18 resultados para Assistencia hospitalar - Custos - Brasil

em Universidade Federal do Rio Grande do Norte(UFRN)


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The relevance of rising healthcare costs is a main topic in complementary health companies in Brazil. In 2011, these expenses consumed more than 80% of the monthly health insurance in Brazil. Considering the administrative costs, it is observed that the companies operating in this market work, on average, at the threshold between profit and loss. This paper presents results after an investigation of the welfare costs of a health plan company in Brazil. It was based on the KDD process and explorative Data Mining. A diversity of results is presented, such as data summarization, providing compact descriptions of the data, revealing common features and intrinsic observations. Among the key findings was observed that a small portion of the population is responsible for the most demanding of resources devoted to health care

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This study has as main objective to verify the proportionality of the costs with elaboration of didactic material and costs with tutelage and instruction incurred in a higher education institution, located in national territory, and that offers a degree course in the education area in the modality of EaD online. The purpose of the measurement of this proportionality of the costs was of answering these they are, among other, the relevant costs incurred by the institution research object. This is a research of exploratory stamp whose methodological procedure adopted for your development, in what it refers the collection, analysis of the data and the investigation means, it is the case study, as well as the documental and bibliographical research. The found results indicate that the costs with elaboration of didactic material and the costs with tutelage and instruction are relevant, however they are not the only ones considered as such. The costs involved with acquisition and operation of specific softwares they also constitute an relevant costs. The structure of the costs can be altered in agreement with the analyzed period and in agreement with the characteristics of synchronism of the offered course. It was also verified that the technology used in this education modality it ends up generating additional costs incurred with professionals of specific knowledge in technology

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En Brasil, la violencia interpersonal (homicidios) se ha incrementado de forma significativa, convirtiéndose en una preocupación cada vez mayor en todos los ámbitos políticos de la sociedad. Hoy es uno de los más graves problemas sociales y de salud pública. Se refiere a los problemas sociales, ya que interfiere en la distribución de la oferta de bienes y servicios a los ciudadanos; sino también un problema de salud, porque la violencia es uno de los fenómenos que causan gran impacto en la morbilidad y mortalidad del país, y genera un alto costo para el Sistema Único de Saúde (SUS). Esta es una crisis social, que es el resultado de un mundo capitalista globalizado, que exige a todos sus instrumentos de dominación (dinero, poder y competitividad en estado puro), en virtud del cual la violencia y los conflictos interpersonales se materializan en el territorio. El Río Grande do Norte (RN) ha estado siguiendo esta realidad que es nacional, con el aumento de las tasas de mortalidad por homicidios. En este sentido, este estudio tuvo como objetivo analizar la violencia interpersonal (agresión / homicidio), en Brasil y en el estado del RN, para entender cómo esto afecta a su población, en la morbilidad y mortalidad durante los años 2001 a 2011. Para ambos hicimos uso de método descriptivo / cuantitativo para determinar la magnitud, el tamaño, el perfil de las víctimas y los costos del SUS generados por el problema. Como resultado, podemos diagnosticar que en Brasil, la violencia se ha presentado una nueva dinámica regional, promovida por un proceso de interiorización del fenómeno en todo el país, este proceso de internalización se ha reflejado en la última década, el crecimiento de la violencia en el estado del RN, que ha causado un gran impacto en las tasas de la mortalidad del estado. Acerca la victimización, se puede ver que hay un perfil vulnerable formado por, varón, baja instrucción joven, sola y negro. Con respecto a los datos de morbilidad hospitalaria, la demanda creciente del fenómeno genera costes para el sistema de salud, y las graves consecuencias humanas, como la escalada del miedo y la destrucción de una generación de jóvenes brasileños. Por lo tanto, la falta de una política pública para afrontamiento, prevención y mitigación del problema revela el fracaso de la gestión pública, con consecuencias sociales y de salud, tanto individual como colectivamente.

