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

Análise de qualidade da atenção à criança na estratégia saúde da família: o óbito infantil evitável como referência

Alma-Ata declaration bring the Primary Attention to the Health (PAH) as first level of health attention for individuals, family and community, which considers infant group as priority. Several initiatives that gave bases to integral attention to the children health formalized in the principles of Unique Health System. Family Health Strategy (FHS) comes to strengthen this attention, instituting new ways of work organization and professional practices that gave impact in their quality indicators. One of them is children mortality, showing decline in their values. Though, studies indicates persistence of avoidable infant deaths. In Natal RN, this reality is also perceptible leading to inquietudes, mainly at the space of services production, it means, which motivated the accomplishment of the present study intending to analyse the way that the organizational and structural processes as long as the professional practices in FHS interfered in the quality of children s health attention who died by avoidable death in the year of 2007 in municipal district of Natal-RN. It treats, therefore, to an exploratory and descriptive survey of cases study type, thar had as primary sources the oficial documents of MH, the family prontuary, pregnant card, child card and testimony obt ined from instrument of research elaborated based in investigation form of infant death by MH, applied to 10 mothers of children who had avoidable death. In analysis it was appealed silmultaneous triangulation of methods and sources, allowing a bigger aproximation from obtained informations. To elucidate the cases, the aspects studied were analyzed to the light of explicative model of Social Determinants of Health. Among individual and family aspects were highlighted the related to age, schooling, family habits and customs and mother s economic condition, besides of pregnancy age, newborn weight and associated diseases, which don t differ from literature about the theme. Reffering to the factors organizational and structural processes and professionals practice, highlihgted, the treatment given by the professionals, the territorialization and adscription of areas, the difficulty of having access to the services or sleepers and the reference and counterreference. But also, the ausence or few greet, the lack of communication, few assiduity and ponctuality by professionals in service, among others. In a general way mothers considers the attendance received in the hospital good and very good , opnions that in the Basic Attention weren t so favorable, in spite of many of predictible actions in this level have been performed in the studied cases. It is observed, therefore, that the social determinants of health has a strong influence in ocurrence of infant deaths, what implicates in a large actuation by Infant Mortality Committee from municipal district. This way, it becomes fundamental the reflection and evaluation about the effectiveness and execution by the processes of vigilance to health in FHUs; the rethink about the social determinants of health in a wide and articulate way to the services quality, to permanent education, to management in service, to the given attention and to the way how it is installed the popular participation and social control. To the professionals it is presented the great challenge to review their daily practice, their values, behaviors and commitment, which ones must be guided by logical of sharing, work in team, humanescence and alterity, not only by the accomplishment of a professional duty

Uma perspectiva de extensão do modelo de aceitação de tecnologia para explicar o uso de linguagens de desenvolvimento WEB: pesquisa com desenvolvedores Pyton e Java

The spread of the Web boosted the dissemination of Information Systems (IS) based on the Web. In order to support the implementation of these systems, several technologies came up or evolved with this purpose, namely the programming languages. The Technology Acceptance Model TAM (Davis, 1986) was conceived aiming to evaluate the acceptance/use of information technologies by their users. A lot of studies and many applications have used the TAM, however, in the literature it was not found a mention of the use of such model related to the use of programming languages. This study aims to investigate which factors influence the use of programming languages on the development of Web systems by their developers, applying an extension of the TAM, proposed in this work. To do so, a research was done with Web developers in two Yahoo groups: java-br and python-brasil, where 26 Java questionnaires and 39 Python questionnaires were fully answered. The questionnaire had general questions and questions which measured intrinsic and extrinsic factors of the programming languages, the perceived usefulness, the perceived ease of use, the attitude toward the using and the programming language use. Most of the respondents were men, graduate, between 20 and 30 years old, working in the southeast and south regions. The research was descriptive in the sense of its objectives. Statistical tools, descriptive statistics, main components and linear regression analysis were used for the data analysis. The foremost research results were: Java and Python have machine independence, extensibility, generality and reliability; Java and Python are more used by corporations and international organizations than supported by the government or educational institutions; there are more Java programmers than Python programmers; the perceived usefulness is influenced by the perceived ease of use; the generality and the extensibility are intrinsic factors of programming languages which influence the perceived ease of use; the perceived ease of use influences the attitude toward the using of the programming language

