scholarly journals Tratamento cirúrgico da obesidade pelo Sistema Único de Saúde: Um estudo do acesso em nove serviços no Estado de São Paulo

2019 ◽  
Vol 19 (77) ◽  
Author(s):  
Luiza Fior Pelegrini ◽  
Beatriz Helena Tess ◽  
Olímpio J N V Bittar ◽  
Denis Pajecki
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Health Care ◽  
Health System ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
Publicly Funded ◽  
The Public ◽  
Primary Health

O artigo investigou as formas de acesso a nove serviços de cirurgia bariátrica que operaram, em 2013, 50 ou mais pacientes pelo Sistema Único de Saúde no Estado de São Paulo. Para isso, utilizou-se metodologia qualitativa com base em informações coletadas por entrevistas presenciais com os responsáveis pelos serviços. Cinco centros estavam no interior do Estado, cinco eram de natureza privada sem fins lucrativos e sete eram hospitais de ensino. As análises apontaram duas categorias conforme a integração com a rede de saúde: pouco ou fortemente integrado; e quatro categorias segundo o tipo de acesso: porta aberta, triagem própria, órgão de regulação ou Unidade Básica de Saúde. Dos quatro serviços pouco integrados à rede de saúde, três eram do tipo porta aberta e um realizava triagem própria; dos cinco centros fortemente integrados à rede de saúde, quatro receberam os pacientes encaminhados por instâncias de regulação e um por Unidade Básica de Saúde. As conclusões indicam que há grande heterogeneidade nas características organizacionais e nas formas de acesso aos serviços participantes deste estudo. Apesar de previsto na normatização do sistema público de saúde que a porta de entrada preferencial à rede deve ser pela Atenção Primária à Saúde, esse fluxo foi observado em somente um serviço. Há necessidade de padronização do modelo organizacional de acesso aos serviços que oferecem tratamento cirúrgico pelo Sistema Único de Saúde aos indivíduos portadores de obesidade.Palavras-chave: Obesidade. Cirurgia bariátrica. Acesso aos serviços de saúde. Organização e administração. Sistema Único de SaúdePublicly funded surgical treatment of obesity: A study on the access in nine services in the State of São PauloAbstractThe paper researched the accessibility to bariatric surgery centers in the public health system in the State of Sao Paulo, Brazil. A case series study with a qualitative approach. Semi-structured interviews were conducted in person with nine chiefs of bariatric surgical units that had performed 50 or more procedures publicly funded in 2013. Five were in the interior of the State, five were of private non-profit nature and seven were teaching hospitals. The analyzes pointed out categories according to integration with the public health network and type of access. Of the four services weakly integrated to the health system, three were open access and one performed self-screening; of the five centers strongly integrated into the health network, four received patients referred by regulatory bodies and one from a Primary Health Care Unit. Although the governmental obesity care policy states that the preferential access of patients are the Primary Health Care Units, in this study it was observed in only one service. There is a need for standardization of the organizational model of access to services that offer publicly funded surgical care to individuals with obesity.Keywords: Obesity. Bariatric surgery. Health services accessibility. Organization and administration. Unified Health System.

scholarly journals Health system financing paradigm in the state of São Paulo

2019 ◽  
Vol 53 ◽  
pp. 39
Author(s):  
Adilson Soares
Keyword(s):  
Public Health ◽  
Health Care ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
High Complexity ◽  
Primary Health ◽  
Capita Spending ◽  
Per Capita ◽  
The City

OBJECTIVE: To analyze the allocation of financial resources in the Brazilian Unified Health System (SUS) in the state of São Paulo by level of care, health region, source of funds and level of government. METHODS: This is an exploratory study based on 2014 data extracted from the Public Health Budget Database, presented in absolute terms, relative terms and per capita. RESULTS: In 2014, R$52.1 bi were spent on public health, 58.0% having corresponded to the expenditures of the municipalities and 42.0% to those of the state government. Regional per capita spending varied from R$561.75 to R$824.85. As for the per capita spending on primary health care, which represented 37.5% of the municipalities’ total expenditure, the lowest value was found in the city of São Paulo and the highest, in Araçatuba. Campinas had the highest per capita expenditure on medium and high complexity care, while Presidente Prudente had the lowest. The highest regional percentage of the current net revenue spent on health was verified in Registro, and the lowest, in the city of São Paulo. CONCLUSIONS: The paradigm of the health sector’s financing in São Paulo revealed that the expenditure on primary health care, level elected by health policy as strategic because it depends on coordination and integral health care in the attention networks, was not considered a priority in relation to the expenditure with the medium and high complexity, exposing the iniquities in the state’s regions.

