Auditoria no Sistema Único de Saúde: o papel do auditor no serviço odontológico

A auditoria, na saúde, verifica os processos e resultados da prestação de serviços, pressupondo o desenvolvimento de um modelo de atenção adequado, de acordo com as legislações vigentes. Nesta pesquisa, objetivou-se analisar as atividades da auditoria no Sistema Único de Saúde no serviço de saúde bucal, buscando demonstrar as ações e a sua inserção nas três esferas de governo. Foram realizadas análise documental e levantamentos bibliográficos sobre os sistemas de auditoria e o papel do auditor no serviço odontológico desde 1969. Os resultados mostraram que foram encontrados seis artigos sobre auditoria odontológica no SUS e que a atuação do auditor odontológico é abrangente no gerenciamento do sistema, consistindo no controle, na avaliação, na supervisão e na orientação, bem como na garantia da participação social e acesso aos serviços. Na saúde bucal o auditor analisa, monitora e fiscaliza o planejamento das estratégias e os procedimentos efetuados; realiza o cadastramento dos profissionais, das unidades de saúde e a programação física orçamentária; viabiliza os dados para o sistema de informação e o pagamento dos serviços prestados; examina o cumprimento das pactuações, dando um enfoque educativo e não mais policialesco à resolubilidade dos problemas. Conclui-se que existem poucos estudos sobre auditoria odontológica no SUS e que o sistema de auditoria é um instrumento administrativo confiável e essencial para os gestores no desenvolvimento das ações de saúde.

Selecting green suppliers based on GSCM practices: Using fuzzy TOPSIS applied to a Brazilian electronics company

Due to an increased awareness and significant environmental pressures from various stakeholders, companies have begun to realize the significance of incorporating green practices into their daily activities. This paper proposes a framework using Fuzzy TOPSIS to select green suppliers for a Brazilian electronics company; our framework is built on the criteria of green supply chain management (GSCM) practices. An empirical analysis is made, and the data are collected from a set of 12 available suppliers. We use a fuzzy TOPSIS approach to rank the suppliers, and the results of the proposed framework are compared with the ranks obtained by both the geometric mean and the graded mean methods of fuzzy TOPSIS methodology. Then a Spearman rank correlation coefficient is used to find the statistical difference between the ranks obtained by the three methods. Finally, a sensitivity analysis has been performed to examine the influence of the preferences given by the decision makers for the chosen GSCM practices on the selection of green suppliers. Results indicate that the four dominant criteria are Commitment of senior management to GSCM; Product designs that reduce, reuse, recycle, or reclaim materials, components, or energy; Compliance with legal environmental requirements and auditing programs; and Product designs that avoid or reduce toxic or hazardous material use. © 2013 Elsevier B.V. All rights reserved.

Experiences gained from GDDS compliance in the English-speaking Caribbean

Includes bibliography

Sistema de auditoria no SUS: análise dos dados de produção e glosas no serviço odontológico na rede pública

Pós-graduação em Odontologia Preventiva e Social - FOA

Cleaner Production initiatives and challenges for a sustainable world: an introduction to this special volume

This special volume of the Journal of Cleaner Production is comprised of articles presented at the 3rd International Workshop Advances in Cleaner Production held in Sao Paulo, Brazil, in 2011. The content underscores the recognition of the pressing and inescapable need for making changes from unsustainable to sustainable production and consumption patterns. The 48 articles from 15 countries provide different, but complimentary approaches to help industrial and societal sectors in advancing on their paths towards sustainability. Initiatives and challenges are included, which systematically address problems affecting raw material changes, technological modifications, product and policy changes. The findings range from proposals for alternative uses of wastes, substitution of raw materials for environmentally friendlier substances, optimization of industrial processes by source reductions of wastes and emissions and documented economic and environmental advantages of a wide array of initiatives. The roles of operational and managerial practices are also stressed, highlighting the role of diverse stakeholders as promoters of implementation and internalization of innovative cleaner technologies within companies. Systemic assessment tools are employed and experimented with in order to more effectively evaluate the environmental performance of systems on the biosphere scale. The methodological procedures and proposals presented can help in the design and management of production systems, for governmental and corporate policy development, for implementing and monitoring CP Programs, prevention and mitigation strategies, and evaluation of the outcomes of CP initiatives in the production and service sectors. (C) 2013 Elsevier Ltd. All rights reserved.

