Performance evaluation of hospitals that provide care in the public health system, Brazil

OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System.METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction.RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed.CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

Performance evaluation of hydrocyclone filter for microirrigation

In this study a hydrocyclone filter of 20 cm was selected and its performance was evaluated by studying the variation of discharge, pressure drop, influent concentration, and filtration efficiency with elapsed time of operation. The filter was tested with clean water to determine clean pressure drop and later it was tested with four concentrations of solid suspension, viz. 300; 600; 900 and 1,200 mg L-1. In the concentration of 300 mg L-1, the variation of pressure drop was low. But for the other concentrations of solid suspension, the variation was significant. The maximum pressure drops obtained were 41.19, 45.11, 50.01 and 52.95 kPa at 350, 390, 280 and 190 minutes of elapsed time, respectively. The maximum efficiency of solid suspension was 30.3, 32.96, 43.89 and 52.5% where as the minimum efficiencies were 9.91, 9.93, 9.62 and 9.9%, respectively. The hydrociclone tested presented inefficiency to filter small particles as clay. The initial removal efficiency of higher concentration was bigger than for lower concentration but, the final efficiency are almost the same irrespective of the concentration of solid suspension. The present tested hydrocyclone could be used as a pre-filter microirrigation to prevent emitter clogging.

O PAPEL DO BALANCED SCORECARD NA GESTÃO DA INOVAÇÃO

Este trabalho objetiva estudar como o balanced scorecard se relaciona com o processo de inovação nas organizações. Como contribuição, expande a utilidade do modelo, especificando estímulos externos, tensões dinâmicas, estratégias de inovação e percepção de sucesso da inovação. Trata-se de um estudo descritivo, desenvolvido por meio de questionário, aplicado a 121 empresas. Para análise de dados, empregaram-se equações estruturais. Quanto aos achados, percebe-se um processo complexo, de longo prazo e vital para as empresas, que têm sua percepção de sucesso influenciada por elementos externos à organização (estímulos externos) e internos (tensão dinâmica e estratégias de inovação). A gestão da inovação torna-se temerária na ausência de mecanismos que equilibrem as tensões evidenciadas pelos indicadores, inclusive conflitantes numa dimensão temporal de longo prazo, e o risco fica ainda maior quando a percepção de sucesso é captada exclusivamente pelos indicadores financeiros de curto prazo.

Gestão de desempenho por competências: integrando a gestão por competências, o balanced scorecard e a avaliação 360 graus

Este artigo avalia a percepção de funcionários do Banco do Brasil acerca do novo modelo de gestão de desempenho adotado pela empresa. A pesquisa, de caráter descritivo e exploratório, utilizou-se de questionário semi-estruturado para coleta de dados quantitativos e qualitativos. A amostra foi constituída por 532 funcionários de nove unidades do banco, nas quais o modelo foi implementado para fins de validação. Foram realizadas análises descritivas, de variância e fatorial entre as variáveis componentes do estudo, e análise de conteúdo dos dados qualitativos. Os resultados indicam ser muito positiva a percepção dos sujeitos da pesquisa. O novo instrumento foi considerado mais eficaz, democrático e participativo, conseguindo integrar pressupostos de modelos e instrumentos de gestão referenciados pela literatura como modernos e eficazes, como a gestão por competências, o balanced scorecard e a avaliação 360 graus. Para finalizar, são apresentadas recomendações práticas e sugestões para realização de pesquisas futuras.

Performance evaluation of primary care services for the treatment of tuberculosis

Objective Evaluating the performance of primary care services for the treatment of tuberculosis according to the assessment referential of health services (structure/process) in Cabedelo, a port city in the state of Paraíba. Method An evaluation quantitative, cross-sectional study, in which were carried out 117 interviews with health professionals using a structured instrument. The analysis was based on the construction of indicators using a standardized value for the reduced variable (z=1). Results The structural indicators showed regular performance for the following variables: professional training, access to record instruments and coordination with other services. The process indicators related to external actions and information about the disease had unsatisfactory performance. The directly observed treatment and the flows of reference/counter-reference had regular performance. Conclusion The focused professional qualification, the fragmentation of practices and the unsystematic home care constitute obstacles for carrying out actions aimed at providing expanded, continuous and resolute care.



