Identificação de ineficiências na cadeia de valor da saúde, a partir da análise da gestão de compras de quatro hospitais privados do município de São Paulo

Os estudos e pesquisas sobre as razões do crescimento dos custos na Saúde apontam um conjunto de fatores, como o aumento dos preços dos materiais e medicamentos, os avanços tecnológicos, o envelhecimento da população, entre outros. Porém, poucos são os estudos que procuram analisar como a interação entre as partes que constituem o sistema de saúde pode resultar em ineficiências, ou que procuram desvendar a lógica de como se dão as trocas de valores entre os players desse mercado e sua racionalidade, a fim de identificar fatores que elevem os custos no sistema sem um aumento de benefícios aos usuários finais. Sabe-se que grande parte dos gastos na saúde ocorre dentro dos hospitais. Sendo assim, este trabalho buscou analisar a gestão de compras dos hospitais, para descrever aspectos relevantes no relacionamento entre algumas partes envolvidas na dinâmica da compra hospitalar, conhecer especificidades da gestão de compras destas organizações, e verificar algumas ineficiências na cadeia de valor da saúde. Foram escolhidos quatro hospitais privados do município de São Paulo, onde foram entrevistados um executivo da alta administração, um gestor de compras e um médico. A partir da percepção destes entrevistados foram identificadas algumas ineficiências, como a dependência de alguns hospitais nas margens de comercialização de materiais e medicamentos, que mostra a existência de um custo no sistema, desvinculado do real valor agregado pelos hospitais; a dificuldade em se padronizar os materiais cirúrgicos que representam um dos maiores gastos em compras nestas instituições; a existência práticas de marketing dos fornecedores que tentam anular a racionalidade da compra, a dificuldade de alinhamento de objetivos entre hospitais, operadoras de planos de saúde, médico e fornecedores, entre outros.

Pirólise térmica e catalítica de resíduos de vácuo gerados no refino de petróleo

In this study, was used a very promising technique called of pyrolysis, which can be used for obtaining products with higher added value. From oils and residues, since the contribution of heavier oils and residues has intensified to the world refining industry, due to the growing demand for fuel, for example, liquid hydrocarbons in the range of gasoline and diesel. The catalytic pyrolysis of vacuum residues was performed with the use of a mesoporous material belonging the M41S family, which was discovered in the early 90s by researchers Mobil Oil Corporation, allowing new perspectives in the field of catalysis. One of the most important members of this family is the MCM-41, which has a hexagonal arrangement of mesopores with pore diameters between 2 and 10 nm and a high specific surface area, making it very promising for use as a catalyst in petroleum refining for catalytic cracking, and their mesopores facilitate the access of large hydrocarbon molecules. The addition of aluminum in the structure of MCM-41 increases the acidity of the material, making it more positive for application in the petrochemical industry. The mesoporous material of the type Al-MCM41 (ratio Si / Al = 50) was synthesized by hydrothermal method starting from the silica gel, NaOH and distilled water added to the gel pseudobohemita synthesis. Driver was used as structural CTMABr. Removal of organic driver (CTMABr) was observed by TG / DTG and FTIR, but this material was characterized by XRD, which was observed the formation of the main peaks characteristic of mesoporous materials. The analysis of adsorption / desorption of nitrogen this material textural parameters were determined. The vacuum residues (VR's) that are products of the bottom of the vacuum distillation tower used in this study are different from oil fields (regions of Ceará and Rio de Janeiro). Previously characterized by various techniques such as FTIR, viscosity, density, SARA, elemental analysis and thermogravimetry, which was performed by thermal and catalytic degradation of vacuum residues. The effect of AlMCM-41 was satisfactory, since promoted a decrease in certain ranges of temperature required in the process of conversion of hydrocarbons, but also promoted a decrease in energy required in the process. Thus enabling lower costs related to energy expenditure from degradation during processing of the waste

Síntese e caracterização de zeólita beta hierarquizada e materiais híbridos micro-mesoporosos aplicados no craqueamento de PEAD

A catalyst of great interest to the scientific community tries to unite the structure of ordered pore diameter from mesoporous materials with the properties of stability and acid activity to microporous zeolites. Thus a large number of materials was developed in the past decades, which although being reported as zeolites intrinsically they fail to comply with some relevant characteristics to zeolites, and recently were named zeolitic materials of high accessibility. Among the various synthesis strategies employed, the present research approaches the synthesis methods of crystallization of silanized protozeolitic units and the method of protozeolitic units molded around surfactant micelles, in order for get materials defined as hierarchical zeolites and micro-mesoporous hybrid materials, respectively. As goal BEA/MCM-41 hybrid catalysts with bimodal pore structure formed by nuclei of zeolite Beta and cationic surfactant cetyltrimethylammonium were developed. As also was successfully synthesized the hierarchical Beta zeolite having a secondary porosity, in addition to the typical and uniform zeolite micropores. Both catalysts were applied in reactions of catalytic cracking of high density polyethylene (HDPE), to evaluate its properties in catalytic activity, aiming at the recycling of waste plastics to obtain high value-added raw materials and fuels. The BEA/MCM-41 hybrid materials with 0 days of pre-crystallization did not show enough properties for use in catalytic cracking reactions, but they showed superior catalytic properties compared to those ordered mesoporous materials of Al-MCM-41 type. The structure of Beta zeolite with hierarchical porosity leads the accessibility of HDPE bulky molecules to active centers, due to high external area. And provides higher conversion to hydrocarbons in the gasoline range, especially olefins which have great interest in the petrochemical industry

Características econômicas do valor de uso e de não uso de parques sobre dunas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

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