Análise do modelo de gestão implantado no Centro de Atenção Psicossocial CAPS II OESTE de 1995 a 2005, situado no distrito sanitário Oeste do município de Natal/RN, à luz da Co-gestão

This dissertation has as aim the praxis of co-management of the health service of CAPS II OESTE of Natal-RN, where health workers, family members got to materialize guidelines and principles of psychiatric Brazilian reform in real possibilities of subjectivity construction, whereas they changed social relations in daily life. The path chosen to record was from testimonials and contributions of those who meant their done. Redeeming this story from social representations of the majority of their builders was an instigating, delicate and rewarding task, emphasizing the living memory, rebuilt in a line of time which could not be found in simple documentary collections. Mainly, by knowing that service routine was intense and had as characteristic the singular mobility itself from a creation process and therefore not always its dynamic allowed adequate records. At the same time, from this occurred the field and bibliographic research which allowed the detailed information from the prior milestones and motivated to the practice here reported. The rereading of concepts in an interface with the reports of the interviewees enabled the verification that the model of mental health advocated by psychiatric reform was understood. Once noticed the presence of the beliefs and values of people in motivating energy for the progress of reform, it has gone to fetch theoretical subsidies of administrative order to understand how they saw this building and that uniqueness has been printed. The theoretical way and praxis have tracked here has allowed to analyze how occurred such a process of production and subjectivity and collectives that when organize enabled themselves for analysis and intervention, including in crisis situations. Therefore, it was revealed that ethical and multi-disciplinarity, the humanitarian sense, the coresponsibility, co-production and horizontal management were the key factors for spread from a changing protagonist. One can thus conclude that co-management from that collective has been multi-disciplinary weaving a cross

A influência da cultura organizacional na adoção de práticas de qualidade Seis Sigma: um estudo exploratório no segmento de farmácia de manipulação do Estado do Rio Grand do Norte

In recent debates about the issues of quality, the theme organizational culture and Six Sigma has appeared ever more frequently. In this context several authors suggest that the adoption of Six Sigma practices is influenced by culture. This work focuses on the relationship of organizational culture and quality to the practices of Six Sigma quality. Thus a descriptive-exploratory and correlational study of forty pharmacies of manipulation from Rio Grande do Norte was undertaken. Data collection identified features of companies and the level of use of the practices of Six Sigma quality that have been identified in the literature. For the Organizational Culture evaluation was used the Competitive Value Model (Cameron & Quinn, 1996), tested on north-American organizations and considered a high value academic and professional instrument. This model has been involved with the taximetrics created by Cameron who classifies quality culture in four levels. The results suggest that the Group and Developmental cultures are associated with higher levels of use of the practices of Six Sigma quality than the Rational and Hierarchical Cultures. Regarding the levels of the culture s quality, the highest levels were most frequently cited in Errors Prevention and Perpetual Improvement and Creativity, being the last one more positively related to the Six Sigma indicators

Análise tecnológica sobre os aspectos ambientais de empreendimentos hoteleiros da Praia de Ponta Negra Natal/RN: um modelo de sistema de gestão ambiental

The present work aimed the elaboration of an environmental study focused on the hotel sector in order to present an analysis of the environmental aspects of Ponta Negra Beach, in Natal, RN, Brazil and also the aspects of the small and medium hotels existing in this area. By means of this work, it is possible to elaborate a model of a simplified System of Environmental Management which can attend to the exigencies required by NBR ISO 14001: 2004, as well as to present economical viability and possibility to be implemented in a way that hotels may converge to the sustainable environmental development of the tourism in Ponta Negra Beach. The research methodology presents itself divided into three items: execution of the environmental characterization of Ponta Negra Beach, by way of technical visits and interpretation of satellite images and cartograms of the main environmental characteristics of the region; execution of the work already made concerning the development, application and interpretation of the evaluation of the environmental aspects of each hotel, considering the hotels and the period of data collection, these used in evaluation, research instrument and a description of the procedure utilized for the analysis of the collected data and the utilized methodology for the elaboration of a model of a simplified System of Environmental Management. In a general way, it has been concluded that the practices executed by hotels in Ponta Negra Beach are impact-like and harmful to the environment. The simple implementation of analysis procedures and control of the environmental aspects could suggestively contribute to the reduction of environmental impacts promoted by the hotel section at this beach and in the nearby areas. It had been noticed that the study contributed to the sensitization of managers concerning the environmental problems since, in many other times, the detected problem was, in fact, the non-acquaintance about the environmental aspects and impacts from those hotels administrators, because of the lack of surveys and studies about the theme. It had also been noticed the arousing of a possible environmental attitude from some managers

