Public-private relationship in surgical hospitalizations through the Unified Health System

Sá, Liane Alves de; Covre, Eduardo Rocha; Melo, Willian Augusto de; Gomes, Rogério Miranda; Tostes, Maria Fernanda do Prado

doi:10.1590/1518-8345.4901.3467

Cited by 6 publications

(2 citation statements)

References 7 publications

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“…The aforementioned seals, in many services, the decisive factor for changes in the care process and in the degree of interventions performed ( 13 ) . This means that the service management method leads to the quality of care offered to people ( 22 ) . Thus, existence of a risk in this process, which can be, for example, signaled by the logic of the New Public Management, cannot be denied.…”

Section: Discussionmentioning

confidence: 99%

Cesarean childbirth: an institutional socio-clinical study of the professional practices and discourses

Silva

Fortuna

Monceau

2021

Rev. Latino-Am. Enfermagem

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Objective: to analyze how the social, historical, economic and professional elements influence the institutionalization process of cesarean childbirth in Brazil and France. Method: a qualitative study grounded on the theoretical framework of the institutional socioclinic. The data were produced through focus groups and individual interviews, supported by semi-structured scripts, with health professionals, mothers and fathers and a research diary. The study had 83 participants. The analysis was based on the theoretical framework and thematic analysis. Cross analysis was developed between the different types of data, services and groups, as well as between countries. Results: the participants were characterized in terms of schooling, employment, level of training and workplace. The countries researched have their own peculiar health and educational structure and are marked by a social-historical-economic construction outlined by patriarchy. The New Public Management influences both contexts and makes health care precarious. The technical and organizational dimensions reinforce an intellectual and social division of work and knowledge in health. Conclusion: the institutionalization process of childbirth in the countries is marked by social, economic and professional aspects. Practices and speeches of the professionals in their work process influence the occurrence, or not, of cesarean sections.

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Section: Discussionmentioning

confidence: 99%

Cesarean childbirth: an institutional socio-clinical study of the professional practices and discourses

Silva

Fortuna

Monceau

2021

Rev. Latino-Am. Enfermagem

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“…With the merging of the health insurance cost settlement platform with the e-Health service platform and the increase in health insurance reimbursement rates, the process of paperless inhospital payments was further advanced. However, unlike the pay-as-you-go health insurance system outside of China (50), payment before seeing a doctor is still a predominant modality within the country. Currently, payment for medical expenses in Europe and USA is mainly achieved by credit card, and the use of digital wallets is still relatively low (51).…”

Section: Restrict Exchange Of Money At the Workplacementioning

confidence: 99%

Anti-violence measures developed by ILO and WHO: Analysis of the prevalence of workplace violence and the effects of implementation in a general hospital in China

Luo

et al. 2022

Front. Public Health

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ObjectiveWorkplace violence (WPV) not only affects workers' physical and mental health but also increases turnover rates and social costs. There are no studies that have consistently followed the prevalence of WPV and the effectiveness of anti-violence measures in cross-sectional studies of the same hospital. The main aim of this study was to understand the prevalence of WPV among medical staff in a hospital in China and the effectiveness of implemented anti-violence measures.MethodsA cross-sectional survey, which was conducted by using a questionnaire developed by the International Labor Organization and the World Health Organization, was administered in a tertiary hospital in China in 2022 to investigate the occurrence of violence in the past year. Valid data were collected from 1,195 respondents via cell phone. WPV was compared between this survey and a baseline survey conducted at the same hospital in 2017 using the same questionnaire. The relationship between years and gender and occupation was explored using the Cochran–Armitage trend test. Descriptive statistics and chi-square tests were used to respond to the effects of the anti-violence interventions.ResultsAfter the implementation of anti-violence measures, the prevalence of WPV decreased from 48.47 in 2017 to 33.95% in 2021. The recognition of safety measures increased from 80.16 in 2017 to 87.70% in 2021(P < 0.001), improvement of the work environment increased from 56.57 in 2017 to 65.10% in 2021(P < 0.001), restricted of public access increased from 34.36 in 2017 to 55.60% in 2021(P < 0.001), the patient protocols increased from 37.42 in 2017 to 38.40% in 2021, patient screening increased from 32.11 in 2017 to 41.90% in 2021(P < 0.001), and strict restrictions on workplace cash activities from 29.65% in 2017 to 36.00% in 2021(P < 0.05). The percentage of health workers who felt that anti-violence measures were not at all helpful to their current work decreased from 2017 to 2021.ConclusionsThe prevalence of workplace violence has decreased, recognition of interventions has increased, and the proportion of interventions that are perceived by HWs as not helpful at all has decreased. This study demonstrates that the 12 anti-violence measures recommended by the International Labor Organization are applicable in China. Based on this, hospitals should focus on the improvement of the intervention effect of the following measures to further prevent violence.

