Fisioterapia e reabilita����o em Portugal : o financiamento como factor cr��tico do desempenho

RESUMO - Num contexto em que a presta����o de cuidados de Fisioterapia e Reabilita����o �� identificada como apresentando uma desigualdade e desajustamento da oferta regional superior �� dos restantes cuidados de sa��de, assim como uma falta de adequa����o dos pre��os praticados, perante as condi����es de oferta e procura actualmente existentes, o presente trabalho tem por objectivo investigar, no dom��nio do Desempenho, a influ��ncia do Financiamento na defini����o da presta����o destes cuidados, tendo como pressuposto gen��rico que as decis��es estrat��gicas e a reestrutura����o produtiva das organiza����es de sa��de s��o condicionadas pelo sistema de pre��os. Considera-se que o actual sistema de Financiamento/Pagamento provoca um constrangimento na qualidade da resposta destes cuidados a dois n��veis: um primeiro n��vel, ao colocar o pagamento no ��mbito dos Meios Complementares de Diagn��stico e Terap��utica (MCDTs) a contratar pelo Servi��o Nacional de Sa��de, com isso determinando a configura����o organizativa do sistema; um segundo n��vel de constrangimento que incide sobre as estruturas das organiza����es prestadoras, pela modela����o que induz, nomeadamente a n��vel da sua produ����o. Na impossibilidade de tratar as duas dimens��es do problema, pela falta de indicadores de desempenho deste sector, analisou-se, relativamente ao segundo n��vel de constrangimento, a produ����o de fisioterapia de tr��s organiza����es que, potencialmente, teriam o mesmo o mesmo perfil de oferta por se enquadrarem num mesmo perfil de procura. Os resultados reflectem o pressuposto gen��rico do trabalho e abrem espa��o para colocar como futura hip��tese de investiga����o a raz��o da(s) causa(s) que poder��o estar subjacentes �� discrep��ncia encontrada na m��dia de tratamentos por sess��o (duas vezes e meia) na produ����o das duas organiza����es que foi poss��vel comparar.------------------- ABSTRACT - In a context where the provision of Physical Therapy and Rehabilitation care is identified as having a regional mismatch of supply and inequality above all the others health cares, and a lack of adequacy of prices in the current conditions of supply and demand, the present work has, as main purpose, to investigate, in the field of Performance, the Payment���s influence in shaping the provision of such health care. The general assumption tracking this analysis is that the strategic decisions on productive structure of health care organizations are influenced by the price systems. It is considered that the current Finance / Payment system causes two levels of constraints on the quality of such health care: a first constraint, as it putts its payment under the Supplementary Means of Diagnosis and Therapy (MCDTs), witch ends up establishing the organizational setup of the system; a second level of constraint by modelling the internal structure of these organizations. The lack of indicators characterizing the performance of this sector, addressed the present study to the second dimension, in witch was analysed the physical therapy production in three organizations that, potentially, would have the same profile of supply responding to similar characteristics of demand. The results reflect the above mentioned general assumption that supported the work, and leave an open space for future research, about the reason (s) that lay behind the discrepancy found between the average of treatments per session (two and a half times) in

Introdu����o e difus��o de novas tecnologias : impacto do financiamento e do estatuto jur��dico hospitalar

RESUMO - Os gastos com a sa��de, em Portugal, como nos pa��ses da Uni��o Europeia e da OCDE, t��m crescido a um ritmo superior ao do crescimento econ��mico, assumindo uma import��ncia crescente face ao PIB. Entre estes factores surge a velocidade da introdu����o da inova����o e dos desenvolvimentos tecnol��gicos dos dom��nios do diagn��stico e da terap��utica. Uma das mais dif��ceis e importantes quest��es para as pol��ticas de sa��de �� a rela����o entre a sa��de e os gastos com a presta����o de cuidados de sa��de. Estudos recentes sugerem que os cuidados de sa��de ocupam um papel importante na melhoria da sa��de da popula����o, e que os recentes avan��os tecnol��gicos s��o custo-efectivos aceites na generalidade por cada ano de vida ganho. Este trabalho visa estudar a influ��ncia que o financiamento e o estatuto jur��dico hospitalar t��m na introdu����o e adop����o de novas tecnologias em sa��de. Para isso, al��m da revis��o bibliogr��fica, foi realizada uma an��lise a uma base de dados, cujos elementos se cingem a pacientes com doen��as cardiovasculares atendidos num dos hospitais do Servi��o Nacional de Sa��de, entre 2000 e 2006. --- ------------------------------------ABSTRACT - Health expenditures in Portugal, as in EU countries and in the OECD, have developed at a higher rate than economic growth, assuming an increasing importance to the GDP. Among these factors appears the speed of the introduction of innovation and technological development in diagnosis and therapy areas. One of the most difficult and most important questions for health policy is the relationship of health to health care spending. Studies now suggest that medical care has played an important role in improving the health of the population, and recent technical advances are cost-effective at generally accepted values of an added year of life. This work aims to study the influence that the prospective payment and the hospital���s legal status have in introduction and adoption of new technologies in health. For this, besides the literature review, an analysis was made to a database, whose elements are confined to patients with cardiovascular disease treated in the hospitals of t