Evidências da relação entre evolução da gestão ambiental e a adoção de práticas de Green Supply Chain Management no setor eletroeletrônico brasileiro

The objective of this research is to examine if the environmental management evolution is positively related towards the adoption of green supply chain management practices (GSCM) by companies in the electronics sector in Brazil. To reach this objective, a quantitative research was conducted by survey with 100 companies in the electronics sector in Brazil. The collected data were processed using descriptive statistics, Exploratory Factor Analysis and Structural Equation Modeling. The most important results are: in the sample, GSCM practices to the recovery of investment, as the resale of scrap and other waste materials, and the adequacy with legislation and auditing, obtained high scores; and research hypothesis (H1) was confirmed and considered statistically valid, indicating that, in fact, the evolution of environmental management influences the adoption of GSCM practices.

Decentralization and corruption: evidence from primary health-care programmes

The aim of this article is to evaluate whether there is an association between decentralization and corruption. In order to do so we analyse Brazilian health-care programmes that are run locally. To construct objective measures of corruption, we use the information from the reports of the auditing programme of the local governments of Brazil. Results point that there is no relationship between decentralization and corruption, whatever the measure of decentralization used.

Discretionary-based disclosure: evidence from the Brazilian market

The primary objective of this paper is to identify the factors that explain Brazilian companies level of voluntary disclosure. Underpinning this work is the Discretionary-based Disclosure theory. The sample is composed of the top 100 largest non-financial companies listed in the Bolsa de Valores de São Paulo (Brazilian Securities, Commodities, and Futures exchange - BOVESPA). Information was gathered from Financial Statements for the years ending in 2006, 2007, and 2008, with the use of content analysis. A disclosure framework based on 27 studies from these years was created, with a total of 92 voluntary items divided into two dimensions: economic (43) and socio-environmental (49). Based on the existing literature, a total of 12 hypotheses were elaborated and tested using a panel data approach. Results evidence that: (a) Sector and Origin of Control are statistically significant in all three models tested: economic, socio-environmental, and total; (b) Profitability is relevant in the economic model and in the total model; (c) Tobin s Q is relevant in the socio-environmental model and in the total disclosure model; (d) Leverage and Auditing Firm are only relevant in the economic disclosure model; (e) Size, Governance, Stock Issuing, Growth Opportunities and Concentration of Control are not statistically significant in any of the three models.

Perspektiv på revision : tankemönster, förväntningsgap och dilemman

Auditing is an important activity in today’s society and is characterised by several dilemmas. The assumption underlying this thesis is that auditing is influenced in prac-tice by the thought patterns of auditors. These patterns are shaped in an environment that is both regulated and self-regulated. The purpose of the thesis is to describe, analyse and compare the thought patterns of Swedish auditors and important stake-holders with regard to the way in which auditors audit information provided by listed companies and how they make statements about this information. The purpose is also to make some suggestions about how the auditing activity can be modified in order to reduce conflicting interests. The methodological approach combines the use of the repertory grid technique and open-ended interview questions. Interviews were carried out with 82 auditors and 73 stakeholders. To validate the findings, four focus groups, consisting of auditors, investors and creditors, were consulted. The findings indicate that auditors devote a relatively large amount of time and considerable effort to objects that can be verified satisfactorily, but not to objects that they perceive as being of primary importance to investors and creditors. A similar gap is found in the thought patterns of investors and creditors. Moreover, several expec-tation gaps are found, in particular regarding auditors’ statements. On the one hand, the auditors studied were reluctant to make statements about any other information than information obtained according to current practice; on the other hand, the inves-tors and creditors expressed a need for additional information about the outcome of the audit and the choice of auditing objects. The concluding suggestions concern measures that can reduce the discrepancies identi-fied, including (i) the introduction of a mandatory primary audit and a market-oriented secondary audit, (ii) extended information about the outcome of the audit and the choice of auditing objects that will benefit the stakeholders, (iii) a somewhat less expo-sed position of the auditors, and (iv) the importance of a changed balance of power in the auditing arena and the need for an integrated and dynamic approach to auditing. Keywords: auditing, accounting information, auditors, stakeholders, agency theory, thought patterns, expectation gap, repertory grid.

