No abstract

Some rights reserved 1 2 3 4 15 14 13 12 World Bank Studies are published to communicate the results of the Bank's work to the development community with the least possible delay. The manuscript of this paper therefore has not been prepared in accordance with the procedures appropriate to formally edited texts. This work is a product of the staff of The World Bank with external contributions. Note that The World Bank does not necessarily own each component of the content included in the work. The World Bank therefore does not warrant that the use of the content contained in the work will not infringe on the rights of third parties. The risk of claims resulting from such infringement rests solely with you. The fi ndings, interpretations, and conclusions expressed in this work do not necessarily refl ect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Nothing herein shall constitute or be considered to be a limitation upon or waiver of the privileges and immunities of The World Bank, all of which are specifi cally reserved.

is the Human Development Sector Leader for Argentina, Paraguay, and Uruguay at the World Bank, based in Buenos Aires. Previously, he served as Human Development Sector Leader for Brazil, based in Brasilia; human development country sector coordinator for the Western Balkans, based in Sarajevo; and human development economist, based in Washington, DC. He holds a bachelor's degree in economics from Bocconi University in Milan, a master of science degree in demography from the London School of Economics, and a doctorate in statistical demography from Princeton University. Magnus Lindelow is the Human Development Sector Leader (Health, Education, and Social Protection) at the World Bank in Brazil. He holds a doctorate in economics from Oxford University. At the World Bank, he has worked on health system reform, service delivery, public expenditure management, and poverty and social protection issues. Over the last few years, he has been involved in projects and research in Cambodia, China,

ResumoContexto: O abuso de álcool é considerado atualmente um dos maiores problemas de saúde devido ao impacto mundial que esta problemática gera em termos sociais e financeiros. Objetivos: Discutir, a partir do referencial econômico, as conseqüências sociais do abuso do álcool e introduzir os conceitos relacionados à economia da saúde. Métodos: Revisão da literatura com base nos sistemas MEDLINE, LILACS e SciELO de artigos publicados nas línguas, portuguesa e inglesa no período de 1987 a 2007, e posterior busca manual com base na bibliografia de interesse dos artigos selecionados. Resultados: Foram encontrados 50 artigos sobre estudos econômicos e conceitos econômicos em diversas áreas; desses, 15 diretamente relacionados ao custo social do abuso do álcool. O método de apuração dos custos e a composição dos itens de custos foram semelhantes em todos os estudos. Conclusões: Os estudos econômicos se apresentam incipientes no Brasil e avançados nos países desenvolvidos. A necessidade de pesquisas nacionais que abordem o custo social do abuso do álcool tem como uma das finalidades promover subsídios para se pensar e efetivar a construção de políticas públicas mais consistentes e que estejam em consonância com o perfil epidemiológico e socioeconômico do país.Gallassi, A.D. et al. / Rev. Psiq. Clín 35, supl 1; 25-30, 2008 Palavras-chave: Impacto econômico, custos sociais, abuso do álcool, conceitos econômicos, políticas públicas. AbstractBackground: Alcohol abuse is currently considered one of the largest worldwide health problems due to its social and financial impact. Objectives: To discuss the economic and social impact of alcohol abuse and to introduce concepts related to health economics. Methods: Literature review of articles written in Portuguese and in English (published between 1987 and 2007) stored in the MEDLINE, LILACS and SciELO databases was carried out. Results: Fifty articles on economic studies and economic concepts in various areas were found, among which 15 were directly related to the social costs of alcohol abuse. The costs assessment methods and the composition of cost items were similar in all studies. Conclusions: Economic studies are new in Brazil, but are advanced in developed countries. National research on the social costs of alcohol abuse is necessary in order to promote knowledge as a means of creating and implementing public policies that are more consistent with and in alignment with the epidemiological and socioeconomic profile of the country.

The sample consisted of 90 TRD+ and 122 TRD- patients. TRD+ patients used significantly more resources from the psychiatric service, but not from non-psychiatric clinics, compared to TRD- patients. Furthermore, TRD+ patients were significantly more likely to require hospitalizations. Overall, TRD+ patients imposed significantly higher (81.5%) annual costs compared to TRD- patients (R$ 5,520.85; US$ 3,075.34 vs. R$ 3,042.14; US$ 1,694.60). These findings demonstrate the burden of MDD, and especially of TRD+ patients, to the tertiary public health system. Our study should raise awareness of the impact of TRD+ and should be considered by policy makers when implementing public mental health initiatives.

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 Estabelecimento s 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.

No abstract

Abstract