Fisioterapia e reabilitação em Portugal : o financiamento como factor crítico do desempenho

RESUMO - Num contexto em que a prestação de cuidados de Fisioterapia e Reabilitação é identificada como apresentando uma desigualdade e desajustamento da oferta regional superior à dos restantes cuidados de saúde, assim como uma falta de adequação dos preços praticados, perante as condições de oferta e procura actualmente existentes, o presente trabalho tem por objectivo investigar, no domínio do Desempenho, a influência do Financiamento na definição da prestação destes cuidados, tendo como pressuposto genérico que as decisões estratégicas e a reestruturação produtiva das organizações de saúde são condicionadas pelo sistema de preços. Considera-se que o actual sistema de Financiamento/Pagamento provoca um constrangimento na qualidade da resposta destes cuidados a dois níveis: um primeiro nível, ao colocar o pagamento no âmbito dos Meios Complementares de Diagnóstico e Terapêutica (MCDTs) a contratar pelo Serviço Nacional de Saúde, com isso determinando a configuração organizativa do sistema; um segundo nível de constrangimento que incide sobre as estruturas das organizações prestadoras, pela modelação que induz, nomeadamente a nível da sua produção. Na impossibilidade de tratar as duas dimensões do problema, pela falta de indicadores de desempenho deste sector, analisou-se, relativamente ao segundo nível de constrangimento, a produção de fisioterapia de três organizações que, potencialmente, teriam o mesmo o mesmo perfil de oferta por se enquadrarem num mesmo perfil de procura. Os resultados reflectem o pressuposto genérico do trabalho e abrem espaço para colocar como futura hipótese de investigação a razão da(s) causa(s) que poderão estar subjacentes à discrepância encontrada na média de tratamentos por sessão (duas vezes e meia) na produção das duas organizações que foi possível 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

Penicillium glabrum cork colonising isolates – preliminary analysis of their genomic similari

Cork stopper manufacturing process includes an operation, known as stabilisation, by which humid cork slabs are extensively colonised by fungi. The effects of fungal growth on cork are yet to be completely understood and are considered to be involved in the so called “cork taint” of bottled wine. It is essential to identify environmental constraints which define the appearance of the colonising fungal species and to trace their origin to the forest and/or as residents in the manufacturing space. The present article correlates two sets of data, from consecutive years and the same season, of systematic biologic sampling of two manufacturing units, located in the North and South of Portugal. Chrysonilia sitophila dominance was identified, followed by a high diversity of Penicillium species. Penicillium glabrum, found in all samples, was the most frequent isolated species. P. glabrum intra-species variability was investigated using DNA fingerprinting techniques revealing highly discriminative polymorphic markers in the genome. Cluster analysis of P. glabrum data was discussed in relation to the geographical location of strains, and results suggest that P. glabrum arise from predominantly the manufacturing space, although cork resident fungi can also contrib

Dynamics of cork mycobiota throughout stopper manufacturing process: from diversity to metabolite

Dissertation presented to obtain the Ph.D degree in Biology

Managerial strategies in canning industries: A case study of early twentieth century Portugal

Business History, Vol, 51 Issue 1, p45-58

How to optimize Lipton’s business model in order to stimulate tea consumption in Portugal and increase Lipton Leaf tea market share?: The importance of distribution and sales channels management in a B2B2C market

Field Lab Entrepreneurial Innovative Ventures

How to monitor and improve Unilever JM Supply Chain processes to become the best of Portugal’s sector in 2015?

Unilever Jerónimo Martins is a Portuguese joint-venture leading firm in what concerns the supply chain industry of fast-moving consumer goods in Portugal. The scope of analysis of this Work Project is focusing on Unilever-JM operations and services in the Portuguese market regarding quality, efficiency and effectiveness over B2B customers. It will be analysed the possibility of development and implementation of a performance measurement system, Tableau de Bord, which will be crucial for the identification of potential opportunities of improvement with impact in the supply chain processes. This will be completed through the establishment of KPI’s to monitor and manage periodically logistics, planning and customer service processes’ performance, which are the ones where the bottlenecks are impacting more in the supply chain. In this work project the nexus causality for the problems will also be discussed and some recommendations will be prepared to tackle the inefficiencies found through the monitoring of the previous core processes, in order to improve efficacy and quality service of the supply chain.