Application of x-ray computed tomography in the evaluation of soil porosity in soil management systems

The study aimed to evaluate a methodology to quantify the porosity of the soil using computed tomography in areas under no-tillage, conventional tillage and native forest. Three soil management systems were selected for the study: forest, conventional tillage and no-tillage. In each soil management system, undisturbed soil samples were collected in the surface layer (0.0 to 0.10 m). The tomographic images were obtained using a X-ray microtomography. After obtaining the images, they were processed, and a methodology was evaluated for image conversion into numerical values. The statistical method which provided the greatest accuracy was the percentile method. The methodology used to analyze the tomographic image allowed quantifying the porosity of the soil under different soil management. The method enabled the characterization of soil porosity in a non-evasive and non-destructive way.

Performance evaluation of 3D computer vision techniques

This work presents the implementation and comparison of three different techniques of three-dimensional computer vision as follows: • Stereo vision - correlation between two 2D images • Sensorial fusion - use of different sensors: camera 2D + ultrasound sensor (1D); • Structured light The computer vision techniques herein presented took into consideration the following characteristics: • Computational effort ( elapsed time for obtain the 3D information); • Influence of environmental conditions (noise due to a non uniform lighting, overlighting and shades); • The cost of the infrastructure for each technique; • Analysis of uncertainties, precision and accuracy. The option of using the Matlab software, version 5.1, for algorithm implementation of the three techniques was due to the simplicity of their commands, programming and debugging. Besides, this software is well known and used by the academic community, allowing the results of this work to be obtained and verified. Examples of three-dimensional vision applied to robotic assembling tasks ("pick-and-place") are presented.

STRATEGIES FOR SUPERIOR PERFORMANCE IN RECESSIONS: PRO OR COUNTER-CYCLICAL?

Recessions are recurring events in which most firms suffer severe impacts while others are less affected or may even prosper. Strategic management has made little progress in understanding such performance differences. In a scenario of decreased demand, intensified competition, and higher uncertainty, most firms try to survive by pro-cyclically cutting costs and investments. But firms could take advantage of undervalued resources in the market to counter-cyclically invest in new business opportunities to overtake competitors. We survey Brazilian firms in various industries about the 2008-2009 recession and analyze data using PLS-SEM. We find that while most firms pro-cyclically reduce costs and investments in recessions, a counter-cyclical strategy of investing in opportunities created by changes in the market enables superior performance. Most successful are firms with a propensity to recognize opportunities, an entrepreneurial orientation to invest, and the flexibility to efficiently implement investments.

MODELING A COMPUTER APPLICATION FOR MANAGEMENT OF MAINTENANCE ACTIVITIES OF UNPAVED ROADS

ABSTRACTThis study presents a contribution to the modeling of a computer application employing a method of serviceability performance for unpaved roads, aiming the management of maintenance/restoration activities of the primary surface layer. The proposed methodology consisted of field inspections during dry (April to September) and rainy (October to March) periods, during which objective evaluations were performed to survey of defects and their densities and degrees of severity. To aid the functional classification of analyzed road sections and the determination of the defect with major influence on the serviceability of these roads, the method of serviceability performance proposed by Silva (2009)was implemented in the Visual Basic for Applications (VBA) language in Microsoft Excel software. With the use of the computer application proposed it was possible to identify among the defects analyzed in field, through the index of serviceability of the sampling unit per defect type (ISUdef), which one had the greatest influence on determining the relative serviceability index per road section (IST). The results allow us to conclude that the computer application Road achieved satisfactory results, since the objective evaluation criteria applied to road sections denotes consistency regarding their serviceability.

Effects of fumonisin B1 on selected biological responses and performance of broiler chickens

The objective of this study was to determine the effects of three doses of fumonisin B1 (0, 100, and 200mg/kg of feed) on biological variables (relative weight of liver [RWL], total plasma protein [TPP], albumin [Alb], calcium [Ca], phosphorus [P], uric acid [UA], alanine aminotransferase [ALT], aspartate aminotransferase [AST], gamma glutamyltransferase [GGT], alkaline phosphatase [AP], total cholesterol [Chol], triglycerides [Tri], sphinganine-to-sphingosine ratio [SA:SO], and C-reactive protein [CRP]), morphological evaluation of the small intestine (villus height [VH], crypt depth [CD], and villus-to-crypt ratio [V:C]), histological evaluation, and on performance (body weight [BW], feed intake [FI], and feed conversion rate [FCR]) of broiler chickens. Significant effects of FB were observed on BW and FI (reduced), on RWL, TPP, Ca, ALT, AST, GGT, Chol, and Tri (increased) at both 14 and 28 days evaluations. In addition, significant increase was observed on FCR, Alb, P, SA:SO, and CRP and significant reduction in UA, VH, and V:C only at the 28 days evaluation. Significant histological lesions were observed on liver and kidney of FB inoculated broilers at 14 and 28 days. Those results show that FB has a significant effect on biological and histological variables and on performance of broiler chickens.

