de observações sistemáticas do cuidado de enfermagem prestado aos pacientes internados nestas duas unidades de um Hospital Universitário. Os resultados apontaram a necessidade das enfermeiras priorizarem seu tempo principalmente para a orientação de pacientes que internam pelo SUS, além de envidarem esforços para assegurar o respeito aos direitos dos pacientes de serem previamente esclarecidos e de darem seu consentimento, com liberdade, antes da realização de qualquer procedimento em si.
FONTE: Texto & Contexto Enfermagem, Florianopolis, v. 14, n. 1, p.38-43, 2005.
REFERENCIA: CHAVES, Patrícia Lemos; COSTA, Veridiana Tavares; LUNARDI, Valéria Lerch. A enfermagem frente aos direitos de pacientes hospitalizados. Texto & Contexto Enfermagem, Florianopolis, v. 14, n. 1, p.38-43, 2005.
255. The urgent need to improve health care quality: Institute of medicine national roundtable on health care quality.
AUTOR(ES): Mark R. Chassin; Robert W. Galvin; National Roundtable on Health Care Quality.
ANO: 1998
RESUMO: Objective.— To identify issues related to the quality of health care in the United States, including its measurement, assessment, and improvement, requiring action by health care professionals or other constituencies in the public or private sectors. Participants.— The National Roundtable on Health Care Quality, convened by the Institute of Medicine, a component of the National Academy of Sciences, comprised 20 representatives of the private and public sectors, practicing medicine and nursing, representing academia, business, consumer advocacy, and the health media, and including the heads of federal health programs. The roundtable met 6 times between February 1996 and January 1998. It explored ongoing, rapid changes in health care and the implications of these changes for the quality of health and health care in the United States. Evidence.— Roundtable members held discussions with a wide variety of experts, convened conferences, commissioned papers, and drew on their individual professional experience. Consensus Process.— At the end of its deliberations, roundtable members reached consensus on the conclusions described in this article by a series of discussions at committee meetings and reviews of successive draft documents, the first of which was created by the listed authors and the Institute of Medicine project director. The drafts were revised following these discussions, and the final document was approved according to the formal report review procedures of the National Research Council of the National Academy of Sciences. Conclusions.— The quality of health care can be precisely defined and measured with a degree of scientific accuracy comparable with that of most measures used in clinical medicine. Serious and widespread quality problems exist throughout American medicine. These problems, which may be classified as underuse, overuse, or misuse, occur in small and large communities alike, in all parts of the country, and with approximately equal frequency in managed care and fee-for-service systems of care. Very large numbers of Americans are harmed as a direct result. Quality of care is the problem, not managed care. Current efforts to improve will not succeed unless we undertake a major, systematic effort to overhaul how we deliver health care services, educate and train clinicians, and assess and improve quality.
FONTE: The Journal Of The American Medical Association, Chicago, v. 280, n. 11, p.1000-1005, 1998.
REFERENCIA: CHASSIN, Mark R.; GALVIN, Robert W.; National Roundtable On Health Care Quality. The urgent need to improve health care quality: Institute of medicine national roundtable on health care quality. The Journal Of The American Medical Association, Chicago, v. 280, n. 11, p.1000-1005, 1998.
256. Commentary: A Systematic Review of Health Care Efficiency Measures.
AUTOR(ES): Leah F. Binder; Barbara Rudolph
ANO: 2009
RESUMO:
FONTE: Health Services Research, Chicago, v. 44, n. 3, p.806-811, 2009.
REFERENCIA: BINDER, Leah F.; RUDOLPH, Barbara. Commentary: a systematic review of health care efficiency measures. Health Services Research, Chicago, v. 44, n. 3, p.806-811, 2009.
257. A Teaching Framework for Cross-cultural Health Care—Application in Family Practice.
AUTOR(ES): Elois Ann Berlin; William C. Fowkes, Jr
ANO: 1983
RESUMO: Significant demographic changes in patient populations have contributed to an increasing awareness of the impact of cultural diversity on the provision of health care. For this reason methods are being developed to improve the cultural sensitivity of persons responsible for giving health care to patients whose health beliefs may be at variance with biomedical models. Building on methods of elicitation suggested in the literature, we have developed a set of guidelines within a framework called the LEARN model. Health care providers who have been exposed to this educational framework and have incorporated this model into the normal structure of the therapeutic encounter have been able to improve communication, heighten awareness of cultural issues in medical care and obtain better patient acceptance of treatment plans. The emphasis of this teaching model is not on the dissemination of particular cultural information, though this too is helpful. The primary focus is rather on a suggested process for improved communication, which we see as the fundamental need in cross-cultural patient-physician interactions.
FONTE: Western Journal Of Medice, San Francisco, v. 139, n. 6, p.934-938, 1983.
REFERENCIA: BERLIN, Elois Ann; FOWKES, William C. A teaching framework for cross-cultural health: application in family practice. Western Journal Of Medice, San Francisco, v. 139, n. 6, p.934-938, 1983.
258. Guidelines for appropriate care: the importance of empirical normative analysis.
AUTOR(ES): Marc Berg; Ruud ter Meulen; Masja van den Burg
ANO: 2001
RESUMO: The Royal Dutch Medical Association recently completed a research project aimed at investigating how guidelines for 'appropriate medical care' should be construed. The project took as a starting point that explicit attention should be given to ethical and political considerations in addition to data about costs and effectiveness. In the project, two research groups set out to design guidelines and cost-effectiveness analyses (CEAs) for two circumscribed medical areas (angina pectoris and major depression). Our third group was responsible for the normative analysis. We undertook an explorative, qualitative pilot study of the normative considerations that played a role in constructing the guidelines and CEAs, and simultaneously interviewed specialists about the normative considerations that guided their diagnostic and treatment decisions. Explicating normative considerations, we argue, is important democratically: the issues at stake should not be left to decision analysts and guideline developers to decide. Moreover, it is a necessary condition for a successful implementation of such tools: those who draw upon these tools will only accept them when they can recognize themselves in the considerations implied. Empirical normative analysis, we argue, is a crucial tool in developing guidelines for appropriate medical care.
FONTE: Health Care Analysis, Chichester, v. 9, n. 1, p.77-99, 2001.
REFERENCIA: BERG, Marc; MEULEN, Ruud Ter; BURG, Masja Van Den. Guidelines for appropriate care: the importance of empirical normative analysis. Health Care Analysis, Chichester, v. 9, n. 1, p.77-99, 2001.
259. Sociobehavioral determinants of compliance with health and medical care recommendations.
AUTOR(ES): Philadelphia, v. 13, n. 1, p.10-24, 1975.
ANO: 1975
RESUMO: Over the past two decades, hundreds of articles, editorials, and commentaries have been published describing the considerable disruptive effects on quality of care of individuals noncompliance with health and medical advice. While much research has been directed at determining factors responsible for poor compliance, past studies have tended to focus upon easily measured characteristics of the patients, regimen, or illness which, unfortunately, are usually neither predictive nor alterable. This paper systematically reviews the literature on patient acceptance of recommended health behaviors, attempting to find social-psychological and related variables which have proven to be consistent predictors of compliance. The review suggests that certain health beliefs (especailly personal estimates of vulnerability to, and seriousness of, the disease, and faith in the efficacy of care), health-related motivations, perceptions of psychological and other costs of the recommended action, various aspects of the doctor-patient relationship, and social influence are the most productive dimensions for present intervention and further exploration. Building upon an earlier formulation, an hypothesized model is presented which combines these elements for explaining and predicting compliance behavior. Further research should, with standardized questionnaires and analysis techniques, employ prospective, experimental designs for a variety of population groups, settings, and regimens, to evaluate the ability of practical attempts to modify the model variables and thus enhance compliance.
FONTE: Medical Care, Philadelphia, v. 13, n. 1, p.10-24, 1975.
REFERENCIA: BECKER, Marshall H.; MAIMAN, Lois A.. Sociobehavioral determinants of compliance with health and medical care recommendations. Medical Care, Philadelphia, v. 13, n. 1, p.10-24, 1975.
260. Health Care Efficiency Measures: Identification, Categorization, and Evaluation.
AUTOR(ES): Agency for Healthcare Research and Quality. AHRQ.
ANO: 2008
RESUMO: Designed for stakeholders, payers, and quality improvement and accrediting organizations, this report presents a comprehensive and impartial review of the evidence on efficiency measurement. The goal of the Agency for Healthcare Research and Quality was to identify, analyze, and classify current definitions; lay out a linguistic roadmap to help illuminate discussions; and identify some next steps.
FONTE: Rockville: AHRQ Publication, 2008.
REFERENCIA: AGENCY FOR HEALTHCARE RESEARCH AND QUALITY. Health care efficiency measures: identification, categorization, and evaluation. Rockville: AHRQ Publication, 2008. N°08-0030.
261. Evaluating the Healthcare System: Effectiveness, Efficiency, and Equity.
AUTOR(ES): Lu Ann Aday; Charles E. Begley; David R. Lairson
ANO: 2004
RESUMO: This upcoming third edition defines and illustrates the measurement and relevance of effectiveness, efficiency, and equity as criteria for evaluating healthcare system performance. Specific examples of the application of health services research in addressing contemporary health policy problems at the national, state, and local level are presented. This new edition will include a significant amount of new material. In particular, the book will draw upon a growing body of research on the social and economic determinants of population health, and explore the distinct and complementary roles of health services and public health research and policy in improving the health of individuals and communities. An important healthcare and public health problem area woven throughout the book in demonstrating the effectiveness, efficiency, and equity concepts in the context of these issues is breast and cervical cancer prevention and treatment and related cancer morbidity and mortality outcomes. This example provides a useful opportunity to explore the medical and non-medical predictors of health and healthcare disparities, the role of primary versus secondary prevention, and the utility of the effectiveness, efficiency, and equity benchmarks in guiding the design of state and federal policy to ameliorate disparities.
FONTE: Chicago: Health Administration Press, 2004. 354 p.
REFERENCIA: ADAY, Lu Ann; BEGLEY, Charles E.; LAIRSON, David R.Evaluating the healthcare system: effectiveness, efficiency, and equity. 3. ed. Chicago: Health Administration Press, 2004. 354 p.
262. Concepts and principles for tackling social inequities in health: Levelling up Part 1.
AUTOR(ES): Margaret Whitehead; Gö ran Dahlgren
ANO: 2006
RESUMO:
FONTE: Copenhagem: Who, Regional Office For Europe, 2006. 34 p.
REFERENCIA: WHITEHEAD, Margaret; DAHLGREN, Göran. Concepts and principles for tackling social inequities in health: levelling up part 1.Copenhagem: Who, Regional Office For Europe, 2006. 34 p.
263. The concepts and principles of equity and health.
AUTOR(ES): Margaret Whitehead
ANO: 1992
RESUMO: In 1984, the 32 member states of the World Health Organization European Region took a remarkable step forward in agreeing unanimously on 38 targets for a common health policy for the Region. Not only was equity the subject of the first of these targets, but it was also seen as a fundamental theme running right through the policy as a whole. However, equity can mean different things to different people. This article looks at the concepts and principles of equity as understood in the context of the World Health Organization's Health for All policy. After considering the possible causes of the differences in health observed in populations--some of them inevitable and some unnecessary and unfair--the author discusses equity in relation to health care, concentrating on issues of access to care, utilization, and quality. Lastly, seven principles for action are outlined, stemming from these concepts, to be borne in mind when designing or implementing policies, so that greater equity in health and health care can be promoted.
FONTE: International Journal Of Health Services, Amityville, v. 22, n. 3, p.429-445, 1992.
REFERENCIA: WHITEHEAD, Margaret. The concepts and principles of equity and health. International Journal Of Health Services, Amityville, v. 22, n. 3, p.429-445, 1992.
264. The concepts and principles of equity and health.
AUTOR(ES): Margaret Whitehead
ANO: 1990
RESUMO:
FONTE: Copenhagen: Who, Regional Office For Europe, 1990. 29 p.
REFERENCIA: WHITEHEAD, Margaret. The concepts and principles of equity and health. Copenhagen: Who, Regional Office For Europe, 1990. 29 p.
265. Introducción a la economía de la salud.
AUTOR(ES): P. West; J. Cullis
ANO: 1979
RESUMO:
FONTE: Oxford: Oxford University Press, 1979.
REFERENCIA: WEST, P.; CULLIS, J. Introducción a la economía de la salud. Oxford: Oxford University Press, 1979.
266. Equity in the Finance and Delivery of Health Care: An International Perspective.
AUTOR(ES): Eddy Van Doorslaer; A. Wagstaff; F. Rutten
ANO: 1992
RESUMO: This volume presents the results of research which has been facilitated by funding from the European Comunity and it represents a significant contribution to knowledge about equity in the finance and delivery of health care in 10 countries. It compares the experience of nine European countries and the US using a consitent methodology, so as to draw out comparable results from 10 very different health care systems. Such an approach facilitates not only a greater understanding of the performance of the health care systems of individual countries but also the identification of the lessons that can be learnt from international comparisons. In recent years there has developed a recoginition that many health and health care problems are similar across many countries and their solution can be usefully formed by the abandonment both of isolation and the belief that individual country problems are unique. The content of this book aims to demonstrate that given to efficient research teams, research funding can produce both significant new knowledge of direct relevance to the reform of health care systems world-wide, and also, collaborate mutually formative work between Europeans and others living outside a united Eruope.
FONTE: Oxford: Oxford University Press, 1992. 440 p.
REFERENCIA: DOORSLAER, Eddy Van; WAGSTAFF, A.; RUTTEN, F.. Equity in the finance and delivery of health care: an international perspective. Oxford: Oxford University Press, 1992. 440 p.
267. Inequality Reexamined.
AUTOR(ES): Amartya Sen
ANO: 1992
RESUMO:
FONTE: Oxford: Clarendon Press, 1992.
REFERENCIA: SEN, Amartya. Inequality Reexamined. Oxford: Clarendon Press, 1992.
268. Towards a mixed Economy of welfare in Health Care.
AUTOR(ES): R. Pinker
ANO: 1988
RESUMO:
FONTE: London: Iea Health Unit Paper, 1988. p. 49-54.
REFERENCIA: PINKER, R.Towards a mixed Economy of welfare in Health Care. In: GREEN, David G.Acceptable inequalities?: Essays on the Pursuit of Equality in Health Care. London: Iea Health Unit Paper, 1988. p. 49-54.
269. Equity in health care: confronting the confusion.
AUTOR(ES): G.H. Mooney
ANO: 1983
RESUMO: Despite general agreement that equity is part of the objective of the UK National Health Service (as indeed it is in other health services), there is little consensus on what is meant by equity in health care. This paper suggests seven possible definitions of equity not with the intention of trying to decide which is in any sense best but rather simply to try to reduce some of the confusion surrounding the concept of equity. These definitions include equality of expenditure per capita; equality of inputs per capita; equality of input for equal need; equality of access for equal need; equality of utilisation for equal need; equality of marginal met need; and equality of health. The paper then takes a closer look at some of the issues surrounding these definitions. The difference between equity by access and by utilisation lies in separating supply and demand (or need) issues. Thus equality of access is about equal opportunity: the question of whether or not the opportunity is exercised is not relevant to equity defined in terms of access. Utilisation is a function of both supply and demand. If access, a supply side phenomenon, is equalised, unless demand is the same, utilisation will not be equalised.(ABSTRACT TRUNCATED AT 250 WORDS)
FONTE: Effective Health Care, Netherlands, v. 1, n. 4, p.179-185, 1983.
REFERENCIA: MOONEY, G. H.Equity in health care: confronting the confusion. Effective Health Care, Netherlands, v. 1, n. 4, p.179-185, 1983.
270. Equidad, Salud y Atención Sanitaria.
AUTOR(ES): J. Le Grand
ANO: 1988
RESUMO:
FONTE: Canarias: Asociación Española de Economía de La Salud, 1988. p. 53-69.
REFERENCIA: LE GRAND, J.Equidad, Salud y Atención Sanitaria.In: VIII Jornada de Economia de la Salud. Canarias: Asociación Española de Economía de La Salud, 1988. p. 53-69.
271. Annotated Bibliography on Equity in Health, 1980-2001.
AUTOR(ES): Barbara Starfield; James Macinko
ANO: 2002
RESUMO: The purposes of this bibliography are to present an overview of the published literature on equity in health and to summarize key articles relevant to the mission of the International Society for Equity in Health (ISEqH). The intent is to show the directions being taken in health equity research including theories, methods, and interventions to understand the genesis of inequities and their remediation. Therefore, the bibliography includes articles from the health equity literature that focus on mechanisms by which inequities in health arise and approaches to reducing them where and when they exist.
FONTE: London, v. 1, n. 1, p.2-19, 2002.
REFERENCIA: MACINKO, James; STARFIELD, Barbara. Annotated Bibliography on Equity in Health, 1980-2001. International Journal For Equity In Health, London, v. 1, n. 1, p.2-19, 2002.
272. Introduction.Challenging Inequities in Health.
AUTOR(ES): Timothy Evans
ANO: 2001
RESUMO: There is a growing sense that the "health gap" between socioeconomic groups is getting worse in many countries. To address this gap, conceptual clarity and empirical evidence are needed along with a greater focus on equity in policy-making. This book is designed to present cutting-edge research and policy analysis to a wide non-specialist readership of students, professionals and policy-makers. It brings together in one volume new perspectives on the conceptual foundations of health equity, empirical evidence on the scale and nature of he inequities in health in twelve countries around the world, and assessments of the associated policy developments and their implications for the future. It aims to help build global capacity to measure, monitor and interpret developments in health equity at a national and international level. The in-depth country analyses draw on epidemiology, demography, economics and other fields to approach health inequalities from several different angles. The topics covered range from adolescent livelihoods in Tanzania to the health burden of indigenous peoples in Mexico, from health equity in Japan to the gender gap in life expectancy in Russia. The book is a unique demonstration of global cooperation in bringing together and giving equal weight to work on health equity carried out in the southern and northern hemispheres.
FONTE: New York: Oxford University Press, 2001. p. 3-44.
REFERENCIA: EVANS, Timothy et al. Introduction. In: EVANS, Timothy et al. Challenging Inequities in Health. New York: Oxford University Press, 2001. p. 3-44.
273. Equal Opportunity or Equal Social Outcome?
AUTOR(ES): Marc Fleurbaey
ANO: 1995
RESUMO: John Rawls's work (1971) has greatly contributed to rehabilitating equality as a basic social value, after decades of utilitarian hegemony,particularly in normative economics, but Rawls also emphasized that full equality of welfare is not an adequate goal either. This thesis was echoed in Dworkin's famous twin papers on equality (Dworkin 1981a,b), and it is now widely accepted that egalitarianism must be selective. The bulk of the debate on ‘Equality of What?’ thus deals with what variables ought to be submitted for selection and how this selection ought to be carried out.
FONTE: Economics and Philosophy, Cambridge, v. 11, n. 1, p.25-55, 1995.
REFERENCIA: FLEURBAEY, Marc. Equal Opportunity or Equal Social Outcome? Economics and Philosophy, Cambridge, v. 11, n. 1, p.25-55, 1995.
274. Is inequality bad for our health?
AUTOR(ES): Norman Daniels; Bruce Kennedy; Ichiro Kawachi
ANO: 2000
RESUMO:
FONTE: Boston: Beacon Press, 2000. 99 p.
REFERENCIA: DANIELS, Norman; KENNEDY, Bruce; KAWACHI, Ichiro. Is inequality bad for our health? Boston: Beacon Press, 2000. 99 p.
275. Inequality of Health Services is in desirable.
AUTOR(ES): Anthony Culyer
ANO: 1988
RESUMO:
FONTE: London: Iea Health Unit Paper, 1988. p. 31-45.
REFERENCIA: CULYER, Anthony. Inequality of Health Services is in desirable. In: GREEN, David G.Acceptable Inequalities. London: Iea Health Unit Paper, 1988. p. 31-45.
276. Efficiency and equity implications of the health care reforms.
AUTOR(ES): Roy A. Carr-Hill
ANO: 1994
RESUMO: The purpose of the paper is to reflect on the recent health care reforms in both developed and developing countries, in the light of the evidence that has accumulated over the last few years about the efficiency and equity of different fiscal and organisational arrangements. The scene is set by a brief review of the definitions of efficiency and equity and of the confusions that often arise; and of the problems of making assessments in practice with real data. The evidence about effectiveness, efficiency and equity at the macro level are reviewed: among OECD countries, there is little evidence that variations in the levels and composition of health service expenditure actually affect levels of health; equity in financing and delivery appears to mirror equity in other sectors in the same countries; about the only solid--although rather limp--conclusion which is transferable is that costs can be contained best via global budgeting. The range of reforms in the North is sketched: despite calls to give people 'freedom' to opt out, public finances continues to be preferred among OECD countries; and the evidence that health care markets can actually function is 'weak'. Whilst geographical redistribution of finance has proved to be possible, inequalities in health remain in most countries. But the overwhelming impression is that the quality of the data base for many of these studies is appalling, and the analytice techniques used are simplistic. The move to introduce user charges in the South is discussed. It seems unlikely that they will raise a significant fraction of overall revenue; exemptions intended for the poor do not always work; and other trends are likely to exacerbate the patchy coverage of health care systems in the South. The final section reflects on the pressures for increased accountability. The emphasis on consumerism in the North has led to an increasing number of poorly designed 'patient satisfaction' surveys; in the South, there has been an increasing rhetoric on community participation, but little sign of actual devolution of control. The flavour of the decade is 'outcome measurement' which has been promoted feverish but with little rigour. We must also be concerned that this emphasis will, once again, be hijacked by the most articulate.
FONTE: Social Science & Medicine, Oxford, v. 39, n. 9, p.1189-1201, nov. 1994.
REFERENCIA: CARR-HILL, Roy A. Efficiency and equity implications of the health care reforms. Social Science & Medicine, Oxford, v. 39, n. 9, p.1189-1201, nov. 1994.
277. Defining health inequality: why Rawls succeeds where social welfare theory fails.
AUTOR(ES): Antoine Bommier; Guy Steclov
ANO: 2002
RESUMO: While there has been an important increase in methodological and empirical studies on health inequality, not much has been written on the theoretical foundation of health inequality measurement. We discuss several reasons why the classic welfare approach, which is the foundation of income inequality analysis, fails to provide a satisfactory foundation for health inequality analysis. We propose an alternative approach which is more closely linked to the WHO concept of equity in health and is also consistent with the ethical principles espoused by Rawls [A Theory of Justice. Harvard University Press, Cambridge, MA, 1971]. This approach in its simplest form, is shown to be closely related to the concentration curve when health and income are positively related. Thus, the criteria presented in our paper provide an important theoretical foundation for empirical analysis using the concentration curve. We explore the properties of these approaches by developing policy scenarios and examining how various ethical criteria affect government strategies for targeting health interventions.
FONTE: Journal Of Health Economics, Amsterdam, v. 21, n. 3, p.497-513, maio 2002.
REFERENCIA: BOMMIER, Antoine; STECLOV, Guy. Defining health inequality: why Rawls succeeds where social welfare theory fails. Journal Of Health Economics, Amsterdam, v. 21, n. 3, p.497-513, maio 2002.
278. Notas sobre la consideración econômica de la equidad: Utilización y acceso.
AUTOR(ES): J. Artelles
ANO: 1983
RESUMO:
FONTE: Madrid: Comunidad de Madrid, Consejeria de Salud Y Bienestar Social, Instituto Regional de Estudios, 1983. p. 23-30.
REFERENCIA: ARTELLES, J. Notas sobre la consideración econômica de la equidad: utilización y acceso. In: ARTELLS, J. Planificación y economía de la salud en las autonomías. Madrid: Comunidad de Madrid, Consejeria de Salud Y Bienestar Social, Instituto Regional de Estudios, 1983. p. 23-30.
279. Equal Opportunity.
AUTOR(ES): S. Anan; F. Peter
ANO: 2000
RESUMO:
FONTE: Boston: Beacon Press, 2000. p. 48-52.
REFERENCIA: ANAN, S; PETER, F. Equal Opportunity. In: DANIELS, Norman; KENNEDY, Bruce; KAWACHI, Ichiro. Is inequality bad for our health? Boston: Beacon Press, 2000. p. 48-52.
280. Policies and strategies to promote social equity in health. Background document to WHO - Strategy paper for Europe.
AUTOR(ES): Margaret Whitehead; Gö ran Dahlgren
ANO: 1991
RESUMO: This is the second in a series of discussion papers from the WHO Regional Office for Europe. The first covers concepts and principes of equity in relation to health, and should be read in conjunction with this paper (Whitehead 1990). The present paper sets out to develop the discussion further by outlining a strategic approach to promote greater equity in health between different social and occupational groups. This draws on the work of WHO advisory groups and associated litterature listed at the back, together with practical examples from industrialized countries where strategies have been put into action. The first part (section 1-9) of the paper outlines why equity is seen as a priority and distinguishes different policy levels for interventions. Specific equity aspects related to each policy level are then highlighted as well as some case studies. The second part of the paper (section 10-14) deals with putting policy into practice. Special attention is then paid to the need for comprehensive approaches to combat social and occupational inequities in health as illustrated in terms of a strategy matrix. Furthermore the democratice process within which healthy public policies are to be discussed and determined is discussed as well as organizational aspects as regards the implementation of an equity oriented health policy. Finally checklists are presented focusing upon how to make things happen.
FONTE: Stockholm: Institute for Futures Studies (Arbetsrapport),1991. n° 2007:14.
REFERENCIA: DAHLGREN, Göran; WHITEHEAD, Margaret. Policies and strategies to promote social equity in health. Background document to WHO - Strategy paper for Europe. Stockholm: Institute for Futures Studies (Arbetsrapport),1991. n° 2007:14.
281. Latin American Social Medicine: roots, development during the 1990s, and current challenges.
AUTOR(ES): Debora Tajer
ANO: 2003
RESUMO:
FONTE: American Journal of Public Health, New York, v. 93, n. 12, p.2023-2027, dez. 2003.
REFERENCIA: TAJER, Débora. Latin American Social Medicine: roots, development during the 1990s, and current challenges. American Journal of Public Health, New York, v. 93, n. 12, p.2023-2027, dez. 2003.
282. Promoting equity in health through research and understanding.
AUTOR(ES): Barbara Starfield
ANO: 2004
RESUMO: Developing strategies to reduce inequities in health requires an understanding of how inequities occur, determining the salient factors in their production, and deciding which ones are most amenable to change. The recognition of several principles regarding the manifestations and genesis of inequities can help to decide on strategies. In making decisions, it is important to consider whether the aim is to reduce disparities in the occurrence of ill health or to reduce disparities in the severity (including co-morbidity, disability, dysfunction and fatality) of ill health. Evidence shows that the major impact on equity of health services, particularly regarding their potential to reduce severity, is attributable to the strength of primary care resources and services in communities and countries. Virtually every influence on the genesis of inequities is determined by the political context in which policy is made. The issue of health services is not different in this regard from other types of strategies. There is no longer any doubt about the pervasive influence of social factors on health. Almost two centuries of descriptive research provides convincing evidence of associations between social structures and relationships and health status in all countries and in all societies; if there is anything new from more recent research, it is that the association is not limited to differences between the lowest social strata and other social strata. Rather, the association is noted throughout the social spectrum. That is, there is a social gradient in health such that, for many if not most manifestations of ill health, the lower the social stratum, the worse the health. The challenge for the future is to understand why this is the case, to create a consensus that these inequalities are unnecessary and unacceptable, and to devise strategies that are both effective and possible. This paper will focus on the first of these aims, in a context that facilitates attention to the second and third aims.
FONTE: Developing World Bioethics, Oxford, v. 4, n. 1, p.76-95, maio 2004.
REFERENCIA: STARFIELD, B. Promoting equity in health through research and understanding. Developing World Bioethics, Oxford, v. 4, n. 1, p.76-95, maio 2004.
283. A Conceptual Framework for Action on the Social Determinants of Health.
AUTOR(ES): Orielle Solar; Alec Irwin
ANO: 2007
RESUMO:
FONTE: Geneva :World Health Organization, 2007. 77 p.
REFERENCIA: SOLAR, Orielle; IRWIN, Alec. A Conceptual Framework for Action on the Social Determinants of Health. Geneva :World Health Organization, 2007. 77 p.
284. How Did Social Medicine Evolve, and Where Is It Heading?
AUTOR(ES): D. Porter
ANO: 2006
RESUMO:
FONTE: PloS Medicine, San Francisco, v. 10, n. 3,out. 2006.
REFERENCIA: PORTER, D. How did social medicine evolve, and where is it heading? PloS Medicine, San Francisco, v. 10, n. 3,out. 2006.
285. McKeown and the idea that social conditions are fundamental causes of disease.
AUTOR(ES): Bruce G. Link; Jo C. Phelan
ANO: 2002
RESUMO: In an accompanying commentary, Colgrove indicates that McKeown's thesis-that dramatic reductions in mortality over the past 2 centuries were due to improved socioeconomic conditions rather than to medical or public health interventions-has been "overturned" and his theory "discredited." McKeown sought to explain a very prominent trend in population health and did so with a strong emphasis on the importance of basic social and economic conditions. If Colgrove is right about the McKeown thesis, social epidemiology is left with a gaping hole in its explanatory repertoire and a challenge to a cherished principle about the importance of social factors in health. We return to the trend McKeown focused upon-post-McKeown and post-Colgrove-to indicate how and why social conditions must continue to be seen as fundamental causes of disease.
FONTE: American Journal of Public Health, New York, v. 92, n. 5, p.730-732, maio 2002.
REFERENCIA: LINK, Bruce G.; PHELAN, Jo C.McKeown and the idea that social conditions are fundamental causes of disease. American Journal of Public Health, New York, v. 92, n. 5, p.730-732, maio 2002.
286. New perspective on the health of Canadians: a working document.
AUTOR(ES): Marc Lalonde
ANO: 1974
RESUMO:
FONTE: Ottawa: Information Canada, 1974. 77 p.
REFERENCIA: LALONDE, Marc. New perspective on the health of Canadians: a working document. Ottawa: Information Canada, 1974. 77 p.
287. Social cohesion, social capital, and health.
AUTOR(ES): Lisa F. Berkman; Ichiro Kawachi
ANO: 2000
RESUMO:
FONTE: New York: Oxford University Press, 2000. p. 174-190.
REFERENCIA: KAWACHI, I; BERKMAN, L. Social cohesion, social capital, and health. In: BERKMAN, Lisa F.; KAWACHI, Ichiro. Social Epidemiology. New York: Oxford University Press, 2000. p. 174-190.
288. Social capital and health: does egalitarianism matter?:A literature review.
AUTOR(ES): M. Kamrul Islam; Juan Merlo; Ichiro Kawachi; Martin Lindströ m; Ulf-G Gerdtham.
