Financiamento e gasto público em saúde: o caso do Rio Grande do Norte

Conselho Nacional de Desenvolvimento Científico e Tecnológico

O trabalho em saúde como espaço pedagógico: desafios e possibilidades

The ongoing transformations in brazilian society, arising from technical and organizational changes in the working world, are making, with much emphasis, heated debates resurge related to themes and issues that refer to the relationship between work, skills and education. Thus, this study is inserted in the link between education and work, pointing to the work as an educational principle according to Antonio Gramsci. This paper aims to discuss the interfaces between education and work in the everyday health care teams and learn about the activities developed by health teams related to the learning processes in and with the work to analyze the opportunities and challenges of transforming spaces of health work in an environment of lifelong learning. This is a descriptive, exploratory with a qualitative approach case study developed from semi-structured interviews with the health staff professionals of the Unidade de Terapia Intensiva da Casa de Saúde Dix-Sept Rosado in Mossoró / RN , who answered open questions about the relationship between education and work. The interviews were conducted during the month of January 2010, the same being recorded, transcribed and analyzed, culminating in the production of new knowledge on the subject. It is understood that work and education activities are eminently human, therefore only the human being works and educates. Given the statements of participants, it is noticed that all work processes in health are learning moments. This happens through new demands imposed by the everyday of the services, by interaction with a multidisciplinary team, participation in educational activities and individual study. It was noticed that the institution in this case does not promote study courses related to Intensive Care and that there are obstacles to the realization of educational activities on and with the work, such as: excessive workload, inability to release staff to participate in events, low pay, which leads the worker to have more than one employment, rejection of new knowledge by some workers and lack of physical infrastructure and incentives for the activities. The daily situations must be transformed in learning, selfanalyzing the problems of practice and valuing the work process itself in its intrinsic context. We conclude that dealing with the web of relationships between educational processes and production processes of health services, unraveling the intricacies of the world of work and education requirements in this sector are increasingly on the agenda of Sistema Único de Saúde workers and managers. The continuing consideration of this issue becomes an essential condition for the proper discharge of their responsibilities. We consider that bringing the education to everyday life is the result of recognition of the educational potential of the work situation

Fatores da satisfação, fidelidade e recomendação em serviço de saúde: estudo em setor ambulatorial de hospital

This thesis deals with the factors affecting customer satisfaction, loyalty and recommendation in the health care sector. It is adapted a model proposed by Johnson et al. (2001) of quality and loyalty antecedent factors and it is conducted a survey with a sample of 109 customers of a hospital on the ambulatory in Natal city, a capital of a Northeastern State of Brazil. It is carried descriptive and multiple regression statistical analysis. The main findings related to satisfaction are that quality factors of doctor professionalism, clerical staff efficiency, consultancy room comfort, time to provide the medical consultancy but also hospital localization are the most significant factors affecting satisfaction. Regarding personal full loyalty, satisfaction with the hospital and affective commitment are the main factors yet for partial loyalty image and calculate commitment play the main role. For recommendation satisfaction, image and brand are the main factors. The overall model used fairly explains the satisfaction, loyalty and recommendation outcomes with varying factors regarding each final purpose, e.g. loyalty or recommendation

Impactos da certificação ISO 9000 no desempenho estratégico :um estudo em empresas brasileiras do setor químico

This thesis deals with analyzing the contribution grade of the ISO 9000 quality system to the strategic performance of the Brazilian firms in the Chemistry sector, using the Balanced Scorecard system as reference. An exploratory research is developed to get technical information about these two management systems, with emphasis in their integration. After, a quantitative research is implemented using a questionnaire, to know and to obtain necessaries data for improving statistical estimations of the multiple relationships between the variables and the strategic performance for the universe of 352 Brazilians firms that make use of ISO 9000 as quality system. The size of the sample totalized 111 firms, which represent more than 31% of the selected universe. The main results show different visions of directors and managers about the significant variables that contribute for the strategic performance of the analyzed firms. The ISO 9000 system presents a big contribution to the strategic performance, when referred by the four perspectives of the Balanced Scorecard: learning and growth; internal process; customer and financial. Better performance was verified in the learning and growth perspective and reasonable performance was verified in the financial perspective

Fatores que afetam a satisfação de pacientes em serviços de saúde :um estudo em setor ambulatorial de hospital

This thesis shows concepts and models related to customer satisfaction measurement, focusing in detail on patients satisfaction evaluations in a policlinic sector of a hospital located in Natal RN. To reach this aim, two hundred and fifty one patients of this hospital were interviewed. The methodology approach includes a theoretical basis through a review and study of previous research on the topic, governmental initiatives and management systems which deal with excellence and need more reports concerning customers perceptions about satisfaction. Furthermore, it was included some models of nationals index about customer satisfaction. The Norwegian model was used in this thesis. The use of this approache, together with a multiple regression analysis, led to results that shows the factors which affect patients satisfaction in a policlinic sector. They are four as following: The evaluation of physician attendance; its results; simplicity of accessibility when health services are needed; and both support and tranquility given by the hospital. The study results can support researches of a conceptual model to determinate the aspects which affect the patient s satisfaction and could be a contribution to a development of a national costumer satisfaction index