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Public policies have been studied in the various fields of humanities and social sciences, from different theoretical and technical aspects. However, there is still a lack of studies that incorporate the dimension that encompasses the political action and its interference in such actions, also recognizing the importance of the institutional setting of the Brazilian presidential model in implementing these policies. This fragmented and multiparty system has led to power heterogeneous sets of political parties. Thus, the ministerial offices, more than assisting the President´s government project, manage particularized agendas, which are party biased and have the influence of interest groups in hegemonic themes addressed by government agencies. When these agendas operate in sectoral and specialized policies, the friction level is apparently low. However, when this occurs in intersectoral actions, such as in regional development, there is evidence of strong signs of competition among government agencies, which in theory, should operate in an integrated manner. Although this is not a specific feature of Luiz Inacio Lula da Silva´s government- the period to be studied- there was similar behavior in Fernando Henrique Cardoso´s presidency, one realizes that the expansion of coalition on behalf of governance is increasingly interfering in the outcome of intersectoral public policies, due to these multiple arguments in action. In order to understand these processes, this study focused on the Sustainable and Integrated Development Programme for Differentiated Meso-Regions (PROMESO), part of the National Policy for Regional Development (NPRD). The program provides interface with various government agencies and their public policies in a clear intersectoral design. The research sought to identify and analyze the relationships between government agencies and their programs with interest groups, whether political parties or other segments of civil society, highlighting the logic of favoritism, which poses in second place the integration of actions in the intersectoral policies. Therefore, besides the theoretical debate that incorporates several categories of political science, public administration, public policy, geography and economics, the study focused on secondary sources, using different government agencies databases in order to raise information. It was observed that the interference of partisan politics has been disastrous for some public policies. Thus, the research confirms that cooperative character is fragile within government agencies, often limited to official documents, and that there is indeed, a striking feature of competition, especially when it comes to transversalized policies

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Offshore wind power emits low amounts of gases, is renewable and has better performance than onshore due to its greater stability and higher wind power density, less visual and noise impact, among others. Brazil has a high capacity of generation, but has not yet developed any offshore projects. High costs are a strong impediment. This study is an effort towards pricing offshore resources through Livelized Cost of Energy - LCOE, which represents the minimum return to cover the costs of development, production and maintenance of a wind project. Initially LCOE was calculated for all Brazilian onshore wind farms listed at Bloomberg New Energy Finance R○, accounting for 71 farms. Then hypothetical offshore wind farms were created from the onshore farms, tripling the cost of generation, which is consistent with the literature, and estimating the offshore energy for two locations off the Brazilian coast using satellite data extracted from National Oceanic and Atmospheric Administration. The results demonstrate that offshore resources have the potential to significantly reduce the energy price due to the better performance of the wind at sea

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Malaria is a disease of global distribution, recognized by governments around the world as a serious public health problem, affecting more than 109 countries and territories and endangering more than 3.3 billion people. The economic costs of this disease are also relevant: the African continent itself has malaria-related costs of about $ 12 billion annually. Nowadays, in addition to chloroquine, Plasmodium falciparum is resistant to many drugs used in the treatment of malaria, such as amodiaquine, mefloquine, quinine and sulfadoxine-pyrimethamine; resistance of Plasmodium vivax to treatments, although less studied, is also reported. Nature, in general, is responsible for the production of most known organic substances, and the plant kingdom is responsible for the most of the chemical diversity known and reported in the literature. Most medicinal plants commercialized in Brazil, however, are of exotic origin, which makes the search for endemic medicinal plants, besides a patent necessity, a fascinating subject of academic research and development. This study aimed to: (i) verify the antimalarial activity of ethanolic and hydroalcoholic extracts of Boerhavia paniculata Rich. And acetonic extract of Clethra scabra Pers. in Swiss albino mice infected by Plasmodium berghei NK65, (ii) observe possible combined effects between the course of infection by P. berghei NK65 and administration of these extracts in Swiss albino mice, and (iii) conduct a preliminary study of the acute toxicity of these extracts in Swiss albino mice. All extracts notable pharmacological activities - with parasite infections inhibitions ranging from 22% to 54%.These characteristics suggest that the activities are relevant, although comparatively lower than the activity displayed by the positive control group (always above 90%). The general framework of survival analysis demonstrates an overall reduction in survival times for all groups. Necroscopy has not pointed no change in color, shape, size and/or consistency in the evaluated organs - the only exception was the livers of rats submitted to treatment to hydroalcoholic extracts: these organs have been presented in a slightly congestive aspect with mass increasing roughly 28% higher than the other two groups and a p-value of 0.0365. The 250 mg/Kg ethanolic group has been pointed out by the Dunn s post test, as the only class with simultaneous inequalities (p<0.05) between positive and negative control groups. The extracts, notably ethanol extract, have, in fact, a vestigial antimalarial activity, although well below from the ones perceived to chloroquine-treated groups; nevertheless, the survival times of the animals fed with the extracts do not rise by presence of such therapy. Both the toxicopharmacological studies of the synergism between the clinical course of malaria and administration of extracts and the isolated evaluation of toxicity allow us to affirm the absence of toxicity of the extracts at the level of CNS and ANS, as well as their non-influence on food and water consumption patterns, until dosages of 500 mg/Kg. Necroscopic analysis leads us to deduct a possible hepatotoxic effect of hydroalcoholic extract at dosages of 500 mg/Kg, and an innocuous tissue activity of the ethanol extract, in the same dosage. We propose a continuation of the studies of these extracts, with protocol modifications capable of addressing more clearly and objectively their pharmacological and toxicological aspects