Construindo o diálogo entre competência, recursos e desempenho organizacional

Este artigo objetiva estudar como os recursos impactam o desempenho organizacional. Partindo da noção de competência como processo de coordenação e mobilização de recursos, utilizou-se o referencial do balanced scorecard (BSC) para mensurar a influência dessa coordenação sobre os indicadores de desempenho nas múltiplas perspectivas do BSC. A revisão da literatura sobre esse tema mostrou que se privilegia o uso de indicadores financeiros ou de processos internos, e que menos estudos avaliam indicadores de aprendizagem, impactos sobre os clientes, ou analisam mais de uma perspectiva simultaneamente. Um estudo de caso em profundidade em empresa de saneamento utilizando dados e indicadores sugere que fatores ambientais relacionados à demanda são os maiores determinantes do desempenho. A satisfação dos funcionários sugere associação com todas as perspectivas do BSC.

INTERNATIONALIZATION OF BRAZILIAN FRANCHISE CHAINS: A COMPARATIVE STUDY

The primary goal of this paper is to comprehend the fundamental organizational differences between Brazilian franchise chains that only operate in the home market and Brazilian franchise chains that operate internationally. The sample chosen for this study comprehends 96 Brazilian franchises operating in the home market and 67 franchises with international operations; logistic regression was used to analyze data obtained from these sources. Our findings suggest that the development of a brand in international operations can be strategic for certain Brazilian franchise chains; this seems to be, however, a scarce resource for many franchises and it could be developed through international operations. With regard to the fees charged, the outcomes demonstrate that Brazilian franchises with international operations tend to charge lower fees from its franchisees to install new units. Regarding the monitoring and control of franchises, there is evidence that the monitoring capability is one of the determining factors in the development of Brazilian franchises international operations.

Challenges and perspectives of academic evaluation

Academic evaluation has been an essential component of modern science since its inception, as science has moved away from personalized patronage toward its contemporary role as an essential enterprise of contemporary, democratic societies. In recent years, Brazil has experienced sustained growth in its scientific output, which is nowadays fully compatible with its status as a high middle-income country striving to become a fully developed, more equitable country in the years to come. Growth usually takes place amidst challenges and dilemmas and, in Brazil as elsewhere, academic evaluation is not exempt from such difficulties. In a large, profoundly heterogeneous country with a national evaluation system and nationwide on-line platforms disseminating information on the most disparate fields of knowledge, the main challenges refer to how to pay attention to detail without losing sight of comprehensiveness and how to handle social and regional diversity while preserving academic excellence as the fundamental benchmark.

Geração e gestão do valor por meio de métricas baseadas nas perspectivas do capital intelectual

No presente estudo, tomou-se como ponto de partida pesquisa em que se discutem possibilidades de as empresas alcançarem valor superior com base no alinhamento estratégico, na gestão do capital intelectual e na adoção do Balanced Scorecard (BSC). Investigou-se a associação entre a geração de valor e os componentes do capital intelectual segundo preceitos, entre outros, de Stewart (1999; 2001) M'Pherson e Pike (2001) e Kaplan e Norton (2004), além de trazer à tona a questão da implementação e extensão da utiliza- ção do Balanced Scorecard. As proxies empregadas para caracte- rizar geração de valor foram a média do price-to-book value (razão entre o valor de mercado e o valor patrimonial) e o retorno médio das ações no período estudado. Para caracterizar os componentes do capital intelectual, adotaram-se índices computados a partir da percepção de executivos de topo responsáveis por processos corporativos de planejamento e controle, com base na revisão de literatura e com base em procedimento de fatoração. O estudo utilizou testes não paramétricos para identificar se há evidências de diferente apreciação e retorno no mercado acionário para segmentos homogêneos de empresas com perfis diferenciados quanto aos índices de capital intelectual. Os resultados mostraram-se conclusivos e significantes - em reforço à proposição de sintonia entre a percepção do valor sob o enfoque do mercado de capitais e a percepção da performance em múltiplas perspectivas por parte de gestores. Quanto à adoção do BSC, foram identificados indícios de interferência favorável à performance nas empresas classificadas como de melhores padrões de geração de valor.