Melhoria da segurança pública: uma proposta para alocação de unidades policiais utilizando o modelo das p-medianas e do caixeiro viajante

The decrease in crime is one of the core issues that cause concern in society today. This study aims to propose improvements to public safety from the choice of points to the location of police units, ie the points which support the car and the police. For this, three models were developed in order to assist decision making regarding the best placement of these bases. The Model of Police Units Routing has the intention to analyze the current configuration of a given region and develop optimal routes for round preventative. The Model of Allocation and Routing for New Police Units (MARNUP) used the model of facility location called p-median weighted and traveling salesman problem (TSP) combined aiming an ideal setting for regions that do not yet have support points or to assess how far the distribution is present in relation to that found in solution. The Model Redefinition and Routing Unit Police (MRRUP) seek to change the current positioning taking into account the budgetary constraints of the decision maker. To verify the applicability of these models we used data from 602 points to instances of police command that is responsible for the capital city of Natal. The city currently has 31 police units for 36 of these 19 districts and police have some assistance. This reality can lead to higher costs and higher response times for answering emergency calls. The results of the models showed that in an ideal situation it is possible to define a distance of 500 km/round, whereas in this 900 km are covered by approximately round. However, a change from three-point lead reduced to 700 km / round which represents a decrease of 22% in the route. This reduction should help improve response time to emergency care, improving the level of service provided by the increase of solved cases, reducing police shifts and routing preventive patrols

Qualidade do serviço de informação digital :um estudo exploratório em web sites de Programas de Pós-Graduação

This dissertation of Mestrado investigated the performance and quality of web sites. The target of the research is the proposal of an integrated model of evaluation of services of digital information in web educational sites. The universe of the research was constituted by eighteen Brazilian Universities that offer after-graduation courses, in the levels of mestrado and doutorado in the area of Engineering of Production. The adopted methodology was a descriptive and exploratory research, using the technique of systematic comment and focus group, for the collection of the data, using itself changeable independent dependents and, through the application of two instruments of research. The analysis protocol was the instrument adopted for evaluation and attainment of qualitative results. E the analysis grating was applied for evaluation and attainment of the quantitative results. The qualitative results had identified to the lack of standardization of web sites, under the attributes of content, hierarchy of information, design of the colors and letters. It of accessibility for carriers of auditory and visual special necessities was observed inexistence, as well as the lack of convergence of medias and assistivas technologies. The language of the sites also was evaluated and all present Portuguese only language. The general result demonstrated in grafico and tables with classification of the Universities, predominating the Good note As for the quantitative results, analysis method ed was estatistico, in order to get the descriptive and inferencial result between the dependent and independent variaveis. How much a category of analysis of the services of the evaluated sites, was found it props up and the index generality weighed. These results had served of base for ranking of existence or inexistence the Universities, how much of the information of services in its web sites. In analysis inferencial the result of the test of correlation or association of the independent variaveis (level, concept of the CAPES and period of existence of the program) with the caracteristicas, called was gotten categories of services. For this analysis the estatisticos methods had been used: coefficient of Spearman and the Test of Fisher. But the category you discipline of the Program of Mestrado presented significance with variavel independent and concept of the CAPES. Main conclusion of this study it was ausencia of satandardization o how much to the subjective aspects, design, hierarchy of information navigability and content precision and the accessibility inexistence and convergence. How much to the quantitative aspects, the information services offered by web sites of the evaluated Universities, still they do not present a satisfactory and including quality. Absence of strategies, adoption of tools web, techniques of institucional marketing and services that become them more interactive, navigable is perceived and with aggregate value

Modelo de classificação para pequenas empresas supermercadistas quanto ao uso de técnicas de prevenção de perdas: um estudo de caso