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Desde a criação da tecnologia e do seu uso pelas empresas, a relação custo e benefício nem sempre foi bem elucidada tanto para os responsáveis pela área de tecnologia quanto para a alta direção. Mas, apesar disto, cada vez mais as organizações investem maciçamente em tecnologia, esperando que esta seja a solução para diversos problemas. Por isto, esta questão tem se tornado crucial para o processo de tomada de decisões, visto que investimentos nesta área costumam ser dispendiosos e, na atual conjuntura, estas análises precisam ser extremamente criteriosas para que se miniminizem as possibilidades de insucesso dos projetos, principalmente numa economia estabilizada e de concorrência acirrada. Uma das alternativas que as empresas têm buscado para atingir o sucesso e correr menos riscos é a terceirização da área de TI. Partindo desta visão, a presente dissertação tem por objetivo realizar uma investigação sobre a terceirização dos serviços de TI em todos os seus aspectos, isto é, desde a sua motivação, serviços efetivamente terceirizados, vantagens, desvantagens e possíveis obstáculos, a visão do alinhamento estratégico da TI, os processos de gestão de contratos e formas de controle e, por fim, tendências futuras. Trata-se de uma pesquisa de múltiplos casos, envolvendo franquias do Sistema Coca-Cola no Brasil. O estudo apresenta uma pesquisa bibliográfica sobre o processo de tomada de decisão empresarial, a análise de investimentos, a gestão e a terceirização da TI, o que permitem definir as dimensões de análise da pesquisa. Na pesquisa de campo foram entrevistados os gerentes da área de TI, nas cidades de Brasília-DF, Goiânia-GO e Ribeirão Preto-SP. A pesquisa de campo permitiu identificar como as mesmas avaliam seus investimentos em TI, como esta área é gerenciada, o que as levou a optar pela terceirização e como os processos terceirizados afetam a organização. Por se tratar de uma pesquisa qualitativa, optou-se por analisar comparativamente as três organizações. Com a realização deste estudo, obtiveram-se, como principais resultados, que as organizações estão utilizando a terceirização em TI para focar no negócio principal e, mesmo encontrando diversas desvantagens, inclusive com relação a custos, acreditam que os benefícios justificam. Ainda identificaram-se alguns obstáculos internos para a terceirização, principalmente quanto ao receio de se perder a inteligência do negócio. O acompanhamento dessas atividades terceirizadas é realizado pela equipe interna e por critérios estruturados, onde se verificam os níveis de serviço