ANO: 2006
RESUMO: The aim of the paper is to critically review the notion of social capital and review empirical literature on the association between social capital and health across countries. The methodology used for the review includes a systematic search on electronic databases for peer-reviewed published literature. We categorize studies according to level of analysis (single and multilevel) and examine whether studies reveal a significant health impact of individual and area level social capital. We compare the study conclusions according to the country's degrees of economic egalitarianism. Regardless of study design, our findings indicate that a positive association (fixed effect) exists between social capital and better health irrespective of countries degree of egalitarianism. However, we find that the between-area variance (random effect) in health tends to be lower in more egalitarian countries than in less egalitarian countries. Our tentative conclusion is that an association between social capital and health at the individual level is robust with respect to the degree of egalitarianism within a country. Area level or contextual social capital may be less salient in egalitarian countries in explaining health differences across places.
FONTE: International Journal For Equity In Health, London, v. 5, n. 3, p.2-28, 2006.
REFERENCIA: SLAM, Muhammad Kamrul et al. Social capital and health: does egalitarianism matter?:a literature review. International Journal For Equity In Health, London, v. 5, n. 3, p.2-28, 2006.
289. Health Inequalities: Concepts, Frameworks and Policy.
AUTOR(ES): Hilary Graham; Michael P. Kelly
ANO: 2004
RESUMO:
FONTE: London: National Institute For Health And Clinical Excellence, 2004.12 p.
REFERENCIA: GRAHAM, Hilary; KELLY, Michael P. Health Inequalities: concepts, frameworks and policy. London: National Institute For Health And Clinical Excellence, 2004.12 p.
290. Unequal Lives: Health and socio-economic inequalities.
AUTOR(ES): Hilary Graham
ANO: 2007
RESUMO: Unequal Lives provides an evidence-based introduction to social and health inequalities. It brings together research from social epidemiology, sociology and social policy to guide the reader to an understanding of why people’s lives and people’s health remain so unequal, even in rich societies where there is more than enough for all. The book introduces the non-specialist to key concepts like health inequalities and health inequities, social class and socioeconomic position, social determinants and life course, as well as to the key indicators of health and socioeconomic position. It provides a wealth of evidence on socioeconomic inequalities in health at both national and global level, and explores how these inequalities persist as countries industrialise, patterns of employment and family life change, and chronic diseases emerge as the big killers.
FONTE: Buckingham: Open University Press, 2007. 260 p.
REFERENCIA: GRAHAM, Hilary. Unequal Lives: health and socio-economic inequalities. Buckingham: Open University Press, 2007. 260 p.
291. Social determinants and their unequal distribution: clarifying policy understandings.
AUTOR(ES): Hilary Graham
ANO: 2004
RESUMO: Public health policy in older industrialized societies is being reconfigured to improve population health and to address inequalities in the social distribution of health. The concept of social determinants is central to these policies, with tackling the social influences on health seen as a way to reduce health inequalities. But the social factors promoting and undermining the health of individuals and populations should not be confused with the social processes underlying their unequal distribution. This distinction is important because, despite better health and improvement in health determinants, social disparities persist. The article argues that more emphasis on social inequalities is required for a determinants-oriented approach to be able to inform policies to address health inequalities.
FONTE: The Milbank Quarterly, New York ,v. 82, n. 1, p.101-124, 2004.
REFERENCIA: GRAHAM, Hilary. Social determinants and their unequal distribution: clarifying policy understandings. The Milbank Quarterly, New York ,v. 82, n. 1, p.101-124, 2004.
292. El papel del trabajo en la determinacion de las desigualdades en salud: Reflexión crítica sobre el Informe de la Comisión de Conocimiento sobre las Condiciones de Empleo de la OMS (EMCONET).
AUTOR(ES): Silvia Tamez Gonzá lez; Catalina Eibenschutz Hartman; Iliana Camacho Cuapio
ANO: 2010
RESUMO:
FONTE: Rio de Janeiro: Cebes, 2010. p. 60-86.
REFERENCIA: TAMEZ GONZÁLEZ, Silvia; HARTMAN, Catalina Eibenschutz; CUAPIO, Iliana Camacho. El papel del trabajo en la determinacion de las desigualdades en salud: reflexión crítica sobre el informe de la comisión de conocimiento sobre las condiciones de empleo de la OMS (EMCONET). In: NOGUEIRA, Roberto Passos. Determinação social da saúde e reforma sanitária. Rio de Janeiro: Cebes, 2010. p. 60-86.
293. The Role of Macrosocial Determinants in Shaping the Health of Populations.
AUTOR(ES): Sandro Galea; Sara Putnam
ANO: 2007
RESUMO: The roots of epidemiology, coincident with the origin of public health, lie in exploring how social conditions may influence health and how these conditions may be manipulated so as to improve the health of populations (Mc Leod, 2000; Halliday, 2000; Hamlin & Sheard, 1998). However, in the last half century, with the advent of antibiotics as treatments for infectious diseases, the shift from infectious disease to chronic disease considerations, and the focus on genetic determination of disease, epidemiologic inquiry has grown increasingly concerned not with the social determination of population health, but rather with the individual exposures or characteristics that influence individual risk of health and disease (March & Susser, 2006). It is the central tenet of this book that social factors that lie beyond the individual and that affect whole populations, factors that we term "macrosocial", should remain central in our thinking about the production of health and disease, and that public health research and practice would be well served by an improved understanding of how these macrosocial factors shape population health. Setting the stage for the chapters to follow, in this introductory chapter we explore the challenges faced by most current inquiry concerned with the determination of health and argue that epidemiologic inquiry about macrosocial factors can help improve our understanding of population health and potentially guide the development of more effective public health interventions. We note that this introduction, and this book, adopt very much an "epidemiologic" perspective. We mean this to refer to a central concern with the determination of health and disease and to inquiry aimed at understanding those factors that may influence health. Although the field formally constituted as "epidemiology" today is certainly most concerned with these questions, we do not mean to endorse an exclusive reliance on the methods of epidemiology and certainly do not intend to exclude the role of other disciplinary perspectives. As the chapters in this book amply illustrate, we suggest that disciplines such as economics, sociology, and health policy, among many others, play a central role in our understanding of the determination of health and of how those interested in the health of populations may fruitfully identify areas of intervention that can improve health.
FONTE: New York: Springer, 2007. p. 3-12.
REFERENCIA: GALEA, Sandro; PUTNAM, Sara. The Role of Macrosocial Determinants in Shaping the Health of Populations. In: GALEA, Sandro. Macrosocial Determinants of Population Health. New York: Springer, 2007. p. 3-12.
294. Transcending the known in public health practice: the inequality paradox: the population approach and vulnerable populations.
AUTOR(ES): Katherine L. Frohlich; Louise Potvin
ANO: 2008
RESUMO: Using the concept of vulnerable populations, we examine how disparities in health may be exacerbated by population-approach interventions. We show, from an etiologic perspective, how life-course epidemiology, the concentration of risk factors, and the concept of fundamental causes of diseases may explain the differential capacity, throughout the risk-exposure distribution, to transform resources provided through population-approach interventions into health. From an intervention perspective, we argue that population-approach interventions may be compromised by inconsistencies between the social and cultural assumptions of public health practitioners and targeted groups. We propose some intervention principles to mitigate the health disparities associated with population-approach interventions.
FONTE: American Journal of Public Health, New York, v. 98, n. 2, p.216-221, fev. 2008.
REFERENCIA: FROHLICH, K.L.; POTVIN, L. Transcending the known in public health practice: the inequality paradox: the population approach and vulnerable populations. American Journal of Public Health, New York, v. 98, n. 2, p.216-221, fev. 2008.
295. Models of population health: their value for US public health practice, policy, and research.
AUTOR(ES): Barbara Starfield; Daniel Friedman
ANO: 2003
RESUMO: This issue of the American Journal of Public Health contains 6 articles focusing on models of population health. These models are schematic representations of factors that affect the health of populations, measured primarily as the average level of health in the population, but increasingly also considering the distribution of health within populations. Taken together, these articles provide an introduction to current US, Canadian, and European debates over population health, the factors that influence population health, and the policy and programmatic implications of models of population health.
FONTE: American Journal of Public Health, New York, v. 93, n. 3, p.366-369, mar. 2003.
REFERENCIA: FRIEDMAN, Daniel J.; STARFIELD, Barbara. Models of population health: their value for US public health practice, policy, and research. American Journal of Public Health, New York, v. 93, n. 3, p.366-369, mar. 2003.
296. Producing health, consuming health care.
AUTOR(ES): Robert G. Evans; Greg L. Stoddart
ANO: 1994
RESUMO:
FONTE: Hawthorne: Aldine de Gruyer, 1994. p. 27-64.
REFERENCIA: EVANS, Robert G.; STODDART, Greg L. Producing health, consuming health care. In: MARMOR, Theodore; BARER, Morris; EVAN, Robert. Why are some people healthy and others not?: the determinants of health of populations. Hawthorne: Aldine de Gruyer, 1994. p. 27-64.
297. Consuming research, producing policy?
AUTOR(ES): Robert G. Evans; Greg L. Stoddart
ANO: 2003
RESUMO: The authors’ 1990 article “Producing Health, Consuming Health Care” presented a conceptual framework for synthesizing a rapidly growing body of findings on the nonmedical determinants of health. The article received a very positive response, and here the authors reflect on what lessons might be learned from that response about the style or content of effective interdisciplinary communication. Much substantive knowledge has been accumulated since 1990, and a number of different frameworks have been developed before and since. The authors situate theirs within this literature and consider how they might have modified it if they “knew then what they know now.” They ask what impact this article, and the much broader stream of research on the determinants of health, has had on public policy?
FONTE: American Journal of Public Health, New York, v. 93, n. 3, p.371-379, mar.2003.
REFERENCIA: EVANS, Robert G.; STODDART, Greg L. Consuming research, producing policy? American Journal of Public Health, New York, v. 93, n. 3, p.371-379, mar.2003.
298. The Social Basis of Disparities in Health.
AUTOR(ES): Finn Diderichsen; Timothy Evans; Margaret Whitehead
ANO: 2001
RESUMO:
FONTE: New York: Oxford University Press, 2001. p. 13-23.
REFERENCIA: DIDERICHSEN, Finn; EVANS, Timothy; WHITEHEAD, Margaret. The Social Basis of Disparities in Health. In: EVANS, Timothy et al. Challenging Inequities in Health: From Ethics to Action. New York: Oxford University Press, 2001. p. 13-23.
299. As causas sociais das iniqüidades em saúde no Brasil.
AUTOR(ES): Comissã o Nacional Sobre Determinantes Sociais da Saú de
ANO: 2008
RESUMO: As atividades desenvolvidas pela CNDSS estiveram organizadas em cinco linhas de ação. No âmbito de cada uma destas linhas, foram desenvolvidas diversas atividades que contaram com a participação de especialistas, profissionais e participantes de instituições colaboradoras, além de membros da Comissão. A primeira linha de ação se refere à Produção e Disseminação de Conhecimentose Informações, tendo por objetivo produzir conhecimentos e informações sobre as relações entre os determinantes sociais e a situação de saúde, particularmente as iniqüidades em saúde, com vistas a fundamentar políticas e programas. A segunda linha de ação se refere a Políticas e Programas e teve por objetivo promover, coordenar e avaliar políticas, programas e intervenções governamentais e não governamentais sobre os DSS, realizadas a nível local, regional e nacional. A terceira linha de ação se refere à Mobilização da Sociedade Civil e teve por objetivo chamar a atenção de diversos setores da sociedade sobre a importância dos DSS esobre as possibilidades de atuação sobre eles. A quarta linha de ação corresponde à Construção e Manutenção de Portal sobre DSS (www.determinantes.fiocruz.br), com o objetivo de coletar e registrar informações e conhecimentos sobre DSS, disponíveis nos sistemas de informação e na literatura científica nacional e internacional, constituindo-se num espaço de referência para os interessados no tema. A quinta linha de ação se refere à Cooperação Internacional, que inclui Cooperação com a Comissão sobre Determinantes Sociais da Saúde da OMS (CSDH) e com os países da América Latina, para promoção do enfoque de DSS em suas políticas de saúde e/ou criação de suas respectivas comissões nacionais.
FONTE: Rio de Janeiro:Editora Fiocruz, 2008. 216 p.
REFERENCIA: COMISSÃO NACIONAL SOBRE DETERMINANTES SOCIAIS DA SAÚDE (CNDSS). As causas sociais das iniqüidades em saúde no Brasil. Rio de Janeiro:Editora Fiocruz, 2008. 216 p.
300. The McKeown thesis: a historical controversy and its enduring influence.
AUTOR(ES): J. Colgrove
ANO: 2002
RESUMO: The historical analyses of Thomas McKeown attributed the modern rise in the world population from the 1700s to the present to broad economic and social changes rather than to targeted public health or medical interventions. His work generated considerable controversy in the 1970s and 1980s, and it continues to stimulate support, criticism, and commentary to the present day, in spite of his conclusions' having been largely discredited by subsequent research. The ongoing resonance of his work is due primarily to the importance of the question that underlay it: Are public health ends better served by targeted interventions or by broad-based efforts to redistribute the social, political, and economic resources that determine the health of populations?
FONTE: American Journal of Public Health, New York, v. 92, n. 5, p.725-729, maio 2002.
REFERENCIA: COLGROVE, J. The McKeown thesis: a historical controversy and its enduring influence. American Journal of Public Health, New York, v. 92, n. 5, p.725-729, maio 2002.
301. Social organization, stress, and health.
AUTOR(ES): Michael Marmot; Richard Wilkinson
ANO: 1999
RESUMO:
FONTE: New York: Oxford University Press, 1999. p. 17-43.
REFERENCIA: MARMOT, Michael; WILKINSON, Richard G. Social organization, stress, and health. In: MARMOT, Michael; WILKINSON, Richard G. Social determinants of health. New York: Oxford University Press, 1999. p. 17-43.
302. Reproduçao social e a investigaçao em saúde coletiva.
AUTOR(ES): J. Breilh
ANO: 1990
RESUMO:
FONTE: São Paulo: HUCITEC/ABRASCO, 1990. p. 137-165.
REFERENCIA: BREILH, J. Reproduçao social e a investigaçao em saúde coletiva. In: Costa, Dina Czeresnia, org. Epidemiologia, teoria e objetivo. São Paulo: HUCITEC/ABRASCO, 1990. p. 137-165.
303. A historical perspective framework for social epidemiology.
AUTOR(ES): Lisa F. Berkman; Ichiro Kawachi
ANO: 2000
RESUMO:
FONTE: New York: Oxford University Press, 2000. p. 3-12.
REFERENCIA: BERKMAN, Lisa F.; KAWACHI, Ichiro. A historical perspective framework for social epidemiology. In: BERKMAN, Lisa F; KAWACHI, Ichiro. Social Epidemiology. New York: Oxford University Press, 2000. p. 3-12.
304. Modelos de determinação social das doenças crônicas não-transmissíveis.
AUTOR(ES): Naomar Almeida Filho
ANO: 2004
RESUMO: Este ensaio revisa criticamente marcos referenciais e modelos teóricos de determinação social das chamadas Doenças Crônicas Não-Transmissíveis. A sociologia funcionalista gerou modelos socioculturais de saúde que influenciaram o campo de investigação epidemiológica da chamada "nova morbidade" (basicamente enfermidades crônicas e degenerativas), posteriormente agrupados sob o rótulo genérico de Teoria do Estresse. Analisam-se abordagens neodurkheimianas das desigualdades sociais, baseadas no conceito de capital social, criticando especialmente os usos quase-teóricos da noção de "estilo de vida" no campo da saúde. Discutem-se ainda alguns modelos derivados do materialismo dialético que se tornaram bastante influentes na epidemiologia social latino-americana, com base nos conceitos de trabalho e classe social. Finalmente, considerando lacunas teóricas e conceituais dessas teorias parciais no que diz respeito ao espaço simbólico da vida social, apresentam-se as bases conceituais de um enfoque teórico alternativo – a "teoria do modo de vida e saúde". Tomada como síntese possível dos modelos objeto desta revisão crítica, considera-se esta teoria como especialmente indicada para a elaboração de modelos epidemiológicos de determinação social de doenças crônicas não-transmissíveis.
FONTE: Ciência Saúde Coletiva, Rio de Janeiro, vol.9, n.4, p. 865-884, 2004.
REFERENCIA: ALMEIDA-FILHO, Naomar. Modelos de determinação social das doenças crônicas não-transmissíveis. Ciência Saúde Coletiva, Rio de Janeiro, vol.9, n.4, p. 865-884, 2004.
305. The world health report 2000: Health systems improving performance.
AUTOR(ES): World Health Organization
ANO: 2000
RESUMO:
FONTE: Geneva: WHO, 2000. 215 p.
REFERENCIA: WORLD HEALTH ORGANIZATION. The world health report 2000: health systems improving performance. Geneva: WHO, 2000. 215 p.
306. Towards integrated and coeherent health information systems for performance monitoring: The Canadian experience.
AUTOR(ES): Michael Wolfson; Richard Alvarez
ANO: 2002
RESUMO:
FONTE: Paris: OECD, 2002. p. 133-155.
REFERENCIA: WOLFSON, Michael; ALVAREZ, Richard. Towards integrated and coeherent health information systems for performance monitoring: The Canadian experience. In: OECD. Measuring up: Improving Health Systems Performance in OECD Countries: Conference presentations. Paris: OECD, 2002. p. 133-155. Session 5.
307. Uma metodologia de avaliação do desempenho do sistema de saúde brasileiro.
AUTOR(ES): Francisco Viacava; Cé lia Almeida; Rosâ ngela Caetano; Má rcia Fausto; James Macinko; Mô nica Martins; José Carvalho de Noronha; Heligonda Maria Dutilh Novaes; Eliane dos Santos Oliveira; Silvia Marta Porto; Ligia M. Vieira da Silva; Cé lia Landmann Szwarcwald
ANO: 2004
RESUMO: Este artigo é uma síntese de alguns dos principais resultados das discussões realizadas ao longo de 18 meses entre pesquisadores de diversas instituições, afiliadas à Abrasco, e procura contribuir para a formulação de uma metodologia que permita: a) compreender quais são e como se inter-relacionam os fatores que influenciam a eficiência, a efetividade e a eqüidade no desempenho do SUS; b) melhorar a formulação de políticas e c) monitorar as desigualdades no acesso e na qualidade dos serviços recebidos pelos diferentes grupos sociais no Brasil. A metodologia desenvolvida nutre-se de elementos utilizados nas propostas de avaliação de desempenho dos sistemas de saúde canadense, australiano, inglês e a da OPS e tem o formato de um painel de controle (dashboard), onde podem ser visualizadas simultaneamente diferentes dimensões da avaliação. O artigo descreve a experiência na adaptação e desenvolvimento da metodologia e fornece sugestões no sentido de aplicá-la para melhorar a formulação da política de saúde no Brasil.
FONTE: Ciência e Saúde Coletiva, Rio de Janeiro, vol.9, n.3, p. 711-724, 2004.
REFERENCIA: VIACAVA, Francisco et al. Uma metodologia de avaliação do desempenho do sistema de saúde brasileiro. Ciência e Saúde Coletiva, Rio de Janeiro, vol.9, n.3, p. 711-724, 2004.
308. Sistemas de repasses financeiros a unidades de assistência à saúde: uma Proposta Preliminar para a Rede Pública Brasileira.
AUTOR(ES): Maria Alicia Dominguez Ugá
ANO: 1994
RESUMO:
FONTE: Brasília: OPAS, 1994. p. 74-98. (Série Economia e Financiamento 4).
REFERENCIA: UGÁ, Maria Alicia Domínguez. Sistemas de repasses financeiros a unidades de assistência à saúde: uma Proposta Preliminar para a Rede Pública Brasileira. In: BRASIL/OPAS/OMS. O Financiamento da Saúde no Brasil. Brasília: OPAS, 1994. p. 74-98. (Série Economia e Financiamento 4).
309. Financiamento e alocação de recursos em saúde no Brasil.
AUTOR(ES): Maria Alicia Dominguez Ugá ; Silvia Marta Porto
ANO: 2008
RESUMO: Este capítulo aborda um tema que vem sendo objeto de intenso interesse no cenário internacional, principalmente a partir da década de 1980: um lado, o financiamento dos sitemas de saúde, tendo em vista o aumento constante dos gastos, decorrente tanto do envelhecimento da população como da incorporação de tecnologias de alto custo; por outro, a alocação de recursos na perspectiva da eqüidade no acesso aos serviços de saúde em contextos de desigualdades sociais. Assim, o capítulo é composto de duas partes, abordando cada um desses macrotemas. Cada parte, por sua vez, contém três seções: a primeira é de caráter conceitual; a segunda contextualiza a questão no cenário internacional; e, finalmente, a terceira é destinada à análise do caso brasileiro.
FONTE: Rio de Janeiro:Editora Fiocruz, 2008. p. 473-505.
REFERENCIA: UGÁ, Maria Alicia Domínguez; PORTO, Silvia Marta. Financiamento e alocação de recursos em saúde no Brasil. In: GIOVANELLA, Lígia et al.,org. Políticas e sistemas de saúde no Brasil. Rio de Janeiro:Editora Fiocruz, 2008. p. 473-505.
310. Desenvolvimento, economia e saúde.
AUTOR(ES): Maria Alicia Dominguez Ugá ; Á quilas Mendes
ANO: 2009
RESUMO:
FONTE: Porto Alegre: Associação Brasileira de Economia da Saúde (Abres), 2009.
REFERENCIA: UGÁ, Maria Alicia Domínguez; MENDES, Áquilas. Desenvolvimento, economia e saúde. Porto Alegre: Associação Brasileira de Economia da Saúde (Abres), 2009.
311. O financiamento do SUS: trajetória, contexto e constrangimentos.
AUTOR(ES): Maria Alicia Dominguez Ugá ; Rosa Maria Marques
ANO: 2005
RESUMO: Na obra se mesclam conquistas e entraves, reflexões e críticas, todos advindos do pensamento de autores e atores que, mais que conhecer, vivem esta realidade, seja pelas pesquisas que desenvolvem, seja pelas frentes em que atuam. Conhecer a história do SUS, percorrer suas trilhas e mirar seus horizontes é o que este livro propicia. Saúde e Democracia é, portanto, uma referência para todos aqueles que buscam, ao conhecer os rumos da saúde pública do Brasil, apreender mais da própria história para construir o futuro.
FONTE: Rio de Janeiro: Editora Fiocruz, 2005. p. 193-233.
REFERENCIA: UGÁ, Maria Alicia Domínguez; MARQUES, Rosa Maria. O financiamento do SUS: trajetória, contexto e constrangimentos. In: LIMA, Nísia Trindade et al. Saúde e democracia: história e perspectivas do SUS. Rio de Janeiro: Editora Fiocruz, 2005. p. 193-233.
312. Uma análise da progressividade do financiamento do Sistema Único de Saúde (SUS).
AUTOR(ES): Maria Alicia Dominguez Ugá ; Isabela Soares Santos
ANO: 2006
RESUMO: Este artigo analisa o grau de progressividade dos tributos que financiam o Sistema Único de Saúde (SUS). Nele são identificados os principais tributos que financiam o SUS e, com base nos microdados da Pesquisa de Orçamentos Familiares 2002-2003, é inferida a distribuição do ônus do pagamento dos tributos diretos e indiretos que financiam o SUS e analisado o grau de progressividade dos mesmos. Foi, ainda, calculado o índice de Kakwani do financiamento do SUS, que sintetiza o grau de progressividade de um sistema tributário. Os dados mostraram que o índice de Kakwani do financiamento público é de 0,008 e que, portanto, o financiamento do SUS corresponde a um sistema quase proporcional, que onera proporcionalmente à renda. Em uma sociedade com o grau de desigualdade da brasileira, que exibe um índice de Gini de 0,57, ter um financiamento do SUS proporcional é fortemente questionável sob a ótica da justiça social: ao contrário, seria desejável construir bases de financiamento do SUS francamente progressivas, de forma a contra-restar a fortíssima concentração de renda da nossa sociedade.
FONTE: Cadernos de Saúde Pública, Rio de Janeiro, vol.22, n.8, p. 1597-1609, 2006.
REFERENCIA: UGÁ, Maria Alicia Domínguez; SANTOS, Isabela Soares. Uma análise da progressividade do financiamento do Sistema Único de Saúde (SUS). Cadernos de Saúde Pública, Rio de Janeiro, vol.22, n.8, p. 1597-1609, 2006.
313. Os hospitais de pequeno porte e sua inserção no SUS.
AUTOR(ES): Maria Alicia Dominguez Ugá ; Elaine Machado Lopez
ANO: 2007
RESUMO: Este artigo analisa o segmento dos hospitais de pequeno porte (HPP) brasileiros, considerando sua distribuição geográfica, sua natureza jurídica, tipo de unidade sanitária, estrutura e produção de serviços. Tendo em vista que a Portaria GM/MS No 1.0441 de 2004 induz estes hospitais a adequar seu perfil ao novo papel que lhe foi definido na rede, foram comparados dados referentes a dezembro de 2005 com os de abril de 2004. Os resultados mostram que os HPP representam 62% da rede hospitalar brasileira e 18% dos leitos existentes, distribuídos, majoritariamente, em municípios de pequeno porte interioranos. São hospitais de baixa complexidade e densidade tecnológica e exibem uma baixa taxa de ocupação (32,8%). Não se observam mudanças no perfil da sua produção entre 2004 e 2006, em função do tempo decorrido desde a implantação da política e fundamentalmente porque esta política não foi acompanhada de uma política de investimentos e de recursos humanos. Trata-se de um segmento estratégico para a integralidade do cuidado no SUS, por sua participação no parque hospitalar e por sua capilaridade para o interior do país e pelo seu potencial de agregar resolubilidade à atenção básica, de garantir continuidade da assistência entre os diferentes níveis de complexidade.
FONTE: Ciência e Saúde Coletiva, Rio de Janeiro, vol.12, n.4, p. 915-928, 2007.
REFERENCIA: UGÁ, Maria Alicia Domínguez ; LOPEZ, Elaine Machado. Os hospitais de pequeno porte e sua inserção no SUS. Ciência e Saúde Coletiva, Rio de Janeiro, vol.12, n.4, p. 915-928, 2007.
314. Desigualdades geográficas e sociais no acesso aos serviços de saúde no Brasil: 1998 e 2003.
AUTOR(ES): Claudia Travassos; Evangelina X. G. de Oliveira; Francisco Viacava
ANO: 2006
RESUMO: Este estudo objetivou avaliar o padrão das desigualdades geográficas e sociais no acesso aos serviços de saúde em 2003 e compará-lo com o padrão existente em 1998, usando os dados da Pesquisa Nacional por Amostra de Domicílios (PNAD). A população estudada foi de crianças e adultos residentes em áreas urbanas que referiram restrição de atividades nos últimos 15 dias nas duas pesquisas. A variável dependente foi o uso de serviços de saúde nos 15 dias que antecederam a entrevista. Os modelos de uso de serviços de saúde testados foram controlados por idade e sexo, e incluíram renda familiar per capita, escolaridade, grande região e alguns estados da federação. O estudo reafirmou o padrão de que no Brasil o acesso é fortemente influenciado pela condição social das pessoas e pelo local onde residem. Este padrão existe tanto para os adultos como para as crianças. Houve alguma diminuição das desigualdades sociais no acesso, mas as desigualdades geográficas no acesso aumentaram no período de estudo. Na região Sul, uma das mais desenvolvidas do país, persiste um padrão de forte desigualdade social e o estado do Rio Grande do Sul destaca-se pela magnitude das desigualdades sociais no acesso. A amostra da PNAD apresenta limitações para estudos de eqüidade na utilização de serviços de saúde no âmbito estadual.
FONTE: Ciência e Saúde Coletiva, Rio de Janeiro, v. 11, n. 4, p.975-986, 2006.
REFERENCIA: TRAVASSOS, Claudia; OLIVEIRA, Evangelina X. G. de; VIACAVA, Francisco. Desigualdades geográficas e sociais no acesso aos serviços de saúde no Brasil: 1998 e 2003. Ciência e Saúde Coletiva, Rio de Janeiro, v. 11, n. 4, p.975-986, 2006.
315. (IM) Previdência social: 60 anos de história da previdência no Brasil.
AUTOR(ES): Jaime Oliveira; Sonia Teixeira
ANO: 1989
RESUMO:
FONTE: Petrópolis: Vozes; Rio de Janeiro: Abrasco, 1989. 360 p.
REFERENCIA: OLIVEIRA, Jamie; TEIXEIRA, Sonia. (IM) Previdência social: 60 anos de história da previdência no Brasil. 2. ed. Petrópolis: Vozes; Rio de Janeiro: Abrasco, 1989. 360 p.
316. Principles of performance measurement: Introduction.
AUTOR(ES): Peter C. Smith; Elias Mossialos; Irene Papanicolas; Sheila Leatherman
ANO: 2009
RESUMO:
FONTE: New York: Cambridge University, 2009. p. 3-24.
REFERENCIA: SMITH, Peter C. et al. Principles of performance measurement: introduction. In: SMITH, Peter C et al. Performance measurement for health system improvement: Experiences, challenges and prospects. New York: Cambridge University, 2009. p. 3-24.
317. A utilização de serviços de saúde por sistema de financiamento.
AUTOR(ES): Silvia Marta Porto; Isabela Soares; Maria Alicia Dominguez Ugá
ANO: 2006
RESUMO: Este artigo analisa, a partir de microdados de 1998 e 2003 da PNAD/IBGE, a utilização de serviços de saúde sob a perspectiva de seu financiamento ou, em outras palavras, sob o prisma do sistema de proteção à saúde pelo qual o serviço foi utilizado: se pelo Sistema Único de Saúde (SUS), ou seja, pelo sistema público financiado por meio de tributos; se por planos e seguros de saúde privados e financiados por prêmios pagos por beneficiários e/ou seus empregadores; ou, finalmente, se mediante a compra direta de serviços (pagamento direto no ato da utilização de serviços). Entre os principais resultados da análise, destacam-se os seguintes: 1) o SUS financia a maioria dos atendimentos e das internações realizados no País, participação que aumentou significativamente entre 1998 e 2003; 2) embora o número absoluto de atendimentos realizados pelos três sistemas de financiamento tenha aumentado, a expansão do SUS foi muito mais significativa e a ela correspondeu uma desaceleração do crescimento do gasto privado direto; 3) o SUS é o principal financiador dos dois níveis extremos de complexidade da atenção à saúde: o de atenção básica e o da alta complexidade.
FONTE: Ciência e Saúde Coletiva, Rio de Janeiro, vol.11, n.4, p. 895-910, 2006.
REFERENCIA: PORTO, Silvia Marta; SANTOS, Isabela Soares; UGÁ, Maria Alicia Dominguez. A utilização de serviços de saúde por sistema de financiamento. Ciência e Saúde Coletiva, Rio de Janeiro, vol.11, n.4, p. 895-910, 2006.
