Determinantes de uso de serviços de saúde: análise multinível da região metropolitana de São Paulo

OBJETIVO: Analisar os determinantes individuais e contextuais do uso de serviços de saúde na Região Metropolitana de São Paulo. MÉTODOS: Foram utilizados os dados do estudo São Paulo Megacity, a versão brasileira da pesquisa multicêntrica World Mental Health Survey. Foram analisados 3.588 indivíduos adultos residentes em 69 áreas da Região Metropolitana de São Paulo, SP (38 municípios adjacentes e 31 subprefeituras do município de São Paulo), selecionados por meio de amostragem multiestratificada da população não institucionalizada. Foram ajustados modelos multinível logísticos Bayesianos para identificar os determinantes individuais e contextuais do uso de serviços de saúde nos últimos 12 meses e a presença de médico de referência para cuidados de rotina. RESULTADOS: As características contextuais do local de residência (desigualdade de renda, violência e renda mediana) não apresentaram associação significativa (p > 0,05) com o uso de serviços ou com a presença de médico de referência para cuidados de rotina. A única exceção foi a associação negativa entre residir em uma área com alta desigualdade de renda e a presença de médico de referência (OR 0,77; IC95% 0,60;0,99) após controle das características individuais. O estudo apontou uma forte e consistente associação entre algumas características individuais (principalmente escolaridade e presença de plano de saúde) com o uso de serviços de saúde e ter médico de referência. A presença de doenças crônicas e mentais associou-se fortemente com o uso de serviços no último ano (independentemente de características individuais), mas não com a presença de médico de referência. CONCLUSÕES: Características individuais como maior escolaridade e ter plano de saúde foram determinantes importantes do uso de serviços de saúde na Região Metropolitana de São Paulo. A melhor compreensão desses determinantes é necessária para o desenvolvimento de políticas públicas que permitam o uso equitativo dos serviços de saúde.

Ensaios em economia política aplicada

Esta tese é constituída por três capítulos que se enquadram na área de Microeconomia Aplicada, sendo dois deles de Economia Política Aplicada e o outro de Economia da Educação. O primeiro capítulo investiga se a eleição de mulheres para a prefeitura impacta a inserção de outras mulheres no mercado político, reduzindo-se assim uma preferência pré-estabelecida pelos eleitores de não votar em mulheres. Para realizar o exercício, utiliza-se um experimento de Regressão em Descontinuidade onde explora-se eleições em que uma mulher perdeu ou ganhou por uma margem pequena de votos para um candidato homem, a ponto do gênero eleito ser aleatório. Os resultados mostram que a eleição de uma mulher tem impacto apenas em ambientes mais propícios a eleger mulheres (o que foi mensurado aqui pelo percentual de vereadoras eleitas) ou em locais onde os candidatos tinham maior qualidade (medido pela escolaridade). O segundo artigo estima o impacto da divulgação da qualidade escolar sobre a migração dos alunos entre escolas. A ideia é que ao tornar-se público o sinal de qualidade, escolas e alunos têm incentivos para se adaptarem conforme sua demanda por qualidade. Para isso, explora-se um desenho de Regressão em Descontinuidade Fuzzy devido a um dos critérios de divulgação do IDEB ser a escola ter no mínimo 20 alunos matriculados na série avaliada. Os resultados mostram que as escolas que tiveram IDEB divulgado tiveram maior migração de alunos e, em especial, de alunos em condições de vulnerabilidade. O terceiro artigo avalia a hipótese de exogeneidade da abertura comercial brasileira, promovida no final da década de 1980 e início da de 1990. Há uma vasta literatura que explora os efeitos da abertura comercial sobre o mercado de trabalho, desigualdade de renda, pobreza e crescimento econômico. Tais trabalhos consideram o processo de liberalização brasileiro como não correlacionado com as demandas de nenhum setor de atividade econômica específico, o que justificaria utilizar o período de abertura como um instrumento para lidar com endogeneidade nas estimações. Nós apresentamos evidência de que, embora não correlacionado com nenhum setor em especial, a abertura estava correlacionada com a distribuição de capital político dos governos nesse período, e pode ter funcionado como uma estratégica clara de fortalecimento político ou, pelo menos, teve o contexto político como um facilitador do processo.

Renda e Pobreza entre Famílias no meio Rural do Nordeste

MARIANO, J. L. ; NEDER, H. D. . Renda e Pobreza entre Famílias no meio Rural do Nordeste. In: CONGRESSO DA SOCIEDADE BRASILEIRA DE ECONOMIA E SOCIOLGOGIA RURAL, 42., 2004, Cuiabá - MT. Anais... Cuiabá, 2004. Dinâmicas Setoriais e Desenvolvimento Regional.