Qualidade em serviços de saúde: uma contribuição à definição de um modelo paramétrico e padrão de qualidade do tempo agendado para consulta ambulatorial

The knowledge management has received major attention from product designers because many of the activities within this process have to be creative and, therefore, they depend basically on the knowledge of the people who are involved in the process. Moreover, Product Development Process (PDP) is one of the activities in which knowledge management manifests in the most critical form once it had the intense application of the knowledge. As a consequence, this thesis analyzes the knowledge management aiming to improve the PDP and it also proposes a theoretical model of knowledge management. This model uses five steps (creation, maintenance, dissemination, utilization and discard) through the verification of the occurrence of four types of knowledge conversion (socialization, externalization, combination and internalization) that it will improve the knowledge management in this process. The intellectual capital in Small and Medium Enterprises (SMEs) managed efficiently and with the participation of all employees has become the mechanism of the creation and transference processes of knowledge, supporting and, consequently, improving the PDP. The expected results are an effective and efficient application of the proposed model for the creation of the knowledge base within an organization (organizational memory) aiming a better performance of the PDP. In this way, it was carried out an extensive analysis of the knowledge management (instrument of qualitative and subjective evaluation) within the Design department of a Brazilian company (SEBRAE/RN). This analysis aimed to know the state-of-the-art of the Design department regarding the use of knowledge management. This step was important in order to evaluate in the level of the evolution of the department related to the practical use of knowledge management before implementing the proposed theoretical model and its methodology. At the end of this work, based on the results of the diagnosis, a knowledge management system is suggested to facilitate the knowledge sharing within the organization, in order words, the Design department

Melhoria de desempenho e ISO 9000: um estudo em empresas brasileiras do setor hoteleiro na perspectiva do Balanced Scorecard

This Thesis deals with the performance improvement on hotels that have adopted the ISO 9000 Quality Management Systems. It is researched the Brazilian hotels that have an ISO 9001 registration with an assessment form based on the Balanced Scorecard approach. The main findings are that ISO 9000 provided improvement on the performance of the hotels in general and also in all the BSC perspectives, and that are different perception on managers and directors, what suggests a need for a tool like BSC to register the performance improvements on the same basis. The Thesis contributes to provide information on the performance improvement in hotels, one of the claimed regarding the low ISO 9000 adoption rate in Brazilian hotels

Análise de desempenho na rede metropolitana de saúde da Universidade Federal do Rio Grande do Norte : um dimensionamento aplicado a telemedicina e a telessaúde utilizando QoS baseado no padrão IEEE 802.1Q

It s notorious the advance of computer networks in recent decades, whether in relation to transmission rates, the number of interconnected devices or the existing applications. In parallel, it s also visible this progress in various sectors of the automation, such as: industrial, commercial and residential. In one of its branches, we find the hospital networks, which can make the use of a range of services, ranging from the simple registration of patients to a surgery by a robot under the supervision of a physician. In the context of both worlds, appear the applications in Telemedicine and Telehealth, which work with the transfer in real time of high resolution images, sound, video and patient data. Then comes a problem, since the computer networks, originally developed for the transfer of less complex data, is now being used by a service that involves high transfer rates and needs requirements for quality of service (QoS) offered by the network . Thus, this work aims to do the analysis and comparison of performance of a network when subjected to this type of application, for two different situations: the first without the use of QoS policies, and the second with the application of such policies, using as scenario for testing, the Metropolitan Health Network of the Federal University of Rio Grande do Norte (UFRN)

Influência das condições de saúde bucal no desempenho das atividades diárias de adolescentes escolares

