A eficiência do gasto e da qualidade da saúde pública: uma análise nos municípios do estado do Rio Grande do Norte (2004 e 2008)

The overall objective of this study is to analyze the efficiency in the use of resources and the quality of public health in the municipalities of Rio Grande do Norte, from 2004 to 2008. It also seeks to identify the determinants of municipal inefficiency and measure the productivity of public spending on health. To this end, three methods of analysis are used: the DEA, the Malmquist index and the Tobit regression model. Among other findings, it appears that municipalities considered more inefficient in the measurement of expenditure on health make the largest expense in this function. On the other hand, from 2004 to 2008, only 13 municipalities showed an increase in the productivity of public spending. It is also noted that municipalities considered efficient in quality of health, although having more physical and human resources, offer fewer health services to the population. In all, the major determinants of health spending inefficiencies are the variables: age of the mayor, coalition, population density, literacy race and budget revenues. Regarding the inefficiency of the health quality, variables such as: coalition, literacy race have strong influence on this behavior. Thereby, the hypotheses proposed by the study have been fully accepted. In other words, for the efficiency of the quality and health spending it is needed more than resources, i.e., the expenditure shows itself as essential, but not enough, for political and economic aspects also interfere with the performance of spent and in the quality of health care offered to the population

Ensino de Entropia: um enfoque histórico e epistemológico.

The rational construction necessary to systematize scientific knowledge in physics, introduces difficulties of understanding in some of its concepts. One of these concepts which exemplify properly this difficulty in learning or teaching is entropy. This thesis propose the construction of a didactic route which constitute itself a historical and epistemological course to entropy, intending to contribute for teaching this concept as well as other physics concepts. The basic assumption to build this route is that through the historical review of the development of this concept in the way suggested by Bachelard s (1884-1962) epistemology it is possible to make subjects, to be taught and learned, more meaningful. Initially I composed a brief biographical note to give the reader an idea about the issues, interests and reflections, related to science, and how I dealt with them in my private and professional life, as well as the role they played to lead me to write this thesis. The strategy to construct the route to entropy was to split the usual contents of basic thermodynamics in three moments in a way they can constitute epistemological units , which can be identified by the way of thinking in the corresponding moments of scientific knowledge production: a technical and empiricist moment, a rationalist and positivist moment and a post-positivist rationalist one. The transition between each moment is characterized by a rupture with the former way of thinking; however the progress in the construction of knowledge in the area is evident. As the final part of this work I present an analysis based on elements of Bachelard s epistemology that are present in each moment. This analysis is the basic component of the didactic route that I propose myself to build. The way I made this route guide to entropy could contribute to the construction of other didactic routes in physics and other sciences, in a way to unveil hidden meanings and as a tool to humanize scientific knowledge.