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‣ Avaliação da capacidade funcional, do estado de saúde e da rede de suporte social do idoso atendido na Atenção Básica; Assessment of functional capacity, physical health status and the social support network of elderly patients seen by primary health care providers

Alvarenga, Marcia Regina Martins
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 19/12/2008 Português
Relevância na Pesquisa
88.22879%
Este estudo tem como objeto as necessidades de saúde de idosos atendidos na Atenção Básica. Objetivo geral: analisar a capacidade funcional, o estado de saúde e a rede de suporte social de idosos assistidos por Equipes de Saúde da Família no município de Dourados,MS. Casuística e método: estudo transversal, com amostra aleatória constituída por 503 idosos assistidos pela ESF. As variáveis independentes foram sociodemográficas e condições de saúde e as dependentes: auto-avaliação de saúde; risco nutricional através do Nutrition Screening Initiative, grau de dependência pela Medida de Independência Funcional, déficit cognitivo pelo Mini-Exame do Estado Mental, sintomas depressivos através da Escala de Depressão Geriátrica. A rede de suporte social foi descrita pelo Mapa Mínimo de Relações do Idoso. A descrição dos dados foi apresentada em freqüência absoluta, relativa, média, desvio-padrão. Calculou-se o coeficiente de Alpha de Cronbach para as escalas; teste t-Student para analisar diferenças entre médias de variáveis contínuas; teste Qui-quadrado de Mantel-Haenzsel para as categóricas; teste Qui-quadrado de Pearson para verificar associações e modelo de regressão logística para abordagem multivariada. Todos os resultados foram analisados considerando p<0...

‣ Working for God? Evidence from a Change in Financing of Nonprofit Health Care Providers in Uganda

Reinikka, Ritva; Svensson, Jakob
Fonte: Banco Mundial Publicador: Banco Mundial
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
88.3408%
What motivates religious nonprofit health care providers? This paper uses a change in financing of nonprofit health care providers in Uganda to test two theories of organizational behavior. We show that financial aid leads to more laboratory testing, lower user charges, and increased utilization. These findings are consistent with the view that religious nonprofit providers are intrinsically motivated to serve (poor) people and that these preferences matter quantitatively.

‣ Setting Incentives for Health Care Providers in Serbia

Cashin, Cheryl; Koettl, Johannes; Schneider, Pia
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
Relevância na Pesquisa
98.82009%
The Serbian Government plans to reform its provider payment system for health care by setting incentives for providers to improve the quality and efficiency of care. Funds for health care are currently allocated on the basis of the number of staff and beds at health facilities. This encourages health care providers to use more staff and beds to define their budgets but does not reward improvements in productivity, quality of care or health outcomes.

‣ The Comparative Nature of Faith-Inspired Health Care Provision in Sub-Saharan Africa : Strengthening the Evidence for Faith-inspired Health Engagement in Africa, Volume 2

Olivier, Jill; Wodon, Quentin
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
Relevância na Pesquisa
88.92211%
This role of faith-inspired health care providers in sub-saharan Africa and public-private partnerships is comprised of a three volume series on strengthening the evidence for faith inspired engagement in health in sub-Saharan Africa. An increasing level of interest in the role of faith in development has generated much debate and dialogue at the international and national levels over the last decade. Despite difficulties in communication and differences in cultures within such debates, there has been a continued reaffirmation of the potential benefits that faith-inspired communities can bring towards efforts to achieve the millennium development goals (MDGs), especially in the areas of health. This series focuses on assessing the role and market share of faith-inspired providers and on assessing the extent to which they are involved in and benefit from public-private partnerships. The purpose of this series of three HNP discussion papers is to round up various analytical perspectives and emerging research on faith engagement in health in Africa from a range of researchers and practitioners from the north as well as the south. The series is structured into three volumes: a first volume on the role and market share of faith-inspired providers and public-private partnerships...

‣ The Role of Faith-inspired Health Care Providers in Sub-Saharan Africa and Public-Private Partnerships : Strengthening the Evidence for Faith-inspired Health Engagement in Africa, Volume 1

Olivier, Jill; Wodon, Quentin
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
Relevância na Pesquisa
99.08088%
This role of faith-inspired health care providers in sub-saharan Africa and public-private partnerships is comprised of a three volume series on strengthening the evidence for faith inspired engagement in health in sub-Saharan Africa. An increasing level of interest in the role of faith in development has generated much debate and dialogue at the international and national levels over the last decade. Despite difficulties in communication and differences in cultures within such debates, there has been a continued reaffirmation of the potential benefits that faith-inspired communities can bring towards efforts to achieve the millennium development goals (MDGs), especially in the areas of health. This series focuses on assessing the role and market share of faith-inspired providers and on assessing the extent to which they are involved in and benefit from public-private partnerships. The purpose of this series of three HNP discussion papers is to round up various analytical perspectives and emerging research on faith engagement in health in Africa from a range of researchers and practitioners from the north as well as the south. The series is structured into three volumes: a first volume on the role and market share of faith-inspired providers and public-private partnerships...

