Sistemas de custeio na gestão hospitalar

The cost management in any organization provides a number of benefits such as security in the good management of resources, but it is little used in the public hospital sector which is shaped like a paradox, facing the complexity of hospital organization and the underfunding situation of Cheers. The purpose of this book was to develop and submit an application method of a costing system in public hospitals. This proposal was developed in partnership with the Secretariat of the State of Paraná Health, with financial support from PPSUS and Araucaria Foundation. The study was conducted as an action research in two public hospitals in Paraná, but it can be replicated in any hospital from the premises of the developed method. For this, We developed the concepts of administration and public governance, the right to health in Brazil, the costs in the public sector and the detailed presentation of the proposed costing system model. The results constitute an important management tool for hospitals and Ministry of Health, enabling greater security leaders in the face of difficulties and challenges in this segment. Thus, it is expected that the book will contribute to governments for better management of public funds allocated to health; with academia, as a still incipient theme in literature; and society, so that more hospitals were professionalize its cost management and thereby provide a more efficient and effective service.

Biomonitoramento da comunidade de macroinvertebrados de um reservatório de abastecimento público no sul do Brasil

The faunal inventory of the macroinvertebrate community is important to the environmental assessment, since this biota is sensitive to human disturbance. The reservoir of Rio Verde, located on the first plateau of Paraná, is inserted into an agricultural region with several forest fragments Araucaria. The aim of this study was to evaluate the environmental integrity of the reservoir through ecological indexes of macroinvertebrate community benthic and associated with macrophytes. Five sampling points were defined in the study area, which comprise distinct microhabitats in the basin. There were four sampling campaigns, each by weather station: Spring (2014); Summer (2015); Autumn (2015) and Winter (2015). In each sample were measured abiotic various parameters in the field and be collected water samples for nutrient analysis in the laboratory. The macroinvertebrates were collected in triplicate at adapted Macan method using mesh sieve 1 mm and CPUE (catch per unit effort) for 20 minutes. In order to pellet sample was used a dredger model Petersen 2L. Still in the field, by season, samples were collected from macrophytes Myriophyllum aquaticum (Vell) Verdc. and Potamogeton montevidensis A. Benn. in triplicates in the fluvial region of the reservoir, to analyze the associated fractal dimension and macrofauna. For this we used a PVC sampler specific volume 0.025 m3. the following ecological descriptors were calculated in each case: abundance, wealth tax, wealth Margalef, Shannon-Wiener diversity, evenness evenness through the Past software. The index Biological Monitoring Working Party (BMWP) for monitoring sampling points was also calculated. Regarding the statistical analysis, we used the analysis of PERMANOVA to compare points and seasons and canonical correspondence analysis (CCoA) for variables. Regarding M. aquaticum and P. montevidensis it was not verified difference to the average associated macroinvertebrates. However there was a difference for abundance of organisms in the fractal dimension and biomass of specimens. M. aquaticum is more complex and took more macrofauna in relation to P. montevidensis. Regarding the monitoring of the reservoir, it showed up mesotrophic with moderate nutrient concentrations and within the regulatory limits. Benthic macrofauna showed statistical differences in relation to the reservoir region, sample point and temporal variation. The BMWP index showed that the river region has the highest biotic integrity (in all samples above 70 points), and the ecological descriptors of wealth and Margalef diversity of Shannon- Wiener higher. In point 4 (dam downstream) were recorded evidence of possible impacts due to lower wealth and BMWP index which resulted in a questionable quality water. New approaches are needed to focus on the aquatic community in the best understanding of this ecosystem and also with a view to environmental preservation of the Green River Basin.