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Social behavior of Guiana dolphins, Sotalia guianensis, at Pipa Beach, RN, Brazil: dynamics, sequence, breathing synchrony, and responses to dolphin watching. Social animals form groups that can range from temporary to permanent. Depending on the nature of the social relationships developed between individuals, groups present a particular social organization and the effect of these interactions shapes the activity patterns of these animals. This study investigates: (i) fission-fusion dynamics of Guiana dolphins, through the analysis of three dimensions of the social system (variation in spatial cohesion, variation in size and composition of groups), (ii) sequence, routine and behavioral stability, (iii) breathing intervals in synchronized groups and (iv) behavioral responses of the animals to dolphin watching. Systematic observations of Guiana dolphins were made from a platform located in cliffs about 25 m above sea level that surround Madeiro Bay, Pipa Beach. Sampling occurred from December 2007 to February 2009 between 0600 h and 1600 h, and the groups of Guiana dolphins were investigated according to their size (alone and group) and composition (adults, adults and juveniles, and adults and calves). According to the analysis of fission-fusion dynamics, Guiana dolphin groups frequently changed their composition, modifying their patterns of spatial grouping and cohesion every 20 minutes on average. More than 50% of the individuals maintained a distance of up to 2 m from other group members and new individuals were attracted to the group, especially during feeding, leaving it for foraging. Large groups were more unstable than small, while groups containing only adults were more stable than groups of adults and juveniles. According to the Z-score analysis to investigate the sequence and behavioral routine, lone individuals were more ! .7! ! involved in foraging and feeding, while resting was more common in groups. Foraging and feeding were more common in homogeneous groups (individuals of the same age class), while heterogeneous groups (different age classes) were often involved in socialization, displaying a broader behavioral repertoire. Foraging and resting behavior presented higher stability (continuous duration in minutes) than the other behaviors. The analysis of breathing intervals in synchronized groups showed significant differences depending on type of behavior, composition and area preference. During resting, breathing intervals were of longer duration, and groups with calves showed shorter breathing intervals than groups without calves. Lone individuals also preferred areas called corral , often used for the entrapment of fishes. The Markov chain analysis revealed behavioral changes in the presence of boats, according to the type of group composition. Groups composed of adults presented decreased resting and increased in traveling during the presence of boats. Groups of adults and juveniles showed a massive reduction of socialization, while the behavior transition probability traveling-traveling was higher in groups of adults and calves. In the presence of the boats, stability of resting was reduced by one third of its original duration and traveling more than doubled. The behavioral patterns analyzed are discussed in light of socio-ecological models concerning costs and benefits of proximity between individuals and behavioral optimization. Furthermore, significant changes in behavioral patterns indicate that Guiana dolphins, at Pipa Beach, have suffered the effects of tourism as a result of violation of rules of conduct established for the study area

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The creation of the Humanization Program of Hospital Care and the increasing number of academic works and journal articles that discuss more humane practices in the health care services express the emphasis given to the theme in Brazil. In these discussions, however, it is not usual to find reference to architecture as a relevant factor in the humanization of hospitals, even though it is known that the physical structure of the building may help the recovering of the patients; elements such as gardens, the use of colors and open spaces may soften the impact caused by the hospital routine on patients. Considering the contribution the architectural project may bring to the humanization of hospitals, the aim of this study was to verify how the architects perceive the hospital humanization process. Besides having searched for subsides in informal interviews with health professionals, in visits to hospitals and in related seminars, the study was based on semi-structured interviews with architects of Natal, Rio Grande do Norte, who are specialists in this kind of projects. The content analysis of the interviews showed that physical space and attendance are essential to the humanization process. Those professionals see two humanization tendencies: while private hospitals have the structural physical appearance considered as humanized, public hospitals emphasize the humanization in attendance, fact that illustrates the contradictions in Brazilian health system. The interviewees consider the post-occupancy evaluation of the building as a learning exercise that contributes to new projects, but surprisingly they do not mention the patients opinion as part of it. Two annoying facts have emerged from the interviews, as also seen in preliminary stages of the study: rare are the works that focus on the person-environment relationship, and the definition of humanized hospital environments is still broad and inaccurate. This suggests the need of new studies in order to better understand how the two factors shown in this study attendance and physical space interact towards a true hospital humanization