‣ Mapping, Cost, and Reach to the Poor of Faith-inspired Health Care Providers in Sub-Saharan Africa : Strengthening the Evidence for Faith-inspired Health Engagement in Africa, Volume 3

Olivier, Jill; Wodon, Quentin
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
Relevância na Pesquisa
99.02708%
This role of faith-inspired health care providers in sub-saharan Africa and public-private partnerships is comprised of a three volume series on strengthening the evidence for faith inspired engagement in health in sub-Saharan Africa. An increasing level of interest in the role of faith in development has generated much debate and dialogue at the international and national levels over the last decade. Despite difficulties in communication and differences in cultures within such debates, there has been a continued reaffirmation of the potential benefits that faith-inspired communities can bring towards efforts to achieve the millennium development goals (MDGs), especially in the areas of health. This series focuses on assessing the role and market share of faith-inspired providers and on assessing the extent to which they are involved in and benefit from public-private partnerships. The purpose of this series is three HNP discussion papers is to round up various analytical perspectives and emerging research on faith engagement in health in Africa from a range of researchers and practitioners from the north as well as the south. The series is structured into three volumes: a first volume on the role and market share of faith-inspired providers and public-private partnerships...

‣ Multiple Payers in Health Care : A Framework for Assessment

Zweifel, Peter
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
Relevância na Pesquisa
88.75167%
The starting point of the debate about the pros and cons of multipayer systems is the suspicion that in many health care systems, consumers do not get sufficient value for money. This contribution argues that one cause may be a non-optimal choice of payment systems. Optimal payment of health care providers importantly depends on the amount of information available to the (prospective) patient. If patients have full information about both the effort exerted and the effectiveness of the service provider, the conventional fee-for-service payment is optimal from their point of view. If patients cannot observe true effort exerted while providers are reasonably homogenous with respect to effectiveness, the optimal payment function consists of a fixed payment and a bonus for especially favorable outcomes in terms of health. If the patient in addition does not know whether a given health care provider effective or ineffective, a special informational rent designed to attract the unrecognized favorable type is appropriate. Now...

‣ Selecting Health Care Providers

Baeza, Cristian; Montenegro Torres, Fernando
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
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88.84656%
A strategic purchaser seeks to achieve the necessary correspondence between the needed health care services and goods (interventions) and the providers. In order to achieve this matching it is important to define with precision and in great detail what are the interventions needed to achieve in the most efficient way the goals of the purchaser before entering in the contracting process. The greater the complexity of the intervention the greater the need to contract with integrated delivery systems and not with individual providers. In the absence of integrated delivery systems, purchasers can provide the coordination of services and other related managerial activities in order to offer a continuum of care to the target population. However, this hands on approach is a heavy burden for purchasers and ideally this approach should be only transitory in order to focus on monitoring outcomes rather than micro-managing the provision of health care services.

‣ Market Share of Faith-Inspired Health Care Providers : Reach to the Poor in Africa

Wodon, Quentin; Olivier, Jill; Tsimpo, Clarence; Nguyen, Minh Cong
Fonte: Taylor and Francis Publicador: Taylor and Francis
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
88.0182%
Market share estimates—typically in the 30 percent to 40 percent range—are frequently wielded as the most concrete evidence of faith-inspired activity and impact in the area of health care provision in Sub-Saharan Africa. In fact, there are few speeches, reports, or articles that do not make some mention of market share, attaching some percentage to the significance of faith-inspired healthcare provision in the continent as a whole, or in specific countries. Such statements usually appear in the early stages of a text, and are the basis on which a further argument is made, for example that this sector therefore requires further attention or resources from governments and donors. A systematic review of this literature reveals that these statements have currently reached the point of becoming almost indisputable “truth,” as they are now frequently made without any referencing.