Emprego formal na região nordeste brasileira: seus efeitos na inclusão social

This work aims to study the problem of the formal job in the Brazilian Northeast region and its effect in the social inclusion, taking for base the analysis of variables defined in the Atlas of Social Exclusion, which is based on the 2000 Brazilian Census, choosing the county as unit of analysis. As methodological options, an exploratory data analysis was performed, followed by multivariate statistical techniques, such as weighted multiple regression analysis, cluster analysis and exploratory analysis of spatial data. The results pointed out to low rates of formal job for the active age population as well as low indexes of social inclusion in the Northeast region of Brazil. A strong association of the formal job with the indicators of social inclusion under investigation, was evidenced (schooling, inequality, poverty, youth and income form government transfers), as well as a strong association of the formal job with the new index of social inclusion (IIS), modified from the IES. At the Federative Units, in which better levels of formal job had been found, good indexes of social inclusion are also observed. Highlights for the state of the Rio Grande do Norte, with the best conditions of life, and for the states of the Maranhão and Piauí, with the worst conditions. The situation of the Northeast region, facing the indicators under study, is very precarious, claiming for the necessity of emphasizing programs and governmental actions, specially directed to the raise of formal job levels of the region, reflecting, thus, in improvements on the income inequality, as well as in the social inclusion of the population of Northeastern natives.

Avaliação dos impactos do programa bolsa família na renda, na educação e no mercado de trabalho das famílias pobres do Brasil

This study aims to verify the impact of the Bolsa Família Program (BFP) in income and school attendance of poor Brazilian families. It is intended to also check the existence of a possible negative effect of the program on the labor market, titled as sloth effect. For such, microdata from the IBGE Census sample in 2010 were used. Seeking to purge possible selection biases, methodology of Quantilic Treatment Effect (QTE) was applied, in particular the estimator proposed by Firpo (2007), which assumes an exogenous and non-conditional treatment. Moreover, Foster- Greer-Thorbecke (FGT) index was calculated to check if there are fewer households below the poverty line, as well as if the inequality among the poor decreases. Human Opportunity Index (HOI) was also calculated to measure the access of young people / children education. Results showed that BFP has positively influenced the family per capita income and education (number of children aged 5-17 years old attending school). As for the labor market (worked hours and labor income), the program showed a negative effect. Thus, when compared with not benefiting families, those families who receive the BFP have: a) a higher family income (due to the shock of the transfer budget money) b) more children attending school (due to the conditionality imposed by the program); c) less worked hours (due to sloth effect in certain family groups) and d) a lower income from work. All these effects were potentiated separating the sample in the five Brazilian regions, being observed that the BFP strongly influenced the Northeast, showing a greater decrease in income inequality and poverty, and at the same time, achieved a greater negative impact on the labor market

Diferenciais de rendimentos por gênero: uma análise dos efeitos composição e estrutura salarial no Brasil (1976, 1987, 1996 e 2009)

This study aims to analyze the income differentials by gender in Brazil, in the years 1976, 1987, 1996 and 2009. Specifically, there are two objectives. First, attempt to analyze the importance of the effects of composition and wage structure in the job market. In the second, to verify which socioeconomic variables explain the effects of composition and wage structure in the job market. The information in this study was obtained from the microdata of Pesquisa Nacional por Amostra de Domicílios (PNAD) regarding the respective years. In the first stage of the methodology we used: the index of income distribution Theil-T; the income gap decompositions proposed by Oaxaca (1973) and Blinder (1973); and Firpo et al. (2007). In the second stage we applied the RIF regression method (Recentered Influence Function) of Firpo et al. (2007). The results show that income inequality is higher among men than among women in the country. It was observed that the component of inequality between people of the same gender represented the largest share in the decomposition of income inequality between genders. It was found, in the decomposition of the average income, a downward trend of income gap, but the differential remains favorable to the men. We noticed that the impact of the composition effect in reducing the gap was offset by the positive effect of wage structure. Regarding the distribution quantis, income differential between genres appeared greater at the bottom, in the years 1976, 1987 and 2009; and at the top of the distribution, in 1996 featuring, respectively, the sticky floor and glass ceiling effects in Brazil. As for the decomposition of the RIF, it turns out that the composition effect assisted in the downfall of the income gap between 1976 and 2009, but was offset by the positive effect of the wage structure in quantis 10th, 50th, and 90th. The main socioeconomic variables influenced the drop in income gap were: the composition effect, the manual labor occupations, service sector and low-grade and high school, and the wage structure effect, schooling low and high experience professional and technical occupations and urban centers

Avaliação da qualidade da assistência aos portadores de úlceras venosas atendidos no ambulatório de um hospital universitário em Natal/RN