Instruments are used in odontology to measure the Quality of Life Related to Oral Health (OHRQoL) to scale how the oral condition interferes with functional areas, of the people s psychological and social life. This cross-sectional study, held in Natal/RN, with 215 students from the Federal Institute of Education, Science and Technology of Rio Grande do Norte (IFRN) has investigated the association between the performance of daily activities and oral health status of school adolescents from 15 to 19 years of age, through the normative index DMFT (permanent teeth decayed, missing and filled), CPI (Community Periodontal Index) and DAI (dental Aesthetic Index) and subjective questionnaire assessment of quality of life related oral health OIDP index (oral impacts on daily performance). It was also carried out the socioeconomic characteristics of students through IFRN own data. Concerning the analysis of data was performed a descriptive analysis of the variables by their absolute and relative frequencies and measures of central tendency. The chi-square test was used to assess the association between the dependent variable and the independent categorical variables and the Student t test for quantitative. It was also conducted a further multiple analysis out using Poisson regression with robust variance between the outcome "presence of impact" and the independent variables that showed p <0.20. It was used for all the statistical tests a significance level of 5%. Among the adolescents surveyed, 51.16% reported that at least one activity assessed by OIDP had hampered its implementation due to some dental problem. The difficulties were more pronounced in the activities of eating (31.6%), oral hygiene (25.6%) and smile (25.1%).The tooth position, followed by toothache, were the causes of the impacts reported by most teenagers. There was a significant association between the presence and impact of the presence of one or more decayed teeth (p = 0.012), the presence of gum bleeding (p = 0.012) and for orthodontic treatment (p = 0.003), independently of other variables. There was no significant association between oral health status and socioeconomic and demographic characteristics of the adolescents. The survey results showed that there is an association between oral health status of the population studied and reports of difficulties in carrying out daily activities evaluated. The worse the oral health status, the greater the impact of this condition on the adolescents quality of life

Inovação e desempenho exportador: uma perspectiva estratégica em uma empresa de alimentos no setor de candies no Rio Grande do Norte

A crescente globalização da economia tem se revelado uma grande oportunidade e um importante desafio para as empresas. Para atingir altos níveis de desempenho nas atividades de negócios internacionais, faz-se necessário adotar estratégias que confiram um diferencial competitivo em relação aos concorrentes. Assim, este trabalhou buscou avaliar o impacto de fatores estratégicos e da inovação sobre o desempenho exportador em uma empresa de alimentos no setor de candies no Rio Grande do Norte, a partir dos fundamentos teóricos e empíricos discutidos pelos estudiosos da área. A pesquisa tem caráter descritivo com métodos qualitativos e quantitativos, quanto ao planejamento da pesquisa optou-se pela pesquisa bibliográfica e pelo estudo de caso, na forma de levantamento apoiado por questionário, e procurou-se testar o modelo e identificar fatores positivamente correlacionados com desempenho nas atividades de exportação da empresa objeto de estudo. As inovações implementadas foram avaliadas, confrontadas com as estratégias de internacionalização adotadas pela empresa. Através de uma matriz importância desempenho pudemos observar vários fatores e sua importância no caseestudado. Para análise qualitativa utilizamos a matriz importância desempenho, onde pudemos sugerir melhorias nas estratégias adotados pela empresa estudada. Para a análise quantitativa, o uso do survey mostrou a correlação entre os fatores pesquisados através da análise de variância (ANOVA) que é um teste paramétrico usado para verificar se existe uma diferença significativa entre as médias e se os fatores estão influenciando na variável resposta. Dessa forma, esta técnica estatística permite que vários grupos sejam comparados. A análise das estratégias e da iniciativas de inovação na empresa estudada indicam que há uma correlação entre elas e a importância dessa interação para o seu desempenho exportador.

Sistemas de medição de desempenho para projetos de PD&I no Setor de Petróleo e Gás Natural

Organizations are seeking new ideas, tools and methods aiming to improve management process and performance. On the other hand, system performance measurement needs to portray organizational changes and provide managers with a set of true and more appropriate information for the decision-making process. This work aims to propose a performance measurement system in the academic field regarding Research, Development and Innovation (RDI) in the oil and gas industry. The research performed a bibliographic review in a descriptive exploratory manner. A field research was conducted with an expert focus group in order to gather new indicators. As for the validation of these indicators, a survey with experienced professional was also realized. The research surveyed four segments in and outside of the Federal University of Rio Grande do Norte-Brazil such as oil and gas project coordinators, staff at Academic Planning Offices, FUNPEC employees as well as coordinators from Petrobrás. The performance measuring system created from this study features three interrelated performance indicators pointed out as: process indicators, outcome indicators and global indicators. The proposal includes performance indicators that seek to establish more appropriate strategies for effective institution management. It might help policy making of university-industry interaction policies

A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em saúde bucal coletiva

RONCALLI, Angelo Giuseppe. A organização da demanda em serviços públicos de saúde bucal: universalidade, eqüidade e integralidade em Saúde Bucal Coletiva. raçatuba, 2000. 238p. Tese (Doutorado em Odontologia Preventiva e Social). Faculdade de Odontologia, Universidade Estadual Paulista “Júlio de Mesquita Filho”

Análise de desempenho sobre redes IEEE 802.3/PM-AH: protoclo multicilos para automação hospitalar