‣ Working for God? Evaluating Service Delivery of Religious Not-for-Profit Health Care Providers in Uganda

Reinikka, Ritva; Svensson, Jakob
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
Relevância na Pesquisa
98.70992%
Reinikka and Svensson exploit a unique micro-level data set on primary health care facilities in Uganda to address the question: What motivates religious not-for-profit (RNP) health care providers? The authors use two approaches to identify whether an altruistic (religious) effect exists in the data. First, examining cross-section variation, they show that RNP facilities hire qualified medical staff below the market wage, are more likely to provide propoor services and services with a public good element, and charge lower prices for services than for-profit facilities, although they provide a similar (observable) quality of care. RNP and for-profit facilities both provide better quality care than their government counterparts, although government facilities have better equipment. These findings are consistent with the view that RNP facilities are driven in part by altruistic concerns and that these preferences matter quantitatively. Second, the authors exploit a near natural experiment in which the government initiated a program of financial aid for the RNP sector. They show that financial aid leads to more laboratory testing of suspected malaria and intestinal worm cases...

‣ Are Incentives Everything? Payment Mechanisms for Health Care Providers in Developing Countries

Gauri, Varun
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
Relevância na Pesquisa
88.75324%
This paper assesses the extent to which provider payment mechanisms can help developing countries address their leading health care problems. It first identifies four key problems in the health care systems in developing countries: 1) public facilities, which provide the bulk of secondary and tertiary health care services in most countries, offer services of poor quality; 2) providers cannot be enticed to rural and urban marginal areas, leaving large segments of the population without adequate access to health care; 3) the composition of health services offered and consumed is sub-optimal; and 4) coordination in the delivery of care, including referrals, second opinions, and teamwork, is inadequate. The paper examines each problem in turn and assesses the extent to which changes in provider payments might address it.

‣ Validation of an HIV-related stigma scale among health care providers in a resource-poor Ethiopian setting

Feyissa, G.; Abebe; Girma; Woldie, M.
Fonte: Dovepress Publicador: Dovepress
Tipo: Artigo de Revista Científica
Publicado em //2012 Português
Relevância na Pesquisa
98.67835%
Background: Stigma and discrimination (SAD) against people living with human immunodeficiency virus (HIV) are barriers affecting effective responses to HIV. Understanding the causes and extent of SAD requires the use of a psychometrically reliable and valid scale. The objective of this study was to validate an HIV-related stigma scale among health care providers in a resource-poor setting. Methods: A cross-sectional validation study was conducted in 18 health care institutions in southwest Ethiopia, from March 14, 2011 to April 14, 2011. A total of 255 health care providers responded to questionnaires asking about sociodemographic characteristics, HIV knowledge, perceived institutional support (PIS) and HIV-related SAD. Exploratory factor analysis (EFA) with principal component extraction and varimax with Kaiser normalization rotation were employed to develop scales for SAD. Eigenvalues greater than 1 were used as a criterion of extraction. Items with item-factor loadings less than 0.4 and items loading onto more than one factor were dropped. The convergent validity of the scales was tested by assessing the association with HIV knowledge, PIS, training on topics related to SAD, educational status, HIV case load, presence of an antiretroviral therapy (ART) service in the health care facility...

‣ Assessment of Systems for Paying Health Care Providers in Mongolia; Implications for Equity, Efficiency and Universal Health Coverage

Joint Learning Network; Mongolia Ministry of Health; World Bank; World Health Organization
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Report; Economic & Sector Work :: Policy Note; Economic & Sector Work
Português
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98.88815%
Achieving access to basic health services for the entire population without risk of financial hardship or impoverishment from out-of-pocket expenditures (‘universal health coverage’ or UHC) is a challenge that continues to confront most low- and middle-income countries. As coverage expands in these countries, issues of financial sustainability, efficiency, and quality of care quickly rise to the surface. Strategic health purchasing is an important lever to efficiently manage funds for UHC through the definition of what is purchased (which services and benefits the covered population is entitled to receive), from whom services are purchase (which providers are contracted to deliver the covered services), and how and how much the providers are paid. The assessment was conducted to help inform the design and implementation of Mongolia’s provider payment systems going forward. Health care provider payment systems, the way providers are paid to deliver the covered package of services, are an important part of strategic purchasing to balance system revenues and costs in a way that creates incentives for providers to improve quality and deliver services more efficiently. This ultimately makes it possible to expand coverage within limited funds (Langenbrunner...

