Saúde nas grandes metrópoles e populações socialmente vulneráveis

Barata, Rita Barradas

doi:10.11606/issn.2316-9036.v0i107p27-42

Cited by 6 publications

(7 citation statements)

References 9 publications

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“…Apesar de a regionalização impulsionar a constituição de Redes de Atenção à Saúde para fortalecer, de forma universal e equânime, a integralidade garantida pelo SUS 26 , faz-se necessário reverter as condições estruturais, diante do déficit na arrecadação dos menores municípios e do crônico subfinanciamento federal 4,27 , para viabilizar o caráter coordenador da APS. Na realidade dos maiores centros, além de garantir a sustentabilidade financeira de um modelo regionalizado de APS, é fundamental a modernização da A&M para superar, alinhado ao desenvolvimento urbano e populacional, os constrangimentos na expansão da ESF em território geopolítico 28 .…”

Section: Discussionunclassified

Desempenho da atenção primária à saúde, segundo clusters de municípios convergentes no estado de São Paulo

Pinheiro

Carneiro

Sala³

et al. 2022

Rev. bras. epidemiol.

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RESUMO: Objetivo: Descrever o desempenho da atenção primária à saúde, segundo clusters de municípios paulistas que apresentaram indicadores homogêneos. Métodos: Trata-se de um estudo descritivo, com base em dados secundários extraídos de fontes oficiais do Sistema Único de Saúde, referentes ao ano de 2018. Foi elaborada uma matriz de análise, com a proposição de indicadores de desempenho (acesso, efetividade e adequação) e contexto (população, determinantes de saúde e financiamento), selecionados e organizados em dimensões e subdimensões. Para identificar os grupos de municípios homogêneos, foi utilizada a análise de cluster Resultados: Dos 645 municípios, constituíram-se seis clusters. Os clusters 2 e 3 foram formados, predominantemente, por municípios pequenos e com maior acesso; entre eles, o cluster 3 apresentou menor vulnerabilidade social e maior investimento em saúde. Os clusters 1, 4 e 5, em contrapartida, foram formados por municípios maiores e com menor acesso; entre eles, o cluster 4 apresentou maior vulnerabilidade social, menor cobertura de planos privados de saúde e maior percentual de recursos utilizados em saúde; e o cluster 5, maior produto interno bruto per capita e maior cobertura de planos privados de saúde. O cluster 6, formado pelo município de São Paulo, demonstrou ser um caso particular. Ainda, o cluster 2 chamou atenção. Apresentando maior cobertura, sinalizou menor efetividade e adequação. Entre todos os clusters, o cluster 3 alcançou o melhor desempenho. Conclusão: Os resultados podem subsidiar a gestão regional e municipal, diante da complexidade do território paulista, apontando para cenários que demandam maiores inciativas de gestão pública.

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Section: Discussionunclassified

Desempenho da atenção primária à saúde, segundo clusters de municípios convergentes no estado de São Paulo

Pinheiro

Carneiro

Sala³

et al. 2022

Rev. bras. epidemiol.

View full text Add to dashboard Cite

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“…Although regionalization drives the establishment of Health Care Networks to strengthen, in a universal and equitable way, the integrality guaranteed by the SUS 26 , the structural conditions must be reversed, given the deficit in the collection of the smallest municipalities and the chronic federal underfunding 4,27 , to enable the coordinating character of PHC. In the reality of the largest centers, in addition to ensuring the financial sustainability of a regionalized PHC model, the modernization of E&M is essential to overcome, in line with urban and population development, the constraints in the expansion of the FHS in geopolitical territory 28 .…”

Section: Discussionmentioning

confidence: 99%

Primary health care performance according to clusters of convergent municipalities in the state of São Paulo

Pinheiro

Carneiro

Sala³

et al. 2022

Rev. bras. epidemiol.

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Objective: To describe the performance of Primary Health Care, according to conglomerates of São Paulo cities that present homogeneous indicators. Methods: This is a descriptive study, based on secondary data extracted from official sources of the Unified Health System, for the year 2018. An analysis matrix was created, with the proposition of performance (access, effectiveness and adequacy) and context indicators (population, health determinants and financing) selected and organized in dimensions and sub-dimensions. Cluster Analysis was used to identify the groups of homogeneous municipalities. Results: 645 municipalities were divided in 6 conglomerates. Clusters 2 and 3 were formed predominantly by small municipalities with greater access to health; cluster 3 has less social vulnerability and greater investment in health. Clusters 1, 4 and 5 were formed by the largest municipalities with less access to health; cluster 4 presents greater social vulnerability, less coverage of private health plans and a greater percentage of health resources; cluster 5 was characterized by greater Gross Domestic Product per capita and greater coverage of private health plans. Cluster 6, formed by the city of São Paulo, was a particular case. Cluster 2 drew attention, as it was shown to have increased coverage, but signaled lower efficacy and adequacy levels. Cluster 3 had the best performance among all clusters. Conclusion: These findings can support regional and municipal management, given the complexity of the territory of São Paulo, pointing to scenarios that demand broader public management initiatives.

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“…It is therefore inferred that there is a conversion of biological facts into collective actions and health is influenced by environment and epidemiological issues 12 . In other words, problems of social well-being are not simply technical issues, and the contradictions of the public health system have an impact on the quality of life of the caregiver 18 . Therefore, health is the result of a process involving different dimensions of living conditions and the social contexts in which social groups exist 19 .…”

Section: Category: Contradictionsmentioning

confidence: 99%

Difficulties encountered in care for elderly persons with dementia: coping based on participatory research

Silva

Caldas

David

et al. 2018

Rev. bras. geriatr. gerontol.

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Objective: to analyze the proposal of an action plan created by nurses to deal with difficulties in caring for the elderly. The aim of the present study was therefore to analyze the difficulties that family caregivers find in relation to access to services, material resources and the support network when meeting the care needs of the elderly in accordance with Brazilian public policy. Method: the methodology of participatory research and content analysis proposed by Bardin was used. The context was the Geriatric service of a university hospital. The group of co-researchers included eight nurses and 12 caregivers of elderly people with dementia. Results: the following categories emerged from the analysis: contradictions and work proposals. The contradictions category revealed reflections about the difference between the proposed care for the elderly and the reality of a lack of care and the precarious conditions of health services. This situation leads to overburdening of caregivers. The work proposals refer to the strategies used by nurses to establish a relationship of support to family caregivers to cope with the difficulties involved in care for the elderly. Conclusion: nurses recognize that they are professionals capable of receiving, listening to and managing the needs of family caregivers of the elderly, thus promoting the health of the elderly and the caregivers themselves, preparing the family of the patient for home care and coping with difficulties experienced in elderly care.

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Saúde nas grandes metrópoles e populações socialmente vulneráveis

Cited by 6 publications

References 9 publications

Desempenho da atenção primária à saúde, segundo clusters de municípios convergentes no estado de São Paulo

Desempenho da atenção primária à saúde, segundo clusters de municípios convergentes no estado de São Paulo

Primary health care performance according to clusters of convergent municipalities in the state of São Paulo

Difficulties encountered in care for elderly persons with dementia: coping based on participatory research

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