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This work presents results derived from a study related to impact on non-controllable costs in the determination of energy taxes. This is done analyzing tax review practiced by concessionaries responsible for the distribution of electrical energy located in the Northeastern Region of Brazil, between 2003 and 2004. This Region was chosen as a study area due to the researcher s expectation in congregating companies that deliver services to markets that have similar social-economical profiles. A brief explanation related to the restructuring of the electrical sector in Brazil is presented, pointing out that there was privatization of the great majority of these companies. The study also points out the definition of regulating rules in service delivery process. The components of taxes that are practiced by these companies aimed at final consumers, as well as the market as a whole and the revision process that is executed by Agência Nacional de Energia Elétrica ANEEL for the definition of these taxes are demonstrated in the research. A brief historical of the concessionaires that were focus of the research is presented, totaling five companies. Some data used by ANEEL in the tax review process was analyzed as well as data on components of approved taxes. It is concluded that as a media 47, 49% of the components of taxes in the researched companies correspond to the non-controllable costs. These is done considering previous classification by ANEEL in the tax review process. Although, if it is considered that these companies since 2006, by the means of participation in energy auctions are able to negotiate energy prices for their own needs, it is concluded that these concession contracts guarantee the delivery of the service to the costumer in the total tribute. The percentage of non-controllable costs is 16, 27% average of the tax. This means, amongst other information, that the government has a great deal of responsibility in the formation of price practiced by these companies and its target markets

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To acting in emergencies it is important that health professionals develop specific and differentiated skills, which shows us the importance of training in emergency planning. So undergraduate courses in medicine and nursing should encourage the development of these skills and evaluate them through various instruments targeted to the different fields. The aim of this study was to implement an optional and interprofessional curricular component, focusing on interprofessional education in pre-hospital emergency for medical and nursing courses Federal University of Rio Grande do Norte (UFRN). This is an exploratory descriptive study, with 24 medical and nursing graduates of last year undergraduate of supervised training, who underwent theoretical and practical training in the care of pre-hospital emergency services. There were theoretical and practical lessons per week for one school semester, taught by doctors and nurses of the Emergency Medical Service (EMS), where the topics discussed were: basic and advanced life support, safe transport in clinical emergencies, trauma, gynecological, obstetric, pediatric and psychiatric diseases, and have been carried out practical activities in ambulances. The students were evaluated by pre-test, post-test and practical stations made through the Objective Structured Clinical Evaluation (OSCE), in the skills laboratory of the Health Sciences Center. During the activities the students were encouraged to critical and reflective thinking, highlighting the importance of integration between the various health care professionals. It was observed that 88% of the students had a score increase over the pre-test. In the evaluation process carried out by medical students and nursing UFRN have similar expectations regarding the essential skills acquired during the training activity. The results of this study will form the basis for the organization of interprofessional education activity in pre-hospital emergency medical students and nursing, as well as helped to organize practices stations, identifying basic clinical skills, and implementing student assessment tools UFRN.

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In Brazil, the National Agency of Electric Energy (ANEEL) represents the energy regulator. The rates review have been one of its main tasks, which establish a pricing practice at a level to cover the efficient operating costs and also the appropriate return of the distributors investments. The changes in the procedures to redefine the efficient costs and the several studies on the methodologies employed to regulate this segment denote the challenge faced by regulators about the best methodological strategy to be employed. In this context, this research aims to propose a benchmarking evaluation applied to the national regulation system in the establishment of efficient operating costs of electricity distribution utilities. The model is formulated to promote the electricity market development, partnering with government policies ant to society benefit. To conduct this research, an integration of Data Envelopment Analysis (DEA) with the Stochastic Frontier Analysis (SFA) is adopted in a three stages procedure to correct the efficiency in terms of environmental effects: (i) evaluation by means of DEA to measure operating costs slacks of the utilities, in which environmental variables are omitted; (ii) The slacks calculated in the first stage are regressed on a set of environmental variables by means of SFA and operating costs are adjusted to account the environmental impact and statistical noise effects; and, (iii) reassess the performance of the electric power distribution utilities by means of DEA. Based on this methodology it is possible to obtain a performance evaluation exclusively expressed in terms of management efficiency, in which the operating environment and statistical noise effects are controlled.

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The article talks about the challenge of the construction of public policies for the child in the age group from 0 to 6 years old in Brazil, in the perspective of the right guarantees. One can presuppose that to comprehend the development of these policies, it is necessary to analyze the historical route of its assistance, possibilities and limits. It is also important to consider the contradictory relationships of power present in society, and its influence in the building of the conception of child and childhood that are very far to be neutral words, so they are policies. In this point of view, this work analyzes the arrangement of the current policies of assistance to children, making clear the shape as they were reorganized by the neo liberal policies and set of instructions of international organizations. The studies show that, instead of public and universal policies, programs and actions are introduced based on the focus in the fight against poverty, made with low costs and questionable quality.