Gest��o dos custos dos acidentes de trabalho em meio hospitalar

RESUMO - No contexto econ��mico actual, os custos pelos acidentes devem ser tidos em conta por todos os gestores das organiza����es, com especial destaque ao sector da sa��de. Assim a an��lise econ��mica deste estudo visa alertar para o impacto econ��mico dos acidentes de trabalho em contexto hospitalar e sensibilizar os gestores para a an��lise do custo-beneficio da preven����o. Existem custos facilmente constat��veis, tais como, o tempo perdido no dia do acidente, quer pelo sinistrado quer pelos colegas de trabalho que o assistem, as despesas de uma ida ao servi��o de urg��ncia, a paragem da produ����o, a forma����o de m��o-de-obra alternativa, a substitui����o dos trabalhadores, o pagamento de horas extras, o restabelecimento dos trabalhadores, os sal��rios pagos aos trabalhadores sinistrados, as despesas administrativas e o aumento do pr��mio do seguro, entre outros. Existem outros custos que n��o s��o t��o evidentes e por conseguinte, dificilmente quantific��veis, como �� o caso da deteriora����o da imagem da empresa e o impacto sentimental que estes provocam nos colegas de trabalho que se traduz em quebras de produtividade. A an��lise econ��mica foi realizada tendo em conta a defini����o de v��rias vari��veis, de v��rias rubricas de custos pertencentes ao mesmo dom��nio. Neste projecto pretende-se analisar o custo global da sinistralidade segundo tr��s ��pticas distintas. A ��ptica da variabilidade, da imputabilidade e da responsabilidade, de forma a ser poss��vel obter o custo marginal devido �� ocorr��ncia de um novo acidente, o montante de custos assumidos pelas empresas e os custos unit��rios segundo a natureza e a localiza����o da les��o. ---------- ABSTRACT - In the current economic context, the costs originated by labour accidents must be taken in account by all the managers of the organisations, in this case, especially by the health sector. Thus, the economic analysis of this study case aims, to alert for the economic impact of the industrial accidents and motivate the managers for the analysis of the cost-benefit for prevention. There are kinds of costs easily quantified such as, the lost time in the day of the accident, expenses in the urgencies service, production interruption, workforce formation, workers��� substitution, extra work payment, employers��� healing, wages paid to injured workers���, administrative expenses and a biggest insurers������ prime, among other things. The economic analysis of the labour injuries, was developed taking in account the definition of some variables, of some cost categories which belong to same domain. In this project we pretend to analyse the global cost labour injuries according to three distinct optics: variability, imputability and responsibility. Thus, it became possible to get the cost due to an occurrence of a new accident, the unitary sum of costs assumed by the companies and costs according to nature and the localisation of the injury.

CDR, um res��duo ou um produto, e a sua viabilidade t��cnico-econ��mica: an��lise do estudo do caso

Disserta����o apresentada na Faculdade de Ci��ncias e Tecnologia da Universidade Nova de Lisboa para obten����o do Grau de Mestre em Engenharia do Ambiente, Perfil Engenharia Sanit��ria

Home Banking

The object of this dissertation is focused on the study of the home banking service and how the allocation of losses due to computer fraud is processed in the scope of this service. When considering the questions raised by the allocation of losses associated with fraudulent operations, it is important to consider, mainly, the behaviour of the user of the home banking service. In our opinion, courts have been too demanding towards the user when judging his action in the use of this service. In this study, we have concluded that, when the user ���falls��� into a computer fraud scheme, he should not be liable for gross negligent behaviour, even if, due to the fraud, the user revealed all his access codes to a hacker on a page similar to that of his bank. In general, such facts will not be sufficient to qualify the user���s action as grossly negligent. Therefore, the user, under the terms of the Payment Services��� System, must bear the loss up to a maximum of ���150, and the bank will face the remainder of the losses. However, if the user, victim of a fraudulent technique, ignored the safety warnings issued by the bank, one must consider, given the specific case, that he contributed to gross negligence in unauthorised payment transactions. Thus, the user must bear all the losses up to the moment when he notifies the bank about the unauthorised transactions. It is the bank���s responsibility to, given the specific case, adduce evidence of the client���s contribution to the identified losses.