scholarly journals Access to colposcopy in the State of São Paulo, Brazil: probabilistic linkage study of administrative data

2022 ◽  
Vol 38 (1) ◽  
Author(s):  
Lewis Fletcher Buss ◽  
Lise Cury ◽  
Caroline Madalena Ribeiro ◽  
Gulnar Azevedo e Silva ◽  
José Eluf Neto
Keyword(s):  
Public Health ◽  
Cervical Cancer ◽  
Health System ◽  
Public Health System ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
The Public ◽  
Reference Cohort

Cervical cancer screening is a multistage process, therefore access to both the primary test and subsequent diagnostic procedures is essential. Considering women undergoing screening on the public health system in the State of São Paulo, Brazil, we aimed to estimate the proportion of women accessing colposcopy within six months of an abnormal smear result. We retrieved records from two administrative databases, the Information System on Uterine Cervical Cancer (SISCOLO) that contains smear results and the Outpatient Information System of the Brazilian Unified National Health System (SIA/SUS) that records colposcopies. A reference cohort consisted of women, aged 25 years or older, with an abnormal smear result between May 1, 2014, and June 30, 2014. We excluded prevalent cases. We linked the reference cohort and records in the SIA/SUS extending to December 31, 2014. After excluding prevalent cases, 1,761 women with abnormal cytology results were left. A total of 700 (39.8%) women were linked to a colposcopy record within the follow-up period; this dropped to 671 (38.1%) women when follow-up was censored at six months. We could notice a slightly higher attendance in women living in the metropolitan region of São Paulo compared with residents of the rest of the state. We found no association between colposcopy attendance and age or cytology class. These results emphasize that access to colposcopy in the public health system in São Paulo is limited. This compromises the quality of screening, and the issue needs to be prioritized in service planning.

scholarly journals Prevalence and costs of headaches for the public health system in a town in the interior of the state of São Paulo

2001 ◽  
Vol 59 (3A) ◽  
pp. 504-511 ◽  
Author(s):  
Marcelo E. Bigal ◽  
Janaína O.M. Bigal ◽  
Carlos A. Bordini ◽  
José G. Speciali
Keyword(s):  
Public Health ◽  
Health System ◽  
Hospital Admissions ◽  
Public Health System ◽  
Well Being ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
The Public

Despite the high prevalence, impact and economic importance of headaches, studies on this subject are rare in Brazil. The aim of the present study was to estimate the prevalence of headaches in the public health system of a town in the interior of the State of São Paulo, as well as to estimate the costs resulting from its management. Data refer to the year of 1998 and were obtained according to the following steps: 1) territorial and demographic characterization of the municipality; 2) characterization of the financial indices and social well-being; 3) budget characteristics of the municipality; 4) evaluation of the structuring of the medical service; 5) determination of the prevalence of headaches at different patient care levels; and 6) calculation of the costs of headaches. Headaches represented 7.9% of all visits at basic health units, 9.7% in the emergency room and 1.1% of hospital admissions. The total costs were R$ 85,131.31 (US$ 70,942.76) corresponding to R$ 7.59 (US$ 6,32) per inhabitant/year. The present study shows the need for epidemiological and economic impact studies, which would provide the basis for the rational use of health funds.

scholarly journals Perception of HIV among pregnant women in the public health system in two municipalities of the state of São Paulo

2015 ◽  
Vol 14 (4) ◽  
pp. 282-286
Author(s):  
Cléa Adas Saliba Garbin ◽  
Karina Tonini dos Santos Pacheco ◽  
Thaís Fonseca Santiago ◽  
Simone Miyada ◽  
Artênio José Ísper Garbin ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Pregnant Women ◽  
Public Health System ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
The Public

scholarly journals The Impact of Antipsychotic Polytherapy Costs in the Public Health Care in Sao Paulo, Brazil

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0124791 ◽  
Author(s):  
Denise Razzouk ◽  
Monica Kayo ◽  
Aglaé Sousa ◽  
Guilherme Gregorio ◽  
Hugo Cogo-Moreira ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Sao Paulo ◽  
Public Health Care ◽  
São Paulo ◽  
The Public ◽  
The Impact

scholarly journals Assessment in the primary care of the State of São Paulo, Brazil: incipient actions in sexual and reproductive health

