Management of health facilities

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Cad. Saúde Pública  vol.20 suppl.2

Cad. Saúde Pública vol.20 suppl.2

The distribution of presenting illnesses among children whose case management was observed, based on the “gold standard” survey- or classification, is presented in Figure 1. Dif- ferences in profiles between those children seen by IMCI trained health workers and non- IMCI trained health workers were not statisti- cally significant. Of all children, the majority (52%) presented at the facility with a cough or cold. Twenty-eight percent had a fever, 15% had diarrhea with no dehydration, 81% presented with anemia, and 9% with wheezing. Ten per- cent of all children sampled at the facilities had asthma, while 46% had other illnesses current- ly not included in IMCI guidelines, the most frequent diagnosis of which included skin or throat problems. A large percentage of children (58%) who were included in this survey pre- sented at the facilities with more than one ill- ness. Among children who had other, non-IMCI related, illnesses, 78% had these illnesses in combination with an IMCI-related illness, while 22% only had this other illness.
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Facilities and difficulties experienced in Permanent Health Education, in the Family Health Strategy

Facilities and difficulties experienced in Permanent Health Education, in the Family Health Strategy

ABSTRACT Permanent Health Education is present in the health services, being the process by which the teams seek improvement, organization and qualification of the actions. It was aimed to analyze facilities and difficulties in the accomplishment of Permanent Health Education, in the Family Health Strategy. This is a qualitative study, which used the research-action technique. Facilities include the use of active methodologies, the integration of the team, the opening of the management and the planning of activities. And as difficulties, the lack of participation of the professionals, work overload, infrastructure, devaluation of some knowledge and incomprehension of the methods used.
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Availability of psychotropic medications in primary health care facilities in the Gambia

Availability of psychotropic medications in primary health care facilities in the Gambia

Dr. Mariatou Tala Jallow in her study “Essential Drugs in the Gambia” in 1993 revealed that the Gambia is faced with numerous challenges in this field. She identified problems of ineffective drugs legislation and regulations, supply systems, poor drug management, logistics, insufficient financial resources and human resource constrains as major challenges. The enormous positive achievements because of the Alma Ata declaration have been unevenly distributed leaving a big gap in the domain of mental health services. The situation in Gambia is not much different from Ghana. In Ghana, about 13 % of the adult population is estimated to be affected by mental health disorders of varying forms. In managing these patients, psychotropic medications are mostly employed which are consumed for prolonged periods of time. There were frequent shortages of commonly prescribed psychotropic medications across the country. Oppong continued that even when psychotropic medications are subsidized by the private sector, the average cost of a day's supply of the most common antipsychotic was 4 % of the daily minimum wage (Oppong S. 2016).
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Rev. bras. epidemiol.  vol.13 número2

Rev. bras. epidemiol. vol.13 número2

This cross-sectional study selected he- althcare facilities by convenience sampling with the criteria of demand volumes betwe- en 800 and 1,000 visits/month; presence of a multi-professional team; regularly ope- rating healthcare facilities capable of being regional references for the care of cases of violence; accessible and good quality medical records; assured privacy in inter- views; management and teams sensitive to the problem; and belonging to different administrative health regions. The selec- tion of healthcare facilities respected the geographic distribution in the North, South, Center, West, and East regions of the city of São Paulo, also including the municipalities of Santo André, Diadema, and Mogi das Cruzes, all in Greater São Paulo.
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Facilities and difficulties experienced in Permanent Health Education, in the Family Health Strategy

Facilities and difficulties experienced in Permanent Health Education, in the Family Health Strategy

PHE is a strategy that provides subsidies, methods, manners and engenderings for the qualification and organization of health work. In addition, it contributes significantly to the reorientation of processes within the health teams, stressing the different actors in the sense of seeking something more in their daily work. Moreover, it contributes positively to the management and administration of the dif- ferent spaces in the health field. It is impor- tant to emphasize that this study occurred in a specific municipality, with less than 20 thousand inhabitants, a reality similar to that of the great majority of municipali- ties in the Country in this respect, since, according to IBGE 23 , 73% of the brazilian
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Application of frequent itemsets mining to analyze patterns of one-stop visits in Taiwan.

Application of frequent itemsets mining to analyze patterns of one-stop visits in Taiwan.