Modela����o de processos para as principais ��reas de recursos humanos

Esta disserta����o tem por principal objetivo propor modelos BPMN que possam representar as boas pr��ticas em gest��o recursos humanos, a fim de facilitar a identifica����o dos principais requisitos dos pacotes de software para a Gest��o de Recursos Humanos. Assim, foram estudadas as sub-��reas recrutamento e sele����o, avalia����o de desempenho, forma����o e desenvolvimento, c��lculo e pagamento de sal��rios e recompensas, e a gest��o de carreira. Para o desenho dos modelos BPMN foi adotada a metodologia design science, adequada aos projetos de investiga����o em tecnologias e sistemas de informa����o que t��m por objetivo o design de artefactos a partir de bases te��ricas. Os modelos desenvolvidos foram disponibilizados para avalia����o por gestores e executivos da ��rea de gest��o de recursos humanos o que permitiu refinar e melhorar os mesmos.

Projecto de cria����o de metodologia de an��lise da Usabilidade para selec����o de plataforma SaaS de Gest��o de Projectos online CATCH, Global Marketing

O aparecimento de solu����es de software baseadas na Cloud vieram democratizar o acesso a aplica����es de suporte �� actividade empresarial, permitindo a micro e pequenas empresas aceder a ferramentas que outrora apenas as grandes empresas poderiam financiar, dada a introdu����o de novas formas de pagamento mensais com base em contratos flex��veis, acesso via internet e aus��ncia de instala����o de hardware espec��fico ou compra de licen��as por utilizador ��� a verdadeira utiliza����o de software como um servi��o, vulgo SaaS (Software as a Service). As aplica����es de tipo SaaS aportam in��meros benef��cios para as empresas e mesmo vantagens competitivas importantes, estando dispon��veis solu����es em diversas ��reas, nomeadamente para a Gest��o de Projectos, como ferramentas de CRM (Customer Relationship Management) e CMS (Content Management System), entre outros. Assim, as empresas de Marketing e Comunica����o, caso da empresa em que se centra este Projecto, t��m hoje em dia acesso a um conjunto de aplica����es SaaS, que pelo seu custo acess��vel e f��cil acesso online, permitem ��s empresas mais pequenas serem rapidamente t��o competitivas quanto as maiores, por norma com processos mais pesados e tradicionais. Adicionalmente, assistimos tamb��m ao fen��meno da consumeriza����o das TI, em que os consumidores passam a querer ter o mesmo tipo de User Experience (UX) de que usufruem na utiliza����o de aplica����es fora do seu trabalho, aplicadas �� vida empresarial. Este Projecto argumenta que a Usabilidade deve ser um dos elementos chave para a selec����o correcta de uma aplica����o online de Gest��o de Projectos (do tipo SaaS), algo que deveria ser facilitado pela aplica����o de uma metodologia de teste da Usabilidade, dispon��vel numa plataforma online de acesso livre. A metodologia dever�� ser eficaz e pass��vel de ser utilizada por colaboradores de uma micro ou pequena empresa, apoiando o seu processo decis��rio de investimento, sendo eles especialistas ou n��o na mat��ria. A metodologia proposta neste projecto explorat��rio pressup��e uma complementaridade entre a avalia����o Heur��stica de Usabilidade pelo m��todo de Nielsen e o M��todo de Purdue - Purdue Usability Testing Questionnaire (PUTQ).