318. Evaluación y mejora del desempeño de los sistemas de salud en la Región de las Américas.
AUTOR(ES): Organizacion Panamericana de Salud
ANO: 2001
RESUMO:
FONTE: Washington: OPS, 2001. 71 p.
REFERENCIA: ORGANIZACION PANAMERICA DE SALUD. Evaluación y mejora del desempeño de los sistemas de salud en la Región de las Américas. Washington: OPS, 2001. 71 p.
319. Assessment of the world health report.
AUTOR(ES): Vicente Navarro
ANO: 2000
RESUMO:
FONTE: The Lancet, New York, v. 356, n. 4, p.1598-1601, 4 nov. 2000.
REFERENCIA: NAVARRO, Vicente. Assessment of the world health report. The Lancet, New York, v. 356, n. 4, p.1598-1601, 4 nov. 2000.
320. What can we learn from international comparisons of health systems in health system reform?
AUTOR(ES): Barbara McPake; Anne Mills
ANO: 2000
RESUMO: Most commonly, lessons derived from comparisons of international health sector reform can only be generalized in a limited way to similar countries. However, there is little guidance as to what constitutes ‘‘similarity’’ in this respect. We propose that a framework for assessing similarity could be derived from the performance of individual policies in different contexts, and from the cause and effect processes related to the policies. We demonstrate this process by considering research evidence in the ‘‘public–private mix’’, and propose variables for an initial framework that we believe determine private involvement in the public health sector. The most influential model of public leadership places the private role in a contracting framework. Research in countries that have adopted this model suggests an additional list of variables to add to the framework. The variables can be grouped under the headings ‘‘demand factors’’, ‘‘supply factors’’, and ‘‘strength of the public sector’’. These illustrate the nature of a framework that could emerge, and which would help countries aiming to learn from international experience.
FONTE: Bulletin Of The World Health Organization, Geneva, v. 78, n. 6, p.811-820, 2000.
REFERENCIA: MCPAKE, Barbara; MILLS, Anne. What can we learn from international comparisons of health systems in health system reform? Bulletin Of The World Health Organization, Geneva, v. 78, n. 6, p.811-820, 2000.
321. Sistema de Indicadores de Percepção Social (SIPS).
AUTOR(ES): Instituto de Pesquisa de Economia Aplicada
ANO: 2010
RESUMO:
FONTE: Brasília: IPEA, 2011. 20 p.
REFERENCIA: BRASIL. INSTITUTO DE PESQUISA DE ECONOMIA APLICADA. Sistema de Indicadores de Percepção Social (SIPS). Brasília: IPEA, 2011. 20 p.
322. Performance measurement and performance management in OECD health systems.
AUTOR(ES): Jeremy Hurst; Melissa Jee-Hughes
ANO: 2001
RESUMO:
FONTE: Paris: OECD Labour Market and Social Policy Occasional Papers,OECD Publishing, n. 47, 29 jan. 2001.
REFERENCIA: HURST, Jeremy; JEE-HUGHES, Melissa. Performance measurement and performance management in OECD health systems. Paris: OECD Labour Market and Social Policy Occasional Papers,OECD Publishing, n. 47, 29 jan. 2001.
323. Challenging inequity through health systems: final report of the knowledge network on health systems.
AUTOR(ES): Lucy Gilson; Rene Loewenson; Jane Doherty; Victoria Francis
ANO: 2007
RESUMO:
FONTE: Geneva: World Health Organization, 2007. 122 p.
REFERENCIA: GILSON, Lucy et al. Challenging inequity through health systems: final report of the knowledge network on health systems. Geneva: World Health Organization, 2007. 122 p.
324. Producing health, consuming health care.
AUTOR(ES): Robert G. Evans; Gregory L. Stoddart
ANO: 1990
RESUMO:
FONTE: Social Science & Medice, Oxford, v. 31, n. 12, p.1347-1363, 1990.
REFERENCIA: EVANS, Robert G.; STODDART, Gregory L. Producing health, consuming health care. Social Science & Medice, Oxford, v. 31, n. 12, p.1347-1363, 1990.
325. Política nacional de avaliação de desempenho do Sistema Único de Saúde.
AUTOR(ES): Ministé rio da Saú de. Comitê Nacional de Avaliaç ã o de Desempenho do Sistema de Saú de.
ANO: 2007
RESUMO:
FONTE: Brasília: Ministério da Saúde, 2007.
REFERENCIA: BRASIL. Ministério da Saúde. Comitê Nacional de Avaliação de Desempenho do Sistema de Saúde. Política nacional de avaliação de desempenho do Sistema Único de Saúde. Brasília: Ministério da Saúde, 2007.
326. Mais Saúde: direito de todos 2008/2011.
AUTOR(ES): Ministé rio da Saú de.
ANO: 2008
RESUMO:
FONTE: Brasília,DF: Editora do Ministério da Saúde, 2008. 100 p.
REFERENCIA: BRASIL. MINISTÉRIO DA SAÚDE. SECRETARIA-EXECUTIVA. Mais Saúde: direito de todos. 2. ed. Brasília, DF: Editora do Ministério da Saúde, 2008. 100 p.
327. Pacto de Indicadores da Atenção Básica: instrumento de negociação qualificador do processo de gestão do SUS.
AUTOR(ES): Secretaria de Atenç ã o á Saú de; Departamento de Atenç ã o Bá sica.
ANO: 2003
RESUMO:
FONTE: Revista Brasileira Saude Materno Infantil, Recife, v. 3, n. 2, jun. 2003 .p. 221-224.
REFERENCIA: BRASIL. Ministério da Saúde; Secretaria de Atenção á Saúde e Departamento de Atenção Básica. Pacto de Indicadores da Atenção Básica: instrumento de negociação qualificador do processo de gestão do SUS. Revista Brasileira Saude Materno Infantil, Recife, v. 3, n. 2, jun. 2003 .p. 221-224.
328. Who benefits from public spending on health care in Asia?
AUTOR(ES): Owen O' Donnell; Eddy van Doorslaer; Ravi P. Rannan-Eliya; Aparnaa Somanathan; Shiva Raj Adhikari; Deni Harbianto; Charu C. Garg; Piya Hanvoravongchai; Mohammed N. Huq; Anup Karan; Gabriel M. Leung; Chiu Wan Ng; Badri Raj Pande; Keith Tin; Kanjana Tisayaticom; Laksono Trisnantoro; Yuhui Zhang; Yuxin Zhao
ANO: 2005
RESUMO: We examine the benefit incidence of public health care subsidies in eleven Asian territories, including India, Indonesia and two provinces of China. The use of concentration indices and a high degree of consistency in the application of methods provide results that, unlike much of the existing evidence, are comparable across countries. Unlike many studies that examine utilisation data only or assume constant unit costs, we exploit detailed health accounts to allow for variation in unit expenditures across health services, facilities and regions. We distinguish between hospital and non-hospital care and between inpatient and outpatient care. We examine not only the distribution of quantities of health care but also that of the value of subsidies. Hong Kong is the only territory that achieves a strong pro-poor distribution of all public health services. Public health care is more moderately pro-poor in Malaysia and Thailand and is evenly distributed in Sri Lanka. In the remainder of the low-income territories examined, the better-off receive more of the subsidy than the poor. The pro-rich bias is greatest in Nepal, Heilongjiang (China) and Indonesia, followed by India, Gansu (China), Bangladesh and Vietnam. The pro-rich bias is stronger for inpatient care than hospital outpatient care. In most territories, non-hospital care is pro-poor. But the greater share of the subsidy goes to hospital care and so this dominates the overall distribution. While public health subsidies are typically not pro-poor, they are inequality reducing in all cases but for Nepal. This is because a given subsidy represents a greater proportionate increase in the living standards of the poor. Relative differences in welfare are narrowed. Hong Kong, Malaysia, Sri Lanka and Thailand have demonstrated that the allocation of sufficient public resources coupled with a policy of universal access can ensure greater benefits to the poor than is currently realised in many health systems throughout the developing world. Growing incomes not only make such policies more feasible, they also make them more effective, with respect to the target efficiency of spending, by availing the private sector opt-out.
FONTE: Sri Lanka: Institute For Health Policy, 2005.
REFERENCIA: O'DONNELL, Owen et al. Who benefits from public spending on health care in Asia? Sri Lanka: Institute For Health Policy, 2005. Working Paper Number 3.
329. An evidence-based approach to benchmarking the fairness of health-sector reform in developing countries.
AUTOR(ES): Norman Daniels; Walter Flores; Supasit Pannarunothai; Peter N. Ndumbe; John H. Bryant; T.J. Ngulube; Yuankun Wang
ANO: 2005
RESUMO: The Benchmarks of Fairness instrument is an evidence-based policy tool developed in generic form in 2000 for evaluating the effects of health-system reforms on equity, efficiency and accountability. By integrating measures of these effects on the central goal of fairness, the approach fills a gap that has hampered reform efforts for more than two decades. Over the past three years, projects in developing countries on three continents have adapted the generic version of these benchmarks for use at both national and subnational levels. Interdisciplinary teams of managers, providers, academics and advocates agree on the relevant criteria for assessing components of fairness and, depending on which aspects of reform they wish to evaluate, select appropriate indicators that rely on accessible information; they also agree on scoring rules for evaluating the diverse changes in the indicators. In contrast to a comprehensive index that aggregates all measured changes into a single evaluation or rank, the pattern of changes revealed by the benchmarks is used to inform policy deliberation about which aspects of the reforms have been successfully implemented, and it also allows for improvements to be made in the reforms. This approach permits useful evidence about reform to be gathered in settings where existing information is underused and where there is a weak information infrastructure.
FONTE: Bulletin Of The World Health Organization, Geneva, v. 83, n. 7, p.534-540, jul. 2005.
REFERENCIA: DANIELS, Norman et al. An evidence-based approach to benchmarking the fairness of health-sector reform in developing countries. Bulletin Of The World Health Organization, Geneva, v. 83, n. 7, p.534-540, jul. 2005.
330. Getting Evidence into Practice to Reduce Health Inequalities:Context and Progress on HDA Implementation.
AUTOR(ES): Viv Speller; Mike Kelly
ANO: 2003
RESUMO: The objectives of the HDA's Evidence into Practice activities are: to bring together evidence of effectiveness in improving the health of the public, drawn from syntheses of research with the practical knowledge of how such effectiveness might be implemented; to bring about changes in public health practice based on evidence, theory and practical knowledge and wisdom; to ensure the sustainability and viability of these changes; and to identify good practice and link it to the best available evidence. The rationale underlying these objectives is to find the most effective means of improving the population's health and supporting the targeting of such work to tackle health inequalities within that population.
FONTE: London: NHS Health Development Agency, 2003. 25 p.
REFERENCIA: SPELLER, Viv; KELLY, Mike. Getting evidence into practice to reduce health inequalities: context and progress on HDA implementation. London: Nhs Health Development Agency, 2003. 25 p.
331. Evidence of effectiveness and health inequalities.
AUTOR(ES): Mike P. Kelly
ANO: 2004
RESUMO: Aside from being an opportunity to feed into the Choosing Health? consultation and the Public Health White Paper, this event was organised by the Department of Health to encourage open debate on the current barriers to tackling health inequalities and identify solutions that will drive activity at all levels. Professor Kelly's presentation discusses the HDA's role in reducing inequalities, focussing on work done to date on the HDA Evidence Base and the evidence gathering processes.
FONTE: London: NHS Health Development Agency, 2004. 15 p.
REFERENCIA: KELLY, Mike P.Evidence of effectiveness and health inequalities. London: NHS Health Development Agency, 2004. 15 p.
332. Data, Data Everywhere...:Improving access to population health and health services research data in Canada.
AUTOR(ES): Charlyn Black; Kimberlyn McGrail; Cathy Fooks; Patricia Baranek; Lisa Maslove; Health Network; CPRN
ANO: 2005
RESUMO:
FONTE: Vancouver: The Centre For Health Services And Policy Research; Ottawa: The Canadian Policy Research Networks, 2005. 144 p.
REFERENCIA: BLACK, Charlyn et al. Data, data everywhere...: improving access to population health and health services research data in Canada. Vancouver: The Centre For Health Services And Policy Research; Ottawa: The Canadian Policy Research Networks, 2005. 144 p.
333. Benchmarking-a policy analysis.
AUTOR(ES): Suzanne Wait
ANO: 2004
RESUMO:
FONTE: London: The Nuffield Trust, 2004. 57 p.
REFERENCIA: WAIT, Suzanne. Benchmarking: a policy analysis. London: The Nuffield Trust, 2004. 57 p.
334. Monitoring and Evaluation of Decentralization Reforms in Developing Country Health Sectors.
AUTOR(ES): Paul L. Hutchinson; Anne K. LaFond
ANO: 2004
RESUMO:
FONTE: Bethesda: Partnerships For Health Reformplus, 2004. 91 p.
REFERENCIA: HUTCHINSON, Paul L.; LAFOND, Anne K.Monitoring and evaluation of decentralization reforms in developing country health sectors. Bethesda: Partnerships For Health Reformplus, 2004. 91 p.
335. Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European populations.
AUTOR(ES): Martijn Huisman; Anton E Kunst; Matthias Bopp; Jens-Kristian Borgan; Carme Borrell; Giuseppe Costa; Patrick Deboosere; Sylvie Gadeyne; Myer Glickman; Chiara Marinacci; Christoph Minder; Enrique Regidor; Tapani Valkonen; Johan P Mackenbach
ANO: 2005
RESUMO: BACKGROUND: Studies of socioeconomic disparities in patterns of cause of death have been limited to single countries, middle-aged people, men, or broad cause of death groups. We assessed contribution of specific causes of death to disparities in mortality between groups with different levels of education, in men and women, middle-aged and old, in eight western European populations. METHODS: We analysed data from longitudinal mortality studies by cause of death, between Jan 1, 1990, and Dec 31, 1997. Data were included for more than 1 million deaths in 51 million person years of observation. FINDINGS: Absolute educational inequalities in total mortality peaked at 2127 deaths per 100000 person years in men, and at 1588 deaths per 100000 person years in women aged 75 years and older. In this age-group, rate ratios were greater than 1.00 for total mortality and all specific causes of death, apart form prostate cancer in men and lung cancer in women, showing increased mortality in low versus high educational groups. In men, cardiovascular diseases accounted for 39% of the difference between low and high educational groups in total mortality, cancer for 24%, other diseases for 32%, and external causes for 5%. Among women, contributions were 60%, 11%, 30%, and 0%, respectively. The contributions of cerebrovascular disease, other cardiovascular diseases, pneumonia, and COPD strongly increased by age, whereas those of cancer and external causes declined. Although relative inequalities in total mortality were closely similar in all populations, we noted striking differences in the contribution of specific causes to these inequalities.
FONTE: The Lancet, New York, v. 365, n. 9458, p.493-500, 2005.
REFERENCIA: HUISMAN, Martijn et al. Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European populations. The Lancet, New York, v. 365, n. 9458, p.493-500, 2005.
336. The effects of specialist supply on populations' health: assessing the evidence.
AUTOR(ES): Barbara Starfield; Leiyu Shi; Atul Grover; James Macinko
ANO: 2005
RESUMO: Analyses at the county level show lower mortality rates where there are more primary care physicians, but this is not the case for specialist supply. These findings confirm those of previous studies at the state and other levels. Increasing the supply of specialists will not improve the United States' position in population health relative to other industrialized countries, and it is likely to lead to greater disparities in health status and outcomes. Adverse effects from inappropriate or unnecessary specialist use may be responsible for the absence of relationship between specialist supply and mortality.
FONTE: Health Affairs (Project Hope), Millwood, p.97-107, 2005. Web Exclusives.
REFERENCIA: STARFIELD, Barbara et al. The effects of specialist supply on populations' health: assessing the evidence. Health Affairs (Project Hope), Millwood, p.97-107, 2005. Web Exclusives.
337. Action on the social determinants of health: learning from previous experiences.
AUTOR(ES): World Health Organization
ANO: 2010
RESUMO: Today an unprecedented opportunity exists to improve health in some of the world’s poorest and most vulnerable communities by tackling the root causes of disease and health inequalities. The most powerful of these causes are the social conditions in which people live and work, referred to as the social determinants of health (SDH). The Millennium Development Goals (MDGs) shape the current global development agenda. The MDGs recognize the interdependence of health and social conditions and present an opportunity to promote health policies that tackle the social roots of unfair and avoidable human suffering. The Commission on Social Determinants of Health (CSDH) is poised for leadership in this process. To reach its objectives, however, the CSDH must learn from the history of previous attempts to spur action on SDH. This paper pursues three questions: (1) Why didn’t previous efforts to promote health policies on social determinants succeed? (2) Why do we think the CSDH can do better? (3) What can the Commission learn from previous experiences – negative and positive – that can increase its chances for success?
FONTE: Geneva: Who Document Production Services, 2010.
REFERENCIA: WORLD HEALTH ORGANIZATION. Action on the social determinants of health: learning from previous experiences. Geneva: Who Document Production Services, 2010.
338. Health inequalities: concepts, frameworks and policy.
AUTOR(ES): Hilary Graham; Michael P. Kelly
ANO: 2004
RESUMO: At the heart of public health in contemporary Britain is a paradox. Britain is now collectively healthier than it has ever been in its history. Life expectancy improves and some of the great killer diseases are in retreat as the benefits of both a preventive approach to public health and advances in treatment bear fruit. Yet at the same time, the problem of health inequalities remains stubbornly ubiquitous. While the health of the population as a whole may be improving, the health of the least and less well off either improves more slowly than the rest of the population or in some cases gets worse in absolute terms. This is a challenge to policy makers and practitioners. It suggests that while some of our policy and interventions undoubtedly work they also manifestly fail some sections of the population. To sharpen the tools for policy making in this arena, this paper reviews some of the important conceptual problems associated with discussions of health inequalities.
FONTE: London: NHS Health Development Agency, 2004. 12 p.
REFERENCIA: GRAHAM, Hilary; KELLY, Michael P. Health inequalities: concepts, frameworks and policy. London: NHS Health Development Agency, 2004. 12 p.
339. Action on the Social Determinants of Health: learning from previous experiences.
AUTOR(ES): World Health Organization
ANO: 2010
RESUMO: Today an unprecedented opportunity exists to improve health in some of the world’s poorest and most vulnerable communities by tackling the root causes of disease and health inequalities. The most powerful of these causes are the social conditions in which people live and work, referred to as the social determinants of health (SDH). The Millennium Development Goals (MDGs) shape the current global development agenda. The MDGs recognize the interdependence of health and social conditions and present an opportunity to promote health policies that tackle the social roots of unfair and avoidable human suffering. The Commission on Social Determinants of Health (CSDH) is poised for leadership in this process. To reach its objectives, however, the CSDH must learn from the history of previous attempts to spur action on SDH. This paper pursues three questions: (1) Why didn’t previous efforts to promote health policies on social determinants succeed? (2) Why do we think the CSDH can do better? (3) What can the Commission learn from previous experiences – negative and positive – that can increase its chances for success?
FONTE: Geneva: Who Document Production Services, 2010.
REFERENCIA: WORLD HEALTH ORGANIZATION. Action on the social determinants of health: learning from previous experiences. Geneva: Who Document Production Services, 2010.
340. The development of a strategy for tackling health inequalities in the Netherlands.
AUTOR(ES): Johan P Mackenbach; Karien Stronks
ANO: 2004
RESUMO: Over the past decade, the Dutch government has pursued a research-based approach to tackle socioeconomic inequalities in health. We report on the most recent phase in this approach: the development of a strategy to reduce health inequalities in the Netherlands by an independent committee. In addition, we will reflect on the way the report of this committee has influenced health policy and practice. A 6-year research and development program was conducted which covered a number of different policy options and consisted of 12 intervention studies. The study results were discussed with experts and policy makers. A government advisory committee developed a comprehensive strategy that intends to reduce socioeconomic inequalities in disability-free life expectancy by 25% in 2020. The strategy covers 4 different entry-points for reducing socioeconomic inequalities in health, contains 26 specific recommendations, and includes 11 quantitative policy targets. Further research and development efforts are also recommended. Although the Dutch approach has been influenced by similar efforts in other European countries, particularly the United Kingdom and Sweden, it is unique in terms of its emphasis on building a systematic evidence-base for interventions and policies to reduce health inequalities. Both researchers and policy-makers were involved in the process, and there are clear indications that some of the recommendations are being adopted by health policy-makers and health care practice, although more so at the local than at the national level.
FONTE: International Journal For Equity In Health, London, v. 11, n. 3, p.1-7, 2004.
REFERENCIA: MACKENBACH, Johan P.; STRONKS, Karien. The development of a strategy for tackling health inequalities in the Netherlands. International Journal For Equity In Health, London, v. 11, n. 3, p.1-7, 2004.
341. Equity, capabilities and health.
AUTOR(ES): Paul Anand; Paul Dolan
ANO: 2005
RESUMO: This paper provides an introduction to a collection of articles concerning the relevance of Amartya Sen's work, the capability approach and related ethical claims, to health-care rationing.
FONTE: Social Science & Medicine, Oxford, v. 60, n. 2, p.219-222, 2005.
REFERENCIA: ANAND, Paul; DOLAN, Paul. Equity, capabilities and health. Social Science & Medicine, Oxford, v. 60, n. 2, p.219-222, 2005.
342. Selecting Indicators for the Quality of Health Promotion, Prevention and Primary Care at the Health Systems Level in OECD Countries.
AUTOR(ES): Martin Marshall; Sheila Leatherman; Soeren Mattke; the Members of the OECD Health Promotion Prevention and Primary Care Panel
ANO: 2004
RESUMO:
FONTE: Paris: OECD Health Technical Papers, 2004. 49 p. N°16.
REFERENCIA: MARSHALL, Martin et al. Selecting indicators for the quality of health promotion, prevention and primary care at the health systems level in OECD countries. Paris: OECD Health Technical Papers, 2004. 49 p. N°16.
343. Health systems in transition: learning from experience.
AUTOR(ES): Josep Figueras; Martin McKee; Jennifer Cain; Suszy Lessof
ANO: 2004
RESUMO:
FONTE: Copenhagen: European Observatory On Health Systems And Policies, 2004. 152 p.
REFERENCIA: FIGUERAS, Josep et al. Health systems in transition: learning from experience. Copenhagen: European Observatory On Health Systems And Policies, 2004. 152 p.
344. The Reform of the Health Care System in Portugal.
AUTOR(ES): Sté phanie Guichard
ANO: 2004
RESUMO: An ambitious reform to increase efficiency of the Portuguese health care system was launched in 2002. In contrast to previous attempts of gradual reforms, which were never fully implemented, the strategy has been to create a big bang in the health sector, making changes essentially irreversible. The reform has two main aims: to deliver better-quality public health services than at present but at no higher cost; and to reduce the underlying growth rate of public health-care spending over the medium term. New legislation approved includes the separation of the functions of regulation, financing and provision of health care services; setting up new models of financing for providers, which impose harder budget constraints; the introduction of incentives towards productivity, management and quality improvements; the possibility for the private sector to play a larger role in service provision; and the promotion of generic drugs.
FONTE: Paris: OECD Economics Department Working Papers, 2004. 53 p. N°405.
REFERENCIA: GUICHARD, Stéphanie. The reform of the health care system in Portugal. Paris: OECD Economics Department Working Papers, 2004. 53 p. N°405.
345. Measuring progress in Healthy People 2010.
AUTOR(ES): Kenneth G. Keppel; Jeffrey N. Pearcy; Richard J. Klein
ANO: 2004
RESUMO: Background—Healthy People 2010 (HP2010) objectives are based on two overarching goals: 1) to increase years and quality of healthy life, and 2) to eliminate disparities among subgroups of the population. Four hundred and sixty-seven specific objectives consistent with these goals were outlined, baseline data were identified when available, and specific tar- gets were set for the year 2010. This report discusses the tech niques that are being used to measure progress toward these two goals. Process—In order to promote consistency in monitoring across different objectives, a minimum template of subgroups was adopted for the population-based objectives in HP2010. A workgroup of individuals representing the U.S. Department of Health and Human Services agencies involved in HP2010 was convened to consider the issues related to monitoring progress toward the two goals of HP2010. The workgroup concurred with the recommendations in this report. Recommendations—Progress toward target attainment can be monitored for all objectives with at least one data point beyond the baseline. For those objectives that are based on data for a population, progress toward target attainment can also be measured for subgroups of the population. Progress toward the elimination of disparity for individual population subgroups can be measured in terms of the percent difference between each subgroup rate and the most favorable or ‘‘best’’ subgroup rate in each domain. For purposes of measuring disparity relative to the ‘‘best’’ subgroup rate, all measures are expressed in terms of adverse events. Keywords: goals c objectives c health disparity
FONTE: Healthy People 2010 Statistical Notes, Hyattsville, n. 25, p.1-16, 2004.
REFERENCIA: KEPPEL, Kenneth G.; PEARCY, Jeffrey N.; KLEIN, Richard J.. Measuring progress in healthy people 2010. Healthy People 2010 Statistical Notes, Hyattsville, n. 25, p.1-16, 2004.
346. The Lancet's series on health-systems research: a call for papers.
AUTOR(ES): Andy Haines; Cesar Victora; Richard Horton
ANO: 2004
RESUMO:
FONTE: The Lancet, New York, v. 363, n. 9405, p.261-262, 2004.
REFERENCIA: HAINES, Andy; VICTORA, Cesar; HORTON, Richard. The Lancet's series on health-systems research: a call for papers. The Lancet, New York, v. 363, n. 9405, p.261-262, 2004.
347. Evidence-based action needed on health systems.
AUTOR(ES): Andy Haines; Cesar Victora
ANO: 2004
RESUMO:
FONTE: The Lancet, New York, v. 364, n. 9441, p.1204, 2004.
REFERENCIA: HAINES, Andy; VICTORA, Cesar. Evidence-based action needed on health systems. The Lancet, New York, v. 364, n. 9441, p.1204, 2004.
348. Making health systems more equitable.
AUTOR(ES): Davidson R. Gwatkin; Abbas Bhuiya; Cesar G. Victora
ANO: 2004
RESUMO: Health systems are consistently inequitable, providing more and higher quality services to the well-off, who need them less, than to the poor, who are unable to obtain them. In the absence of a concerted effort to ensure that health systems reach disadvantaged groups more effectively, such inequities are likely to continue. Yet this situation need not be accepted as inevitable, for there are many promising measures that might be pursued: establishment of goals for improved coverage in the poor, rather than in entire populations, and use of those goals to direct planning toward the needs of the disadvantaged; use of one or more of the several techniques that seem to have been effective in at least some of the settings where they have been tried; and empowerment of poor clients to have a more central role in health system design and operation.
FONTE: The Lancet, New York, v. 364, n. 9441, p.1273-1280, 2004.
REFERENCIA: GWATKIN, Davidson R.; BHUIYA, Abbas; VICTORA, Cesar G. Making health systems more equitable. The Lancet, New York, v. 364, n. 9441, p.1273-1280, 2004.
349. Private Health Insurance in OECD Countries: The Benefits and Costs for Individuals and Health Systems.
AUTOR(ES): Francesca Colombo; Nicole Tapay
ANO: 2004
RESUMO:
FONTE: Paris: OECD Health Working Paper, 2004. 60 p.
REFERENCIA: COLOMBO, Francesca; TAPAY, Nicole. Private health insurance in OECD countries: the benefits and costs for individuals and health systems. Paris: Oecd Health Working Paper, 2004. 60 p.
350. Challenging Health Care System Sustainability: Understanding Health System Performance of Leading Countries.
AUTOR(ES): The Conference Board of Canada
ANO: 2004
RESUMO:
FONTE: Canada: Incorporated as Aeric, 2004. 114 p.
REFERENCIA: THE CONFERENCE BOARD OF CANADA. Challenging health care system sustainability: understanding health system performance of leading countries.Canada: Incorporated as Aeric, 2004. 114 p.
351. Overcoming health-systems constraints to achieve the Millennium Development Goals.
AUTOR(ES): Phyllida Travis; Sara Bennett; Andy Haines; Tikki Pang; Zulfiqar Bhutta; Adnan A Hyder; Nancy R Pielemeier; Anne Mills; Timothy Evans
ANO: 2004
RESUMO: Effective interventions exist for many priority health problems in low income countries; prices are falling, and funds are increasing. However, progress towards agreed health goals remains slow. There is increasing consensus that stronger health systems are key to achieving improved health outcomes. There is much less agreement on quite how to strengthen them. Part of the challenge is to get existing and emerging knowledge about more (and less) effective strategies into practice. The evidence base also remains remarkably weak, partly because health-systems research has an image problem. The forthcoming Ministerial Summit on Health Research seeks to help define a learning agenda for health systems, so that by 2015, substantial progress will have been made to reducing the system constraints to achieving the MDGs.
FONTE: The Lancet, New York, v. 364, n. 9437, p.900-906, 2004.
REFERENCIA: TRAVIS, Phyllida et al. Overcoming health-systems constraints to achieve the millennium development goals. The Lancet, New York, v. 364, n. 9437, p.900-906, 2004.
352. Informed choices for attaining the Millennium Development Goals: towards an international cooperative agenda for health-systems research.
AUTOR(ES): Task Force on Health Systems Research
ANO: 2004
RESUMO: Health systems constraints are impeding the implementation of major global initiatives for health and the attainment of the Millennium Development Goals (MDGs). Research could contribute to overcoming these barriers. An independent task force has been convened by WHO to suggest areas where international collaborative research could help to generate the knowledge necessary to improve health systems. Suggested topics encompass financial and human resources, organisation and delivery of health services, governance, stewardship, knowledge management, and global influences. These topics should be viewed as tentative suggestions that form a basis for further discussion. This article is part of a wide-ranging consultation and comment is invited. The potential agenda will be presented at the Ministerial Summit on Health Research in November, 2004, and revised in the light of responses. Subsequently, we hope that resources will be committed to generate the evidence needed to build the equitable, effective, and efficient health systems needed to achieve the MDGs.
FONTE: The Lancet, New York, v. 364, n. 9438, p.997-1003, 2004.
REFERENCIA: TASK FORCE ON HEALTH SYSTEMS RESEARCH. Informed choices for attaining the millennium development goals:towards an international cooperative agenda for health-systems research. The Lancet, New York, v. 364, n. 9438, p.997-1003, 2004.
353. Health Outcomes Core Library Project.
AUTOR(ES): Anne Gauthier; Julia Campbell; Jason Lee; Gina Mitchell; Virginia Van Horne
ANO: 2003
RESUMO:
FONTE: Washington: AcademyHealth, 2003. 44 p.
REFERENCIA: GAUTHIER, Anne et al. Health Outcomes Core Library Projec. Washington: AcademyHealth, 2003. 44 p.
