Significant changes have been witnessed in the Brazilian health system over the last 30 years. This article outlines trends in outpatient and hospital care, staffing, and health service use during this period. There was a significant expansion of the public health network, particularly of primary care services, leading to improved access to consultations and a reduction in hospital admissions. However, there is a persistent shortage of health professionals in Brazil's public health system, particularly dentists. Despite improvements in coverage, the public system continues to face serious challenges, particularly with respect to funding, service provision, and its relationship with the private sector.
A segurança do paciente como dimensão da qualidade do cuidado de saúde -um olhar sobre a literatura Patient safety as a dimension of the quality of health care -a look at the literature
The evaluation of the culture of patient safety in hospitals is nowadays considered as a management too, since it helps to identify problem areas and provide valuable information for planning improvements. This study explored the reliability and validity of the Brazilian version of the Hospital Survey on Patient Safety Culture, an instrument that evaluates characteristics of patient safety culture among hospital staff. The reliability of the instrument was evaluated by analyzing the internal consistency of each dimension. The validity of the tool was carried out by means of exploratory and confirmatory factor analysis. The sample was made up of 322 questionnaires that were collected in two Brazilian hospitals in 2012. Cronbach's alpha ranged from 0.52 to 0.91 for the different dimensions, with the exception of two, for which it was much lower. After excluding four items, the exploratory factor analysis presented adjusted indices that were appropriate for a 10 factor model.
Evaluation of performance of health systems: a model for analysisResumo Este artigo apresenta uma revisão da Matriz de Dimensões da Avaliação do Sistema de Saúde no Brasil desenvolvida em 2003, e uma atualização conceitual de parte das subdimensões de avaliação do desempenho dos serviços de saúde: efetividade, acesso, eficiência e adequação. Descreve o processo de seleção dos indicadores utilizados e uma síntese dos resultados para cada subdimensão do desempenho. O comportamento dos indicadores utilizados para avaliar o desempenho dos serviços de saúde no Brasil, no que se refere às quatro subdimensões selecionadas, não é uniforme e as melhorias mais acentuadas são observadas naquelas influenciadas pela atuação dos serviços no campo da atenção primária, as melhorias mais significativas foram observadas nas Efetividade e Acesso. Em relação à Eficiência dos serviços de saúde coexistem situações de alta eficiência com outras de baixo desempenho. A atuação dos serviços de saúde na subdimensão Adequação foi pior do que nas demais apresentadas. Palavras-chave Desempenho do sistema de saú-de, Eficiência, Efetividade, Acesso, Adequação Abstract This paper presents a review of the Dimension Matrix for Evaluation of the Brazilian Health System that was initially developed in 2003, as well as a conceptual update of some of the sub-dimensions for the evaluation of health service performance, namely effectiveness, access, efficiency and appropriateness of health care. It also describes the indicator selection process as well as the results obtained in each performance dimension. The behavior of the indicators used to assess the performance of health services in Brazil, with respect to each sub-dimension, was not uniform. Areas of marked improvement were found in indicators that are influenced by activities in the field of primary care. The most significant improvements were seen in the sub-dimensions of Effectiveness and Access. With respect to the Efficiency of health services, situations of high efficiency coexist with others with substandard performance. The performance of health services in the sub-dimension of Appropriateness of Health Care was the lowest of all indicators.
The differences in the SF-36 scores between age groups, genders and countries confirm that these Brazilian norms are necessary for comparative purposes. The data will be useful for assessing the health status of the general population and of patient populations, and the effect of interventions on health-related quality of life.
A cultura de segurança, aspecto específico da cultura organizacional geral, é definida como o produto de valores, atitudes, competências e padrões de comportamento individuais e de grupo, os quais determinam o compromisso, o estilo e a proficiência da administração de uma organização saudável e segura 2 . Organizações com uma cultura de segurança positiva são caracterizadas pela comunicação fundada na confiança mútua, pelas percepções partilhadas da importância da segurança e pela confiança na efetividade de ações preventivas 3 .Avaliar cultura de segurança permite identificar e gerir prospectivamente questões relevantes de segurança nas rotinas e condições de trabalho. Esta abordagem permite acessar informações dos funcionários sobre suas percepções e comportamentos relacionados à segurança, identificando pontos fracos e fortes de sua cultura de segurança e as áreas mais problemáticas para que se possa planejar e implementar inter-NOTA RESEARCH NOTE
BackgroundIn Brazil, despite the growing use of SF-36 in different research environments, most of the psychometric evaluation of the translated questionnaire was from studies with samples of patients. The purpose of this paper is to examine if the Brazilian version of SF-36 satisfies scaling assumptions, reliability and validity required for valid interpretation of the SF-36 summated ratings scales in the general population.Methods12,423 individuals and their spouses living in 8,048 households were selected from a stratified sample of all permanent households along the country to be interviewed using the Brazilian SF-36 (version 2). Psychometric tests were performed to evaluate the scaling assumptions based on IQOLA methodology.ResultsData quality was satisfactory with questionnaire completion rate of 100%. The ordering of the item means within scales clustered as hypothesized. All item-scale correlations exceeded the suggested criteria for reliability with success rate of 100% and low floor and ceiling effects. All scales reached the criteria for group comparison and factor analysis identified two principal components that jointly accounted for 67.5% of the total variance. Role emotional and vitality were strongly correlated with physical and mental components, respectively, while social functioning was moderately correlated with both components. Role physical and mental health scales were, respectively, the most valid measures of the physical and mental health component. In the comparisons between groups that differed by the presence or absence of depression, subjects who reported having the disease had lower mean scores in all scales and mental health scale discriminated best between the two groups. Among those healthy and with one, two or three and more chronic illness, the average scores were inverted related to the number of diseases. Body pain, general health and vitality were the most discriminating scales between healthy and diseased groups. Higher scores were associated with individuals of male sex, age below 40 years old and high schooling.ConclusionsThe Brazilian version of SF-36 performed well and the findings suggested that it is a reliable and valid measure of health related quality of life among the general population as well as a promising measure for research on health inequalities in Brazil.
As mudanças socioeconômicas, demográficas e tecnológicas e suas implicações nas políticas públicas demandam dos órgãos governamentais a produção de informações. As informações atualizadas de base populacional e de âmbito nacional são essenciais ao processo de planejamento e ao acompanhamento pela sociedade do cumprimento dos princípios constitucionais da saúde, como direito ao acesso igualitário aos serviços de saúde. A Pesquisa Nacional por Amostra de Domicílios (PNAD) é uma fonte de dados importante para o conhecimento e monitoramento de aspectos relevantes da situação de saúde da população brasileira e do acesso, utilização e financiamento de serviços de saúde. Neste artigo, faz-se um breve histórico da evolução dos objetivos, da periodicidade e da abrangência geográfica ao longo de quatro décadas da PNAD no Brasil, enfatizando-se os principais aspectos incluídos nos suplementos de saúde em 1981, 1986, 1998 e 2003. A produção de textos técnicos e acadêmicos, gerados a partir desses suplementos, tem permitido conhecer aspectos importantes da saúde da população brasileira e monitorar, em diferentes recortes geográficos e socioeconômicos, as políticas voltadas para o acesso e uso de serviços de saúde. Argumenta-se sobre a necessidade de iniciar uma discussão mais profunda sobre a continuidade da série histórica iniciada em 1998, frente à implantação, em futuro próximo, do Sistema Integrado de Pesquisas Domiciliares (SIPD) pelo IBGE.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.