O incumprimento do contrato de cr��dito ao consumo pelo consumidor

Consumer relations, established between the Consumer and the Creditor, which carry a consequent inequality of contractual positioning between the parties, have been pushing the legislator to adopt more rigid regulations with regard to lending for the purchase of goods or services of consum issues. In this sense, the Decree-Law 359/91 was approved, meanwhile repealed by the Decree-Law 133/2009, which regulates the consumer credit agreement���s regime in the portuguese legal system. Through this contract, the financier makes available to the consumer a certain amount of money, which the consumer must repay, plus the respective remuneration (interest) and other charges, according to a refund plan agreed by the parties. The consumer will be in delay if he breaches this stipulation. In case of default, the creditor, notwithstanding, can choose to wait for the performance by the debtor, promote the loss of benefit of the term or the termination of the contract. From the outset it would seem that, in one way or another, the financier, by imposing a forced shortening of the contract duration initially agreed, will lose the right to remuneration for the provision of capital agreed, but not verified. Nevertheless, unlike presently, the previous regime allowed the parties to rule otherwise, being permitted to agree to the payment of interest of outstanding installments. On the other hand, in the consumer credit contract the principle of freedom of contractual provision of the parties is strongly mitigated by the special legislation, which prevents the waiver of rights by the consumer, and by the regime of general contractual terms, which restricts the freedom of the financier to stipulate the contractual content freely and the freedom of the consumer to negotiate. For all these reasons, associated with the growing need of credit resource to satisfy their needs of consumption, it is confirm the relevance of legislative intervention on consumers protection in the context of hiring credit.

O incumprimento do contrato de cr��dito ao consumo pelo consumidor

Consumer relations, established between the Consumer and the Creditor, which carry a consequent inequality of contractual positioning between the parties, have been pushing the legislator to adopt more rigid regulations with regard to lending for the purchase of goods or services of consum issues. In this sense, the Decree-Law 359/91 was approved, meanwhile repealed by the Decree-Law 133/2009, which regulates the consumer credit agreement���s regime in the portuguese legal system. Through this contract, the financier makes available to the consumer a certain amount of money, which the consumer must repay, plus the respective remuneration (interest) and other charges, according to a refund plan agreed by the parties. The consumer will be in delay if he breaches this stipulation. In case of default, the creditor, notwithstanding, can choose to wait for the performance by the debtor, promote the loss of benefit of the term or the termination of the contract. From the outset it would seem that, in one way or another, the financier, by imposing a forced shortening of the contract duration initially agreed, will lose the right to remuneration for the provision of capital agreed, but not verified. Nevertheless, unlike presently, the previous regime allowed the parties to rule otherwise, being permitted to agree to the payment of interest of outstanding installments. On the other hand, in the consumer credit contract the principle of freedom of contractual provision of the parties is strongly mitigated by the special legislation, which prevents the waiver of rights by the consumer, and by the regime of general contractual terms, which restricts the freedom of the financier to stipulate the contractual content freely and the freedom of the consumer to negotiate. For all these reasons, associated with the growing need of credit resource to satisfy their needs of consumption, it is confirm the relevance of legislative intervention on consumers protection in the context of hiring credit.

Raptos, sequestros e tomada de ref��ns

In this thesis we address the paradigms and inconsistencies involving crisis kidnappings and hostage-taking. This work particularly focuses on foreign hostages seized by terrorists and guerrilla movements. It highlights major global events that have contributed to the collective awareness of the phenomenon and the evolution of international agreements and protocols. We focus on the episodes involving Portugal or Portuguese abroad, particularly on the kidnapping of Portuguese in the Cabinda enclave. It also deals with the problems associated with the payment of ransoms, the increasing involvement of private agents in addressing these crises, and incongruities in the motivations of the kidnappers.

Contratos de presta����o de servi��os de comunica����es electr��nicas

The object of this dissertation is the analysis of the legal framework applicable to contracts for provision of electronic communications services, while trying to offer solutions to some of the issues regarding this matter. The main focus of this study will be the rules concerning service���s suspension, which have been recently amended. The technological development and the establishment of these services as information transmitters and work tools were noteworthy for its growing importance at the present time. These services include cable television, telephone (landline and mobile) and internet and they are regulated by Law nr 23/96, July 26th, along with other essential public services. Said law sets a group of principles and duties, such as good faith (article 3), continuity and quality of the service (article 7) and the duty to rightfully inform the user (article 4), in order to protect the users. For the analysis of legal framework applicable to these particular contracts it is also fundamental to mention Law nr 5/2004, February 10th, known as Electronic Communications Law. The provisions regarding the service���s suspension are currently prescribed in articles 52.�� and 52.��-A of the law. Given the amendments introduced by Law nr 10/2013, January 28th, consumers are subjected to a regulation different from the one applicable to the other users, established in the new article 52.��-A. From our analysis, we have concluded that the main change from past provisions has to do with the automatic termination of the contract as consequence of the consumer���s failure to pay the price or to conclude a written payment arrangement after service���s suspension.