‣ Some Ramifications of Compensation Limitations in Personal Services Contracts for Direct Health Care Providers

Schauppner, Carl E.
Fonte: Monterey, California: Naval Postgraduate School Publicador: Monterey, California: Naval Postgraduate School
Tipo: Tese de Doutorado Formato: viii, 65 p.
Português
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98.42706%
Approved for public release; distribution is unlimited.; The purpose of this study was to examine the effects of price restrictions in personal services contracts for direct health care providers. This is a unique method of contracting designed specifically to facilitate the hiring of highly specialized health care providers, primarily physicians, that typically demand a high rate of compensation than that generally offered by the services. Legislation that authorized increased use of such contracts for health care services simultaneously mandated wage ceilings. Some economic impacts of wage ceilings in labor markets are presented. Shortages and a loss of military surplus are likely to be associated with wage ceilings. Recent data concerning personal services contracts are presented and examined, the result of the data evaluation provides some surprises. First, many personal services contracts are not being utilized as originally intended. In fact very few are actually used for physicians' services. Second, there is an appearance of impropriety in some of these contracts.; Lieutenant, United States Navy

‣ Nigeria—Improving Primary Health Care Delivery : Evidence from Four States

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Other Health Study; Economic & Sector Work
Português
Relevância na Pesquisa
88.8146%
The delivery of quality primary health care (PHC) services can have a large impact on the health of Nigerians. This study aims mainly at understanding the performance of primary health care providers and the variables driving this performance. The study is primarily based on quantitative surveys at the level of primary health care facilities, health care personnel, and households in their vicinity. These surveys were implemented in four states: Bauchi, Cross River, Kaduna, and Lagos. The purpose of this study is three fold: (i) to contribute to the evidence base of the Federal Government's health system reform efforts; (ii) to inform the Bank's and Canadian International Development Agency (CIDA) sector policy dialogue with the Government; and (iii) to inform the current and eventual health support programs of both donors at state level. This study represents the second phase of the Nigeria Health, Nutrition, and Population Country Status Report (CSR). The first phase aimed at analyzing the health situation of the poor and how the health system was performing in terms of meeting their needs. This first phase identified primary health care as the weakest chain in the entire health sector and the level of care the poor use the most. This second phase of the CSR is therefore focused on the analysis of the delivery of PHC services. In contrast to the first phase...

‣ The Design of Incentives for Health Care Providers in Developing Countries : Contracts, Competition, and Cost Control

Hammer, Jeffrey S.; Jack, William G.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper
Português
Relevância na Pesquisa
88.42958%
The authors examine the design and limitations of incentives for health care providers to serve in rural areas in developing countries. Governments face two problems: it is costly to compensate well-trained urban physicians enough to relocate to rural areas, and it is difficult to ensure quality care when monitoring performance is costly or impossible. The goal of providing universal primary health care has been hard to meet, in part because of the difficulty of staffing rural medical posts with conscientious caregivers. The problem is providing physicians with incentives at a reasonable cost. Governments are often unable to purchase medical services of adequate quality even from civil servants. Using simple microeconomic models of contracts and competition, the authors examine questions about: a) The design of rural service requirements and options for newly trained physicians. b) The impact of local competition on the desirable level of training for new doctors. c) The incentive power that can be reasonably expected from explicit contracts. One problem a government faces is choosing how much training to give physicians it wants to send to rural areas. Training is costly, and a physician relocated to the countryside is outside the government's direct control. Should rural doctors face a ceiling on the prices they charge patients? Can it be enforced? The authors discuss factors to consider in determining how to pay rural medical workers but conclude that we might have to set realistic bounds on our expectations about delivering certain kinds of services. If we can identify reasons why the best that can be expected is not a particularly good...

‣ Barriers to palliative care for children: Perceptions of pediatric health care providers

Davies, B.; Sehring, S.A.; Patridge, J.C.; Cooper, B.A.; Hughes, Ann Maree; Philp, J.C.; Amidi-Nouri, A.; Kramer, R.F.
Fonte: American Academy of Pediatrics Publicador: American Academy of Pediatrics
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
88.44255%
OBJECTIVE. The goal was to explore barriers to palliative care experienced by pediatric health care providers caring for seriously ill children. METHODS. This study explored pediatric provider perceptions of end-of-life care in an academic children's hospital, with the goal of describing perceived barriers to end-of-life care for children and their families. The report focuses on the responses of nurses (n = 117) and physicians (n = 81). RESULTS. Approximately one half of the respondents reported 4 of 26 barriers listed in the study questionnaire as frequently or almost always occurring, that is, uncertain prognosis (55%), family not ready to acknowledge incurable condition (51%), language barriers (47%), and time constraints (47%). Approximately one third of respondents cited another 8 barriers frequently arising from problems with communication and from insufficient education in pain and palliative care. Fourteen barriers were perceived by >75% of staff members as occasionally or never interfering with pediatric end-of-life care. Comparisons between physicians and nurses and between ICU and non-ICU staff members revealed several significant differences between these groups. CONCLUSIONS. Perceived barriers to pediatric end-of-life care differed from those impeding adult end-of-life care. The most-commonly perceived factors that interfered with optimal pediatric end-of-life care involved uncertainties in prognosis and discrepancies in treatment goals between staff members and family members...