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The object of this study was motivated by the need to know the possible causes of differences in results achieved in the implementation of a Computerised Management System (CMS) in a Federal University Hospital, located in northeastern Brazil, to understand the factors that influenced the results in different groups when was used the same systems implementation methodologies. Considering the implication of managers, health professionals, other professionals involved and the existing organizational structure in the period when implantation occurred, aimed to know the perception of these people about the development of CMS in the deployment process in your group or sector and also in the organization.The methodology used in this study was the content analysis which provides a rich set of methodological tools for evaluating speeches,enabling us to discourse from the unknown analysis and subjectivity, but with scientific rigor, allowing, at the end, to understand the disparity in results in the implementation of CMS.It was used as a research tool, a semi-structured interview, which exploits a qualitative approach, as suggested by the authors. It was used the approach of the episodic interview, to be more narrative about the experiences of the interview participants in their practical experience along the CMS deployment process in the hospital.Were interviewed three groups of professional and a group of managers, all with higher education in their professions and who participated in the entire implementation process from the beginning.It followed the Bardin's methodology (2009) in all the phases of treatment and interpretation of data, where emerged three categories: the "Thought and Knowledge"; the "Practices and Changes"; the "Obtained Results". From the category "Thought and Knowledge"emerged three subcategories: the "Administrative", the "Institutional" and the "IT Knowledge". From the category "Practices and Changes" emerged three subcategories: "Reality Prior to CMS"; "The IT Project and the implementation of CMS" and "Impacts of the CMS Implementation". From the category "Results Obtained" emerged three subcategories: "Benefits Promoted by CMS", "Dissatisfaction Observed" and "Level of Use and Understanding CMS ". It was observed that the lack of integration of the sectors was a determinant problem in the implementation of CMS. The CMS implementation project was not well dimensioned and divulged in the institution. Different models of leaderships and of objectives of the sectors influenced in the course of the CMS implementation process. We can mention that an CMS should be a consolidation of organizational practices tool already institutionalized and of integration amongthe sectors and not supporting to isolated practices and personalistsfrom sectors of the institution.

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In the context of current capitalist society, marked by the logic that restricts the human person their status as workforce, in order to generate profits, old age is often treated as an underprivileged life stage. This reality becomes more intense considering the sharp aging process that affects brazilian society is accompanied by the country's entry into a globalized world and tensioned by the dictates of capital. Thus, despite the increasing development of policies to strengthen the guarantee of elderly rights, it is necessary to establish effective strategies of these measures to ensure a higher quality of life to these subjects. Therefore, it is necessary to develop studies that problematize the issue of the elderly, which represent a growing portion of the population, and hence have more visible demands, including in health. With the increase in the elderly population in Brazil it is possible to realize the country is going through a demographic transition and epidemiological changes that contribute to change the landscape of health care of the elderly, especially the hospitalization. Thus, this study aimed to analyze the multiple aspects of ensuring the rights of elderly patients admitted to the State Hospital Dr. Ruy Pereira dos Santos (HRPS), located in Natal / RN, whose most patients are elderly. Specifically sought to understand the aging process, its social consequences and the vulnerability to which it is exposed, especially during the disease situation; understand the process of construction of the Brazilian public health and their actions for older people; learn the expressions of citizenship formation in Brazil with regard to policies for older people; and investigate the design of health professionals about the guarantee of the right of hospitalized elderly. Starting from an integrated coordinated theoretical and practical possibilities, a qualitative research and literature character, documentary and field was held. For this, there were four semi-structured interviews with health research locus Hospital professionals - namely, two social workers, a doctor and a nurse - as well as life stories with the hospitalized elderly patients, one in each deck the said Hospital, totaling three. The results pointed to the difficulty of health policy become effective as law and stressed one historical scenario violation of the rights of elderly hospitalized patients, which persists due to the precarious situation and the difficulty of effective implementation of the Unified Health System (SUS ) and other public policies to that end.