354. The evidence-based approach in health policy and health care delivery.
AUTOR(ES): Louis W. Niessen; Els W. M. Grijseels; Frans F. H. Rutten
ANO: 2000
RESUMO: Evidence-based approaches are prominent on the national and international agendas for health policy and health research. It is unclear what the implications of this approach are for the production and distribution of health in populations, given the notion of multiple determinants in health. It is equally unclear what kind of barriers there are to the adoption of evidence-based approaches in health care practice. This paper sketches some developments in the way in which health policy is informed by the results from health research. It summarises evidence-based approaches in health at three impact levels: intersectoral assessment, national health care policy, and evidence-based medicine in everyday practice. Consensus is growing on the role of broad and specific health determinants, including health care, as well as on priority setting based on the burden of diseases. In spite of methodological constraints, there is a demand for intersectoral assessments, especially in health sector reform. Initiators of policy changes in other sectors may be held responsible for providing the evidence related to health. There are limited possibilities for priority setting at the national health care policy level. Hence, there is a decentralisation of responsibilities for resource use. Health care providers are encouraged to assume agency roles for both patients and society and asked to promote and deliver effective and efficient health care. Governments will have to design a national framework to facilitate their organisation and legal framework to enhance evidence-based health policy. Treatment guidelines supported by evidence on effectiveness and efficiency will be one essential element in this process. With the increasing number of advocates for the enhancement of population health in the policy arenas, evidence-based approaches provide the information and some of the tools to help with priority setting.
FONTE: Social Science & Medicine, Oxford v. 51, n. 6, p.859-869, 2000.
REFERENCIA: NIESSEN, Louis W.; GRIJSEELS, Els W. M.; RUTTEN, Frans F. H.. The evidence-based approach in health policy and health care delivery. Social Science & Medicine, Oxford v. 51, n. 6, p.859-869, 2000.
355. World Oral Health Report 2003.Continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme.
AUTOR(ES): Poul Erik Petersen
ANO: 2003
RESUMO: Chronic diseases and injuries are the leading health problems in all but a few parts of the world. The rapidly changing disease patterns throughout the world are particularly linked to changing lifestyles which include diets rich in sugar, wide-spread use of tobacco and increased consumption of alcohol. In addition to socio-environmental conditions, oral health is highly related to the mentioned lifestyle factors which are common risks to most chronic diseases. Oral diseases qualify as major public health problems due to their high prevalence and incidence in all regions of the world and as for all diseases the greatest burden of oral diseases is on the disadvantaged and socially marginalized populations. The severe impact in terms of pain and suffering, impairment of function and their effect on quality of life must also be considered. Traditional treatment of oral diseases is extremely costly in several industrialized countries and not feasible or possible to most low-income and middle-income countries. The WHO Global Strategy for prevention and control of noncommunicable diseases and the common risk factor approach is a new strategy to managing prevention and control of oral diseases. The WHO Oral Health Programme also has strengthened its work for improved oral health globally through links with other technical programmes within the Department of Health Promotion, Surveillance, Prevention and Management of Noncommunicable Diseases (HPM). This document outlines the current oral health situation at global level and the strategies and approaches for better oral health in the 21st Century.
FONTE: Geneva: World Health Organization, 2003. 38 p.
REFERENCIA: PETERSEN, Poul Erik. World Oral Health Report 2003.: continuous improvement of oral health in the 21st century – the approach of the WHO global oral health programme. Geneva: World Health Organization, 2003. 38 p.
356. Income-Related Inequality in the Use of Medical Care in 21 OECD Countries.
AUTOR(ES): Eddy Van Doorslaer; Cristina Masseria
ANO: 2004
RESUMO:
FONTE: Paris: OECD Health Working Paper, 2004. 88 p.
REFERENCIA: DOORSLAER, Eddy Van; MASSERIA, Cristina. Income-related inequality in the use of medical care in 21 OECD countries. Paris: OECD Health Working Paper, 2004. 88 p.
357. Durée de séjour et mortalité hospitalière au Brésil: comparaison entre hôpitaux publics et privés.
AUTOR(ES): Monica Martins
ANO: 2002
RESUMO:
FONTE: Departamento de Département D’administration de La Santé, Université de Montréal, Montréal, 2002.
REFERENCIA: MARTINS, Monica. Durée de séjour et mortalité hospitalière au Brésil: comparaison entre hôpitaux publics et privés. 2002. 174 f. Faculté Des Études Supérieures (Doutorado) - Departamento de Département D’administration de La Santé, Université de Montréal, Montréal, 2002.
358. Utilizaçäo de indicadores de resultados para a avaliaçäo da qualidade em hospitais de agudos: mortalidade hospitalar após cirurgia de revascularizaçäo do miocárdio em hospitais brasileiros.
AUTOR(ES): José Carvalho de Noronha
ANO: 2001
RESUMO: Não têm sido frequentes no Brasil estudos de avaliação da qualidade dos serviços de saúde. Tem sido adotado entendimento de qualidade como o grau em que o processo de assistência aumenta a probabilidade de resultados favoráveis e diminui a probabilidade de resultados desfavoráveis, dado o estado do conhecimento médico. Indicadores de resultados de efeitos adversos do processo de assistência costumam ser empregados e, entre eles, para aquelas condições e procedimentos onde óbitos ocorrem com frequência, estão as taxas de mortalidade hospitalar. Entre esses procedimentos inclui-se a cirurgia de revascularização do miocárdio. Apesar de frequentes na literatura, particularmente norte-americana, não há estudos de escala realizados no Brasil. Para estudos deste tipo, bases de dados administrativas têm sido empregadas. No Brasil recentemente têm sido exploradas as potencialidades dos bancos de dados do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS) em diversos estudos. Como há registros de óbitos hospitalares no sistema é possível utilizá-lo para a obtenção de dados sobre mortalidade hospitalar. Os bancos de dados do SIH-SUS de 1996 a 1998 foram integrados e as variáveis disponíveis no banco obtido examinadas quanto à possibilidade de inclusão no estudo descritivo de características da cirurgia coronária no país. Foram identificadas aquelas variáveis que poderiam ser utilizadas para proceder algum grau de ajuste de risco para os casos atendidos pelos diferentes hospitais. Para que se obtivesse uma comparação do comportamento do ajuste obtido com essas variáveis com modelos mais completos que incorporassem mais variáveis, inclusive variáveis clínicas, foram estudadas para o mesmo período, as internações realizadas no Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro, utilizando dados de banco específico do Serviço de Cirurgia Cardíaca. Além do estudo descritivo foram desenvolvidos para os casos deste hospital modelos de regressão logística incorporando variáveis pré-operatórias e com as variáveis disponíveis no SIH-SUS para avaliar as diferentes capacidades de ajuste de risco. Após escolha de um modelo de risco com maior capacidade de ajuste, foram calculadas as taxas de mortalidade hospitalar e obtidos os valores de taxas esperadas após o ajuste de risco.
FONTE: Departamento de Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2001.
REFERENCIA: NORONHA, José Carvalho de. Utilizaçäo de indicadores de resultados para a avaliaçäo da qualidade em hospitais de agudos: mortalidade hospitalar após cirurgia de revascularizaçäo do miocárdio em hospitais brasileiros. 2001. 139 f. Tese (Doutorado) - Departamento de Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2001.
359. Health Care in Canada, 2004.
AUTOR(ES): Canadian Institute for Health Information.
ANO: 2004
RESUMO:
FONTE: Ottawa: Cihi, 2004. 106 p.
REFERENCIA: CANADIAN INSTITUTE FOR HEALTH INFORMATION. Health Care in Canada, 2004. Ottawa: Cihi, 2004. 106 p.
360. National Healthcare Disparities Report-2003.
AUTOR(ES): Agency for Healthcare Research and Quality. AHRQ.
ANO: 2003
RESUMO:
FONTE: Rockville: U.S.Departament Of Health And Humam Services, 2003. 227 p.
REFERENCIA: AGENCY FOR HEALTHCARE RESEARCH AND QUALITY. National Healthcare Disparities Report - 2003. Rockville: U.S.Departament Of Health And Humam Services, 2003. 227 p.
361. Health-Care Systems: Lessons from the Reform Experience .
AUTOR(ES): Elizabeth Docteur; Howard Oxley
ANO: 2003
RESUMO: This study presents a broad overview of health-system reforms in OECD countries over the past several decades. Reforms are assessed according to their impact on the following policy goals: ensuring access to needed health-care services; improving the quality of health care and its outcomes; allocating an “appropriate” level of pubic sector and economy-wide resources to health care (macroeconomic efficiency); and ensuring that services are provided in a cost-efficient and cost-effective manner (microeconomic efficiency).While nearly all OECD countries have achieved universal coverage of health-care risks, initiatives to address persistent disparities in access are now being undertaken in a number of countries. In light of new evidence of serious problems with health-care quality, many countries have recently introduced reforms intended to improve this, but it is too soon to generalise as to the relative effects of alternative approaches. A variety of instruments aimed at cost control have succeeded in slowing the growth of (particularly public) health-care spending over the 1980s and 1990s but these have not addressed the root causes of growth and health-care spending continues to rise as a share of GDP in most countries. On the other hand, a few countries have been concerned that spending restrictions have gone too far and hurt health system-performance. There is some evidence that supply of health services has become more efficient, particularly in the hospital sector, but scope for further gains exists. A range of measures, such as better payment methods, have improved the microeconomic incentives facing providers. However, introducing improved incentives through a more competitive environment among providers and insurers has proved difficult.
FONTE: Geneva: The World Health Report, 2003. 26 p.
REFERENCIA: WORLD HEALTH ORGANIZATION. Chapter 7: Health Systems: principled integrated care. Geneva: The World Health Report, 2003. 26 p.
362. Chapter 7: Health Systems: principled integrated care.
AUTOR(ES): World Health Organization
ANO: 2003
RESUMO:
FONTE: Geneva: The World Health Report, 2003. 26 p.
REFERENCIA: WORLD HEALTH ORGANIZATION. Chapter 7: Health Systems: principled integrated care. Geneva: The World Health Report, 2003. 26 p.
363. What are the best strategies for ensuring quality in hospitals?
AUTOR(ES): John Ovretveit
ANO: 2003
RESUMO: Ensuring the safety of patients and personnel and improving quality have become important objectives for national health systems in developed and developing countries alike, in response to research highlighting poor quality, increasing patient expectations, and media reports. There is a general belief, supported by growing research literature, that there are effective methods to improve quality and safety. This report is HEN’s response to a question from a decision-maker. It provides a synthesis of the best available evidence, including a summary of the main findings and policy options related to the issue. HEN, initiated and coordinated by the WHO Regional Office for Europe, is an information service for public health and health care decision-makers in the WHO European Region. Other interested parties might also benefit from HEN.
FONTE: Stockholm: Who Regional Office For Europe, 2003. 25 p.
REFERENCIA: OVRETVEIT, John. What are the best strategies for ensuring quality in hospitals? Stockholm: Who Regional Office For Europe, 2003. 25 p.
364. The pursuit of equity in NHS resource allocation: should morbidity replace utilisation as the basis for setting health care capitations?
AUTOR(ES): Sheena Asthana; Alex Gibson; Graham Moon; John Dicker; Philip Brigham
ANO: 2004
RESUMO: Although the English NHS has been described as a world leader in pioneering methods of distributing expenditure in relation to population needs, concerns about the legitimacy of using the current utilisation-based model to allocate health service resources are mounting. In this paper, we present a critical review of NHS resource allocation in England and demonstrate the feasibility and impact of using direct health estimates as a basis for setting health care capitations. Comparing target allocations for the inpatient treatment of coronary heart disease in a sample of 34 primary care trusts in contrasting locations in England, we find that a morbidity-based model would result in a significant shift in hospital resources away from deprived areas, towards areas with older demographic profiles and towards rural areas. Discussing the findings in relation to a wider policy context that is generally concerned to direct more health care resources towards the poor, the paper concludes by calling for greater clarity between the goals of health care equity and health equity. Whilst the former demands that the legitimate needs of demographically older populations for more health care resources are acknowledged, the goal of health equity requires real political commitment to resource broader social policy initiatives.
FONTE: Social Science & Medicine, Oxford, v. 58, n. 3, p.539-551, 2004.
REFERENCIA: ASTHANA, Sheena et al. The pursuit of equity in NHS resource allocation: should morbidity replace utilisation as the basis for setting health care capitations?. Social Science & Medicine, Oxford, v. 58, n. 3, p.539-551, 2004.
365. Exclusión en Salud en países de América Latina Y el Caribe.
AUTOR(ES): Organizacion Panamericana de la Salud
ANO: 2003
RESUMO:
FONTE: Washington: OPS, 2003. 127 p.
REFERENCIA: ORGANIZACION PANAMERICANA DE LA SALUD. Exclusión en Salud en países de América Latina Y el Caribe. Washington: OPS, 2003. 127 p. (Extensión de la Protección Social en Salude n° 1).
366. Measuring geographic inequities in the Portuguese health care system: an estimation of hospital care needs.
AUTOR(ES): Monica Duarte Oliveira; Gwyn Bevan
ANO: 2003
RESUMO: Portugal created a NHS to achieve greater equity of access to health care. Successive governments continued to assert the importance of equity in the face of evidence of inequities in supply of hospital resources, but lacked methods to provide sound information on the degree of inequities in Portugal and hence how to achieve greater equity. Capitation formulae have been increasingly used in other countries with a NHS to measure geographical inequities and allocate resources to reduce them. The main objective of this paper was to develop a capitation formula to measure need for hospital care for the Portuguese system by transferring this technology from methods used in other countries, and, in particular, in England. We find, however, problems with the common use of standardised mortality ratios (SMRs) as a measure of need and found age-specific mortality ratios to offer more soundly-based estimates. We also raise questions on the use of empirical estimates of utilisation of health care by age and sex as they appear to reflect inadequacies of health care in Portugal. We also believe it is important to improve knowledge of health insurance and care outside the NHS. Our results show that there are considerable inequities on the distribution of hospital resources in Portugal.
FONTE: Health Policy, Limerick, v. 66, n. 3, p.277-293, dez. 2003.
REFERENCIA: OLIVEIRA, Monica Duarte; BEVAN, Gwyn. Measuring geographic inequities in the Portuguese health care system: an estimation of hospital care needs. Health Policy, Limerick, v. 66, n. 3, p.277-293, dez. 2003.
367. Knowledge for better health: a conceptual framework and foundation for health research systems.
AUTOR(ES): Tikki Pang; Ritu Sadana; Steve Hanney; Zulfiqar A. Bhutta; Adnan A. Hyder; Jonathon Simon
ANO: 2003
RESUMO: Health research generates knowledge that can be utilized to improve health system performance and, ultimately, health and health equity. We propose a conceptual framework for health research systems (HRSs) that defines their boundaries, components, goals, and functions. The framework adopts a systems perspective towards HRSs and serves as a foundation for constructing a practical approach to describe and analyse HRSs. The analysis of HRSs should, in turn, provide a better understanding of how research contributes to gains in health and health equity. In this framework, the intrinsic goals of the HRS are the advancement of scientific knowledge and the utilization of knowledge to improve health and health equity. Its four principal functions are stewardship, financing, creating and sustaining resources, and producing and using research. The framework, as it is applied in consultation with countries, will provide countries and donor agencies with relevant inputs to policies and strategies for strengthening HRSs and using knowledge for better health.
FONTE: Bulletin Of The World Health Organization, Geneva, v. 81, n. 11, p.815-820, 2003.
REFERENCIA: PANG, Tikki et al. Knowledge for better health: a conceptual framework and foundation for health research systems. Bulletin Of The World Health Organization, Geneva, v. 81, n. 11, p.815-820, 2003.
368. Comparative evaluation of indicators for gender equity and health.
AUTOR(ES): Vivian Lin; Su Gruszin; Cara Ellickson; John Glover; Kate Silburn; Gai Wilson and Carolyn Poljski.
ANO: 2007
RESUMO: Objectives: This paper reports on a comparative evaluation of indicators that are in use, or proposed for use, by leading inter- national organizations to assess their adequacy for the purpose of monitoring key issues related to gender, equity and health. Methods: A comprehensive health information framework was developed on a generic framework by the ISO (2001) to use for the analysis of gender equity within mainstream health systems. A sample of 1 095 indicators used by key international organizations were mapped to this framework and assessed for technical quality and gender sensitivity. Results: The evaluation found de ciencies in the indicators currently in use, from the viewpoint of both technical quality and underlying conceptual bases, as well as in their coverage of the framework, and especially in relation to health system performance. Conclusions: Routine administrative reporting offered large numbers of indicators but these did not allow for monitoring of gender equity and health. The paper concludes that there is merit in developing a core set of leading indicators that can be used for comparisons across peer countries and communities.
FONTE: International Journal Of Public Health, Birkhäuser, v. 52, n. , p.19-26, 2007.
REFERENCIA: LIN, Vivian et al. Comparative evaluation of indicators for gender equity and health. International Journal Of Public Health, Birkhäuser, v. 52, n. , p.19-26, 2007.
369. Social determinants of health. The solid facts. Second edition.
AUTOR(ES): Richard Wilkinson; Marmot Michael
ANO: 2003
RESUMO:
FONTE: Copenhagen: World Health Organization. Regional Office For Europe, 2003. 31 p.
REFERENCIA: WILKINSON, Richard; MICHAEL, Marmot. Social determinants of health. The solid facts: second edition. 2. ed. Copenhagen: World Health Organization. Regional Office For Europe, 2003. 31 p.
370. Achieving equity in the Australian healthcare system.
AUTOR(ES): Stephen R Leeder
ANO: 2003
RESUMO:
FONTE: The Medical Journal Of Australia, Pyrmont, v. 179, n. 9, p.475-478, 3 nov. 2003.
REFERENCIA: LEEDER, Stephen R. Achieving equity in the Australian healthcare system. The Medical Journal Of Australia, Pyrmont, v. 179, n. 9, p.475-478, 3 nov. 2003.
371. Monitoring equity in health and healthcare: a conceptual framework.
AUTOR(ES): Paula A. Braveman
ANO: 2003
RESUMO: This paper aims at articulating a conceptual framework for monitoring equity in health and healthcare. The focus is on four main questions: What is health equity? What is monitoring? What are the essential components of a system for monitoring health equity? and Why monitor health equity? Monitoring equity in health and healthcare requires comparing indicators of health and its social determinants among social groups with different levels of underlying social advantage, i.e. groups who occupy different positions in a social hierarchy. A framework is presented for formulating the key questions, defining the social groups to be compared, and selecting the health indicators and measures of disparity that are fundamental to monitoring health equity. Although monitoring health equity is a scientific endeavour, its fundamental objective is guided by values; technical challenges should be addressed as part of a broader strategy to confront the political obstacles to greater equity.
FONTE: Journal Of Health, Population, And Nutrition, Bangladesh, v. 21, n. 3, p.181-192, out. 2003.
REFERENCIA: BRAVEMAN, Paula A.Monitoring equity in health and healthcare: a conceptual framework. Journal Of Health, Population, And Nutrition, Bangladesh, v. 21, n. 3, p.181-192, out. 2003.
372. Is the NHS equitable? A review of the evidence.
AUTOR(ES): Anna Dixon; Julian Le Grand; John Henderson; Richard Murray; Emmi Poteliakhoff
ANO: 2003
RESUMO:
FONTE: LSE Health And Social Care, 2003. 38 p.
REFERENCIA: DIXON, Anna et al. Is the NHS equitable?: a review of the evidence. London: LSE Health And Social Care, 2003. 38 p.
373. Tackling socioeconomic inequalities in health: analysis of European experiences.
AUTOR(ES): Johan P. Mackenbach; Martijntje J. Bakker
ANO: 2003
RESUMO: Effective strategies must be developed to reduce socioeconomic inequalities in health. Most efforts take place in isolation, and only the UK experience has been discussed widely in international published work. We therefore analysed policy developments on health inequalities in different European countries between 1990 and 2001. We noted that countries are in widely different phases of awareness of, and willingness to take action on, inequalities in health. We identified innovative approaches in five main areas: policy steering mechanisms; labour market and working conditions; consumption and health-related behaviour; health care; and territorial approaches. National advisory committees in the UK, the Netherlands, and Sweden have proposed comprehensive strategies to reduce health inequalities. Variations between these packages suggest that policymaking in this area still is largely intuitive and would benefit from incorporation of more rigorous evidence-based approaches. Further international exchanges of experiences with development, implementation, and evaluation of policies and interventions to reduce health inequalities can help to enhance learning speed.
FONTE: The Lancet, New York, v. 362, n. 9393, p.1409-1414, 25 out. 2003.
REFERENCIA: MACKENBACH, Johan P.; BAKKER, Martijntje J.Tackling socioeconomic inequalities in health. The Lancet, New York, v. 362, n. 9393, p.1409-1414, 25 out. 2003.
374. Health Systems Performance Assessment: debates, methods and empiricism.
AUTOR(ES): Christopher J. L. Murray; David B.Evans
ANO: 2003
RESUMO: Decision-makers in countries around the world face a series of common problems as they aim to make appropriate choices to improve the performance of their health systems. With eight per cent of the world’s economic output invested in health systems, the way these systems are organized to collect resources and transform them into services for people in need can profoundly influence health outcomes for populations. Yet the scientific evidence-base to inform critical health system decisions is much weaker than the evidence-base to inform individual clinical decisions. Policy advice on health system development has, until recently, been based on case-studies and, sometimes, ideology. Case-studies can be useful partly because health systems and cultures all differ in many ways. There is a great deal of knowledge, however, to be gained from the experiences of groups of countries taken together, learning from common experience.
FONTE: Geneva: World Health Organization, 2003. 35 p.
REFERENCIA: MURRAY, Christopher J. L.; B.EVANS, David. Health systems performance assessment: debates, methods and empiricism. Geneva: World Health Organization, 2003. 917 p.
375. Science or marketing at WHO? A commentary on World Health 2000.
AUTOR(ES): Alan Williams
ANO: 2001
RESUMO:
FONTE: Health Economics, New York, v. 10, n. 2, p.93-100, 09 mar. 2001.
REFERENCIA: WILLIAMS, Alan. Science or marketing at who?: a commentary on world health 2000.Health Economics, New York, v. 10, n. 2, p.93-100, 09 mar. 2001.
376. Proposed strategies for health systems performance assessment.
AUTOR(ES): World Health Organization
ANO: 2001
RESUMO:
FONTE: Geneva: World Health Organization, 2001. 94 p.
REFERENCIA: WORLD HEALTH ORGANIZATION. Proposed strategies for health systems performance assessment. Geneva: World Health Organization, 2001. 94 p.
377. Equity and health sector reforms: can low-income countries escape the medical poverty trap?
AUTOR(ES): Margaret Whitehead; Gö ran Dahlgren; Timothy Evans
ANO: 2001
RESUMO:
FONTE: The Lancet, New York, v. 358, n. 9284, p.833-836, 08 set. 2001.
REFERENCIA: WHITEHEAD, Margaret; DAHLGREN, Göran; EVANS, Timothy. Equity and health sector reforms: can low-income countries escape the medical poverty trap?. The Lancet, New York, v. 358, n. 9284, p.833-836, 08 set. 2001.
378. Causes of inequality in health : who are you? where do you live? or who your parents were?
AUTOR(ES): Adan Wagstaf; Pierella Paci; Heather Joshi
ANO: 2001
RESUMO: Amongst 33-year olds in the UK National Child Development Study (NCDS), ill health (as measured by cardinalised responses to a question on self-assessed health) is concentrated amongst the worse off. We seek to decompose these inequalities in ill health into their socioeconomic causes. In this decomposition, inequalities in health status depend on inequalities in each of the underlying determinants of health and on the elasticities of health status with respect to each of these determinants. We estimate these elasticities using regression models that allow for unobserved heterogeneity at the community level. We find that only 6% of health inequality is accounted for inequalities in unobserved area -level influences, and only 4% by inequalities in parental education and social class. The bulk of health inequality is accounted for by inequalities in income and housing tenure, though inequalities in educational attainment and in maths scores at age 7 also play a part.
FONTE: Washington : The World Bank Policy Research Working Paper, 2001. 20 p. N° 2713.
REFERENCIA: WAGSTAF, Adan; PACI, Pierella; JOSHI, Heather. Causes of inequality in health: who are you? where do you live? or who your parents were?. Washington : The World Bank Policy Research Working Paper, 2001. 20 p. N° 2713.
379. Measuring Equity in Health Care Financing: Reflections on (and Alternatives to) the World Health Organization's Fairness of Financing Index.
AUTOR(ES): Adam Wagstaff
ANO: 1999
RESUMO: The World Health Organization's latest World Health Report proposes an index of fairness in health care financing. The index's chief weakness is that it cannot discriminate among progressive, regressive, and horizontally inequitable health financing systems. An alternative approach proposed in the early 1990s is shown to do a better job. In its latest World Health Report, the World Health Organization (WHO) argues that a key dimension of a health system's performance is the fairness of its financing system. The report discusses how policymakers can improve this aspect of performance, proposes an index of fairness, discusses how it should be put into operation, and presents a league table of countries ranked by the fairness with which their health services are financed. Wagstaff shows that the WHO index cannot discriminate between health financing systems that are regressive and those that are progressive - and cannot discriminate between horizontal inequity and progressiveness or regressiveness. The index cannot tell policymakers whether it deviates from 1 (complete fairness) because households with similar incomes spend different amounts on health care (horizontal inequity) or because households with different incomes spend different proportions of their income on health care vertical inequity, given the WHO's interpretation of the ability-to-pay principle) - although the two have different policy implications. With the WHO's index, progressiveness and regressiveness are both treated as unfair. This makes no sense, because policymakers who may be strongly averse to regressive payments (which worsen income distribution) may in the name of fairness be quite receptive to progressive payments (requiring that the better-off, who may be willing to spend proportionately more on health care, are required to pay proportionately more). Wagstaff compares the WHO index with an alternative and more illuminating approach developed in the income redistribution literature in the early 1990s and used in the late 1990s to study the fairness of various OECD health care financing systems.
FONTE: World Bank Policy Research Working Paper, 1999. 23 p. N° 2550.
REFERENCIA: WAGSTAFF, Adam. Measuring equity in health care financing: reflections on (and alternatives to) the world health organization. Washington: The World Bank Policy Research Working Paper, 1999. 23 p. N° 2550.
380. Explaining trends in inequities: evidence from Brazilian child health studies.
AUTOR(ES): Cesar G Victora; J. Patrick Vaughan; Fernando C Barros; Anamaria C Silva; Elaine Tomasi
ANO: 2002
RESUMO: There is considerable international concern that child-health inequities seem to be getting worse between and within richer and poorer countries. The “inverse equity hypothesis” is proposed to explain how such health inequities may get worse, remain the same, or improve over time. We postulate that as new public-health interventions and programmes initially reach those of higher socioeconomic status and only later affect the poor, there are early increases in inequity ratios for coverage, morbidity, and mortality indicators. Inequities only improve later when the rich have achieved new minimum achievable levels for morbidity and mortality and the poor gain greater access to the interventions. The hypothesis was examined using three epidemiological data sets for time trends in child-health inequities within Brazil. Time trends for inequity ratios for morbidity and mortality, which were consistent with the hypothesis, showed both improvements and deterioration over time, despite the indicators showing absolute improvements in health status between rich and poor.
FONTE: The Lancet, New York, v. 356, n. 1935, p.1093-1098, 23 set. 2000.
REFERENCIA: VICTORA, Cesar G et al. Explaining trends in inequities: evidence from Brazilian child health studies. The Lancet, New York, v. 356, n. 1935, p.1093-1098, 23 set. 2000.
381. Comparison of Health Care System Views and Experiences in Five Nations, 2001: Based on Commonwealth Fund 2001 International Health Policy Survey.
AUTOR(ES): Cathy Schoen; Robert J. Blendon; Catherine M. DesRoches; Robin Osborn
ANO: 2002
RESUMO:
FONTE: The Commonwealth Fund, New York, p.1-6, maio 2002.
REFERENCIA: SCHOEN, Cathy. Comparison of health care systemviews and experiences in five nations, 2001: based on commonwealth fund 2001 international health policy survey. The Commonwealth Fund, New York, p.1-6, maio 2002.
382. Estudo da assistência hospitalar pública e privada em bases populacionais, 1986-1996.
AUTOR(ES): Juan Stuardo Yazlle Rocha; Breno José Guanais Simoes
ANO: 1999
RESUMO: Introdução Tendo em vista que esta última década é o período da criação e implantação do Sistema Único de Saúde (SUS) - público, universal e equânime - com o objetivo de corrigir distorções da estrutura dos serviços e oferecer ampla cobertura às necessidades de saúde da população, foi estudada a evolução da assistência hospitalar pública e privada, em bases populacionais, no período de criação e implantação do SUS. Métodos Foram estudadas 984.142 internações nos hospitais gerais de Ribeirão Preto no período 1986 a 1996, selecionando aquelas dos residentes no próprio município. As internações são classificadas segundo o sistema de financiamento em particulares, de pré-pagamento e do SUS. Estudou-se a composição social dos pacientes de cada sistema assistencial e o perfil de morbidade hospitalar. Resultados e Conclusões Observou-se crescimento contínuo de hospitalizações, tanto em número absoluto como em coeficiente por mil habitantes, passando de 43.773 a 55.844 internações ao ano. Todavia, estudando as categorias das internações, verificou-se que as particulares apresentaram redução em números absolutos e em coeficiente por habitantes - de 3.181 e 7,3 para 2.215 e 3,9; as internações do SUS oscilaram apresentando decréscimo de um terço em números absolutos e percentualmente passando de 33.254 e 76,0 para 29.373 e 51,7 ao final do período. Ao contrário destas, as internações por sistemas de pré-pagamento triplicaram em números absolutos e duplicaram em coeficiente de 7.338 e 16,8 para 25.256 e 44,4. A assistência do SUS foi consumida principalmente por trabalhadores manuais não qualificados e semiqualificados, ficando os profissionais, técnicos, não manuais e qualificados manuais, com serviços privados. A morbidade hospitalar dos pacientes SUS foi diferente do perfil de morbidade dos pacientes dos sistemas privados. A política de saúde no período, limitando o financiamento do SUS, reprimindo demanda e desestimulando os prestadores privados a trabalhar com pacientes SUS levou a uma seletividade negativa para o SUS. O resultado foi que aumentou a diferença nos padrões de assistência entre os serviços públicos e privados.
FONTE: Revista de Saúde Pública, São Paulo, v. 33, n. 1, p.44-54, fev. 1999.
REFERENCIA: ROCHA, Juan Stuardo Yazlle; SIMÕES, Breno José Guanais. Estudo da assistência hospitalar pública e privada em bases populacionais, 1986-1996. Revista de Saúde Pública, São Paulo, v. 33, n. 1, p.44-54, fev. 1999.