The objective of this work is to draw attention to the importance of use of techniques of loss prevention in small retail organization, analyzing and creating a classification model related to the use of these in companies. This work identifies the fragilities and virtues of companies and classifies them relating the use of techniques of loss prevention. The used methodology is based in a revision of the available literature on measurements and techniques of loss prevention, analyzing the processes that techniques needed to be adopted to reduce losses, approaching the "pillars" of loss prevention, the cycle life of products in retail and cycles of continues improvement in business. Based on the objectives of this work and on the light of researched techniques, was defined the case study, developed from a questionnaire application and the researcher's observation on a net of 16 small supermarkets. From those studies a model of classification of companies was created. The practical implications of this work are useful to point mistakes in retail administration that can become losses, reducing the profitability of companies or even making them impracticable. The academic contribution of this study is a proposal of an unpublished model of classification for small supermarkets based on the use of techniques of loss prevention. As a result of the research, 14 companies were classified as Companies with Minimum Use of Loss Prevention Techniques - CMULPT, and 02 companies were classified as Companies with Deficient Use of Loss Prevention Techniques - CDULPT. The result of the research concludes that on average the group was classified as being Companies with Minimum Use of Techniques of Prevention of Losses EUMTPP, and that the companies should adopt a program of loss prevention focusing in the identification and quantification of losses and in a implantation of a culture of loss prevention

O Prêmio Nacional de Qualidade e as políticas e práticas de recursos humanos :um estudo em empresas do setor de transporte público por ônibus da região metropolitana de Natal/RN

This work has goal of analyzing the practices of Human Resources in the per missionary enterprises of urban transportation, by bus, in the metropolitan region of de Natal, based on the standard person of the National Program of Quality 2004 and points if they are able to take part as prize-winning in this standard. Also this work aims, through a theoretical evolution of people management and its current practices, the history of the National prize Quality and its main standards, the importance of the urban transportation, its characteristics and the system itself in the metropolitan region of Natal. The research was carried out in 11 enterprises that operated in the area, with several dimensions and forms of management. The research variations were based on the standard person of the 2004 NPQ that deals with the system of work, preparation and development and life quality. In the statistical treatment, discriminated and exploiting analyses were applied. The main obtained results through the research, we can verify an administrative centralization in managers and owners hands; that 45% of the enterprises don t have a Human Resources Department, however, on the other hand, they practice some human Resources politics, indicated by the variations; as to the items system of work, 55% of the enterprises are able; preparing and development, 43%

Modelo de gerenciamento de estoques de peças de reposição para empresas de transporte urbano de passageiros

This work searches to offer a model to improve spare parts stock management for companies of urban passenger transport by bus, with the consequent progress in their maintenance management. Also known as MRO items (Maintenance, Repair and Operations), these spare parts, according their consumption and demand features, cost, criticity to operation, lead-time, quantity of suppliers, among other parameters, shouldn´t have managed their inventory like normal production items (work in process e final products), that because their features, are managed by more predictable models based, for example, in economic order quantity. In the case specifically of companies of urban passenger transport by bus, items MRO have significant importance in their assets and a bad management of these inventories can cause serious losses to company, leading it even bankrupticy business, in more severe situations which missing spare part provokes vehicles shutdown indefinitely. Given slight attention to the issue, which translates in little literature available about it when compared to that literature about normal items stocks, and due the fact that MRO items be critical to bus urban transport of passengers companies´, it is necessary, so, deepen in this theme searching to give technical and scientific subsidies to companies that work, in many times, empirically, with these so decisive inputs to their business. As a typical portfolio problem, in which there are n items, separated into critical and noncritical, while competing for the same resource, it was developed a new algorithm to aid in a better inventory management of spare parts used only in corrective maintenance (whose failures are unpredictable and random), by analyzing the cost-benefit ratio, which compares the level of service versus cost of each item. The model was tested in a company of urban passenger transport by bus from the city of Natal, who anonymously provided their real data to application in this work

Os princípios da organização focada na estratégia: um estudo em empresas vencedoras do prêmio nacional de qualidade

The Balanced Scorecard (BSC) has been used as a communication tool and strategy monitoring, helping organizations alignment, inserting a new vision with integrated use of performance indicators nonfinancial together with some financial measures. Their proper use leads to a new management style, focused on management strategies, using for this, basically three dimensions: strategy, which should be translated as the primary responsibility for the organizational agenda, the focus that should be concentrated, and the organization with the mobilization of employees. This paper deals with theoretical considerations about strategies, strategic planning, BSC and principles of the organization focused on strategy (OFE). Describes a study of four companies that won the National Quality Award - PNQ, among which, three have adopted the BSC and adopts a particular model of strategic management. The research aimed to make an analysis of the companies regarding adherence to the five principles of OFE, proposed by the BSC, seeking to answer whether the use of BSC is a prerequisite for accession to the Principles of OFE. The results showed that the BSC is a strategic management model that promotes focus and organizational alignment and is a major facilitator in the process, however, cannot be considered a prerequisite for accession to the principles of the OFE, because the four companies studied, including the one that adopt its own model of strategic management, have great levels of adherence to such principles. Making the organization focused on strategy can be considered a natural movement essential for the strategic management, which is not necessarily conditioned by the use of BSC