The Impact of the Sarbanes-Oxley Act on the Cost of Going Public

This paper examines the impact of the Sarbanes-Oxley Act (SOX), a legal framework intended to increase transparency and accountability of listed companies, on the cost of going public in the US. We expect SOX to increase the direct cost of going public, but decrease the underpricing because of reduced asymmetric information. Our main results corroborate these hypotheses. First, we find an increase in the cost of going public of 90 bp of gross proceeds. Second, we record a reduction in underpricing of 6 pp, which is related to a reduced offer price adjustment. This supports our hypothesis that SOX represents a mechanism to reduce asymmetric information.

Implementation of an Anthropomorphic Phantom for the Evaluation of Proton Therapy Treatment Procedures

With an increasing number of institutions offering proton therapy, the number of multi-institutional clinical trials involving proton therapy will also increase in the coming years. The Radiological Physics Center monitors sites involved in clinical trials through the use of site visits and remote auditing with thermoluminescent dosimeters (TLD) and mailable anthropomorphic phantoms. Currently, there are no heterogeneous phantoms that have been commissioned to evaluate proton therapy. It was hypothesized that an anthropomorphic pelvis phantom can be designed to audit treatment procedures (patient simulation, treatment planning and treatment delivery) at proton facilities to confirm agreement between the measured dose and calculated dose within 5%/3mm with a reproducibility of 3%. A pelvis phantom originally designed for use with photon treatments was retrofitted for use in proton therapy. The relative stopping power (SP) of each phantom material was measured. Hounsfield Units (HU) for each phantom material were measured with a CT scanner and compared to the relative stopping power calibration curve. The tissue equivalency for each material was calculated. Two proton treatment plans were created; one which did not correct for material SP differences (Plan 1) and one plan which did correct for SP differences (Plan 2). Film and TLD were loaded into the phantom and the phantom was irradiated 3 times per plan. The measured values were compared to the HU-SP calibration curve and it was found that the stopping powers for the materials could be underestimated by 5-10%. Plan 1 passed the criteria for the TLD and film margins with reproducibility under 3% between the 3 trials. Plan 2 failed because the right-left film dose profile average displacement was -9.0 mm on the left side and 6.0 mm on the right side. Plan 2 was intended to improve the agreements and instead introduced large displacements along the path of the beam. Plan 2 more closely represented the actual phantom composition with corrected stopping powers and should have shown an agreement between the measured and calculated dose within 5%/3mm. The hypothesis was rejected and the pelvis phantom was found to be not suitable to evaluate proton therapy treatment procedures.

Antidumping as Strategic Trade Policy Under Asymmetric Information

In the last two decades, trade liberalization under GATT/WTO has been partly offset by an increase in antidumping protection. Economists have argued convincingly that this is partly due to the inclusion of sales below cost in the definition of dumping during the GATT Tokyo Round. The introduction of the cost- based dumping definition gives regulating authorities a better opportunity to choose protection according to their liking. This paper investigates the domestic government's antidumping duty choice in an asymmetric information framework where the foreign firm's cost is observed by the domestic firm, but not by the government. To induce truthful revelation, the government can design a tariff schedule, contingent on firms' cost reports, accompanied by a threat to collect additional information for report verification (i.e., auditing) and, in case misreporting is detected, to set penalty duties. We show that depending on the concrete assumptions, the domestic government may not only be able to extract the true cost information, but also succeeds in implementing the full-information, governmental welfare-maximizing duty. In this case, the antidumping framework within GATT/WTO does not only offer the means to pursue strategic trade policy disguised as fair trade policy, but it also helps overcome the informational problems with regard to correctly determining the optimal strategic trade policy.