In the current study, the patterns of specialty combinations in one-stop visits were extremely diverse and the number of visits in each combination, even the most frequent one, was relatively low. The practical meaning is that it would be difficult for hospitals to offer customized, integrated, and efficient services under circum- stances of low economies of scale. The one-stop visits are indeed convenient to patients who need various specialties to treat their problems. But the risk of induced demand and polypharmacy deserves further attention. The NHI in Taiwan has to establish a more regulated referral system with family physicians as health gatekeepers, especially for those with multiple chronic diseases.
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Safety assessment driving radioactive waste management solutions (sadrwms methodology) implemented in a software tool (safran)

Safety assessment driving radioactive waste management solutions (sadrwms methodology) implemented in a software tool (safran)

one of several facilities or activities on a site and may be independent of the other facilities, connected to other facilities or an integral part of a larger facility. Commensurately the extent and complexity of the safety case and supporting assessment will differ according to the facility or activity and will also evolve through their lifecycle (e.g. construction, commissioning and operation). In view of these considerations, a graded approach should be applied to the development and review of the safety case and supporting assessment. The guidance and recommendations contained in DS284 is comprehensive and sufficient for the most complex and hazardous facilities. It is the objective of the CRAFT project to illustrate their use in a graded manner to a number of supporting safety reports which cover a range of facilities.
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Balancing Management and Leadership in Complex Health Systems; Comment on “Management Matters: A Leverage Point for Health Systems Strengthening in Global Health”

Balancing Management and Leadership in Complex Health Systems; Comment on “Management Matters: A Leverage Point for Health Systems Strengthening in Global Health”

And so, while issues of management will continue to be critical for strengthening health systems, it is especially important that within complex adaptive health systems, management and leadership be well-balanced, and perhaps even re-balanced: understanding the workings of management and leadership – how they interact and emerge from their contexts to lead to particular outcomes – especially at operational levels of the health system, remains an important area of practice and policy research. Because of the urgency to perform, many LMIC health systems, especially in sub-Saharan Africa, have been locked on management while leaving behind or separating out leadership. We should not allow ourselves to be enticed by the allure of management’s easy visibility and tempting order. Greater focus on systemic approaches to management and leadership capacity strengthening, such as interventions which are longer-term in scope, and address organisational relationships, systemic learning and innovation, is in fact the greater challenge. Ultimately, however, this challenge can help us to move past the existing bureaucratic status quo, and nudge our health systems towards enabling greater leadership, and thus greater change.
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Planning of hospitals and health facilities

Planning of hospitals and health facilities

rity within the l%amework of the Alliance for ProgressJ~, and 13-M/66, "Health and Development PlanningJ1, In essence, these resolutions considered "the over[r]

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What matters most: evidence-based findings of health dimensions affecting the societal preferences for EQ-5D health states Mônica Viegas Andrade Kenya Valéria Micaela de Souza Noronha Ana Carolina Maia Paul Kind

What matters most: evidence-based findings of health dimensions affecting the societal preferences for EQ-5D health states Mônica Viegas Andrade Kenya Valéria Micaela de Souza Noronha Ana Carolina Maia Paul Kind

The TTO elicitation protocol has been fully described elsewhere 43 . It essentially involves presenting participants with choices between two alternatives that comprise varying levels of quantity and quality of life. Health states can be evaluated as either better or worse than death. A double-sided time board is used with one side for health states considered better than dead and the other side for health states worse than dead. For states evaluated better than dead individuals establish the number of years (x<10) in full health that provides them the same expected utility level as living ten years experiencing some specific health condition. TTO value (V) is obtained dividing the length of time in full health by ten . For states considered to be worse than dead individuals compare death with a choice that gives them 10-x years in some specific health state followed by x years (x<10) in full health. In this case TTO value is given by
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Ciênc. saúde coletiva  vol.21 número9

Ciênc. saúde coletiva vol.21 número9

However, it was noted that increased supply of primary health care through the ESF has fa- vored access, but still without ensuring compre- hensiveness. In addition, increased access was more perceived in studies conducted in the South and Southeast, revealing that there are regional disparities in the provision of services. We can conclude that comprehensive child care is a pro- cess under construction in Brazilian PHC, which has found more fertile ground in ESF services. However, it is a model that still requires signifi- cant changes in the service structure and profes- sional profile to achieve its effectiveness.
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Rev. bras. epidemiol.  vol.19 número3