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Pediatric anesthesiology in Brazil, Chile, and Mexico

Quintão,

Concha,

Argüello

et al. 2024

Pediatric Anesthesia

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BackgroundLatin America comprises an extensive and diverse territory composed of 33 countries in the Caribbean, Central, and South America where Romance languages–languages derived from Latin are predominantly spoken. Economic disparities exist, with inequitable access to pediatric surgical care. The Latin American Surgical Outcomes Study in Pediatrics (LASOS‐Peds), a multi‐national collaboration, will determine safety of pediatric anesthesia and perioperative care.ObjectiveBelow, we provide a descriptive initiative to share how pediatric anesthesia in Brazil, Chile, and Mexico operate. Theses descriptions do not represent all of Latin America.Descriptions and ConclusionsBrazil an upper middle‐income country, population 203 million, has a public system insufficiently resourced and a private system, resulting in inequitable safety and accessibility. Surgical complications constitute the third leading cause of mortality. Anesthesiology residency is 3 years, with required rotations in pediatric anesthesia; five hospitals offer pediatric anesthesia fellowships. Anesthesiology is a physician‐only practice. A Pediatric Anesthesia Committee within the Brazilian Society of Anesthesiology offers education through seasonal courses and workshops including pediatric advanced life support. Chile is a high‐income country, population 19.5 million, the majority cared for in the public system, the remainder in university, private, or military systems. Government efforts have gradually corrected the long‐standing anesthesiology shortage: twenty 3‐year residency programs prepare graduates for routine pediatric cases. The Chilean Society of Anesthesiology runs a 1‐month program for general anesthesiologists to enhance pediatric anesthesia skills. Pediatric anesthesia fellowship training occurs in Europe, USA, and Australia, or in two 2‐year Chilean university programs. Public health policies have increased the medical and surgical pediatric specialists and general anesthesiologists, but not pediatric anesthesiologists, which creates safety concerns for neonates, infants, and medically complex. Chile needs more pediatric anesthesia fellowship programs. Mexico, an upper middle‐income country, with a population of about 126 million, has a five‐sector healthcare system: public, social security for union workers, state for public employees, armed forces for the military, and a private “self‐pay.” There are inequities in safety and accessibility for children. Pediatric Anesthesiology fellowship is 2 years, after 3 years residency. A shortage of pediatric anesthesiologists limits accessibility and safety for surgical care, driven by added training at low salary and hospital under appreciation. The Mexican Society of Pediatric Anesthesiology conducts refresher courses, workshops, and case conferences. Insufficient resources and culture limits research.

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Public-private relationship in surgical hospitalizations through the Unified Health System

Cited by 6 publications

References 7 publications

Cesarean childbirth: an institutional socio-clinical study of the professional practices and discourses

Cesarean childbirth: an institutional socio-clinical study of the professional practices and discourses

Anti-violence measures developed by ILO and WHO: Analysis of the prevalence of workplace violence and the effects of implementation in a general hospital in China

Pediatric anesthesiology in Brazil, Chile, and Mexico

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