Com a incorporação de conceitos da automação em ambientes hospitalares surge uma série de novos requisitos pertinentes a área médica. Dentre esses requisitos, um que merece destaque é a necessidade do estabelecimento de uma rede de comunicação segura e eficiente entre os elementos do ambiente hospitalar, visto que, os mesmos encontram-se de maneira distribuída. Nesse sentido, existe uma série de protocolos que podem ser utilizados no estabelecimento dessa rede, dentre os quais, um que merece destaque é o PM-AH (Protocolo Multiciclos para Automação Hospitalar) justamente por ser voltado a automatização de ambientes hospitalares tanto no que diz respeito ao cumprimento dos requisitos impostos nesse tipo de ambiente, como pelo fato de ser projetado para funcionar sobre a tecnologia Ethernet, padrão esse que é comumente utilizado pela rede de dados dos hospitais. Em decorrência disso, o presente trabalho aborda uma análise de desempenho comparativa entre redes PM-AH e puramente Ethernet visando atestar a eficiência do primeiro no que diz respeito ao cumprimento dos requisitos impostos pela automação hospitalar

Recursos intangíveis de um destino turístico: um estudo de desempenho da cidade de Natal tendo como base a teoria das capacidades dinâmicas

O objetivo desta tese foi analisar os recursos intangíveis de um destino turístico. Foi feito um estudo de desempenho da cidade de Natal tendo como base a teoria das capacidades dinâmicas. Inicialmente, foi desenvolvido um instrumento de pesquisa para oportunizar a construção de um modelo de medida com vistas à captação de variáveis latentes para os recursos intangíveis existentes no setor do turismo em Natal-RN. Em seguida, foi realizada uma análise dos recursos intangíveis que são evidenciados pelos turistas acerca da cidade. Finalmente, foi feita a investigação de um modelo de estrutura que estabeleceu as relações entre as variáveis latentes dos recursos intangíveis e a percepção de desempenho do turismo na cidade de Natal. Procedeu-se uma revisão de literatura para construção de um modelo inicial acerca dos ativos intangíveis dentro da teoria das capacidades e foram relacionados dez recursos, quais sejam: recursos humanos prestadores de serviços; recursos humanos como gestores; cultura local; conservação do meio ambiente; know-how empresarial; inovação empresarial; tecnologia; marca; preço; e promoção. Estes dez recursos, em conjunto, seriam responsáveis pelo desempenho do destino turístico. Após ser realizada uma análise de equações estruturais, apenas quatro recursos manifestaram relações com o desempenho: marca; cultura; conservação do meio ambiente; e preço. Análisando dos dados, verificou-se que a variável desempenho positivo da cidade na ótica do turista se manifestou fortemente e foi influenciada de forma forte pela cultura local, marca e conservação do meio ambiente em conjunto. O preço foi influenciado pelo desempenho positivo mostrando que o turista sente que o preço pago foi satisfatório diante dos atributos do destino Provavelmente, isso seja um ponto positivo muito forte para o destino turístico de Natal, pois, em termos de recursos intangíveis e de juntos formarem capacidades, eles são inimitáveis, raros e são capazes de se ajustarem às mudanças organizacionais e ambientais, para reconfigurar os ativos e as estruturas de um destino, corroborando, assim, com a teoria das capacidades dinâmicas. Esses recursos da cidade de Natal, como destino turístico, são únicos e provavelmente têm um peso muito maior para o desempenho da cidade do que problemas existentes na localidade. Logo, esses atributos devem ser estimulados a continuar crescendo e se modificando de acordo com as exigências atuais e futuras de consumo

Saúde bucal no programa de saude da família: o caso do distrito sanitário norte em Natal - RN

The inclusion of the dentist in the Family Health Program (FHP) teams designates a reorganization of the mouth health care in your country and establishes a new scenario in Brazilian odontology, through of a new way to organize the basic health care, creating conditions to consolidate in mouth health practice actions, in the level of the basic attention, the validation of Unique Health System (UHS) constitutional principles. The purpose of this research is to verify if the actuation of mouth health teams (MHT) dentists, in Natal city north sanitary district, is tuned with FHP goals.The target research population was composed by all dentists working in Basic Health Units (BHU) of Natal north sanitary district. Fifth-eight questionnaires were applied and using open and closed questions we look for identify the functional characteristics of each BHU, the dentists professional attributions on each BHU, as well as the clinical procedures that they execute. This research also searched to identify the factors that facilitate and/or difficult the inclusion process and the dentists activities performance on these BHUs, as well as the necessary actions to north sanitary district MHTs to fulfill the objectives proposed by FHP. The results point that the inclusion of mouth health actions in north sanitary district FHPs brought the incorporation of new values to the used practices. Whoever, its necessary a more frequent evaluation of the carried actions, in a way they can be adapted to the real community necessities, and, is fundamental the data accompaniment, for that these serve of base for planning and redirecting activities, in a way that we do not have only a reproduction of traditional practices, fragmented and isolated, but a truly substitution of the traditional practices and a new way of promoting health