‣ Palliative care: challenges for caregivers and health care providers; Cuidados paliativos: desafios para cuidadores e profissionais de saúde

Alves, Railda Fernandes; Universidade Estadual da Paraíba; Andrade, Samkya Fernandes de Oliveira; UEPB; Melo, Myriam Oliveira; UEPB; Cavalcante, Kílvia Barbosa; UEPB; Angelim, Raquel Medeiros; UEPB
Fonte: Eduff Publicador: Eduff
Tipo: ; ; ; Avaliado por pares; Formato: application/pdf
Publicado em 21/06/2015 Português
Relevância na Pesquisa
98.29877%
The palliative care (PC) aims at humanization of care, at the decrease of suffering and at the preservation of the family and patient’s quality of life during his terminal illness. The objectives were to get to know the discourses and practices regarding PC and the difficulties related to the activities of this kind of care. The method was quanti-qualitative. The participants were health care providers and NON-professional caregivers (N=59) from two hospitals in Campina Grande- PB. The instruments were: a questionnaire and an interview. The analysis of information was oriented by the analysis of enunciation. The analysis of discourses has shown that PC is understood as practices towards pain relief, as support to the patient’s family and finally, as the use of medications. There are doubts concerning psychologists’ performances regarding PC, even if correlate practices are done. This study was relevant because it will be able to indicate public policies concerning the increase of people’s quality of life with terminal illnesses.; Os Cuidados Paliativos (CP) visam à humanização do cuidado, à diminuição do sofrimento e à preservação da qualidade de vida do paciente em estado terminal e de sua família. Os objetivos foram conhecer os discursos e as práticas sobre os CP...

‣ Experiences of health care providers managing sexual assault victims in the emergency unit Part 1: Background and methodology

Skhosana,Rebecca M.; Peu,Mmapheko D.
Fonte: Health SA Gesondheid (Online) Publicador: Health SA Gesondheid (Online)
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2009 Português
Relevância na Pesquisa
108.45531%
The objective of this study was to explore and describe the experiences of health care providers managing sexual assault victims in the emergency unit of a community hospital in the Nkangala district in the Mpumalanga Province. A qualitative, phenomenological design was applied. Purposeful sampling was used to select participants from health care providers who were working in the emergency unit and had managed more than four sexual assault victims. Data were collected by means of individual interviews and analysed according to the Tesch method of data analysis by the researcher and the independent co-coder. Main categories, subcategories and themes were identified. Participants expressed their emotions, challenges and police attitudes and behaviours as well as inconsistencies in guidelines and needs identification. It was recommended that members of the multidisciplinary team engage in community activities and that the community participate in matters pertaining to sexual assault. Government should develop clear guidelines that are applicable to rural and urban South Africa. Health care sciences should aim to train more forensic nurses. All relevant departments should work together to alleviate the complications caused by sexual assault incidents.

‣ Experiences of health care providers managing sexual assault victims in the emergency unit Part 2: Discussion of results and literature control

Skhosana,Rebecca M.; Peu,Mmapheko D.
Fonte: Health SA Gesondheid (Online) Publicador: Health SA Gesondheid (Online)
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2009 Português
Relevância na Pesquisa
108.45531%
The objective of this study was to explore and describe the experiences of health care providers managing sexual assault victims in the emergency unit of a community hospital in the Nkangala district in the Mpumalanga Province. A qualitative, phenomenological design was applied. Purposeful sampling was used to select participants from health care providers who were working in the emergency unit and had managed more than four sexual assault victims. Data were collected by means of individual interviews and analysed according to the Tesch method of data analysis by the researcher and the independent co-coder. Main categories, subcategories and themes were identified. Participants expressed their emotions, challenges and police attitudes and behaviours, as well as inconsistencies in guidelines and needs identification. It was recommended that members of the multidisciplinary team engage in community activities and that the community participate in matters pertaining to sexual assault. Government should develop clear guidelines that are applicable to rural and urban South Africa. Health care sciences should aim to train more forensic nurses. All relevant departments should work together to alleviate the complications caused by sexual assault incidents.