Rev. bras. epidemiol. vol.19 número3

ABSTRACT: Introduction: Anemia in children is a public health issue, and the current strategies include treatment and iron supplementation, but their level of adherence or compliance is unknown. Objective: To consider the adherence to multiple micronutrient powders and the associated factors. Methods: Epidemiological study of active surveillance through sentinel facilities in 2,024 children aged 6 to 35 months treated in health facilities of the Ministry of Health of Peru, from October to December 2014. Household visits were conducted in which counting of multiple micronutrient powders was applied and determined an adherence of consumption ≥ 90% envelopes, besides a form on the associated factors (anemia knowledge, iron-rich food, side efects, dosage regimen, drugs used, and motivation) was applied. Descriptive statistics, χ² test, Odds Ratio with a 95% conidence interval (CI), and binary logistic regression or adjusted Odds Ratio (aOR) were used. Results: Of all, 79.1% participants were aged 6 to 23 months; 75.9% received multiple micronutrient powders; and the adherence was equivalent to 24.4% (95%CI 22.3 – 26.6). The factors: continue supplementation (OR = 3.5; 95%CI 1.7 – 7.5); no nausea (OR = 3.0; 95%CI 2.0 – 4.3); no use of antibiotics (OR = 2.5; 95%CI 1.7 – 3.6); and intention to continue treatment (OR = 2.3; 95%CI 1.3 – 4.1) were associated with adherence. The variables: thought of continuing treatment (aOR = 2.6; 95%CI 1.1 – 6.1); presence of side efects, but no discontinuation of the treatment (aOR = 2.5; 95%CI 1.4 – 4.3); no use of antibiotics (aOR = 2.0; 95%CI 1.1 – 3.4); and belief that not only drugs cure anemia (aOR = 1.6; 95%CI 1.0 – 2.6) were associated in the multivariate analysis. Conclusion: There was a low prevalence of adherence to a demanding cut-of point (≥ 90% of envelopes of multiple micronutrient powders), and the associated factors are associated with absence of infections, side efects, and mother’s beliefs.
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Prevalence of mental health problems in children and adolescents from the outskirts of São Paulo City: treatment needs and service capacity evaluation

Prevalence of mental health problems in children and adolescents from the outskirts of São Paulo City: treatment needs and service capacity evaluation

In Embu's public service system, we identified 12 facilities providing mental health treatment for children and adolescents aged 6 and 17 years. These facilities belonged to different se[r]

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Cad. Saúde Pública  vol.26 número7

Cad. Saúde Pública vol.26 número7

Although the Brazilian Ministry of Health promotes comprehensive maternal and child health care through the expansion of the Family Health Strategy, Integrated Management of Childhood Illnesses (IMCI, Neonatal IMCI), and the Pact for the Reduction of Infant Mor- tality in the Northeast and Legal Amazonia, among others, the persistence of ARIs among the main causes of morbidity and mortality in the Brazilian population, inequalities in ac- cess to health, lack of vaccines to prevent the spectrum of infectious agents in ARIs, and the complexity and long-term effects of interventions on social and environmental health determinants, make ARIs a contemporary public health problem, calling for prioritization by health services, policy-makers, and researchers in the areas of communicable diseases and technological innovations in health.
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Development of Public Market of Corporate Bonds in Poland

Development of Public Market of Corporate Bonds in Poland

The bond market Catalyst was launched on 30 September 2009. It was created by two institutions – the Warsaw Stock Exchange and its off-exchange market institution Bond magistrate Spot S.A. Debt instruments are traded on four independent trading platforms. Two of them operated by the WSE are dedicated to retail investors. Two markets available to wholesale investors are operated by Bond Spot S.A. (Gemra, 2011) Retail and wholesale markets comprise Regulated Market (RM) and Alternative Trading System (ATS) with its less strict admission conditions. (The Alternative Trading System operated by Bond Spot was launched six months following the opening of Catalyst, i.e. on 11 January 2013).The architecture of Catalyst (presented in detail in Figure 1) aims at enabling individual and institutional investors to enter transaction and, on the other hand, offering issuers an opportunity to introduce to trading debt instruments of different issue sizes.
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Analysis of the Weekend Effect on the Markets of 121 Equity Indices and 29 Commodities

Analysis of the Weekend Effect on the Markets of 121 Equity Indices and 29 Commodities