Macro determinants of nonperforming loans in Portugal

This study uses a VAR methodology to evaluate the impact of the macroeconomic conditions and money supply in the fluctuation of nonperforming loans for the Portuguese economy. Additionally, the feedback effect of nonperforming loans growth to the economy and specially to the credit supply is analised. The study is motived by the hypothesis that loan quality is procyclical and that the fast growth of credit supply has a positive relation with the growth of nonperforming loans. The hypothesis that nonperforming loans reinforce economic fragilities and credit market frictions is also tested. Empirical results corroborate both hypothesis presented. Hence, it was possible to establish that the macroeconomic conditions measured by GDP and unemployment and the fast growth of credit supply contribute to the development of nonperforming loans. Furthermore, the growth of nonperforming loans reinforces the economic cycle, as it contributes to the deterioration of macroeconomic conditions and creates frictions in the credit market that may results in a credit crunch.

Optimization of export support systems: How to promote exports from Portugal to Germany in the area of information technology and electronics

This work project focuses on developing new approaches which enhance Portuguese exports towards a defined German industry sector within the information technology and electronics fields. Firstly and foremost, information was collected and a set of expert and top managers’ interviews were performed in order to acknowledge the demand of the German market while identifying compatible Portuguese supply capabilities. Among the main findings, Industry 4.0 presents itself as a valuable opportunity in the German market for Portuguese medium sized companies in the embedded systems area of expertise for machinery and equipment companies. In order to achieve the purpose of the work project, an embedded systems platform targeting machinery and equipment companies was suggested as well as it was developed several recommendations on how to implement it. An alternative approach for this platform was also considered within the German market namely the eHealth sector having the purpose of enhancing the current healthcare service provision.

Yacht charter in Portugal- developing a business model for a sailing charter company

Given the signals that Portugal can be a great destination for charter sailing, the purpose of this work is to disprove this. Thereby the model of Porter’s five forces has been used to analyze the Portuguese yacht charter market, whereas a SWOT analysis should give an overview and compare the Portuguese market with the well running charter market of Croatia. The research outcome on the supply side as well as on the demand side should then serve as a foundation for establishing a model of a sailing charter company in Portugal, explained with the aid of the Canvas model.

Setúbal e a Primeira Guerra Mundial (1914-1918)

A presente dissertação é circunscrita no espaço e no tempo, tendo como objecto de estudo fundamental o concelho de Setúbal durante a I Guerra Mundial (1914-1918). Enquadrando historicamente os impactos do conflito no contexto nacional, Setúbal é revisitada entre os finais de oitocentos e os primórdios do século XX a fim de retratar política, económica, social e culturalmente um dos maiores centros urbanos portugueses dos finais da Monarquia Constitucional e do início da I República. Numa lógica de impactos políticos e económico-sociais, esta investigação promove o redescobrir das vivências quotidianas de Setúbal durante um dos períodos mais negros da História da Humanidade. Através do estudo dos mecanismos de acção e intervenção municipais, bem como dos resultados eleitorais e dinâmicas políticopartidárias locais, transmite-se como foram vividos acontecimentos marcantes da vida pública de Portugal, nomeadamente o 14 de Maio de 1915 e o coup d’état sidonista, realçando como dimensões operárias anárquicas e sindicalistas conviviam com grupos conservadores, católicos e monárquicos. Num plano de economia de guerra, o mundo agrícola é abordado em diferentes sectores, nomeadamente na laranja, na cortiça e nos vinhos, dando maior atenção às questões relacionadas com a decadência da fruta e à abertura de novos mercados exportadores, como o Brasil, pela Casa José Maria da Fonseca. A indústria de conservas de peixe, que viveu um boom neste período como resultado da intensa procura externa dos países aliados que tinham nas latas de conserva o alimento das tropas nas trincheiras, representa outro foco de análise deste trabalho. Consequentemente aborda-se o papel da estrutura portuária local na resposta às necessidades de consumo britânicas, francesas e italianas. Por fim, os impactos sociais do conflito em Setúbal constituem um dos enunciados desta investigação, compreendendo como o estudo de uma imprensa dividida na questão intervencionismo versus anti-intervencionismo reflectiu um concelho que viveu como poucos a crise de abastecimentos e a carestia de vida. A proliferação de greves, manifestações contra a guerra, as deserções militares e os assaltos colectivos representam o culminar de um vulcão que entrou em erupção e que ainda sofreu as agruras da epidemia da gripe pneumónica até ao final do ano de 1918.