Avaliação de desempenho em mercados reguladores de transporte urbano por ônibus :proposição de um modelo aplicável ao caso de Natal

Increased competition in the market of urban transport, characteristic of the Brazilian cities from years 90, has required actions of the managing agencies to ensure the universality of service, enhancing efficiency and consumer welfare. It grows in the Brazilian municipalities, the need to adopt a systematic performance evaluation in terms of management system of indicators and targets appropriate to the regulatory context, which has the purpose of evaluating the accomplishment and compliance by dealers, of the services granted during the contract period, marked by increasingly long periods. The introduction of an index operational performance in permission contracts/concession in urban buses is intended to establish a regulatory performance, giving the contract a pro-competitive feature and to allow the managing agency the systematic and continuous monitoring of the performance of the delegated service to avoid major deviations from desired performance. A performance assessment model of public transportation companies by bus, and applicable to the case of Natal is proposed. Sought to add the particularities found in the transport system in order to assess the performance of enterprises, contribute to improving the service quality to the population and enable decision-makers a detailed knowledge of the behavior of the licensees

Proposta de um modelo de medição e avaliação de desempenho como ferramenta de gest ão - um estudo de caso num órgão público

The public sector performance has received much attention in the literature and due to that the purpose of this work is to develop a proposal for a model of performance measurement for a higher education institution unit. First, we performed a theoretical research on public organizations and private institutions of higher education, followed by a literature review on performance measurement and evaluation. This review presents some performance models that are quite frequent in the literature: Total Quality Management (Total Quality Management) - TQM and the PDCA cycle, SMART System, Balanced Scorecard and Môdef Ouanturn. In order to verify the possibility of implementing a performance measurement model for Higher Education Institutions, it was conducted a case study in a support unit of a University, located in the city of Natal, RN, Brazil. The study attempted to identify the key processes of the unit and proposed by the use of Quantum model in order to improve the management and operation of the same. The work aims to contribute to the advancement of knowledge in measurement and performance evaluation in higher education institutions that where still lacks scientific production of this subject compared to other areas. This study also identifies better practices and opportunities for improvement in processes to determine the expected performance indicators to aid a decision-making unit.

Análise da influência da qualidade em um ciclo de serviços na satisfação do cliente: estudo de caso em uma instituição de ensino.

With the increasing offer of education services in Brazil, it is necessary to evaluate the quality of service in education, especially in those institutions for vocational education which have a greater interaction with the labor market, in order to form qualified professionals and meet the growing demand that the country has today[A1] . In Brazil, the evaluation of the quality of library services has influenced the assessment of educational institutions and in this context, there needs to be a process to monitor the quality of services provided by libraries. However, the service is not done in a single moment and thus to a more detailed assessment it needs to be measured and evaluated each different time the customer uses it. Therefore, the aim of this work consists in measuring the quality in every moment of truth of a cycle of library services to assess which are the most relevant moments in the client's perspective at the library of the Federal Institute of Education, Science and Technology of Rio Grande do Norte (IFRN) Campus João Câmara in building the overall quality of service. In the literature review, internal secondary sources were used, from the database of the institution studied, and also external sources, through literature in books, articles, dissertations, theses and journals on compost quality, service quality, cycle services, measuring quality, satisfaction, teaching activities, and on library services specifically. We applied a questionnaire to students in the library based on models of quality measurement SERVPERF and SERVQUAL and its variations such as SERVQUAL pondered and SERVPERF pondered . Through analysis based on concepts of reliability and validity of measuring instruments, it was found that the SERVPERF model is the instrument that most closely matches the dimensions of quality assessed in the library with customer satisfaction measured by the questionnaire. From there, the search results as measured by statistical techniques of analysis, indicated that the initial and final moments of truth of the cycle of service quality had the greatest influence on overall customer satisfaction with the library service