383. World Health Report 2000: dialogue of the deaf?
AUTOR(ES): Kjeld Mø ller Pedersen
ANO: 2002
RESUMO:
FONTE: Health Economics, New York, v. 11, n. 2, p.93-101, 2002.
REFERENCIA: PEDERSEN, Kjeld Møller. World Health Report 2000: dialogue of the deaf?. Health Economics, New York, v. 11, n. 2, p.93-101, 2002.
384. Lineamientos para la elaboración de perfiles de los sistemas de servicios de salud en los Países de la Región.
AUTOR(ES): Organizacion Panamericana de Salud. Division de Desarrollo de Sistemas y Servicios de Salud
ANO: 2000
RESUMO:
FONTE: Washington: OPAS, 2000. 71 p.
REFERENCIA: ORGANIZACION PANAMERICANA DE SALUD; DIVISIÓN DE DESARROLLO DE SISTEMAS Y SERVICIOS DE SALUD. Lineamientos para la elaboración de perfiles de los sistemas de servicios de salud en los Países de la Región. 2. ed. Washington: OPAS, 2000. 71 p.
385. Funciones esenciales de salud pública.
AUTOR(ES): Organizacion Panamericana de Salud; Organizació n Mundial de la Salud
ANO: 2000
RESUMO:
FONTE: Washington: OPAS/OMS, 2000. 12 p.
REFERENCIA: ORGANIZACION PANAMERICANA DE SALUD; ORGANIZACIÓN MUNDIAL DE LA SALUD. Funciones esenciales de salud pública. Washington: OPAS/OMS, 2000. 12 p.
386. Medindo as desigualdades em saúde no Brasil: Uma proposta de monitoramento.
AUTOR(ES): André Nunes; James Richard Silva Santos; Rita Barradas Barata; Solon Magalhã es Vianna
ANO: 2001
RESUMO:
FONTE: Brasília: Organização Pan-americana da Saúde, 2001. 224 p.
REFERENCIA: NUNES, André et al. Medindo as desigualdades em saúde no Brasil: uma proposta de monitoramento. Brasília: Organização Pan-americana da Saúde, 2001. 224 p.
387. Avaliação de programas, serviços e tecnologias em saúde.
AUTOR(ES): Hillegonda Maria D Novaes
ANO: 2000
RESUMO: A área de avaliação de programas, serviços e tecnologias em geral e na saúde, em particular, passa por um processo de expansão e diversificação conceitual e metodológica, bem como por uma crescente demanda para se constituir em instrumento de apoio às decisões necessárias à dinâmica dos sistemas e serviços de saúde, na implementação das políticas de saúde. Apoiando-se em uma revisão da literatura internacional especializada, e tomando por referência a década de 90, foram identificados os critérios nucleares que organizam os processos de avaliação, articulando-os com os recortes adotados pelas principais tipologias de avaliação, atualmente institucionalizadas nos países desenvolvidos, avaliação de programas, avaliação e garantia de qualidade em serviços e avaliação de tecnologias. A participação brasileira no desenvolvimento metodológico da área também é analisada.
FONTE: Revista de Saúde Pública, São Paulo, v. 34, n. 5, p.547-559, 2000.
REFERENCIA: NOVAES, Hillegonda Maria D.Avaliação de programas, serviços e tecnologias em saúde. Revista de Saúde Pública, São Paulo, v. 34, n. 5, p.547-559, 2000.
388. Health inequalities and social group differences: what should we measure?
AUTOR(ES): C.J.L. Murray; E.E. Gakidou; J. Frenk
ANO: 1999
RESUMO: Both health inequalities and social group health differences are important aspects of measuring population health. Despite widespread recognition of their magnitude in many high- and low-income countries, there is considerable debate about the meaning and measurement of health inequalities, social group health differences and inequities. The lack of standard definitions, measurement strategies and indicators has and will continue to limit comparisons--between and within countries, and over time--of health inequalities, and perhaps more importantly comparative analyses of their determinants. Such comparative work, however, will be essential to find effective policies for governments to reduce health inequalities. This article addresses the question of whether we should be measuring health inequalities or social group health differences. To help clarify the strengths and weaknesses of these two approaches, we review some of the major arguments for and against each of them.
FONTE: Bulletin Of The World Health Organization, Geneva, v. 77, n. 7, p.537-543, 1999.
REFERENCIA: MURRAY, C.j.l.; GAKIDOU, E.e.; FRENK, J.. Health inequalities and social group differences: what should we measure?. Bulletin Of The World Health Organization, Geneva, v. 77, n. 7, p.537-543, 1999.
389. Portaria Nº 723/GM de 10 Maio 2001
AUTOR(ES): Ministé rio da Saú de. Secretaria de Vigilâ ncia em Saú de
ANO: 2001
RESUMO:
FONTE: Brasília: 2001. 13 p.
REFERENCIA: BRASIL. Ministério da Saúde. Portaria Nº 723/GM de 10 Maio 2001. Brasília: 2001. 13 p.
390. The influence of income on health: views of an epidemiologist
AUTOR(ES): Michael Marmot
ANO: 2002
RESUMO: Income is related to health in three ways: through the gross national product of countries, the income of individuals, and the income inequalities among rich nations and among geographic areas. A central question is the degree to which these associations reflect a causal association. If so, redistribution of income would improve health. This paper discusses two ways in which income could be causally related to health: through a direct effect on the material conditions necessary for biological survival, and through an effect on social participation and opportunity to control life circumstances. The fewer goods and services are provided publicly by the community, the more important individual income is for health. Under present U.S. circumstances, a policy of counteracting growing income inequalities through the tax and benefit system and of public provision appears justified.
FONTE: Health Affairs, Philadelphia, v. 21, n. 2, p.31-46, 2002.
REFERENCIA: MARMOT, Michael. The influence of income on health: views of an epidemiologist. Health Affairs, Philadelphia, v. 21, n. 2, p.31-46, 2002.
391. Vertical equity: weighting outcomes? or establishing procedures?
AUTOR(ES): Gavin Mooney; Stephen Jan
ANO: 1997
RESUMO: Considerations of equity in the health policy literature have in the main focussed on horizontal equity (the equal treatment of equals) and as a consequence have tended to overlook vertical equity (the unequal, but equitable, treatment of unequals). There is evidence from earlier, if preliminary, work carried out by the authors and a colleague that health care decision makers may well want to embrace concerns for vertical equity in the allocation of health service resources. This paper examines some possibilities for incorporating vertical equity into health care policy through distributive and/or procedural justice. While no firm solutions are offered, it is suggested that the idea of fitting John Broome's notion of 'claims' within a communitarian framework holds promise.
FONTE: Health Policy, Limerick, v. 39, n. 1, p.79-87, 1997.
REFERENCIA: MOONEY, Gavin; JAN, Stephen. Vertical equity: weighting outcomes? or establishing procedures?. Health Policy, Limerick, v. 39, n. 1, p.79-87, 1997.
392. Comparing measures of health inequality.
AUTOR(ES): Orly Manor; Sharon Matthews; Chris Power
ANO: 1997
RESUMO: Several methods are available to measure social inequalities in health. This paper discusses the advantages and disadvantages of different approaches, in particular the odds ratio, the slope and alpha. These methods are illustrated using data from subjects in the 1958 British birth cohort. The inequality measures are compared using health status at ages 23 and 33. Six health indicators are examined, including self-rated health, limiting long-standing illness, psychological health, respiratory symptoms, asthma and obesity. Two social indicators are compared, namely class at birth and educational qualifications. Conclusions do not differ substantially using the three methods for measuring inequality. However, consistent differences were evident between the measures of social position, with greater inequalities apparent for educational qualifications. Choice of social indicator therefore appears to be of primary importance in measuring health inequality.
FONTE: Social Science & Medicine, Oxford v. 45, n. 5, p.761-771, set. 1997.
REFERENCIA: MANOR, Orly; MATTHEWS, Sharon; POWER, Chris. Comparing measures of health inequality. Social Science & Medicine, Oxford v. 45, n. 5, p.761-771, set. 1997.
393. Measuring the magnitude of socio-economic inequalities in health: an overview of available measures illustrated with two examples from Europe.
AUTOR(ES): Johan P. Mackenbach; Anton E. Kunst
ANO: 1997
RESUMO: In this paper we review the available summary measures for the magnitude of socio-economic inequalities in health. Measures which have been used differ in a number of important respects, including (1) the measurement of "relative" or "absolute" differences; (2) the measurement of an "effect" of lower socio-economic status, or of the "total impact" of socio-economic inequalities in health upon the health status of the population; (3) simple versus sophisticated measurement techniques. Based on this analysis of summary measures which have previously been applied, eight different classes of summary measures can be distinguished. Because measures of "total impact" can be further subdivided on the basis of their underlying assumptions, we finally arrive at 12 types of summary measure. Each of these has its merits, and choice of a particular type of summary measure will depend partly on technical considerations, partly on one's perspective on socio-economic inequalities in health. In practice, it will often be useful to compare the results of several summary measures. These principles are illustrated with two examples: one on trends in the magnitude of inequalities in mortality by occupational class in Finland, and one on trends in the magnitude of inequalities in self-reported morbidity by level of education in the Netherlands.
FONTE: Social Science & Medicine, Oxford, v. 44, n. 6, p.757-771, 1997.
REFERENCIA: MACKENBACH, Johan P.; KUNST, Anton E.Measuring the magnitude of socio-economic inequalities in health: an overview of available measures illustrated with two examples from Europe. Social Science & Medicine, Oxford, v. 44, n. 6, p.757-771, 1997.
394. Measuring results of health sector reform for system: A handbook of indicators.
AUTOR(ES): James C. Knowles; Charlotte Leighton: Wayne Stenson
ANO: 1997
RESUMO: This handbook presents indicators for five key dimensions of health system performance: access, equity, quality, efficiency, and sustainability. These performance measures are considered within a framework that maps the linkages between health sector reform, changes in health system performance, and ultimately, changes in health status. It also provides a rationale for focusing on system performance as one of the principal ways to measure results of health sector reform. Through definitions and discussion of each of the five key dimensions, and then presentation and explanation of the indicators themselves, the handbook attempts to make the indicators understandable, accessible, and usable in a way that will bring the intended results. The indicators focus on health system performance—as opposed to specific health services, programs, or health status, for which general consensus about indicators already exists—as a way to measure the results of health care reform in low- and middle-income countries. The handbook brings together what is known and practiced in these countries. It makes no value judgement about approaches to health reform, which may vary widely from country to country, system to system. Rather, it is intended to enable local health professionals and donor organizations to design and implement, and then evaluate and refine health sector reforms based on empirical evidence in order to achieve desired results; and to compare the range and type of results that health sector reform is achieving internationally. Finally, the handbook presents a methodology to select most relevant indicators, depending on intended use in individual countries.
FONTE: Bethesda: Partnerships For Health Reform, 1997. 56 p.
REFERENCIA: KNOWLES, James C.; LEIGHTON, Charlotte; STINSON, Wayne. Measuring results of health sector reform for system: a handbook of indicators. Bethesda: Partnerships For Health Reform, 1997. 56 p. Special Initiatives Report n°1.
395. Estudo da desigualdade na mortalidade hospitalar pelo índice de comorbidade de Charlson.
AUTOR(ES): Nelson Iucif Jr; Juan S Yazlle Rocha
ANO: 2004
RESUMO: OBJETIVO: Avaliar qualidade e eqüidade na assistência à saúde requer métodos de estudo e sistemas de informações adequados. Assim, realizou-se estudo com o objetivo de comparar a mortalidade entre os pacientes idosos atendidos pela rede privada com a dos atendidos pelo Sistema Único de Saúde. MÉTODOS: Foi utilizado um sistema de informações de egressos hospitalares de instituições públicas e privadas e o registro de doenças associadas (comorbidade) além da causa da internação. Foram estudadas 21.695 hospitalizações de pacientes de Ribeirão Preto, SP, internados em 1998 ou 1999, por doenças dos aparelhos circulatório e respiratório. Para análise, segui-se a metodologia preconizada por Charlson, que atribui pontuação para as comorbidades (ICC) e índice comorbidade-idade de Charlson (ICIC) que acrescenta pontuação por década, a partir dos 50 anos de idade. Os pacientes foram estratificados segundo a comorbidade e a década de idade acima de 50 anos, separados os internados pelo SUS dos internados pela rede privada (não-SUS); foi calculado o coeficiente de mortalidade hospitalar para cada estrato. RESULTADOS: Foi observado que o risco de morte aumenta quase seis vezes quando aumenta o número de doenças associadas; o risco de morte é mais do que o dobro para os pacientes do SUS comparados com os do não-SUS — risco relativo 2,12. Associando a comorbidade com a década de idade do paciente foram encontradas diferenças significativas entre pacientes SUS e não-SUS. Quando o risco de morte foi muito baixo ou muito alto não houve diferenças estatísticas entre os pacientes SUS e não-SUS; nas outras situações intermediárias, justamente onde a assistência poderia fazer a diferença, a mortalidade para os pacientes SUS foi maior que o dobro — risco relativo, 2,14. CONCLUSÕES: O diferencial de mortalidade entre os pacientes SUS e não-SUS, segundo os critérios de Charlson, é significativo nos pacientes de risco intermediário, onde o cuidado é mais importante. O Índice de Comorbidade de Charlson tem correlação com a mortalidade hospitalar.
FONTE: Revista de Saúde Pública, São Paulo, v. 38, n. 6, p.780-786, dez. 2004.
REFERENCIA: IUCIF JUNIOR, Nelson; ROCHA, Juan S. Yazlle. Estudo da desigualdade na mortalidade hospitalar pelo índice de comorbidade de Charlson. Revista de Saúde Pública, São Paulo, v. 38, n. 6, p.780-786, dez. 2004.
396. Reforma de los sistemas de salud en América Latina y el Caribe: situación y tendencias.
AUTOR(ES): Alberto Infante; Isabel de la Mata; Daniel Ló pez-Acuñ a
ANO: 2000
RESUMO: A principios de la década de los noventa, casi todos los países de América Latina y el Caribe estaban iniciando, o considerando iniciar, reformas del sector de la salud. El presente trabajo presenta un análisis de la situación de dichas reformas y sus tendencias a finales de la década de los noventa. Para ello los autores han partido de la información contenida en los 20 perfiles de sistemas de servicios de salud concluidos por la Organización Panamericana de la Salud entre agosto de 1998 y octubre de 1999. Siguiendo una metodología empleada con anterioridad, el análisis se organiza en dos niveles: 1) seguimiento de los procesos (dinámica y contenidos) y 2) evaluación de los resultados. En términos de la dinámica de los procesos, el artículo presenta un análisis del contexto y de los actores involucrados en las distintas fases de las reformas: su génesis, diseño y negociación, implementación y evaluación. Respecto a los contenidos de las reformas, se describen y analizan los hallazgos organizados en 12 grandes campos temáticos. La evaluación de los resultados se hace sobre los ocho países que proporcionaron información pertinente y debe considerarse preliminar. No obstante, el artículo presenta información detallada sobre los resultados de las reformas en términos de equidad, efectividad y calidad, eficiencia, sostenibilidad y participación y control sociales. También examina las posibles causas y factores condicionantes de los resultados observados.
FONTE: Revista Panamericana de Salud Pública, Washington, v. 8, n. 1-2, p.13-20, 2000.
REFERENCIA: INFANTE, Alberto; LA MATA, Isabel de; LÓPEZ-ACUÑA, Daniel. Reforma de los sistemas de salud en América Latina y el Caribe: situación y tendencias. Revista Panamericana de Salud Pública, Washington, v. 8, n. 1-2, p.13-20, 2000.
397. WHO health report 2000: inequality index and socioeconomic inequalities in mortality.
AUTOR(ES): Tanja A. J. Houweling; Anton E. Kunst; Johan P. Mackenbach
ANO: 2001
RESUMO: Monitoring of inequality in health has become an increasingly important task of development agencies. We compared the inequality index as published in the World Health Report 2000 with available evidence on socioeconomic inequalities in mortality in 15 industrialised and 43 less-developed countries. We found that the World Health Report index does not correspond with international variations in the size of socioeconomic inequalities in mortality. These findings indicate that the index should not be interpreted as a reflection of socioeconomic inequalities in health, nor should the index be used to replace the indices developed to monitor socioeconomic inequalities in health.
FONTE: The Lancet, New York, v. 357, p.1671-1672, 26 maio 2001.
REFERENCIA: HOUWELING, Tanja A. J.; KUNST, Anton E.; MACKENBACH, Johan P.WHO health report 2000: inequality index and socioeconomic inequalities in mortality. The Lancet, New York, v. 357, p.1671-1672, 26 maio 2001.
398. Health inequalities and the health of the poor: What do we know? What can we do?
AUTOR(ES): D.R.Gwatkin
ANO: 2000
RESUMO: The contents of this theme section of the Bulletin of the World Health Organization on "Inequalities in health'' have two objectives: to present the initial findings from a new generation of research that has been undertaken in response to renewed concern for health inequalities; and to stimulate movement for action in order to correct the problems identified by this research. The research findings are presented in the five articles which follow. This Critical Reflection proposes two initial steps for the action needed to alleviate the problem; other suggestions are given by the participants in a Round Table discussion which is published after these articles. The theme section concludes with extracts from the classic writings of the nineteenth-century public health pioneer, William Farr, who is widely credited as one of the founders of the scientific study of health inequalities, together with a commentary. This Critical Reflection contributes to the discussion of the action needed by proposing two initial steps for action. . That professionals who give very high priority to the distinct but related objectives of poverty alleviation, inequality reduction, and equity enhancement recognize that their shared concern for the distributional aspects of health policy is far more important than any differences that may divide them. . That health policy goals, currently expressed as societal averages, be reformulated so that they point specifically to conditions among the poor and to poor±rich differences. For example, infant mortality rates among the poor or the differences in infant mortality between rich and poor sectors would be more useful indicators than the average infant mortality rates for the whole population.
FONTE: Bulletin Of The World Health Organization, v. 78, n. 1, p.3-18, 2000.
REFERENCIA: GWATKIN,D.R.Health inequalities and the health of the poor: what do we know? what can we do?. Bulletin Of The World Health Organization, v. 78, n. 1, p.3-18, 2000.
399. Financing health care: taxation and the alternatives.
AUTOR(ES): Robert G. Evans
ANO: 2001
RESUMO:
FONTE: Centre for Health Services And Policy Research, 2000. 46 p.
REFERENCIA: EVANS, Robert G.Financing health care: taxation and the alternatives. Centre for Health Services And Policy Research, 2000. 46 p.
400. Policy implications of the gradient of health and wealth.
AUTOR(ES): Angus Deaton
ANO: 2002
RESUMO: Men in the United States with family incomes in the top 5 percent of the distribution in 1980 had about 25 percent longer to live than did those in the bottom 5 percent. Proportional increases in income are associated with equal proportional decreases in mortality throughout the income distribution. I discuss possible reasons for this gradient and ask whether it calls for the redistribution of income in the interest of public health. I argue that the existence of the gradient strengthens the case for income redistribution in favor of the poor but that targeting health inequalities would not be sound policy.
FONTE: Health Affairs, Philadelphia, v. 21, n. 2, p.13-30, 2002.
REFERENCIA: DEATON, Angus. Policy implications of the gradient of health and wealth. Health Affairs, Philadelphia, v. 21, n. 2, p.13-30, 2002.
401. Justice, health, and healthcare.
AUTOR(ES): Norman Daniels
ANO: 2001
RESUMO: Healthcare (including public health) is special because it protects normal functioning, which in turn protects the range of opportunities open to individuals. I extend this account in two ways. First, since the distribution of goods other than healthcare affect population health and its distribution, I claim that Rawls's principles of justice describe a fair distribution of the social determinants of health, giving a partial account of when health inequalities are unjust. Second, I supplement a principled account of justice for health and healthcare with an account of fair process for setting limits of rationing care. This account is provided by three conditions that comprise "accountability for reasonableness."
FONTE: The American Journal Of Bioethics, Cambridge, v. 1, n. 2, p.2-16, 2001.
REFERENCIA: DANIELS, Norman. Justice, health, and healthcare. The American Journal Of Bioethics, Cambridge, v. 1, n. 2, p.2-16, 2001.
402. Health indicators 2001.
AUTOR(ES): Canadian Institute For Helath Information
ANO: 2001
RESUMO:
FONTE: Ottawa: CIHI ICIS, 2001. 14 p.
REFERENCIA: CANADIAN INSTITUTE FOR HEALTH INFORMATION. Health indicators 2001. Ottawa: CIHI ICIS, 2001. 14 p.
403. Social class differences in mortality using the new UK National Statistics Socio-Economic Classification.
AUTOR(ES): Tarani Chandola
ANO: 2000
RESUMO: Social class differences in health in the UK have usually been demonstrated by the Registrar General's social classification (RGSC). It is being replaced by the new UK National Statistics Socio-Economic Classification (NS-SEC). The NS-SEC is explicitly based on differences between employment relations and conditions. The mechanisms underlying social class differences in health remain debatable. Some studies have hypothesised that class differences in work characteristics and employment conditions may explain part of the observed class differences in health. This study investigates the associations of the NS-SEC and other measures of socio-economic status (SES) with mortality outcomes in a 7-year panel study representative of British private households and their members (the British Household Panel Survey, n = 10264). The NS-SEC was neither significantly associated with mortality for respondents of all ages nor with mortality for a younger subsample who were under 65 years at the initial survey. Other measures of SES, especially income and housing tenure showed significant patterns of inequalities in mortality. It may be useful to use other measures of SES along with the NS-SEC when analysing social inequalities in health and mortality.
FONTE: Social Science & Medicine, Oxford v. 50, n. 5, p.641-649, 2000.
REFERENCIA: CHANDOLA, Tarani. Social class differences in mortality using the new UK National Statistics Socio-Economic Classification. Social Science & Medicine, Oxford v. 50, n. 5, p.641-649, 2000.
404. Health inequalities impact assessment.
AUTOR(ES): Donald Acheson
ANO: 2000
RESUMO:
FONTE: Bulletin Of The World Health Organization, v. 78, n. 1, p.75-76, 2000.
REFERENCIA: ACHESON, Donald. Health inequalities impact assessment. Bulletin Of The World Health Organization, v. 78, n. 1, p.75-76, 2000.
405. Social inequalities in health within countries: not only an issue for affluent nations.
AUTOR(ES): Paula Braveman; E. Tarimo
ANO: 2002
RESUMO: While interest in social disparities in health within af uent nations has been growing, discussion of equity in health with regard to low- and middle-income countries has generally focused on north–south and between-country differences, rather than on gaps between social groups within the countries where most of the world’s population lives. This paper aims to articulate a rationale for focusing on within- as well as between-country health disparities in nations of all per capita income levels, and to suggest relevant reference material, particularly for developing country researchers. Routine health information can obscure large inter-group disparities within a country. While appropriately disaggregated routine information is lacking, evidence from special studies reveals signi cant and in many cases widening disparities in health among more and less privileged social groups within low- and middle- as well as high- income countries; avoidable disparities are observed not only across ocioeconomic groups but also by gender, ethnicity, and other markers of underlying social disadvantage. Globally, economic inequalities are widening and, where relevant information is available, generally accompanied by widening or stagnant health inequalities. Related global economic trends, including pressures to cut social spending and compete in global markets, are making it especially dif cult for lower-income countries to implement and sustain equitable policies. For all of these reasons, explicit concerns about equity in health and its determinants need to be placed higher on the policy and research agendas of both international and national organizations in low-, middle-, and high-income countries. International agencies can strengthen or undermine national efforts to achieve greater equity. The Primary Health Care strategy is at least as relevant today as it was two decades ago; but equity needs to move from being largely implicit to becoming an explicit component of the strategy, and progress toward greater equity must be carefully monitored in countries of all per capita income levels.
FONTE: Social Science & Medicine, Oxford, v. 54, n. 11, p.1621-35, jun. 2002.
REFERENCIA: BRAVEMAN, Paula; TARIMO, E. Social inequalities in health within countries: not only an issue for affluent nations. Social Science & Medicine, Oxford, v. 54, n. 11, p.1621-35, jun. 2002.
406. World Health Report 2000: how it removes equity from the agenda for public health monitoring and policy.
AUTOR(ES): Paula Braveman; Barbara Starfield; H Jack Geiger
ANO: 2001
RESUMO:
FONTE: British Medical Journal, London, v. 323, n. 7314, p.678-681, 2001.
REFERENCIA: BRAVEMAN, Paula; STARFIELD, Barbara; GEIGER, H Jack. World Health Report 2000: how it removes equity from the agenda for public health monitoring and policy. British Medical Journal, London, v. 323, n. 7314, p.678-681, 2001.
407. Informações para a gestão do SUS: necessidades e perspectivas.
AUTOR(ES): Ilara Hammerli Sozzi de Moraes; Silvia R.f. Rangel dos Santos
ANO: 2000
RESUMO:
FONTE: Salvador: GTISP/ABRASCO, 2000. p. 1 - 10.
REFERENCIA: MORAES, Ilara Hammerli Sozzi de; SANTOS, Silvia R.f. Rangel dos. Informações para a gestão do SUS: necessidades e perspectivas. In: VI CONGRESSO BRASILEIRO DE SAÚDE COLETIVA, 2000, Salvador. Oficina de Trabalho GTISP/ABRASCO. Salvador: GTISP/ABRASCO, 2000. p. 1 - 10.
408. Annotated Bibliography on Equity in Health, 1980-2001.
AUTOR(ES): James A Macinko; Barbara Starfield
ANO: 2002
RESUMO: The purposes of this bibliography are to present an overview of the published literature on equity in health and to summarize key articles relevant to the mission of the International Society for Equity in Health (ISEqH). The intent is to show the directions being taken in health equity research including theories, methods, and interventions to understand the genesis of inequities and their remediation. Therefore, the bibliography includes articles from the health equity literature that focus on mechanisms by which inequities in health arise and approaches to reducing them where and when they exist.
FONTE: International Journal For Equity In Health, London, v. 1, n. 1, p.1-20, 2002.
REFERENCIA: MACINKO, James A.; STARFIELD, Barbara. Annotated Bibliography on Equity in Health, 1980-2001. International Journal For Equity In Health, London, v. 1, n. 1, p.1-20, 2002.
409. O sistema de saúde Brasil.
AUTOR(ES): Programa de Organizaç ã o e Gestã o dos Sistemas e Serviç os de Saú de; Divisao de Desenvolvimento dos Sistemas e Serviç os de Saú de; Organizaç ã o Pan-America da Saú de
ANO: 2001
RESUMO:
FONTE: OPS, 2001. 35 p.
REFERENCIA: ORGANIZAÇÃO PAN-AMERICA DA SAÚDE; PROGRAMA DE ORGANIZAÇÃO E GESTÃO DOS SISTEMAS E SERVIÇOS DE SAÚDE; DIVISAO DE DESENVOLVIMENTO DOS SISTEMAS E SERVIÇOS DE SAÚDE.O perfil do sistema de saúde Brasil. 2. ed. OPS, 2001. 35 p.
410. Monitoreo de equidad en el acceso a los servicios básicos de salud: guía metodológica.
AUTOR(ES): Programa de Organizació n y Gestió n de Servicios de Salud; Programa Especial de Aná lisis de situació n de Salud
ANO: 2000
RESUMO: En América Latina y el Caribe (ALC), la situación de salud y el acceso a los servicios de salud difiere enormemente tanto entre los países como en ellos. Aunque se han logrado notables ganancias en mejorar la salud general de la población en la región en los últimos decenios, las inequidades entre grupos de población permanecen e incluso tienden a aumentar. Hay pruebas documentadas en la existencia y la magnitud de inequidades en la salud y la atención de salud, donde quién está en mayor desventaja es el pobre, la población rural, el desempleado, los trabajadores en el sector informal en general y las mujeres en particular. Hay también extensa evidencia sobre la relación entre la privación socioeconómica y el menor acceso y uso de los servicios de atención de salud, junto a un evitable e injusto nivel de enfermedad y muerte.
FONTE: Washington: OPAS/OMS, 2000. 43 p.
REFERENCIA: PROGRAMA DE ORGANIZACIÓN Y GESTIÓN DE SERVICIOS DE SALUD; PROGRAMA ESPECIAL DE ANÁLISIS DE SITUACIÓN DE SALUD. Monitoreo de equidad en el acceso a los servicios básicos de salud: guía metodológica. Washington: OPAS/OMS, 2000. 43 p.
411. Clinical Outcome Indicators Report May 2002.
AUTOR(ES): Clinical resource and audit group
ANO: 2002
RESUMO:
FONTE: Scotland: CRAG, 2002. 238 p.
REFERENCIA: CLINICAL RESOURCE AND AUDIT GROUP. Clinical outcome indicators:report May 2002. Scotland: CRAG, 2002. 238 p.
412. Why Care about Health Inequalities.
AUTOR(ES): Adam Oliver
ANO: 2001
RESUMO:
FONTE: London: Office Of Health Economics, 2001.
REFERENCIA: OLIVER, Adam. Why care about health inequalities. London: Office Of Health Economics, 2001.
413. National Health Performance Framework Report - August 2001.
AUTOR(ES): National Health Performance Committee
ANO: 2001
RESUMO: The purpose of this report is to describe and illustrate a national health performance framework that has been developed by the National Health Performance Committee (NHPC). The framework is expected to support benchmarking for health system improvement and to provide information on national health system performance. The performance framework provides a valuable tool to identify trends and patterns, inform decision making, and evaluate progress of efforts to address health challenges.
FONTE: Queensland: Brisbane, 2001. 66 p.
REFERENCIA: NATIONAL HEALTH PERFORMANCE COMMITTEE. National health performance framework report - August 2001. Queensland: Brisbane, 2001. 66 p.
414. National Report on Health Sector Performance Indicators, 2001.
AUTOR(ES): National Health Performance Committee
ANO: 2002
RESUMO: This fifth National Report on Health Sector Performance Indicators has been prepared by the National Health Performance Committee (NHPC). It follows on from earlier reports authored originally by the National Health Ministers' Benchmarking Working Group, the NHPC's predecessor, and later by the NHPC. Previous reports on 'performance' have focused on health and health service indicators, with many of the indicators relating to institutional care and acute care settings. As part of its Terms of Reference, the NHPC agreed to develop a broad national health performance framework that could be used as the basis for its annual report to Ministers. Results of this work were reflected in the publication in August 2001 of the National Health Performance Framework Report, which outlined the new framework. This 2001 Report is the first report to Ministers on health sector performance based on the new framework. It is a significant milestone as it includes not only indicators relating to health sector performance but also health status and health determinants.
FONTE: Queensland: Brisbane, 2002. 80 p.
REFERENCIA: NATIONAL HEALTH PERFORMANCE COMMITTEE. National report on health sector performance indicators, 2001. Queensland: Brisbane, 2002. 80 p.
415. Assessment of validity of the national public health performance standards: the local public health performance assessment instrument.