2017 ◽  
Vol 51 ◽  
Author(s):  
Mariana Arantes Nasser ◽  
Maria Ines Battistella Nemes ◽  
Marta Campagnoni Andrade ◽  
Rogério Ruscitto do Prado ◽  
Elen Rose Lodeiro Castanheira
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Reproductive Health ◽  
Sexually Transmitted Infections ◽  
Sexual And Reproductive Health ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
Sexually Transmitted ◽  
Primary Health

OBJECTIVE The objective of this study is to assess performance in sexual and reproductive health of primary health care services of the Brazilian Unified Health System, in the State of São Paulo, Brazil. METHODS An evaluative framework was built for sexual and reproductive health with the categorization of 99 indicators in three domains: sexual and reproductive health promotion (25), sexually transmitted infections/AIDS prevention and care (43), and reproductive health care (31). This framework was applied to assess the services responses to the questionnaire of Quality Evaluation of Primary Health Care in the Municipalities of São Paulo State (QualiAB), in 2010. Percentages were calculated for positive responses to indicators and performance in the sexual and reproductive health dimension, according to domains, and their contribution to the overall score in sexual and reproductive health (Friedman), relative participation (Dunn), and correlation (Spearman) was verified. RESULTS Overall, 2,735 services participated in the study. They were located in 586 municipalities (distributed throughout the 17 regional health departments of São Paulo), of which 70.6% had fewer than 100,000 inhabitants. The overall average performance of these services for sexual and reproductive health is 56.8%. The actions are characterized by: prenatal with adequate beginning and exams, better organization for immediate rather than for late postnatal care, and selective reproductive planning for some contraceptives; prevention based on specific protection, limitations in the prevention of congenital syphilis, in the treatment of sexually transmitted infections, and in the screening of cervical and breast cancer; specific educational activities, with a restricted vulnerability approach, focus on sexuality over reproduction. The domain of reproductive health has greater participation in the overall score, followed by prevention/care and promotion. The three domains are correlated; the domain of prevention/care has the highest correlation with the other ones. CONCLUSIONS The implementation of sexual and reproductive health in primary health care in the services studied is incipient. The revision of the purpose of the work, the dissemination of technologies, and the investing in permanent education are needed. The evaluative framework built can be used by the sexual and reproductive health program services and management in primary health care, thereby contributing to their actions.

scholarly journals Access to medication in the Public Health System and equity: populational health surveys in São Paulo, Brazil

2016 ◽  
Vol 19 (1) ◽  
pp. 26-37 ◽  
Author(s):  
Camila Nascimento Monteiro ◽  
Reinaldo José Gianini ◽  
Marilisa Berti de Azevedo Barros ◽  
Chester Luiz Galvão Cesar ◽  
Moisés Goldbaum
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Health System ◽  
Socioeconomic Position ◽  
Concentration Index ◽  
Public Health System ◽  
Sao Paulo ◽  
São Paulo ◽  
Cross Sectional ◽  
The Public

ABSTRACT: Introduction: Since 2003, the access to medication has been increasing in Brazil and particularly in São Paulo. The present study aimed to analyze the access to medication obtained in the public sector and the socioeconomic differences in this access in 2003 and 2008. Also, we explored the difference in access to medication from 2003 to 2008. Method: Data were obtained from two cross-sectional population-based household surveys from São Paulo, Brazil (ISA-Capital 2003 and ISA-Capital 2008). Concentration curve and concentration index were calculated to analyze the associations between socioeconomic factors and access to medication in the public sector. Additionally, the differences between 2003 and 2008 regarding socioeconomic characteristics and access to medication were studied. Results: Access to medication was 89.55% in 2003 and 92.99% in 2008, and the proportion of access to medication did not change in the period. Access in the public sector increased from 26.40% in 2003 to 48.55% in 2008 and there was a decrease in the concentration index between 2003 and 2008 in access to medication in the public sector. Conclusions: The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.

scholarly journals Investigation Route of the Coronary Patient in the Public Health System in Curitiba, São Paulo and in Incor - IMPACT Study

2014 ◽  
Author(s):  
Juliano J. Cerci ◽  
Evelinda Trindade ◽  
Rodrigo Julio Cerci ◽  
Daniel Preto ◽  
Pedro A. Lemos ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Sao Paulo ◽  
São Paulo ◽  
Impact Study ◽  
The Public ◽  
Coronary Patient
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