1. The null hypothesis regarding equality of variances of daily average rates of return in two populations, was rejected (for α=5%) in the following 75 cases: ADX, ALL ORDINARIES, ALSIUG, AMM FR FLT, BELEX 15, BOVESPA, BUMIX, BUX, CDAX, CNX NIFTY, CROBEX, RB, CSI 300, CYMAIN, DAX, DJIA, DJTA, DJUA, ESTX 50 PR, EURONEXT 100, HANG SENG, HEX, HSCE, ICEX, IGBC, JCI, JKSE, KLCI, KLSE, KOSPI, KW WEIGHTED IDW, MERVAL, MSE, MSM MAIN 30, NIKKEI, NSE ALL Shares, OMX Stockholm, OMX Talin, OMX Vilnius, PFTS, PLE MAIN, PX, QE MAIN 20, RUSSELL, SASESLCT, SENSEX, SBITOP, SOFIX, SP 500, SP ASX 200, SP TSX Composite, SSE Composite, Straits Times, sWIG80, TDW MAIN, TECDAX, TOPIX, TSE 300, UX, WIG, WIG20, XU 30, coffee, copper, corn, gas oil, gasoline, lean hogs, live cattle, natural gas, orange juice, palladium, platinum, soybean, soybean meal. 2. The null hypothesis regarding equality of two average rates of return was rejected for
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The Liability of the Managing Body within the Insolvency Proceedings in Romania: Case-Law Study

The Liability of the Managing Body within the Insolvency Proceedings in Romania: Case-Law Study

The study aims at identifying the new elements that the Insolvency Code in Romania, Law 85 of 2014, brings in what concerns entailing the liability of the managing body as well as that of other persons having contributed to the debtor's state of insolvency, compared to the previous regulation provided by Law 85 of 2006. The identification of these elements is carried out by making reference to the types of deeds that, following taken legal action, can entail liability and the coverage of the debts by the members of the managing body as well as by other persons having contributed to the debtor's state of insolvency. The analysis of the deeds concentrates around two connected centers of interest: The analysis of the deeds such as they are regulated by the two regulations and the case where for certain deeds there need to be identified the elements of repeatability in the two regulations and then the relevant case-law applicable for the respective deed is analyzed. In conclusion, in this way are identified the case-law variations met by the regulations applicable to the respective deed, in the judgments grounded on Law 85 of 2006. These variations represent landmarks for the regulations comprised by the Romanian Insolvency Code – Law 85 of 2014. Following the analyzed legal precedents – a number of 30 case-law judgments issued by courts of appeal being at the highest level of jurisdiction, there are identified in concreto, the type of acts which may entail the liability of the managing body for the insolvency of the enterprise. Through the present study we aim to guide the local administrators, as well as the future foreign investors who engage in foreign direct investments (FDI) in Romania with regard to the liability of the managing body in within the insolvency proceedings.
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HEALTH ECONOMICS AND MANAGEMENT

HEALTH ECONOMICS AND MANAGEMENT

The choice for an open source VLE involved almost no financial cost to the institution, besides the demand for operational computing structure, which is already available. Actually, a low impact on budget was observed, since the whole process only involved the reallocation of available human resources. From the perspective of a public health organization in a country with serious budgetary constraints, low cost is a relevant factor. We suggest that the organization involvement is crucial for success of the course. This support can be demonstrated by the low rate of absence and dropouts.
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HEALTH ECONOMICS AND MANAGEMENT

HEALTH ECONOMICS AND MANAGEMENT

The Lean Six Sigma methodologies were effective in reducing incorrect postings allocated as non- appropriated revenues and expenses, correct costing, compliance assurance, and accuracy in costs versus outcomes. The initially proposed reduction target was reached, which demonstrates the improvement in the posting process. The closer to Six the Sigma level, the better the excellence of the service, which demonstrates that the data can be relied upon to show the relation between costs and patient outcomes at the hospital investigated.

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HEALTH ECONOMICS AND MANAGEMENT

HEALTH ECONOMICS AND MANAGEMENT

associated with primary care sensible conditions from 1998 to 2009, and observed an annual mean reduction of 3.7% and the São Paulo State was not among those states that had greater reduction in number of hospitalizations. Authors also used PCSI association and observed a reduction in number of hospitalizations in most of units, although some of them revealed stability or increase of hospitalization because of primary care sensible conditions. Factors such as socioeconomic conditions and private or specialized health service are related with hospitalization rates by primary care sensible conditions, and they may generate regional differences. They still affirm that in no state the number of hospitalization by primary care sensible conditions increased in the studied period. However, data analyzed from 2002 to 2007 revealed that number of hospitalization had increased. Rehem et al., (11) described hospitalization because of
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