AUTOR(ES): Joyce Beaulieu; F. Douglas Scutchfield
ANO: 2002
RESUMO: The National Public Health Performance Standards Program (NPHPSP) has developed performance standards measurement instruments, based on the 10 "Essential Services of Public Health" that are being tested in several states. This article is a report on the face and content validity of the instrument designed for local public health systems. Judgments about the face validity of the standards were obtained in a survey of local public health systems that had used the instrument in a test state. The validity of each standard was addressed along the following dimensions: the importance of the standard as a measure of the Essential Service; its completeness as a measure; and its reasonableness for achievement. All standards for each Essential Service were then judged in terms of their completeness in measuring performance of that service. Respondents judged the standards to be highly valid measures of local public health system performance. Some respondents had reservations about whether standards related to "enforcing laws and regulations" were achievable. Holding local public health systems accountable for the activities of other agencies was a factor mentioned in conjunction with those standards. The NPHPSP standards have face and content validity for measuring local public health system performance. Further testing of their validity and reliability is continuing.
FONTE: Public Health Reports, Rockville, v. 117, n. 1, p.28-36, 2002.
REFERENCIA: BEAULIEU, Joyce; SCUTCHFIELD, F. Douglas. Assessment of validity of the national public health performance standards: the local public health performance assessment instrument. Public Health Reports, Rockville, v. 117, n. 1, p.28-36, 2002.
416. O financiamento do sistema de saúde no Brasil e a busca da eqüidade.
AUTOR(ES): Luiza Sterman Heimann; Umberto Catarino Pessoto; Virginia Junqueira; Iracema Ester do N. Castro; Jorge Kayano; Paulo Roberto do Nascimento; Lauro Cesar Ibanhes; Jucilene Leite da Rocha; Roberta Cristina Boaretto; Juliana Lordello Sí coli; Sandra M. Troitiñ o Rodriguez; Carlos Tato Cortizo.
ANO: 2002
RESUMO: O objetivo deste projeto foi elaborar critérios de alocação de recursos financeiros do Sistema de Saúde brasileiro pelos três níveis de gestão (federal, estadual e municipal), para os sistemas municipais de saúde, visando a eqüidade. No campo do conhecimento, a pesquisa partiu de sistematização de modelos epidemiológico, de avaliação em saúde e da discussão do conceito de eqüidade. Procuramos assim contribuir para o desenvolvimento teórico-metodológico da Saúde Coletiva e no campo da Investigação em Serviços e Sistemas de Saúde para o desenvolvimento metodológico de estudos sobre financiamento em saúde visando a eqüidade.
FONTE: São Paulo: Núcleo de Investigação em Serviços e Sistemas de Saúde, Instituto de Saúde - Secretaria de Estado da Saúde São Paulo, 2002. 13 p.
REFERENCIA: HEIMANN, Luiza Sterman et al. O Financiamento do Sistema de Saúde no Brasil e a Busca da Eqüidade. São Paulo: Núcleo de Investigação em Serviços e Sistemas de Saúde, Instituto de Saúde - Secretaria de Estado da Saúde São Paulo, 2002. 13 p.
417. Guide to Inpatient Quality Indicators: Quality of Care in Hospitals.
AUTOR(ES): AHRQ Quality Indicators
ANO: 2004
RESUMO:
FONTE: Agency For Healthcare Research And Quality, 2004. 95 p.
REFERENCIA: AHRQ QUALITY INDICATORS. Guide to inpatient quality indicators: quality of care in hospit. Rockville: Agency For Healthcare Research And Quality, 2004. 95 p.
418. As especificidades do sistema de inovação do setor saúde: uma resenha da literatura como introdução a uma discussão sobre o caso brasileiro.
AUTOR(ES): Eduardo da Motta e Albuquerque; José Eduardo Cassiolato
ANO: 2000
RESUMO: A motivação para esses estudos veio da constatação de que seria muito relevante para o planejamento de uma política científica nacional na área de saúde saber em que medida o investimento em pesquisa retorna à so-ciedade, ou seja, de que maneira a produção de conhecimento e a capacidade de docência e extensão, que no Brasil são intimamente associadas, estão se refletindo na sociedade.
FONTE: Belo Horizonte: Federação de Sociedades de Biologia Experimental, 2000.
REFERENCIA: ALBUQUERQUE, Eduardo da Motta e; CASSIOLATO, José Eduardo. As especificidades do sistema de inovação do setor saúde: uma resenha da literatura como introdução a uma discussão sobre o caso brasileiro. Belo Horizonte: Federação de Sociedades de Biologia Experimental, 2000.
419. Níveis de oferta e modalidades de contratação para especialidades médicas, Outras profissões de saúde e serviços de apoio diagnóstico e terapêutico na Rede Hospitalar no Estado de São Paulo.
AUTOR(ES): Conselho Regional de Medicina do Estado de SP
ANO: 2002
RESUMO:
FONTE: Belo Horizonte: 2002. 324 p.
REFERENCIA: BRASIL.CONSELHO REGIONAL DE MEDICINA DO ESTADO DE SÃO PAULO.Níveis de oferta e modalidades de contratação para especialidades médicas, outras profissões de saúde e serviços de apoio diagnóstico e terapêutico na rede hospitalar no Estado de São Paulo. Belo Horizonte: 2002. 324 p.
420. Summary measures of population health: concepts, ethics, measurement and applications.
AUTOR(ES): Christopher J.L. Murray; Joshua A. Salomon; Colin D. Mathers; Alan D. Lopez
ANO: 2002
RESUMO: With increasing life expectancy, measuring population health levels on the basis of mortality rates alone has become less and less relevant in many populations. At the same time, societies invest substantial resources in promoting healthy life, in addition to preventing premature death. But how effective have these efforts been? What is the appropriate metric to measure health life expectancy, or for that matter the contribution of different diseases and injuries to potential years of healthy life that are lost due to their occurrence? This book addresses the various approaches and viewpoints as to how mortality and ill-health might be combined into a single index to measure overall population health. The various uses of such summary measures of population health are described, and the appropriate measurement framework and specific ethical and social value choices are discussed and debated. The contributors include leading experts in epidemiological methods, ethics, health economics, health status measurement and the valuation of health states. Summary measures of population health are likely to become increasingly topical and debated and this volume will serve as the fundamental reference for their construction and use for scholars across all public health disciplines.
FONTE: World Health Organization, 2002. 770 p.
REFERENCIA: MURRAY, Christopher J. L. et al. Summary measures of population health: concepts, ethics, measurement and applications.World Health Organization, 2002. 770 p.
421. A conceptual framework to measure performance of the public health system.
AUTOR(ES): A. Handler; M. Issel; B.Turnock
ANO: 2001
RESUMO: OBJECTIVES: This article describes a unifying conceptual framework for the public health system as a way to facilitate the measurement of public health system performance. METHODS: A conceptual framework for the public health system was developed on the basis of the work of Donabedian and a conceptual model previously developed by Bernard Turnock and Arden Handler. RESULTS: The conceptual framework consists of 5 components that can be considered in relationship to each other: macro context, mission, structural capacity, processes, and outcomes. Although the availability of measures for each of these components varies, the framework can be used to examine the performance of public health systems as well as that of agencies and programs. CONCLUSIONS: A conceptual framework that explicates the relationships among the various components of the public health system is an essential step toward providing a science base for the study of public health system performance.
FONTE: American Journal Of Public Health, New York, v. 91, n. 8, p.1235-1239, ago. 2001.
REFERENCIA: HANDLER, A.; ISSEL, M.; B.TURNOCK. A conceptual framework to measure performance of the public health system. American Journal Of Public Health, New York, v. 91, n. 8, p.1235-1239, ago. 2001.
422. Oferta de serviços de saúde: uma análise da pesquisa assistência médico-sanitária (AMS) de 1999.
AUTOR(ES): Francisco Viacava; Lí gia Bahia
ANO: 2002
RESUMO: Este trabalho examina os resultados da Pesquisa Assistência Médico-Sanitária (AMS)de 1999 e, para tanto, considera a expansão da capacidade instalada, as relações entreos serviços públicos e privados e os recursos humanos e tecnológicos incorporados aosestabelecimentos de saúde. A análise comparativa dos dados da AMS 1999 com os daAMS 1992 evidencia certa desaceleração no ritmo de crescimento dos estabelecimentosde saúde ambulatoriais, a estagnação nas taxas de crescimento dos estabelecimentoshospitalares, bem como o incremento considerável de determinadas unidades de saúdeespecializadas. O crescimento da rede de estabelecimentos sem internação, aindaque a taxas menores do que em períodos anteriores, e a redução na oferta de leitoshospitalares relativizam o peso dos hospitais no modelo assistencial brasileiro. Entretanto,verifica-se a permanência de uma oferta de serviços ambulatoriais desigualmentedistribuídos pelas diferentes regiões do país, assim como baixos níveis de especializaçãoe de capacitação tecnológica da rede de serviços disponível para os clientes doSistema Único de Saúde (SUS). As disparidades regionais são entrecruzadas pela distribuiçãomunicipal extremamente complexa de determinados recursos. O excesso oua escassez de recursos assistenciais presentes nas grandes cidades e também no interiordo país, os quais decorrem, possivelmente, de uma demanda diferenciada dos segmentospopulacionais vinculados ao SUS e daqueles segmentos financiados pelos planosprivados de saúde, adicionam novas tensões aos velhos desafios de promover a universalizaçãodo acesso, a integralidade das ações de saúde e a redução das desigualdades sociais.
FONTE: Brasília: IPEA, 2002. 48 p.
REFERENCIA: VIACAVA, Francisco; BAHIA, Lígia. Oferta de serviços de saúde: uma análise da pesquisa assistência médico-sanitária (AMS) de 1999. Brasília: IPEA, 2002. 48 p.
423. Selecting common measures of quality and system performance.
AUTOR(ES): Elizabeth A. McGlynn
ANO: 2003
RESUMO: BACKGROUND: The President's Commission on Consumer Protection and Quality in the Health Care Industry recommended that a common set of quality measures be developed for the nation. The results of such common measures will be used to ensure accountability, select providers, and improve quality. Simultaneous consideration of top-down and bottom-up design requirements are likely to produce a set of measures that will serve policy and front-line information needs. OBJECTIVES: To articulate the criteria and process by which common measures should be selected and to illustrate the results of applying this approach in one clinical area. DESIGN: Discussions among the members of the Strategic Framework Board, development of a clinical logic model for acute myocardial infarction (AMI), and application of the criteria to existing quality measures for AMI. FINDINGS: Measures should: (1) be linked to a national goal, (2) have a clear and compelling use, (3) be parsimonious, (4) not impose undue burden on those providing data, (5) help providers improve care delivery, (6) help stakeholders make more informed decisions, and (7) balance the need for continuous improvement with the stability needed to track progress over time. The use of a clinical logic diagram highlights the importance of selecting measures related to primary and secondary prevention in reducing deaths from heart disease. The resulting measures are useful on the front lines of medicine as well as by consumers and purchasers. CONCLUSIONS: Focusing attention on the information necessary to stimulate progress on national goals provides a compelling framework for the choice of a common set of measures.
FONTE: Medical Care, Philadelphia, v. 41, n. 1, p.39-47, jan. 2003.
REFERENCIA: MCGLYNN, Elizabeth A.Selecting common measures of quality and system performance. Medical Care, Philadelphia, v. 41, n. 1, p.39-47, jan. 2003.
424. Indicadores de Medición del Desempeño del Sistema de Salud.
AUTOR(ES): James C. Knowles; Charlotte Leighton: Wayne Stenson
ANO: 1997
RESUMO: O guia apresenta indicadores sobre cinco dimensöes chaves de desempenho do sistema de saúde: acesso, eqüidade, qualidade, eficiência e sustentabilidade. Estas medidas de desempenho relacionam os vínculos entre a reforma do setor saúde, as mudanças no desempenho do sistema de saúde e no estado da saúde. Os indicadores centram-se no desempenho do sistema de saúde como uma forma de medir os resultados desta reforma em países com receitas financeiras médias e baixas. Os indicadores näo analisam o desempenho dos serviços e programas de saúde, nem emitem juízos acerca dos métodos utilizados na reforma, mas procura capacitar os profissionais locais e as organizaçöes no planejamento e implementaçäo, avaliaçäo e aperfeiçoamento das reformas deste setor, basendo-se em uma evidência empírica que permita obter resultados. O guia apresenta-se como uma metodologia para selecionar os indicadores mais importantes.
FONTE: Iniciativa Regional de Reforma Del Sector de La Salud En América Latina Y El Caribe, 1997. 53 p.
REFERENCIA: KNOWLES, James C.; LEIGHTON, Charlotte; STENSON, Wayne. Indicadores de medición del desempeño del sistema de salud. Iniciativa Regional de Reforma Del Sector de La Salud En América Latina Y El Caribe, 1997. 53 p.
425. Annual Report of the Chief Medical Officer 2002.
AUTOR(ES): Department of Health
ANO: 2003
RESUMO:
FONTE: London: 2003. 68 p.
REFERENCIA: DEPARTMENT OF HEALTH. Annual report of the chief medical officer 2002. London: 2003. 68 p.
426. Tackling health inequalities: A Programme for Action.
AUTOR(ES): Department of Health
ANO: 2003
RESUMO:
FONTE: London: 2003. 84 p.
REFERENCIA: DEPARTMENT OF HEALTH.Tackling health inequalities: a programme for action. London: 2003. 84 p.
427. Common Concerns Amid Diverse Systems: Health Care Experiences In Five Countries.
AUTOR(ES): Robert J. Blendon; Cathy Schoen; Catherine DesRoches; Robin Osborn; Kinga Zapert
ANO: 2003
RESUMO: This article reports on a comparative survey of sicker adults in Australia, Can- ada, New Zealand, the United Kingdom, and the United States. The study finds that despite differences among the health care systems, large proportions of citizens across the five countries report dissatisfaction with their health care system and serious problems includ- ing medical and medication errors, faulty patient-physician communication, and poor care coordination. The most crucial policy implication of these findings is that a focus on a small population of intensive health system users could have the potential to both control costs and improve care.
FONTE: Health Affairs, Philadelphia, v. 22, n. 3, p.106-121, 2003.
REFERENCIA: BLENDON, Robert J. et al. Common concerns amid diverse systems: health care experiences in five countries. Health Affairs, Philadelphia, v. 22, n. 3, p.106-121, 2003.
428. Improving performance using indicators. Recent experiences in the United States, the United Kingdom, and Australia.
AUTOR(ES): Vivienne McLoughlin; Sheila Leartherman; Martin Flectcher; John Wyn Owen
ANO: 2001
RESUMO: This article describes recent national performance improvement initiatives in the United States, United Kingdom, and Australia. This comparison is of particular interest because each of these three countries faces similar challenges in delivering health care and improving health. Each has elevated a focus on safety and quality improvement to a national level. Marked differences in the organization and nancing of health care across these three countries provide a unique opportunity to compare and contrast approaches. Drawing on the experience of the authors in each of the three countries and publicly available data sources about speci c national initiatives, we describe the national context for improvement and outline recent performance improvement initiatives and emerging issues and challenges. Similarities and differences in the current evolution of national performance initiatives are described and conclusions are drawn about challenges that all three countries face, particularly in terms of developing meaningful sets of national indicators of health system performance. The challenges for future work include the importance of information infrastructure, the paucity of accurate and accessible clinical data, the need for effective performance measurement processes at a local level to capture useful data, and the tensions of balancing accountability and improvement agendas for measurement.
FONTE: International Journal For Quality In Health Care, Oxford, v. 13, n. 6, p.455-462, 2001.
REFERENCIA: MCLOUGHLIN, Vivienne et al. Improving performance using indicators: recent experiences in the United States, the United Kingdom, and Australia. International Journal For Quality In Health Care, Oxford, v. 13, n. 6, p.455-462, 2001.
429. The Domains of Health Responsiveness. A Human Rights Analysis.
AUTOR(ES): Lawrence Gostin; James G. Hodge; Nicole B. Valentine; Helena Nygren-Krug
ANO: 2003
RESUMO: In addition to improving health and ensuring equitable financing of health systems, the way health systems interact with individuals can impact on their well-being. Some researchers have termed this area of work "patient experience"; WHO has termed this work health system "responsiveness" and has proposed that a health system's performance in this area also be evaluated alongside the measurement of health system performance with more traditional indicators like mortality, morbidity and utilization statistics. If a health system is responsive, it is possible that interactions people have within the health system will improve their well-being, irrespective of improvements to their health.
FONTE: World Health Organization, 2003. 12 p.
REFERENCIA: GOSTIN, Lawrence et al. The domains of health responsiveness: a Human rights analysis. World Health Organization, 2003. 12 p.
430. Australia's Health 2002.
AUTOR(ES): AIHW, Australian Institute Of Health And Welfare
ANO: 2002
RESUMO:
FONTE: Canberra: Australian Government, 2002. 481.p.
REFERENCIA: AIHW, Australian Institute Of Health And Welfare. Australia's Health 2002. Canberra: Australian Government, 2002. 481 p.
431. Health Indicators 2003: Definitions, Data Sources and Rationale.
AUTOR(ES): Canadian Institute for Health Information
ANO: 2003
RESUMO:
FONTE: Ottawa: CIHI ICIS, 2003. 33 p.
REFERENCIA: CANADIAN INSTITUTE FOR HEALTH INFORMATION .Health Indicators 2003: definitions, data sources and rationale. Ottawa: CIHI ICIS, 2003. 33 p.
432. Methodological concerns and recommendations on policy consequences.
AUTOR(ES): Celia Almeida; Paula Braveman; Marthe R. Gold; Celia L. Szwarcwald; Jose Mendes Ribeiro; Americo Miglionico; John S. Millar; Silvia Porto; Nilson do Rosario Costa; Vincente Ortun Rubio; Malcolm Segall; Barbara Starfield; Claudia Travassos; Maria Alicia Ugá ; Joaquim Valente; Francisco Viacava
ANO: 2001
RESUMO:
FONTE: The Lancet, New York, v. 357, n. 9269, p.1692-1697, 26 maio 2001.
REFERENCIA: ALMEIDA, Célia et al. Methodological concerns and recommendations on policy consequences.The Lancet, New York, v. 357, n. 9269, p.1692-1697, 26 maio 2001.
433. Conference News. Equitable Access to Health Care and Infectious Disease Control: Concepts, Measurement and Interventions.
AUTOR(ES): United Nations Research Institute for Social Development.
ANO: 2007
RESUMO: The objective of the symposium was to stimulate critical debate on current concepts and measurement tools related to access to health care, its relationship to social determinants of health, and the focus on pro-poor programmes. To this end, sessions were devoted to reviewing approaches, definitions and measurements of acces in relation to various dimensions of health care; discussing the relationship between access to health care and social determinants of health; reviewing operational approaches for measuring and improving inequities in access; summarizing existing approaches within the United Nations (UN) system to the construction of indicators and measurement tools around access; highlighting the critical role of research on access to health care for reaching the Millennium Development Goals; and identifying research gaps from a social science research perspective.
FONTE: Geneva: United Nations Research Institute for Social Development; 2007.
REFERENCIA: UNITED NATIONS RESEARCH INSTITUTE FOR SOCIAL DEVELOPMENT. Conference news. Equitable access to health care and infectious disease control: concepts, measurement and interventions. Geneva: United Nations Research Institute for Social Development; 2007.
434. Health care quality indicators project 2006 data collection update report.
AUTOR(ES): Sandra Garcia Armesto; Maria Luisa Gil Lapetra; Lihan Wei; Edward Kelley and the Members of the HCQI Expert Group.
ANO: 2007
RESUMO: This report is an update to the OECD Health Working Paper No. 22, Health Care Quality Indicators Project: Initial Indicators Report that was based on data collected between 2003 and 2005 and released in 20064 .
FONTE: Paris: OECD Health Technical Papers, 2007. 157 p.
REFERENCIA: ARMESTO, Sandra Garcia et al. Health care quality indicators project 2006: data collection update report. Paris: OECD Health Technical Papers, 2007. 157 p.
435. Inequalities in health in Scotland: what are they and what can we do about them?
AUTOR(ES): Sally Macintyre
ANO: 2007
RESUMO:
FONTE: MRC Social And Public Health Sciences Unit, Glasgow, n. 17, p.1-16, 2007.
REFERENCIA: MACINTYRE, Sally. Inequalities in health in Scotland: what are they and what can we do about them? MRC Social And Public Health Sciences Unit, Glasgow, n. 17, p.1-16, 2007.
436. The social determinants of health:Developing an evidence base for political action.
AUTOR(ES): Michael P. Kelly; Antony Morgan; Josiane Bonnefoy; Vivian Bergman; Jennifer Butt.
ANO: 2007
RESUMO: This report begins by identifying six problems which make developing the evidence base on the social determinants of health potentially difficult. These are: lack of precision in specifying causal pathways; merging the causes of health improvement with
FONTE: World Health Organization, 2007. 165 p.
REFERENCIA: KELLY, Michael P. The social determinants of health: developing an evidence base for political action. World Health Organization, 2007. 165 p.
437. Improved health system performance through better care coordination.
AUTOR(ES): Maria M. Hofmarcher; Howard Oxley; Elena Rusticelli
ANO: 2007
RESUMO: This report attempts to assess whether -- and to what degree ñ better care coordination can improve health system performance in terms of quality and cost-efficiency.
FONTE: Paris: OECD Health Technical Papers, 2007. 85 p.
REFERENCIA: HOFMARCHER, Maria M.; OXLEY, Howard; RUSTICELLI, Elena. Improved health system performance through better care coordination. Paris: OECD Health Technical Papers, 2007. 85 p.
438. Health Systems Assessment Approach: a How-To Manual.
AUTOR(ES): Mursaleena Islam
ANO: 2007
RESUMO: This approach is designed to provide a rapid and yet comprehensive assessment of key health systems functions. The approach is organized around technical modules that guide data collection, and cover the following áreas:Governance, Health financing.
FONTE: Arlington: Management Sciences For Health, 2007.
REFERENCIA: ISLAM, Mursaleena. Health Systems Assessment Approach: a how-to manual. Arlington: Management Sciences For Health, 2007.
439. Promotion and protection of all human rights, civil, political, economic, social and cultural rights, including the right to development.
AUTOR(ES): United Nations Human Rights Council.
ANO: 2008
RESUMO: The report briefly identifies some of the historical landmarks in the development of health systems, such as the Declaration of Alma-Ata on primary health care (1978).
FONTE: United Nations High Commissioner For Human Rights, 2008. 28 p.
REFERENCIA: UNITED NATIONS HUMAN RIGHTS COUNCIL. Promotion and protection of all human rights, civil, political, economic, social and cultural rights, including the right to development. United Nations High Commissioner For Human Rights, 2008. 28 p.
440. National Healthcare Disparities Report - 2007.
AUTOR(ES): Agency for Healthcare Research and Quality. AHRQ.
ANO: 2008
RESUMO: The National Healthcare Disparities Report (NHDR) describes the quality of and access to care for multiple subgroups across the United States, and also represents a source of information for tracking the Nation’s progress over time.
FONTE: Rockville: U.S.Departament Of Health And Humam Services, 2008. 244 p.
REFERENCIA: AGENCY FOR HEALTHCARE RESEARCH AND QUALITY. National Healthcare Disparities Report - 2007. Rockville: U.S.Departament Of Health And Humam Services, 2008. 244 p.
441. The Good Indicators Guide: understanding how to use and choose indicators.
AUTOR(ES): David Pencheon
ANO: 2008
RESUMO: This short guide focuses on the key principles behind developing, understanding and using indicators. It is designed to be an essential and readable guide to those in senior positions who may not always feel entirely comfortable with this important area.
FONTE: NHS Institute For Innovation And Improvement, 2008. 36 p.
REFERENCIA: PENCHEON, David. The good indicators guide: understanding how to use and choose indicators. NHS Institute For Innovation and Improvement, 2008. 36 p.
442. Conceptual frameworks for health systems performance: a quest for effectiveness, quality, and improvement.
AUTOR(ES): O. A. Aran; N. S. Klazinga; D. M. J. Delnoij; A. H. A. Ten Asbroek; T.Custers
ANO: 2003
RESUMO: Issues. Countries and international organizations have recently renewed their interest in how health systems perform. This has led to the development of performance indicators for monitoring, assessing, and managing health systems.
FONTE: International Journal For Quality In Health Care, Oxford, v. 15, n. 5, p.377-398, out. 2003.
REFERENCIA: ARAN, O. A. et al. Conceptual frameworks for health systems performance: a quest for effectiveness, quality, and improvement. International Journal For Quality In Health Care, Oxford, v. 15, n. 5, p.377-398, out. 2003.
443. The Amazing Noncollapsing U.S. Health Care System — Is Reform Finally at Hand?
AUTOR(ES): Lawrence D. Brown
ANO: 2008
RESUMO:
FONTE: The New England Journal Of Medice, Boston, v. 358, n. 4, p.325-327, 24 jan. 2008.
REFERENCIA: BROWN, Lawrence D.The amazing noncollapsing U.S. health care system: is reform finally at hand? The New England Journal Of Medice, Boston, v. 358, n. 4, p.325-327, 24 jan. 2008.
444. Measuring the health of nations: analysis of mortality amenable to health care.
AUTOR(ES): Ellen Nolte; Martin McKee;
ANO: 2003
RESUMO: Objective To assess whether and how the rankings of the world’s health systems based on disability adjusted life expectancy as done in the 2000 World Health Report change when using the narrower concept of mortality amenable to health care, an outcome.
FONTE: British Medical Journal, London, v. 327, p.1-5, nov. 2003.
REFERENCIA: NOLTE, Ellen; MCKEE, Martin. Measuring the health of nations: analysis of mortality amenable to health care. British Medical Journal, London, v. 327, p.1-5, nov. 2003.
445. State Health Policies Aimed at Promoting Excellent Systems: A Report on States’ Roles in Health Systems Performance.
AUTOR(ES): Catherine Hess; Sonya Schwartz; Jill Rosenthal; Andrew Snyder; Alan Weil;
ANO: 2008
RESUMO: States shape the health system in many ways: as purchasers, regulators, and conveners. Despite these various roles, there is little systematic effort to monitor state choices, learn from the choices states make, and purposefully spread one state’s.
FONTE: Washington: National Academy For State Health Policy, 2008. 91 p.
REFERENCIA: HESS, Catherine et al. State health policies aimed at promoting excellent systems: a report onstates’ roles in health systems performance. Washington: National Academy For State Health Policy, 2008. 91 p.
446. Health Indicators 2008.
AUTOR(ES): Canadian Institute for Health Information
ANO: 2008
RESUMO:
FONTE: Ottawa: CIHI ICIS, 2008. 90 p.
REFERENCIA: CANADIAN INSTITUTE FOR HEALTH INFORMATION. Health indicators 2008. Ottawa: CIHI ICIS, 2008. 90 p.
447. Institutional and Economic Detenninants of Public Health System Performance.
AUTOR(ES): Glen P Mays; Megan C. McHugh; Kyumin Shim; Natalie Perry; Dennis Lenaway; Paul K. Halverson; Ramal Moonesinghe.
ANO: 2006
RESUMO: Objectives. Although a growing body of evidence demonstrates that avail- ability and quality of essential public health services vary widely across com- munities, relatively little is known about the factors that give rise to these varia.
FONTE: New York, v. 96, n. 3, p.523-531, mar. 2006.
REFERENCIA: MAYS, Glen P. et al. Institutional and economic determinants of public health system performance. American Journal Of Public Health, New York, v. 96, n. 3, p.523-531, mar. 2006.
448. Health, United States, 2007.
AUTOR(ES): National Center Health Statistics.
ANO: 2007
RESUMO:
FONTE: Hyattsville: CDC, 2007. 551 p.
REFERENCIA: NATIONAL CENTER HEALTH STATISTICS.Health, United States, 2007. Hyattsville: CDC, 2007. 551 p.
449. A Comparison of the Health Systems in China and India.
AUTOR(ES): Sai Ma; Neeraj Sood;
ANO: 2008
RESUMO: In this paper, we compare the health systems of China and India—the world’s two most pop- ulous countries, each of which is undergoing dramatic demographic, societal, and economic transformations—to determine what approaches to improving health in these.
FONTE: Santa Monica: Rand, 2008. 44 p.
REFERENCIA: MA, Sai; SOOD, Neeraj. A Comparison of the health systems in China and India.Santa Monica: Rand, 2008. 44 p.
450. Where are the patients in decision-making about their own care?
AUTOR(ES): Angela Coulter; Suzanne Parsons; Janet Askham;
ANO: 2008
RESUMO: Patients can play a distinct role in protecting their health, choosing appropriate treatments for episodes of ill health and managing chronic disease. Considerable evidence suggests that patient engagement can improve their experience and satisfaction.
FONTE: Tallinn: World Health Organization, 2008.
REFERENCIA: COULTER, Angela; PARSONS, Suzanne; ASKHAM, Janet. Where are the patients in decision-making about their own care? Tallinn: World Health Organization, 2008.
451. Health system snapshots: perspectives from six countries.
AUTOR(ES): Seá n Boyle et al.
ANO: 2008
RESUMO:
FONTE: London: EuroHealth, v. 14, n. 1, 2008.
REFERENCIA: Health System Snaphots: perspectives from six countries. London: EuroHealth, v. 14, n. 1, 2008.
452. Atenção hospitalar por condições sensíveis á atenção ambulatorial (CSAA) e as mudanças no seu padráo etário:uma análise exploratória dos dados de Minas Gerais.
AUTOR(ES): Ignez Helena Oliva Perpetuo; Laura Rodriguez Wong
ANO: 2006
RESUMO: Ao longo da última década as internações por "causas sensíveis à atenção ambulatorial" (CSAA) se tornaram um instrumento valioso para monitoramento do acesso aos serviços e avaliação da qualidade da atenção primária à saúde. Tais causas são condições, que devidamente tratadas pelo serviço básico de saúde, não deveriam exigir internação. Estudos desta natureza são importantes, pois se sabe que este tipo de internações é mais freqüente entre populações mais vulneráveis. A partir dos dados sobre causa da internação do SIH-SUS é possível calcular Coeficientes de Internação Hospitalar (CIH) por CSAA e seu impacto no total de internações do SUS. Os dados para o período 1998-2004, para o total do país, indicam uma tendência de diminuição deste coeficiente, passando de mais de 400 internações para pouco mais de 200 internações por 10.000 habitantes SUS-dependentes. Pneumonias e Gastrenterites marcam avassaladora presença neste coeficiente. Constata-se que as internações por CSAA representam uma alta proporção no total de internações. Em 1998, cerca de 50%, no caso dos menores de 5 anos, e mais de um terço do total de internações em todas as outras idades, com exceção das idades 15 a 34 anos. Numa situação de estrutura por idades em processo de envelhecimento, como é o caso generalizado de Minas Gerais, as internações por CSAA, que estão estreitamente ligadas à composição por idade da população, devem ser objeto primordial de monitoramento.