Study descriptive that was designed to assess the quality of care for people with venous ulcers (VUs) tended at the ambulatory of a university hospital in Natal / RN. The target population of the study was composed by 40 users bearers of venous ulcers served in the ambulatory of angiology of a university hospital in the level of tertiary education. The study received assent of the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol No. 169/06). The collect of data was performed using a form of interview and tour with collection of measures biophysiologic, for a team comprised by the researchers and an academic of nursing, in the period of three months. The data were analyzed in SPSS 14.0, using descriptive statistics and presented in the form of charts, tables and graphs. Identified a clientele of holders of VUs predominantly female, married, aged up to 59 years, low level of education and household income, from Natal, retirees or those exercising professions and occupations that require long periods standing or sitting. In relation to the characteristics of health, those surveyed had risk factors for venous disease and had UVs chronic, located in Zone 2, lost tissue in grade II and serous exudates on average quantity. The assistance to holders of UVs has been characterized by a lack of professional nurses and unavailability of products for the realization of the right curative in ambulatory and outside it; by the inadequacy of products used in VUs, for long periods of treatment without resolution, where the compressive therapy is not priority, by the lack of completeness in the levels of assistance; by monitoring the bearer of UVs only by doctors and the nurses, even with the other team of professionals in the health service; by the completion of guidelines by health professionals and the lack the standardization of conducting laboratory and specifics tests. The assistance was assessed as inadequate in aspects: reference and counter-reference (75.0%), number of consultations with angiologists last year (87.5%), documentation of the clinical findings (85.0%), use of compressive therapy in the past 30 days (77.5%), part of the team interdisciplinary (97.5%), completion of laboratory and specifics tests in the last year (100%), availability of products used in achieving the curative in ambulatory (80, 0%), and indication of products used in the conduct of dressing outside the clinic (70.0%) and appropriate in the guidelines made on the use of socks, lifting of the members and prescription of exercises regular (82.5%) and indication products used in achieving the curative in ambulatory (97.5%). We conclude that the assistance provided to holders of UV was inadequate in 80% of cases interviewed, becoming non-resolutive and assistematic

Delays in stabilization or in reforms? The debt crisis

Empirical analyses attributing the 1980s' debt crisis to inconsistent stabilization policies rest on an inappropriate long-run approach. Revising this long-run approach yields opposite results: terms of trade shocks and foreign indebtedness explain this crisis, regardless of domestic stabilization policies. This prompts us to consider a new hypothesis, of delays in trade-policy reforms, with a model in which terms-of-trade variation (under shocks) is endogenous to export structure and efficiency of resource allocation. Evidence from the structural equations model shows that allocation distortions negatively affect changes in terms of trade, which then explain this crisis. A political economy extension demonstrates that income inequality and regional trade policy determine the distortions, which in turn leads to this crisis.

Migração e seletividade na região nordeste: um estudo a partir dos dados do censo demográfico de 2010

The aim of this study is to analyze the effect of migration on the income differential between northeastern migrants and nonmigrants and there by verify that the immigrants make up a group or not positively selected. The assumption that will be tested is that the presence of these immigrants affects income inequality in the region receptor, which may explain part of the high-stopping inequality in the Brazilian Northeast. The study is based on the literature selectivity migration introduced by Roy (1951), Borjas (1987) and Chiswick (1999). Does the estimated wage equation Mincer (1974) through the method of OLS, using information from the microdata sample of the 2010 Census, the Brazilian Institute of Geography and Statistics (IBGE). The results which correspond to the comparison of socioeconomic profile, showed that immigrants are more qualified and, on average, better paid than non-migrants. With the estimation of the model, it was found that, keeping all other variables constant, the income that immigrants earn is 14.43% higher than that of non-migrants. Thus, there was existence of positive selectivity in migration directed to the Northeast

Desigualdade regional da mortalidade neonatal no Brasil

In Brazil, despite the decline in infant mortality in recent decades it still has high rates going against recommended by WHO. Being the largest percentage of infant mortality rate composed of neonatal deaths. Objective: A study was conducted to analyze the spatial distribution of neonatal mortality and its correlation with the biological, socioeconomic and maternal and child health care in the Brazilian states in the period from 2006 to 2010. Method: The study made thematic maps and correlation (LISA) for verification of spatial dependence and multiple linear regression models. Results: Was found that there is no spatial autocorrelation for neonatal mortality in the Brazilian states (R = 0.002, p = 0.48). Most of variables were correlated (r> 0.3, p <0.05) with neonatal mortality, forming clusters in the North and Northeast, with the highest rates of teenage mothers, low household income per capita, lower prenatal appointments and beds of Neonatal Intensive Care Unit. The number of Neonatal UCI beds remained independent effect after regression analysis. Conclusion: The study concludes that regional inequalities in living conditions and especially the access to maternal and child health services contribute to the unequal distribution of neonatal mortality in Brazil

Fatores associados à realização dos exames de rastreamento para o câncer de próstata: um estudo de base populacional

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Social Panorama of Latin America 1998

Includes bibliography

Social Panorama of Latin America 2005

Includes bibliography

Social Panorama of Latin America 1999-2000

Includes bibliography

Globalization and development

Includes bibliography