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.

Desempenho de sulcadores no desenvolvimento e produtividade da soja em solo submetido a diferentes níveis de compactação

On the national scene, soybean crop occupies a prominent position in cultivated area and volume production, being cultivated largely in the no tillage system. This system, due to the intense traffic of machines and implements on its surface has caused soil compaction problems, which has caused the yield loss of crops. In order to minimize this effect the seeder-drill uses the systems to opening the furrow by shank or the double disc type. The use of the shank has become commonplace for allowing the disruption of the compacted surface layer, however requires greater energy demand and may cause excessive tillage in areas where there is not observed high levels of compaction. Thus, this study aimed to evaluate the effects of furrowers mechanisms and levels of soil compacting on traction requirement by a seeder-drill and on the growing and productivity of soybean in an Oxisol texture clay, in a two growing seasons. The experimental design consisted of randomized blocks with split plots with the main plots composed of four levels of soil compaction (N0 – no tillage without additional compaction, N1, N2 and N3 – no tillage subjected to compaction through two, four and six passes with tractor, respectively) corresponding to densities of soil 1.16, 1.20, 1.22 and 1.26 g cm-3, and subplots by two furrowers mechanisms (shank and double disc) with four replicates. To evaluate the average, maximum and specific traction force requested by the seeder-drill, was used a load cell, with capacity of 50 kN and sensitivity of 2 mV V-1, coupled between the tractor and seeder-drill, whose data are stored in a datalogger system model CR800 of Campbell Scientific. In addition, were evaluated the bulk density, soil mechanical resistance to penetration, sowing depth, depth and groove width, soil area mobilized, emergence speed index, emergence operation, final plant stand, stem diameter, plant height, average number of seeds per pod, weight of 1,000 seeds, number of pods per plant and crop productivity. Data were subjected to analysis of variance, the mean of furrowers were compared by Tukey test (p≤0.05), while for the factor soil compaction, polynomial regression analysis was adopted, selected models by the criterion of greater R2 and significance (p≤0.05) of equation parameters. Regardless of the crop season, penetration resistance increase as soil compaction levels up to around 0.20 m deep, and bulk density influenced the sowing quality parameters, however, did not affect the crop yield. In the first season, there was a higher productivity with the use of the shank type. In the second crop season, the shank demanded greater energetic requirement with the increase of bulk density and opposite situation with the double disc. The locking of sowing lines allow better performance of the shank to break the compacted layer.