FONTE: Minas Gerais: 2006. 14 p.
REFERENCIA: IGNEZ HELENA OLIVA PERPETUO; Laura Rodriguez Wong, XII Seminário sobre Economia Mineira, 2006, Minas Gerais. Atenção hospitalar por condições sensíveis á atenção ambulatorial (CSAA) e as mudanças no seu padrão etário: uma análise exploratória dos dados de Minas Gerais. Minas Gerais: 2006. 14 p.
453. What we mean by social determinants of health.
AUTOR(ES): Vicente Navarro
ANO: 2009
RESUMO: This article analyzes the changes in health conditions and quality of life in the populations of developed and developing countries over the past 30 years, resulting from neoliberal policies developed by many governments and promoted by the World Bank, International Monetary Fund, World Health Organization, and other international agencies. It challenges interpretations by the analysts of "globalization", including the common assumption that states are disappearing. The author shows that what has been happening is not a reduction of state interventions but a change in the nature and character of those interventions, resulting from major changes in class (and race and gender) power relations in each country, with establishment of an alliance between the dominant classes of developed and developing countries-a class alliance responsible for the promotion of its ideology, neoliberalism. This is the cause of the enormous health inequalities in the world today. The article concludes with a critical analysis of the WHO report on social determinants of health, applauding its analysis and many of its recommendations, but faulting it for ignoring the power relations that shape these social determinants. It is not inequalities that kill people, as the report states; it is those who are responsible for these inequalities that kill people.
FONTE: International Journal Of Health Services, Amityville, v. 39, n. 3, p.423-441, 2009.
REFERENCIA: NAVARRO, Vicente. What we mean by social determinants of health. International Journal Of Health Services, Amityville, v. 39, n. 3, p.423-441, 2009.
454. National Healthcare Disparities Report.
AUTOR(ES): Agency for Health Care Research and Quality
ANO: 2009
RESUMO:
FONTE: Quality Of Health Care, 2009. 295 p.
REFERENCIA: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY . National healthcare disparities report. Quality Of Health Care, 2009. 295 p.
455. Temas especiais: análise de séries temporais de causas de morte selecionadas.
AUTOR(ES): Secretaria de Vigilâ ncia em Saú de/MS
ANO: 2004
RESUMO: Com este livro, a Secretaria de Vigilância em Saúde dá início a uma série de publicações sobre a situação da saúde no Brasil. Seu objetivo é descrever e analisar os seguintes temas: determinantes e condicionantes da saúde-doença; dados sobre gravidez, pré-natal e parto; evolução da mortalidade no Brasil; mortalidade em 2001 segundo as regiões e os estados, séries temporais para algumas doenças selecionadas e para a mortalidade por acidentes de transporte terrestre e agressões; uma descrição da situação das doenças de notificação compulsória no Brasil. Além disso, é apresentada uma análise da evolução da cobertura e da qualidade do Sistema de Informações sobre Mortalidade (SIM) e do Sistema de Informações de Nascidos Vivos (Sinasc).
FONTE: Brasilia: Ministério da Saúde, 2004. p. 235-298.
REFERENCIA: Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Saúde Brasil 2004: uma análise da situação de saúde. In: Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde.Temas especiais: análise de séries temporais de causas de morte selecionadas. Brasilia: Ministério da Saúde, 2004. p. 235-298.
456. Modelling Counts - The Poisson and Negative Binomial Regression.
AUTOR(ES): Nicholas P. Jewell
ANO: 2006
RESUMO:
FONTE: Califórnia: 2006. p. 7-20.
REFERENCIA: JEWELL, Nicholas P.Modelling Counts: the poisson and negative binomial regression. In: JEWELL, Nicholas P.; HUBBARD, Alan. Analysis of longitudinal studies in epidemiology. Califórnia: 2006. p. 7-20.
457. The Australian health care system: The potential for efficiency gains: A review of the literature.
AUTOR(ES): Emily Hurley; Ian McRae; Ian Bigg; Liz Stackhouse; Anne-Marie Boxall; Peter Broadhead
ANO: 2009
RESUMO: The health system is only one factor among many that determine broad population health outcomes at the national level. While some studies indicate there may be gains Australia can make to the efficiency of the health system, there are others which conclude that the Australian health system is one of the most efficient in the world. It does not seem to matter, from an efficiency perspective, what the balance is between public and private expenditure. Evidence suggests that there is no one right way to structure a health care system to ensure optimal efficiency.
FONTE: National Health And Hospitals Reform Commission, 2009. 66 p.
REFERENCIA: HURLEY, Emily et al. The Australian health care system: the potential for efficiency gains: a review of the literature. National Health And Hospitals Reform Commission, 2009. 66 p.
458. Portaria Nº 91/GM de 10 de Janeiro de 2007.
AUTOR(ES): Ministé rio da Saú de
ANO: 2007
RESUMO: Regulamenta a unificação do processo de pactuação de indicadores e estabelece os indicadores do Pacto pela Saúde, a serem pactuados por municípios, estados e Distrito Federal.
FONTE: Brasília: 2007. 37 p.
REFERENCIA: BRASIL. Ministério da Saúde.Portaria Nº 91/GM de 10 de janeiro de 2007. Brasília: 2007. 37 p.
459. Health and lifestyle indicators for Strategic Health Authorities, 1994-2002.
AUTOR(ES): Shaun Scholes; Alison Prescott; Madhavi Bajekal
ANO: 2004
RESUMO: Given the need to combine data across adjacent years to produce reliable sub-national estimates, programme changes in the topic and population coverage of the HSfE set limits to the types of indicators that could be included in this analysis. In this study we have calculated GOR and SHA level estimates based on the following criteria: - indicator set restricted the core variables collected every year, in either the interview or nurse visit stages of the survey estimates based on the adult general population sample in each year (i.e. only about half the sample included in boost years) - separate estimates for men, women and all persons - data pooled over consecutive three year periods, to calculate 3-year moving averages, with aggregated 1994-96 data providing the first time point and 2000-2002 the last in the series (the mid-points of the 3-year averages span seven years, 1995 to 2001) - observed and age-standardised rates calculated, to allow comparisons between SHAs and within a SHA over time.
FONTE: Department Of Health, 2004. 36 p.
REFERENCIA: SCHOLES, Shaun; PRESCOTT, Alison; BAJEKAL, Madhavi. Health and lifestyle indicators for Strategic Health Authorities, 1994-2002. Department Of Health, 2004. 36 p.
460. Diretrizes para a Programação Pactuada e Integrada da Assistência à Saúde.
AUTOR(ES): Ministé rio da Saú de
ANO: 2006
RESUMO: Neste sentido, a programação em curso, que teve o início de sua implantação em 2001, foi elaborada simultanea-mente, e em sintonia, com as diretrizes da política de descentraliza-ção contidas na Norma Operacional de Assistência à Saúde 01 / 02 (NOAS 01/02 01/ 02). A superação de aspectos do marco normativo contido naquele dispositivo implica em importantes alterações nos processos de qualificação da gestão dos municípios e estados, bem como em mudanças nos mecanismos de alocação e transferência de 9recursos, que estão dispostos na portaria GM/399, de 22 de fevereiro de 2006, que divulga o Pacto pela Saúde 2006 e aprova suas diretri-zes operacionais. Estas definições são aqui consideradas como pré-requisitos ou pressupostos que devem orientar a revisão do modelo de programação.
FONTE: Brasília: Editora do Ministério da Saúde, 2006. 148 p. (Série Pactos Pela Saúde).
REFERENCIA: Brasil. Ministério da Saúde. Secretaria-Executiva. Coordenação de Apoio à Gestão Descentralizada. Diretrizes para a programação pactuada e integrada da assistência à saúde. Brasília: Editora do Ministério da Saúde, 2006. 148 p. (Série Pactos Pela Saúde).
461. Diretrizes Operacionais para os Pactos pela Vida, em Defesa do SUS e de Gestão.
AUTOR(ES): Secretaria-Executiva Coordenaç ã o de Apoio à Gestã o Descentralizada
ANO: 2006
RESUMO: O documento a seguir contempla o pacto firmado entre os três gestores do SUS a partir de uma unidade de princípios que, guardando coerência com a diversidade operativa, respeita as diferenças loco-regionais, agrega os pactos anteriormente existentes, reforça a organização das regiões sanitárias instituindo mecanismos de co-gestão e planejamento regional, fortalece os espaços e mecanismos de controle social, qualifica o acesso da população à atenção integral à saúde, redefine os instrumentos de regulação, programação e avaliação, valoriza a macro função de cooperação técnica entre os gestores e propõe um financiamento tripartite que estimula critérios de eqüidade nas transferências fundo a fundo.
FONTE: Brasília: Editora do Ministério da Saúde, 2006. 72 p. (Série A. Normas e manuais técnicos).
REFERENCIA: BRASIL. Ministério da Saúde. Secretaria Executiva. Departamento de Apoio à Descentralização. Coordenação-Geral de Apoio à Gestão Descentralizada. Diretrizes operacionais: pactos pela vida, em defesa do SUS e de gestão. Brasília: Ministério da Saúde, 2006.72 p. (Série Pactos Pela Saúde).
462. Measuring disparities in health status and in access and use of health care in OECD countries.
AUTOR(ES): Michael de Looper; Gaetan Lafortune
ANO: 2009
RESUMO: This paper assesses the availability and comparability of selected indicators of inequality in health status and in health care access and use across OECD countries, focussing on disparities among socioeconomic groups. These indicators are illustrated using national or cross-national data sources to stratify populations by income, education or occupation level. In each case, people in lower socioeconomic groups tend to have a higher rate of disease, disability and death, use less preventive and specialist health services than expected on the basis of their need, and for certain goods and services may be required to pay a proportionately higher share of their income to do so.
FONTE: Paris:OECD Health Technical Papers, 2009. 55 p.
REFERENCIA: LOOPER, Michael; LAFORTUNE, Gaetan. Measuring disparities in health status and in access and use of health care in OECD countries. Paris: OECD Health Technical Papers, 2009. 55 p.
463. Selecting indicators for the quality of health promotion, prevention and primary care at the health systems level in OECD countries.
AUTOR(ES): Martin Marshall; Sheila Leatherman; Soeren Mattke
ANO: 2004
RESUMO: This report presents the consensus recommendations of an international expert panel on indicators for health promotion and primary care. Using a structured review process, the panel selected a set of 27 indicators to cover the three key areas health promotion, preventive care and diagnosis and treatment in primary care. The report describes the review process and provides a detailed discussion of the scientific soundness and policy importance of the 27 indicators.
FONTE: Paris: OECD Health Technical Papers, 2004. 49 p.
REFERENCIA: MARSHALL, Martin; LEATHERMAN, Sheila; MATTKE, Soeren. Selecting indicators for the quality of health promotion, prevention and primary care at the health systems level in OECD countries. Paris: OECD Health Technical Papers, 2004. 49 p.
464. NHS Performance indicators.
AUTOR(ES): Healthcare Commission
ANO: 2005
RESUMO:
FONTE:
REFERENCIA: HEALTHCARE COMMISSION. Performance indicators. Inglaterra: NHS, 2005.
465. Un cadre d'évaluation de la performance des systèmes de services de santé: Le modèle EGIPSS.
AUTOR(ES): Franç ois Champagne; André -Pierre Contandriopoulos; Julie Picot-Touché ; Franç ois Bé land; Hung Nguyen
ANO: 2005
RESUMO:
FONTE: Quebec: CSBE, 2005. 40 p.
REFERENCIA: CHAMPAGNE, François et al. Un cadre d évaluation de la performance des systèmes de services de santé :le modèle EGIPSS. Quebec: CSBE, 2005. 40 p.
466. WHR 2000 to WHR 2010: what progress in health care financing?
AUTOR(ES): Di McIntyre
ANO: 2010
RESUMO:
FONTE: Health Policy Planning, Oxford, v. 25, p.349-351, 2010.
REFERENCIA: McINTYRE, Di. WHR 2000 to WHR 2010: what progress in health care financing? Health Policy Planning, Oxford, v. 25, p.349-351, 2010.
467. Lista de causas de mortes evitáveis por intervenções do Sistema Único de Saúde do Brasil.
AUTOR(ES): Deborah Carvalho Malta; Otaliba Libâ nio de Morais Neto; Elisabeth Carmen Duarte; Má rcia Furquim de Almeida; Lenildo de Moura; Maria Angé lica de Salles Dias; Walter Ferraz; Maria de Fatima Marinho de Souza
ANO: 2007
RESUMO: As causas de mortes evitáveis ou reduzíveis são definidas como aquelas preveníveis, total ou parcialmente, por ações efetivas dos serviços de saúde que estejam acessíveis em um determinado local e época. Essas causas devem ser revisadas à luz da evolução do conhecimento e tecnologia para prática da atenção à saúde. Portanto, este estudo está fundamentado em uma revisão da literatura referente à base conceitual e empírica das listas de causas de morte evitáveis, publicadas entre 1975 e 2004, e nas reflexões de um grupo de trabalho organizado pelo Ministério da Saúde do Brasil. O artigo propõe duas listas brasileiras desses eventos - para menores de cinco anos; e para pessoas com cinco ou mais anos de idade -, tendo por referência a tecnologia disponível no Sistema Único de Saúde (SUS). Embora esse debate se encontre em estágio inicial, seu aprofundamento parece promissor para o desenvolvimento metodológico do monitoramento e avaliação de desempenho da atenção à saúde no Brasil.
FONTE: Epidemiologia e Serviços de Saúde, Brasília, v. 16, n. 4, p.233-244, 2007.
REFERENCIA: MALTA, Deborah Carvalho et al. Lista de causas de mortes evitáveis por intervenções do Sistema Único de Saúde do Brasil. Epidemiologia e Serviços de Saúde, Brasília, v. 16, n. 4, p.233-244, 2007.
468. The role of medical care in contributing to health improvements within societies.
AUTOR(ES): John Bunker
ANO: 2001
RESUMO: In attempting to assess the contributions of medical care to health improvements, the goals of care must first be addressed. The saving of lives in acute life-threatening emergencies is an important such goal, but it represents a very small component of the total medical effort: while lives are saved, the sum of such saving is too small to have a measurable impact on the life expectancy of an entire population. A much larger effort is devoted to preventive or curative measures, and these do have a large and measurable effect on the life expectancy of the population as a whole. An even greater component of medical effort is devoted to improving the quality of life, or more accurately, to preventing or to minimizing the poor quality of life associated with chronic disease: to the relief of pain, disfigurement, and disability. There are no population-based data to allow a direct estimate of the contributions of medical care to life extension or to the quality of life. In the absence of such data, my colleagues and I have created inventories of the outcome benefits of the preventive or curative care for individual conditions. Based on such an inventory of established life extending outcomes of preventive and curative services for individual conditions, I estimate that about half of the 7½ years of increased life expectancy since 1950 can be attributed to medical care. I credit an even larger number of years of relief, or partial relief, of poor quality of life to medical care. The data on which the estimates are based are often incomplete, and the estimates are approximations. They are more than speculative and less than precise.
FONTE: International Journal Of Epidemiology, London, v. 30, n. 6, p.1260-1263, dez. 2001.
REFERENCIA: BUNKER, J et al. The role of medical care in contributing to health improvements within societies. International Journal Of Epidemiology, London, v. 30, n. 6, p.1260-1263, dez. 2001.
469. The quality of health care delivered to adults in the United States.
AUTOR(ES): E.A.McGlynn; S.M.Asch; J.Adams; J.Keesey; J.Hicks; A.DeCristofaro; E.A.Kerr
ANO: 2003
RESUMO: BACKGROUND: We have little systematic information about the extent to which standard processes involved in health care--a key element of quality--are delivered in the United States. METHODS: We telephoned a random sample of adults living in 12 metropolitan areas in the United States and asked them about selected health care experiences. We also received written consent to copy their medical records for the most recent two-year period and used this information to evaluate performance on 439 indicators of quality of care for 30 acute and chronic conditions as well as preventive care. We then constructed aggregate scores. RESULTS: Participants received 54.9 percent (95 percent confidence interval, 54.3 to 55.5) of recommended care. We found little difference among the proportion of recommended preventive care provided (54.9 percent), the proportion of recommended acute care provided (53.5 percent), and the proportion of recommended care provided for chronic conditions (56.1 percent). Among different medical functions, adherence to the processes involved in care ranged from 52.2 percent for screening to 58.5 percent for follow-up care. Quality varied substantially according to the particular medical condition, ranging from 78.7 percent of recommended care (95 percent confidence interval, 73.3 to 84.2) for senile cataract to 10.5 percent of recommended care (95 percent confidence interval, 6.8 to 14.6) for alcohol dependence. CONCLUSIONS: The deficits we have identified in adherence to recommended processes for basic care pose serious threats to the health of the American public. Strategies to reduce these deficits in care are warranted.
FONTE: New England Journal Of Medice, Boston, v. 348, n. 26, p.2635-2645, jun. 2003.
REFERENCIA: ZIMMERMAN, Richard Kent et al. The quality of health care delivered to adults in the United States. New England Journal Of Medice, Boston, v. 348, n. 26, p.2635-2645, jun. 2003.
470. What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and Veterans Affairs practices.
AUTOR(ES): R. K. Zimmerman; T. A. Santibanez; J. E. Janosky; M. J. Fine; M. Raymund; S. A. Wilson; I. J. Bardella; A. R. Medsger; M. P. Nowalk
ANO: 2003
RESUMO: BACKGROUND: Despite strong evidence of the effectiveness of influenza vaccination, immunization rates have reached a plateau that is below the 2010 national goals. Our objective was to identify facilitators of, and barriers to, vaccination in diverse groups of older patients. METHODS: A survey was conducted in 2000 by computer-assisted telephone interviewing of patients from inner-city health centers, Veterans Affairs (VA) outpatient clinics, rural practices, and suburban practices. The inclusion criteria were age > or =66 years and an office visit after September 30, 1998. RESULTS: Overall, 1007 (73%) interviews were completed among 1383 patients. Influenza vaccination rates were 91% at VA clinics, 79% at rural practices, 79% at suburban practices, and 67% at inner-city health centers. There was substantial variability in vaccination rates among practices, except at the VA. Nearly all persons who were vaccinated reported that their physicians recommended influenza vaccinations, compared with 63% of unvaccinated patients (P <0.001). Thirty-eight percent of unvaccinated patients were concerned that they would get influenza from the vaccine, compared with only 6% of vaccinated persons (P <0.001). Sixty-three percent of those vaccinated, in contrast with 22% of unvaccinated persons, thought that an unvaccinated person would probably contract influenza (P <0.001). CONCLUSION: Older patients need intentional messages from physicians that recommend vaccination. Furthermore, more patient education is needed to counter myths about adverse reactions.
FONTE: The American Journal Of Medicine, Darien, v. 114, n. 1, p.31-38, jan. 2003.
REFERENCIA: ZIMMERMAN, Richard Kent et al. What affects influenza vaccination rates among older patients? An analysis from inner-city, suburban, rural, and Veterans Affairs practices. The American Journal Of Medicine, Darien, v. 114, n. 1, p.31-38, jan. 2003.
471. A conceptual framework for public health: NICE's emerging approach.
AUTOR(ES): M.P.Kelly; E.Stewart; A. Morgan; A.Killoran; A.Fischer; A.Threlfall; J.Bonnefoy.
ANO: 2009
RESUMO: This paper outlines the National Institute for Health and Clinical Excellences (NICE) emerging conceptual framework for public health. This is based on the experience of the first 3 years of producing public health guidance at NICE (2005-2008). The framework has been used to shape the revisions to NICE's public health process and methods manuals for use post 2009, and will inform the public health guidance which NICE will produce from April 2009. The framework is based on the precept that both individual and population patterns of disease have causal mechanisms. These are analytically separate. Explanations of individual diseases involve the interaction between biological, social and related phenomena. Explanations of population patterns involve the same interactions, but also additional interactions between a range of other phenomena working in tandem. These are described. The causal pathways therefore involve the social, economic and political determinants of health, as well as psychological and biological factors. Four vectors of causation are identified: population, environmental, organizational and social. The interaction between the vectors and human behaviour are outlined. The bridge between the wider determinants and individual health outcomes is integration of the life course and the lifeworld.
FONTE: Public Health, London, v. 123, n. 1, p.14-20, jan. 2009.
REFERENCIA: KELLY, M. P. et al. A conceptual framework for public health: NICE's emerging approach. Public Health, London, v. 123, n. 1, p.14-20, jan. 2009.
472. Avaliação da efetividade do tratamento hospitalar do acidente vascular cerebral agudo no Sistema Único de Saúde - SUS: utilização da mortalidade hospitalar como Indicador de desempenho.
AUTOR(ES): Cristina Lú cia Rocha Cubas Rolim
ANO: 2009
RESUMO: OBJETIVO: Avaliar a efetividade do tratamento hospitalar do Acidente Vascular Cerebral Agudo no Sistema Único de Saúde - SUS, comparando a mortalidade hospitalar ajustada entre pacientes que realizaram ou não a tomografia computadorizada. MÉTODO: A fonte de informação utilizada foi o Sistema de Informação Hospitalar do SUS (SIH-SUS). Foram selecionadas 328.087 internações ocorridas no SUS em todo o território nacional entre abril de 2006 e dezembro de 2007. As internações foram reunidas e estudadas em 4 grupos: Acidente Isquêmico Transitório (CID-10: G459); Acidente Vascular Cerebral Hemorrágico (CID-10: I60; I61 e I62); Acidente Vascular Isquêmico (CID-10: I63) e Acidente Vascular Cerebral não especificado (CID-10: I64). Foram utilizadas as mortalidades hospitalares até o sétimo e até o trigésimo dias, como medidas de resultado para comparar pacientes que realizaram e não realizaram tomografia computadorizada. RESULTADOS: Em geral os pacientes que realizaram a tomografia computadorizada apresentaram menores taxas de mortalidade hospitalar em relação àqueles que não realizaram o exame, sendo essa diferença em favor da realização do exame observada principalmente até o segundo dia de internação em todos os 4 grupos. A diferença entre os que realizaram e os que não realizaram o exame foi acentuada no grupo do Acidente Vascular Isquêmico (OR: 0,325; p>0,000), sendo que no primeiro dia o odds ratio foi de 0,021(p>0,000), em favor dos que realizaram o exame. CONCLUSÕES: Os exames de tomografia computadorizada no SUS, em geral, são realizados mais tardiamente que o recomendado pela literatura. Apesar das limitações ainda existentes na qualidade da informação diagnóstica disponível no SIH-SUS que restringiram a estratégia de ajuste de risco empregada nesse estudo, sugere-se o uso da tomografia computadorizada, o mais cedo possível, como tecnologia auxiliar no diagnóstico e tratamento do AVC. Além disso, sugere-se o emprego mais amplo de medidas de desempenho, tais como a mortalidade hospitalar aqui empregada, para o monitoramento da qualidade do cuidado prestado no âmbito do SUS.
FONTE: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, 2009.
REFERENCIA: ROLIM, Cristina Lúcia Rocha Cubas. Avaliação da efetividade do tratamento hospitalar do acidente vascular cerebral agudo no Sistema Único de Saúde - SUS: utilização da mortalidade hospitalar como Indicador de desempenho. 2009. 84 f. Dissertação (Mestrado) - Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, 2009.
473. Methodological issues in measuring health disparities.
AUTOR(ES): K. Keppel ; E Pamuk; J. Lynch; O. Carter-Pokras; Kim Insun, V. Mays; J. Pearcy; V.Schoenbach; J.S.Weissman
ANO: 2005
RESUMO: OBJECTIVES: This report discusses six issues that affect the measurement of disparities in health between groups in a population: Selecting a reference point from which to measure disparity. Measuring disparity in absolute or in relative terms. Measuring in terms of favorable or adverse events. Measuring in pair-wise or in summary fashion. Choosing whether to weight groups according to group size. Deciding whether to consider any inherent ordering of the groups. These issues represent choices that are made when disparities are measured. METHODS: Examples are used to highlight how these choices affect specific measures of disparity. RESULTS: These choices can affect the size and direction of disparities measured at a point in time and conclusions about the size and direction of changes in disparity over time. Eleven guidelines for measuring disparities are presented. CONCLUSIONS: Choices concerning the measurement of disparity should be made deliberately, recognizing that each choice will affect the results. When results are presented, the choices on which the measurements are based should be described clearly and justified appropriately.
FONTE: Vital And Health Statistics, Rockville, n. 141, p.1-16, jul. 2005.
REFERENCIA: KEPPEL, Karen et al. Methodological issues in measuring health disparities. Vital And Health Statistics, Rockville, n. 141, p.1-16, jul. 2005.
474. Monitoring and evaluation of health systems strengthening: An operational framework.
AUTOR(ES): World Health Organization
ANO: 2009
RESUMO: This paper presents a framework for monitoring and evaluation of health system strengthening (HSS) anddiscusseshow it can be operationalized at the country level and how global partners can work together to supporttheimplementation.
FONTE: Geneva: WHO, 2009. 26 p.
REFERENCIA: WORLD HEALTH ORGANIZATION. Monitoring and evaluation of health systems strengthening: an operational framework. Geneva: WHO, 2009. 26 p.
475. Towards high-performing health systems.
AUTOR(ES): The OECD Health Project
ANO: 2004
RESUMO: This report serves as an executive summary of the final report on the OECD Health Project,Towards High-Performing Health Systems. It presents the main policy conclusions drawn in the final report,which synthesized key findings from studies conducted as part of the three-year Project and otherrecent work on health at the OECD. The summary report follows the general framework of the finalreport, corresponding to the main health policy goals shared by OECD countries: health care that isaccessible and of high quality, and health systems that are responsive, affordable, and good value formoney. It offers lessons on the effects of various policies intended to manage the adoption anddiffusion of health-related technology, address shortages of nurses and other health-care workers,increase the productivity of hospitals and physicians, manage the demand for health services, reducewaiting times for elective surgery and foster the availability of affordable private health insurancecoverage. In addition, it sheds new light on problems policy makers face, such as judging theappropriate level of health spending, assessing the appropriate role for private financing in healthand long-term care systems, and evaluating the implications for health system performance of waitingtimes for elective surgery.
FONTE: Paris: OECD, 2004. 21 p.
REFERENCIA: THE OECD HEALTH PROJECT. Towards high-performing health systems: summary report. Paris: OECD, 2004. 21 p.
476. Introduction. Learning from High-Performing Systems: Quality by Design.
AUTOR(ES): G. Ross Baker; Anu Maclntosh-Murray; Christina Porcellato; Lynn Dionne; Kim Stelmacovich; Karen Born
ANO: 2008
RESUMO: The recognition that quality is a property of systems and not just individuals or operat-ing units begs several questions:- What aspects of healthcare systems are key to facilitating high performance? - What do we know about the relationships among these elements and among various important outcomes? - What is the best way to study these issues?
FONTE: Toronto: Longwoods Publishing, 2008. p. 11-26.
REFERENCIA: BAKER, G.Ross. et al. Introduction. Learning from high-performing systems: quality by design. In: BAKER, G. Ross et al. High Performing Healthcare Systems: delivering quality by design. Toronto: Longwoods Publishing, 2008. p. 11-26.
477. Health Indicators 2009.
AUTOR(ES): Canadian Institute for Health Information
ANO: 2009
RESUMO: As in previous years, Health Indicators 2009 presents the most recently available information about the health system and the health of the population in Canada s health regions, provinces and territories. In view of the 10-year anniversary, the report also presents national trends over time for selected indicators focusing on the following six themes: heart attacks and cardiac revascularization; stroke; women s health and men s health-selected surgical procedures; hip fractures; joint replacements; and preventing hospital admissions.
FONTE: Ottawa: CIHI ICIS, 2009. 133 p.
REFERENCIA: CANADIAN INSTITUTE FOR HEALTH INFORMATION. Health indicators 2009. Ottawa: CIHI ICIS, 2009. 133 p.
478. Health systems institutional characteristics: a survey of 29 OECD countries.
AUTOR(ES): Valerie Paris; Marion Devaux; Lihan Wei
ANO: 2010
RESUMO: In 2008, the OECD launched a survey to collect information on the health systems characteristics of member countries. This paper presents the informaton provided by 29 of these countries in 2009. It describes country-specific arrangements to organise the population coverage against health risks and the financing of health spending. It depicts the organisation of health care delivery, focusing on the public/private mix of health care provision, provider payment schemes, user choice and competition among providers, as well as the regulation of heallth care suppply and prices. Finally, this document provides information on governnance and resource allocation in health systems (decentralisation in decision-making, nature of budget constraints and priority setting).
FONTE: Paris: OECD Health Technical Papers, 2010. 140 p.
REFERENCIA: PARIS, Valerie; DEVAUX, Marion; WEI, Lihan. Health systems institutional characteristics: a survey of 29 OECD countries. Paris: OECD Health Technical Papers, 2010. 140 p.
479. Denmark: Health system review.
AUTOR(ES): Martin Strandberg-Larsen; Mikkel Bernt Nielsen; Signild Vallgå rda; Allan Krasnik
ANO: 2007
RESUMO: Denmark is a small country with 5.4 million inhabitants; however, it is one the wealthiest countries in the world. It is a monarchy with fairly autonomous cal governments, consisting of 5 regions and 98 municipalities. Population alth, as measured by life expectancy, is relatively low in comparison to her European countries, but it has recently increased. The Danish health re sector is dominated by the public sector and is financed by local and state xes. Somatic and psychiatric health care, carried out at public hospitals, and mary health services, which are delivered by general practitioners (GPs) d other practising health professionals, are administered by the regions. The gions are financed by the State and to a certain extent by the municipalities. e regions own and run most hospitals, and practising health professionals e self-employed and reimbursed by the regions, mainly using a fee-for-vice mechanism. The municipalities are responsible for elderly care, social ychiatry, prevention and health promotion, rehabilitation and other types of re that are not directly related to hospital inpatient care. Access to health care fairly equal when health status is taken into account. For all citizens with idence permits, access to health care is free of charge at hospitals and from Ps, whereas access to pharmaceuticals, dentists and some other services require -payment. During recent years, the focus of health care reforms has been on patient choice, waiting times, quality assurance and coordination of care. A major structural reform in 2007 has changed the political and administrative landscape of health care, dramatically reducing the number of regional and local units and transferring health care responsibilities for prevention and rehabilitation from the regional to the local level.
FONTE: Health Systems In Transition, v. 9, n. 6, p.1-162, 2007.
REFERENCIA: STRANDBERG-LARSEN, Martin et al. Denmark: health system review.Health Systems In Transition, v. 9, n. 6, p.1-162, 2007.
