This article aims at estimating the prevalence of adults engaging in protective and risk health behaviors among members of private health insurance plans. It was used a random sample of individuals over the age of 18 living in the Brazilian state capitals collected on 28,640 telephone interviews in 2008. The results showed that among males there was a high prevalence of the following risk factors: tobacco, overweight, low fruit and vegetable consumption, high meat with fat consumption and alcohol drinking. Among females we found a high prevalence of high blood pressure, diabetes, dyslipidemia and osteoporosis. Men were generally more physically active and women consumed more fruit and vegetables. As more educated males were lower was the prevalence of tobacco, high blood pressure, but also a higher prevalence of overweight, consumption of meat with fat, dyslipidemia and lower number of yearly check-ups done. For females, tobacco smoking, overweight, obesity, decreasing with schooling, and consumption of fruit and vegetables, physical activity, mammography and PAP test, increased with schooling. The health insurance user population constitutes about 26% of Brazilian people and the current study aims to accumulate evidence for health promotion actions by this public.

/pdf/fatores-de-risco-e-protecao-para-doencas-cronicas-nao-1ycvobtqn9.pdf

Fatores de risco e proteção para doenças crônicas não transmissíveis entre beneficiários da saúde suplementar: resultados do inquérito telefônico Vigitel, Brasil, 2008

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 Estabelecimentos de Saude (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.

/pdf/performance-evaluation-of-hospitals-that-provide-care-in-the-6229xeis2p.pdf

Performance evaluation of hospitals that provide care in the public health system, Brazil

The population aging that has arisen from Brazil’s new demographic and epidemiological reality, a relatively recent phenomenon, requires innovative and efficient responses. This article presents a care model for the older population with the most contemporary comprehensive care and an excellent cost-benefit ratio. The proposal is aimed at health promotion, disease prevention and the coordination of care, with an emphasis on low complexity instances of care. The integrated models seek to solve the problem of fragmented and poorly coordinated care in current health systems. For this reason, we propose a low complexity care unit, an epidemiological assessment, a social center and a team formed by a pair of medical and nursing professionals, with the support of gerontologists. There will also be medical records that cover clinical and social aspects, as well as a quality information system - all involving advanced technology, accessible by doctors and clients at any time via cloud technology and a cell phone app. The more the healthcare professional knows their patient’s history, the better the results. The concepts and structure that underlie this model, which aims to reduce waste, offering greater quality at reduced cost, are set out. It is our contribution to benefit - be it in the public or supplementary sector - health care aimed at the fastest growing age group in Brazil.

/pdf/a-contemporary-and-innovative-care-model-for-older-adults-28umjxjgm0.pdf

A contemporary and innovative care model for older adults

The objective of this work is to contribute to the investigation into health costs, by analyzing the evolution of the cost of medical care in health plans in Brazil, considering the marked difference between the categories of contract available. To do so, the information published by the National Supplementary Health Agency (AINS) is used. The variation indices are estimated, using the value indices methodology and its two components, price (average cost per event) and quantity (use frequency). What stands out in the results is that the average cost indices per event have varied more that the quantity indices, a fact which indicates how important it is to research health inflation in more depth.

/pdf/planos-de-saude-uma-analise-dos-custos-assistenciais-e-seus-29qq3xyzjs.pdf

Planos de saúde: uma análise dos custos assistenciais e seus componentes

Este estudio tiene como objetivo identificar el perfil de los articulos sobre el control interno en el sector publico, publicados en revistas nacionales e internacionales indexadas en la base de datos Scopus En articulos publicados en revistas nacionales e internacionales indexadas en la base de datos Scopus, disponible en el Portal Capes-BR, en el area de Social Sciences & Humanities, busquedas se realizaron por el termino internal control in the public sector Se identificaron un total de 133 articulos publicados entre los anos 1983 a 2011 y se observo que hay un aumento en la produccion cientifica en el analisis Sin embargo, no hay literatura especifica utilizada predominantemente en este campo Los temas mas explorados son: a) auditoria, control interno, gestion de riesgos y gobierno b) finanzas publicas c) politicas publicas, y d) desarrollo economico

/pdf/perfil-de-articulos-sobre-el-control-interno-en-el-sector-uaa7tpggo1.pdf

Perfil de artículos sobre el control interno en el sector público en revistas nacionales e internacionales

O sistema de saude dos Estados Unidos e conhecido pelo seu alto custo, o que os americanos, por tradicao, presumem ser o preco de excelencia. Parte da assistencia a saude nos Estados Unidos e de fato excelente, mas sabemos que nele tambem existem serios problemas de qualidade. Ha forte evidencia de que grande parte dos tratamentos esta bastante aquem da excelencia, sendo aplicados em demasia ou em dose insuficiente, e que indices de erro medico continuam alarmantes. Esse livro comeca descrevendo o desempenho insatisfatorio do sistema de saude dos Estados Unidos, suas causas e as razoes pelas quais as reformas anteriores nao alteraram a trajetoria do sistema. Em seguida, apresenta os principios da competicao baseada em valor focado em resultados, necessarios para reformar de fato o sistema, e os passos que cada participante precisa tomar para abracar o novo modelo. O capitulo 1 detalha os assombrosos desafios de desempenho enfrentados pelo sistema de saude dos Estados Unidos, em termos de custo e qualidade. Ele apoia-se em evidencia extraida de um amplo espectro de fontes e estudos, os quais, no seu conjunto, sublinham a profundidade e a abrangencia do problema.

https://www.metodista.br/revistas/revistas-metodista/index.php/OC/article/download/1352/1370

Repensando a saúde. Estratégias para melhorar a qualidade e reduzir os custos. Michael E. Porter e Elizabeth Olmsted Teisberg. Tradução de Cristina Bazan. Porto Alegre: Bookman, 2007

The aim of this article was to identify and analyse the bibliometric features of articles regarding Internal Control and Risk Management presented in Congresso USP (Controllership and Accountancy and Scientific Initiation) and in ENANPAD, between 2001-2011. It was a descriptive, quantitative and longitudinal research, focused on data collection, based on bibliographic and documental research. Out of 9.894 articles presented in those events in the period above, it was selected 165 by means of previously specified key-words. Out of those 165, 100 were presented in ENANPAD and 65 in Congresso USP. It was verified that, through the Lotka Law, those events still do not have an accountancy research elite to study and publish about Internal Control and Risk Management. This fact was also stated concerning other accountancy matters. It was also demonstrated that regarding the 2 events, the amount of articles written by up to 2 authors in the period was 50,3% of the total (44,6% in Congresso USP and 54% in ENANPAD); 78,8% of the authors are men and 68,3% are university professors. Until the end of the research, 38 of the 165 selected articles were published in specialized journals. The rise in the articles presented in ENANPAD throughout the analysed period more than doubled the amount presented in Congresso USP.  Concerning Internal Control, the average rise tax showed a balance between the 2 events. The results favored Congresso USP regarding Management Risks, for its prevalence over ENANPAD was stated.

/pdf/producao-cientifica-sobre-controle-interno-e-gestao-de-38qdiwxcu8.pdf

Produção científica sobre controle interno e gestão de riscos no enanpad e congresso usp: análise bibliométrica no período 2001-2011

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Repensando a saúde. Estratégias para melhorar a qualidade e reduzir os custos. Michael E. Porter e Elizabeth Olmsted Teisberg. Tradução de Cristina Bazan. Porto Alegre: Bookman, 2007

Produção científica sobre controle interno e gestão de riscos no enanpad e congresso usp: análise bibliométrica no período 2001-2011