480. Health Inequalities.
AUTOR(ES): House of Commons; Health Committee
ANO: 2009
RESUMO: During the course of this inquiry, we heard widespread praise and support, both in this country and abroad, for the explicit commitment this Government has made to tackling health inequalities. This has involved a framework of specific policies, underpinned by a challenging and ambitious target. The Government has also continued to switch resources to the neediest areas; the neediest PCTs will receive 70% more funding than the least needy in 2009-10. However, whilst the health of all groups in England is improving, over the last ten years health inequalities between the social classes have widened-the gap has increased by 4% amongst men, and by 11% amongst women-because the health of the rich is improving more quickly than that of the poor. Health inequalities are not only apparent between people of different socio-economic groups-they exist between different genders, different ethnic groups, and the elderly and people suffering from mental health problems or learning disabilities also have worse health than the rest of the population. The causes of health inequalities are complex, and include lifestyle factors-smoking, nutrition, exercise to name only a few-and also wider determinants such as poverty, housing and education. Access to healthcare may play a role, and there are particular concerns about institutional ageism, but this appears to be less significant than other determinants.
FONTE: London: The Stationery Office Limited, 2009. 1 v.
REFERENCIA: HOUSE OF COMMONS; HEALTH COMMITTEE. Health inequalities. London: The Stationery Office Limited, 2009. 1 v.
481. First Steps to Equity: Ideas and Strategies for Health Equity in Ontario,2008-2010.
AUTOR(ES): Dianne Patychuk; Daniela Seskar-Hencic
ANO: 2008
RESUMO: With this document, we celebrate the launch of new Ontario Public Health Standards that include identifying, reporting and using information about health inequities and tailoring strategies to inform actions that meet the needs of priority populations. This document provides some ideas, steps, examples and resources to support people and organizations working for equity in health in Ontario. Equity in Health is about eliminating unnecessary/avoidable, and unfair/unjust differences in health among population groups and communities.
FONTE: Toronto: 2008. 30 p.
REFERENCIA: PATYCHUK, Dianne; SESKAR-HENCIC, Daniela. First steps to equity: ideas and strategies for health equity in Ontario,2008-2010. Toronto: 2008. 30 p.
482. Finland: Health System review.
AUTOR(ES): Lauri Vuorenkoski
ANO: 2008
RESUMO: In practice in Finland there are three different health care systems which receive public funding: municipal health care, private health care and occupational health care systems. The largest share of health care services is provided by the municipal health care. There are also different public financing mechanisms for health care services in Finland: municipal financing based on taxes and National Health Insurance (NHI) financing based on compulsory insurance fees. The Finnish health care system offers relatively good quality health services for reasonable cost with quite high public satisfaction. The most visible problems are long waiting times and personnel shortages in some municipalities.
FONTE: Health Systems In Transition, Copenhagen, v. 10, n. 4, p.1-170, 2008.
REFERENCIA: VUORENKOSKI, Lauri. Finland: health system review. Health Systems In Transition, Copenhagen, v. 10, n. 4, p.1-170, 2008.
483. The impact of private-sector provision on equitable utilisation of coronary revascularisation in London.
AUTOR(ES): J Mindell; E Klodawski; J Fitzpatrick; N Malhotra; M McKee; C Sanderson
ANO: 2008
RESUMO: Objective: To investigate the impact of including private-sector data on assessments of equity of coronary revascularisation provision using NHS data only. Design: Analyses of hospital episodes statistics and private-sector data by age, sex and primary care trust (PCT) of residence. For each PCT, the share of London s total population and revascularisations (all admissions, NHS-funded, and privately-funded admissions) were calculated. Gini coefficients were derived to provide an index of inequality across subpopulations, with parametric bootstrapping to estimate confidence intervals. Setting: London. Participants: London residents undergoing coronary revascularisation April 2001-December 2003. Intervention: Coronary artery bypass graft or angioplasty. Main outcome measures: Directly standardised revascularisation rates, Gini coefficients. Results: NHS-funded age-standardised revascularisation rates varied from 95.2 to 193.9 per 100 000 and privately funded procedures from 7.6 to 57.6. Although the age distribution did not vary by funding, the proportion of revascularisations among women that were privately funded (11.0%) was lower than among men (17.0%). Privately funded rates were highest in PCTs with the lowest death rates (p = 0.053). NHS-funded admission rates were not related to deprivation nor age-standardised deaths rates from coronary heart disease. Privately funded admission rates were lower in more deprived PCTs. NHS provision was significantly more egalitarian (Gini coefficient 0.12) than the private sector (0.35). Including all procedures was significantly less equal (0.13) than NHS-funded care alone. Conclusion: Private provision exacerbates geographical inequalities. Those responsible for commissioning care for defined populations must have access to consistent data on provision of treatment wherever it takes place.
FONTE: Heart And Education Heart, London, v. 94, n. 8, p.1008, 2008.
REFERENCIA: MILDELL, J et al. The impact of private-sector provision on equitable utilisation of coronary revascularisation in London. Heart And Education Heart, London, v. 94, n. 8, p.1008, 2008.
484. Family Health Program and ambulatory care-sensitive conditions in Southern Brazil.
AUTOR(ES): Fú lvio Borges Nedel; Luiz Augusto Facchini; Miguel Martí n-Mateo; Lú cia Ajambura Vieira; Elaine Thumé
ANO: 2008
RESUMO: OBJECTIVE: Ambulatory care-sensitive conditions (ACSC) are health problems managed by actions at the first level of care. The need for hospitalization by these causes is avoidable through an effective and proper primary health care. The objective of the study was to estimate ACSC among patients hospitalized by the Sistema Unico de Sa de (Brazilian Health System). METHODS: Hospital-based cross-sectional study involving 1,200 inhabitants of Bage (Southern Brazil) who were inpatients between September/2006 and January/2007. The patients answered a questionnaire applied by interviewers and were classified according to the model of attention utilized prior to hospitalization. ACSC were defined in a workshop promoted by the Ministry of Health. The variables analyzed included demographic and socioeconomic characteristics, health and health services utilized. Multivariate analysis was conducted by the Poisson model, according to a hierarchical conceptual framework, stratified by sex and model of care. RESULTS: ACSC accounted for 42.6% of the hospitalizations. The probability that the main diagnosis for hospitalization is considered an ACSC is greater among women, children under five years of age, individuals with less then five years of schooling, hospitalization in the year prior to the interview, emergency room consultation, and being an inpatient at the university hospital. Among women, ACSC are associated with age, educational level, length of time the health center has been in existence, living in an area covered by the Programa Sa de da Familia (Family Health Program), use of this service, emergency room consultation during the month prior to the interview and hospital to which patient was admitted. For men, it was associated with age, have undergone another hospitalization in the year prior to the interview and hospital to which patient was admitted. CONCLUSIONS: Analysis of ACSC allows identifying groups with inadequate access to primary health care. Although we could not infer an effect on the risk of hospital admission, analysis by sex and model of care suggests that Family Health Program is more equitable than "traditional" primary health care.
FONTE: Revista de Saúde Pública, São Paulo, v. 42, n. 6, p.1041-1052, 2008.
REFERENCIA: FACCHINII, Luiz Augusto et al. Family health program and ambulatory care-sensitive conditions in southern Brazil. Revista de Saúde Pública, São Paulo, v. 42, n. 6, p.1041-1052, 2008.
485. Specialist human resources for health in Europe: are we ready?
AUTOR(ES): Philipa Mladovsky; Tiziana Leone
ANO: 2010
RESUMO: Given these myriad issues, a key question facing European policy makers is whether workforce planning of medical specialists at the EU level would be a desirable and/or possible exercise. National data on the health workforce in the EU are reported by EUROSTAT.
FONTE: European Observatory On Health Systems And Policies, Copenhagen, v. 12, n. 2, p.1-16, 2010.
REFERENCIA: MLADOVSKY, Philipa; LEONE, Tiziana. Specialist human resources for health in Europe: are we ready? European Observatory On Health Systems And Policies, Copenhagen, v. 12, n. 2, p.1-16, 2010.
486. Access to Health Services: an analysis of the 28-country european quality of life survey, 2003, sponsored by the european foundation for living and working conditions, Dublin.
AUTOR(ES): Richard Rose
ANO: 2004
RESUMO:
FONTE: Aberdeen: University Of Aberdeen, 2004. 11 p.
REFERENCIA: ROSE, Richard. Access to Health Services: an analysis of the 28-country european quality of life survey, 2003, sponsored by the european foundation for living and working conditions, Dublin. Aberdeen: University Of Aberdeen, 2004. 11 p.
487. Redes Integradas de Servicios de Salud Conceptos, Opciones de Política y Hoja de Ruta para su Implementación en las Américas.
AUTOR(ES): Organizacion Panamericana de Salud
ANO: 2010
RESUMO: Este documento propone un marco conceptual y operativo para entender las RISS, señala sus bene? cios en términos del desempeño general del sistema de salud, señala opciones de política y mecanismos institucionales para poder desarrollarlas, y propone una "hoja de ruta" para implementarlas en los países de las Américas. El contenido del documento se centra en la integración de la función de prestación de los servicios de salud, y por lo tanto no profundiza sobre los mecanismos de integración de la función de financiamiento/aseguramiento de los sistemas de salud. Las estrategias de integración del ? nanciamiento/aseguramiento de los sistemas de salud serán desarrolladas en futuros documentos de la OPS/OMS. Del mismo modo, los mecanismos específicos de integración de los programas focalizados en enfermedades, riesgos y poblaciones especí? cas (programas verticales) serán abordados en un documento aparte. La versión actual de este documento (Noviembre de 2008) es de borrador en consulta. Este documento será revisado y mejorado después de la Consulta Regional sobre RISS a realizarse en Belo Horizonte, Brasil, los días 17 a 19 de Noviembre de 2008. Posteriormente, sus contenidos y recomendaciones serán sometidos a consideración de los Cuerpos Directivos de la OPS/OMS (durante el año 2009).
FONTE: Washington: OPAS, 2010. 95 p.
REFERENCIA: ORGANIZACIÓN PANAMERICANA DE LA SALUD.Redes integradas de servicios de salud: conceptos, opciones de política y hoja de ruta para su implementación en las Américas.Washington: OPAS, 2010. 95 p. (La Renovación de la anteción primaria de salud en las americas n.4).
488. Los determinantes sociales de la salud. Una perspectiva desde el taller Latinoamericano de determinantes sociales de la salud, ALAMES.
AUTOR(ES): Oliva Ló pez Arellano; José Carlos Escudero; Luz Dary Carmona
ANO: 2008
RESUMO:
FONTE: Medicina Social, Peru, v. 3, n. 4, p.323-335, nov. 2008.
REFERENCIA: ARELLANO, Oliva López; ESCUDERO, José Carlos; CARMONA, Luz Dary. Los determinantes sociales de la salud. Una perspectiva desde el taller latinoamericano de determinantes sociales de la salud, ALAMES. Medicina Social, Peru, v. 3, n. 4, p.323-335, nov. 2008.
489. European strategies for tackling social inequities in health: Levelling up Part 2.
AUTOR(ES): Gö ran Dahlgren; Margaret Whitehead
ANO: 2006
RESUMO: The document is the result of a wide range of consultations including discussion of earlier versions of this paper at meetings organized by WHO as well as in international fora. This ? nal version has greatly bene? ted also from two European consultations on how to mainstream the social determinants of health and the reduction of health inequities involving ministries of health, cross-government policy-makers, academia and civil societies from over 30 Member States (Edinburgh 2006 and London 2007). It is also the result of inputs from the WHO Regional Of? ce for Europe technical units and WHO Country Of? ces. The document has also built upon comments from a wide range of experts and policy makers working at international, national and sub-national level. Finally, to ensure that this remains a useful tool for countries in tackling social inequities in health, we will develop a process for monitoring and regular updating of the document.
FONTE: Copenhagem: World Health Organization Europe, 2006. 137 p.
REFERENCIA: DAHLGREN, Göran; WHITEHEAD, Margaret. European strategies for tackling social inequities in health. Copenhagem: World Health Organization Europe, 2006. 137 p.
490. Saúde Brasil 2008. 20 anos de Sistema único de Saúde(SUS) no Brasil.
AUTOR(ES): Ministé rio da Saú de. Secretaria de Vigilâ ncia em Saú de.Departamento de Aná lise de Situaç ã o de Saú de.
ANO: 2009
RESUMO: Em sua primeira parte, o livro aborda o contexto brasileiro dos últimos 20 anos, com base nos determinantes sociais em saúde e analisa as estratégias de ofertas de serviços adotadas pelo SUS na atenção primária, secundária e terciária. Apresenta ainda as políticas transversais de atenção à saúde das crianças, mulheres, idosos, trabalhadores; saúde bucal; e ambiental.A segunda parte da publicação é dedicada à análise da situação de saúde da população brasileira nesse mesmo período, percorrendo temas como mortalidade infantil, transição nutricional, doenças transmissíveis, violências e acidentes, doenças cardiovasculares, neoplasias malignas, dentre outros.
FONTE: Brasília: Ministério da Saúde, 2009. 416 p.
REFERENCIA: Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise de Situação de Saúde. Saúde Brasil 2008: 20 anos de sistema único de saúde (SUS) no Brasil. Brasília: Ministério da Saúde, 2009. 416 p. (Série G. Estatística e Informação em Saúde).
491. Health Indicators 2010: Definitions, Data Sources and Rationale.
AUTOR(ES): Canadian Institute for Health Information
ANO: 2010
RESUMO: This document describes methodology used to calculate health indicators produced by the Canadian Institute for Health Information (CIHI). The methodology used for these indicators was designed to maximize inter-regional comparability given the characteristics of available national datasets. For this reason, there may be differences between definitions, data sources, and extraction procedures used in some local, regional, or provincial/territorial reports when compared to those described here. In addition, discrepancies may exist due to on-going updates to databases. Data presented in Health Indicators publications include the latest updates available at the time of indicator calculation.
FONTE: Ottawa: CIHI ICIS, 2010. 47 p.
REFERENCIA: CANADIAN INSTITUTE FOR HEALTH INFORMATION. Health indicators 2010: definitions, data sources and rationale. Ottawa: CIHI ICIS, 2010. 47 p.
492. Georgia health system performance assessment 2009.
AUTOR(ES): World Health Organization
ANO: 2009
RESUMO: This report summarizes the main findings of the World Health Organization (WHO) assessment of the performance of the Georgian health system, which was carried out by the Ministry of Labour, Health and Social Affairs of Georgia, with the technical and financial support from the WHO Regional Office for Europe and from the World Bank. This assessment was carried out between July 2007 and September 2009 and contributes to the efforts pursued by the government of Georgia to strengthen the capacities of the Ministry of Labour, Health and Social Affairs for effective stewardship of the health system.This report presents an assessment of the performance of the Georgian health system against a number of key performance dimensions: the health status of the population; the quality of health services and health care outcomes; health promotion and disease prevention policies; equity and financial protection; access to health care services; efficiency and effectiveness of health services; the effective allocation of health system resources; the health information system and the health system stewardship function of the Ministry of Labour, Health and Social Affairs. Policy recommendations are presented at the end of each section of this report. An executive summary is enclosed and a separate executive report and a technical report form the suite of reports related to this assessment. This health system performance assessment is the first in a series of similar reports released this year by the World Health Organization Regional Office for Europe. Other reports to be released in 2009 include Armenia, Estonia and Portugal.
FONTE: Geneva:WHO, 2009. 134 p.
REFERENCIA: WORLD HEALTH ORGANIZATION .Georgia health system performance assessment 2009. Geneva: WHO, 2009. 134 p.
493. Australia's Health 2008.
AUTOR(ES): AIHW, Australian Institute Of Health And Welfare
ANO: 2008
RESUMO:
FONTE: Canberra: Australian Government, 2008.
REFERENCIA: AIHW, Australian Institute Of Health And Welfare. Australia's health 2008. Canberra: Australian Government, 2008. 610 p.
494. State of the USA Health Indicators: Letter Report.
AUTOR(ES): Institute of Medicine
ANO: 2008
RESUMO: The Committee on the State of the USA Health Indicators was asked to provide guidance on topic areas and indicators that should be included in the health/health care domain of the SUSA website. In conducting its task, the committee was asked to give consideration to the following: 1. Availability of high quality data at the national level to accurately reflect the indicator construct, including the availability of data that can be broken down by important population subgroups (e.g., age, gender, socioeconomic status [SES], race/ethnicity) and geographic region (states, cities, communities); 2. Reliability and quality of data and data sources; 3. Issues that are most salient for intended audiences and users of SUSA; 4. Indicators that are sensitive to changes in other societal domains (socioeconomic or environmental conditions or public policies); and 5. Indicators that permit cross-country comparisons.
FONTE: EUA: National Academy Of Sciences, 2008. 4 p.
REFERENCIA: INSTITUTE Of MEDICINE. State of the USA health indicators:letter report. EUA: National Academy Of Sciences, 2008. 4 p.
495. Avaliação do desempenho do sistema de atenção às urgências do Estado de Goiás.
AUTOR(ES): Fausto Jaime
ANO: 2007
RESUMO:
FONTE: Goiás: Secretaria de Estado da Saúde de Goiás, 2007. 59 p.
REFERENCIA: JAIME, Fausto. Avaliação do desempenho do sistema de atenção às urgências do Estado de Goiás. Goiás: Secretaria de Estado da Saúde de Goiás, 2007. 59 p.
496. A critical analysis on Italian perinatal mortality in a 50-year span.
AUTOR(ES): Marco Scioscia; Antonella Vimercati; Antonio Maiorano; Raffaella Depalo; Luigi Selvaggi
ANO: 2007
RESUMO: BACKGROUND: Perinatal mortality rate is used as an indicator of reproductive health worldwide. In western countries, national mortality registers are usually accurate and reliable. METHODS AND AIMS: We reviewed the data recorded in the past 50 years in Italy on perinatal and infant mortality. Each single class of mortality rate (according to WHO definitions) was assessed on temporal trends allowing a critical speculative analysis, mainly focusing on the last 20 years, in an attempt to evaluate the impact of prenatal diagnosis. RESULTS: Infant mortality rate (IMR) constantly decreased in the study period whereas early neonatal mortality rate progressively diminished in a 5-year comparison till the early 1990s. Perinatal mortality showed a linear negative trend until the 1980s, after which the decrease steadied at about 23% in the following 5-year period. Infant mortality attributable to congenital anomalies throughout a 20-year span (1980-2000) was steady at about 23% although a progressive reduction in general infant mortality was reported. CONCLUSIONS: A higher reduction in neonatal and perinatal mortality rate was found before the wide availability of the ultrasonographic prenatal diagnosis and the introduction of the law on voluntary abortion in Italy. Given these data, it seems that advances in neonatal care have improved the infant survival rates more than prenatal diagnosis, whereas obstetric care is linked to a reduction of the early perinatal mortality rate.
FONTE: European Journal Of Obstetrics & Gynecology and Reproductive Biology, Limerick, v. 30, n. 1, p.60-65, jan. 2007.
REFERENCIA: SCIOSCIA, Marco et al. A critical analysis on Italian perinatal mortality in a 50-year span. European Journal Of Obstetrics & Gynecology and Reproductive Biology, Limerick, v. 30, n. 1, p.60-65, jan. 2007.
497. Australia's Health 2010.
AUTOR(ES): AIHW, Australian Institute of Health and Welfare
ANO: 2010
RESUMO:
FONTE: Canberra: Australian Government, 2010.
REFERENCIA: AIHW, Australian Institute Of Health And Welfare. Australia's health 2010. Canberra: Australian Government, 2010. 567 p.
498. Trends in quality of care for patients with acute myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006.
AUTOR(ES): Eric D. Peterson; Bimal R. Shah; Lori Parsons; Charles V. Pollack Jr; William J. French; John G. Canto; Michael Gibson; William J. Rogers
ANO: 2008
RESUMO: BACKGROUND: Trends in the use of guideline-based treatment for acute myocardial infarction (AMI) as well as its association with patient outcomes have not been summarized in a large, longitudinal study. Furthermore, it is unknown whether gender-, race-, and age-based care disparities have narrowed over time. METHODS AND RESULTS: Using the National Registry of Myocardial Infarction database, we analyzed 2,515,106 patients with AMI admitted to 2,157 US hospitals between July 1990 and December 2006 to examine trends overall and in select subgroups of guideline-based admission, procedural, and discharge therapy use. The contribution of temporal improvements in acute care therapies to declines in in-hospital mortality was examined using logistic regression analysis. From 1990 to 2006, the use of all acute guideline-recommended therapies administered rose significantly for patients with ST-segment elevation myocardial infarction and patients with non-ST-segment myocardial infarction but remained below 90% for most therapies. Cardiac catheterization and percutaneous coronary intervention use increased in patients with ST-segment elevation myocardial infarction and patients with non-ST-segment myocardial infarction, whereas coronary bypass surgery use declined in both groups. Despite overall care improvements, women, blacks, and patients > or =75 years old were significantly less likely to receive revascularization or discharge lipid-lowering therapy relative to their counterparts. Temporal improvements in acute therapies may account for up to 37% of the annual decline in risk for in-hospital AMI mortality. CONCLUSION: Adherence to American Heart Association/American College of Cardiology practice guidelines has improved care of patients with AMI and is associated with significant reductions in in-hospital mortality rates. However, persistent gaps in overall care as well as care disparities remain and suggest the need for ongoing quality improvement efforts.
FONTE: American Heart Journal, St. Louis, v. 156, n. 6, p.1045-1055, dez. 2008.
REFERENCIA: PETERSON, Eric D. et al. Trends in quality of care for patients with acute myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006. American Heart Journal, St. Louis, v. 156, n. 6, p.1045-1055, dez. 2008.
499. Seminário sobre o modelo de atenção à saúde no SUS.
AUTOR(ES): Eugê nio Vilaç a
ANO: 2008
RESUMO:
FONTE: Brasilia: Conass, 2008.
REFERENCIA: VILAÇA, Eugênio. Seminário sobre o modelo de atenção à saúde no SUS. Brasilia: Conass, 2008.
500. A framework for measuring health inequity.
AUTOR(ES): Yukiko Asada
ANO: 2005
RESUMO: BACKGROUND: Health inequality has long attracted keen attention in the research and policy arena. While there may be various motivations to study health inequality, what distinguishes it as a topic is moral concern. Despite the importance of this moral interest, a theoretical and analytical framework for measuring health inequality acknowledging moral concerns remains to be established. STUDY OBJECTIVE: To propose a framework for measuring the moral or ethical dimension of health inequality-that is, health inequity. DESIGN: Conceptual discussion. CONCLUSIONS: Measuring health inequity entails three steps: (1) defining when a health distribution becomes inequitable, (2) deciding on measurement strategies to operationalize a chosen concept of equity, and (3) quantifying health inequity information. For step (1) a variety of perspectives on health equity exist under two categories, health equity as equality in health, and health inequality as an indicator of general injustice in society. In step (2), when we are interested in health inequity, the choice of the measurement of health, the unit of time, and the unit of analysis in health inequity analysis should reflect moral considerations. In step (3) we must follow principles rather than convenience and consider six questions that arise when quantifying health inequity information. This proposed framework suggests various ways to conceptualize the moral dimension of health inequality and emphasises the logical consistency from conception to measurement.
FONTE: Journal Epidemiology Community Health, London, v. 59, n. 8, p.700-705, ago. 2005.
REFERENCIA: ASADA, Yukiko. A framework for measuring health inequity. Journal Epidemiology Community Health, London, v. 59, n. 8, p.700-705, ago. 2005.
501. Access to Health Care Services in Canada.
AUTOR(ES): Statistics Canada
ANO: 2006
RESUMO:
FONTE: Health Statistics Division, Ottawa, p.1-25, 2006.
REFERENCIA: STATISTICS CANADA. Access to health care services in Canada. Health Statistics Division, Ottawa, p.1-25, 2006.
502. Quality of health care. Part 2: measuring quality of care.
AUTOR(ES): Robert H. Brook; Elizabeth A. McGlynn; Paul D. Cleary
ANO: 1996
RESUMO:
FONTE: The New England Journal Of Medice, Boston, v. 335, n. 13, p.966-970, 1996.
REFERENCIA: BROOK, Robert H.; MCGLYNN, Elizabeth A.; CLEARY, Paul D. Quality of health care. Part 2: measuring quality of care. The New England Journal Of Medice, Boston, v. 335, n. 13, p.966-970, 1996.
503. How close have universal health systems come to achieving equity in use of curative services? A systematic review.
AUTOR(ES): Barbara Hanratty; T.Zhang; Margaret Whitehead
ANO: 2007
RESUMO: Most governments in established market economies have developed universal systems of health care, but these are being increasingly threatened by widespread health sector reforms. Hence, it is more important than ever to monitor the effects of policy changes on the ability of universal systems to achieve their equity goals. This article provides evidence for such monitoring. The authors present the results of a systematic review of equity in use of curative health services in universal systems, together with a critical appraisal of the essential components of studies to address this question. Of the 79 studies identified that addressed the review question, only 26 met the inclusion criteria and adjusted for differential health need across socioeconomic groups. The authors found a pro-rich bias in use of specialist hospital services and a reasonably equitable access to primary health care by different socioeconomic groups. There was a wide inter-study variation in the difference in utilization rates between people of high and low socioeconomic groups. Improvements are needed in the way that equity in universal systems is monitored, with particular attention to how need is defined and to the impact on patients of indirect costs.
FONTE: International Journal Of Health Services, Amityville, v. 37, n. 1, p.89-109, 2007.
REFERENCIA: HANRATTY, Barbara; ZHANG, T; WHITEHEAD, Margaret. How close have universal health systems come to achieving equity in use of curative services?: a systematic review. International Journal Of Health Services, Amityville, v. 37, n. 1, p.89-109, 2007.
504. Severity of Illness and Ambulatory Care–Sensitive Conditions.
AUTOR(ES): Elaine J. Yuen
ANO: 2004
RESUMO: This study describes how severity of illness may refine the definition of ambulatory care-sensitive conditions, or ACSCs. Hospital discharge abstract data from Philadelphia were combined with census data to develop population-based adjusted rates of hospitalization for diabetes and asthma, two ACSCs. By stratifying ACSC hospitalization by severity of illness, variations were observed by age, race, and gender. Minority groups may be at higher risk for less access to outpatient primary care and were observed to have higher rates of more severely ill, Stage 3 hospitalization. Geographic map displays indicated wide ranges of age-sex-adjusted rates for high-severity hospitalization in the five-county Philadelphia region. This refined ACSC measure may help to identify specific groups and clinical conditions within a population to assist health care planners estimate health care resources such as facilities, manpower, and programs, as well as to evaluate their outcomes.
FONTE: Medical Care Research And Review, Thousand Oaks, v. 61, n. 3, p.376-391, out. 2004.
REFERENCIA: YUEN, Elaine J..Severity of illness and ambulatory care-sensitive conditions. Medical Care Research and Review, Thousand Oaks, v. 61, n. 3, p.376-391, out. 2004.
505. The health professions and the performance of future health systems in low-income countries: support or obstacle?
AUTOR(ES): Gilles Dussault
ANO: 2008
RESUMO: This paper discusses the present and future role of the health professions in health services delivery systems in low-income countries. Unlike richer countries, most low-income countries do not have a tradition of labour market regulation and the capacity of the professions themselves to regulate the provision of health services by their members tends to be weak. The paper looks at the impact of professional monopolies on the performance of health services delivery systems, e.g. equity of access, effectiveness of services, efficiency in the use of scarce resources, responsiveness to users needs, including protection against the financial impact of utilising health services. It identifies issues which policy-makers face in relation to opening the health labour market while guaranteeing the safety and security of services provided by professionals. The suggestion is made that a social contract, granting privileges of practice in exchange of a commitment to actively maintain and enhance the quality of their services, may be a viable course of action. This would require that the actors in the policy process collaborate in strengthening the capacity of regulatory agencies to perform their role
FONTE: Social Science & Medicine, Oxford, v. 66, n. 10, p.2088-2095, maio 2008.
REFERENCIA: DUSSAULT, Gilles. The health professions and the performance of future health systems in low-income countries: support or obstacle?. Social Science & Medicine, Oxford, v. 66, n. 10, p.2088-2095, maio 2008.
506. Health care quality indicators project: patient safety indicators: report 2009.
AUTOR(ES): Saski Drö sler; Patrick Romano; Lihan Wei.
ANO: 2009
RESUMO:
FONTE: Paris: OECD Health Technical Papers, 2009. 47 p.
REFERENCIA: DRÖSLER, Saski; ROMANO, Patrick; WEI, Lihan. Health care quality indicators project: patient Safety indicators: report 2009. Paris: OECD Health Technical Papers, 2009. 47 p.
507. Who, and what, causes health inequities? Reflections on emerging debates from an exploratory Latin American/North American workshop.
AUTOR(ES): Nancy Krieger, Margarita Alegrí a, Naomar Almeida-Filho, Jarbas Barbosa da Silva, Maurí cio L Barreto, Jason Beckfield, Lisa Berkman, Anne-Emanuelle Birn, Bruce B Duncan, Saul Franco, Dolores Acevedo Garcia, Sofia Gruskin, Sherman A James, Asa Christina Laurell, Maria Inê s Schmidt, Karina L Walters
ANO: 2010
RESUMO:
FONTE: Journal Epidemiology Community Health, London, v. 64, n. 9, p.747-749, set. 2010.
REFERENCIA: KRIEGER, Nancy et al. Who, and what, causes health inequities?: reflections on emerging debates from an exploratory Latin American/North American workshop. Journal Epidemiology Community Health, London, v. 64, n. 9, p.747-749, set. 2010.
508. Achieving a high-performance health care system with universal access: what the United States can learn from other countries.
AUTOR(ES): Jack A. Ginsburg; , R.B. Doherty RB; J.F. Ralston Jr; N. Senkeeto; M. Cooke; C. Cutler; D.A. Fleming; B.P. Freeman, R.A. Gluckman; M. Liebow; R.M. McLean
ANO: 2008
RESUMO: This position paper concerns improving health care in the United States. Unlike previous highly focused policy papers by the American College of Physicians, this article takes a comprehensive approach to improving access, quality, and efficiency of care. The first part describes health care in the United States. The second compares it with health care in other countries. The concluding section proposes lessons that the United States can learn from these countries and recommendations for achieving a high-performance health care system in the United States. The articles are based on a position paper developed by the American College of Physicians' Health and Public Policy Committee. This policy paper (not included in this article) also provides a detailed analysis of health care systems in 12 other industrialized countries. Although we can learn much from other health systems, the College recognizes that our political and social culture, demographics, and form of government will shape any solution for the United States. This caution notwithstanding, we have identified several approaches that have worked well for countries like ours and could probably be adapted to the unique circumstances in the United States.
FONTE: Annals Of Internal Medicine, Philadelphia, v. 148, n. 1, p.55-75, 2008.
REFERENCIA: GINSBURG, Jack et al. Achieving a high-performance health care system with universal access: what the United States can learn from other countries. Annals Of Internal Medicine, Philadelphia, v. 148, n. 1, p.55-75, 2008.
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