scholarly journals Description of e-Health Initiatives to Reduce Chronic Non-Communicable Disease Burden on Brazilian Health System

2021 ◽  
Vol 18 (19) ◽  
pp. 10218
Author(s):  
Daniela Laranja Gomes Rodrigues ◽  
Gisele Silvestre Belber ◽  
Igor da Costa Borysow ◽  
Marcos Aurelio Maeyama ◽  
Ana Paula Neves Marques de Pinho
Keyword(s):  
Health System ◽  
Communicable Disease ◽  
Institutional Development ◽  
Unified Health System ◽  
Access To Health ◽  
Patients With Diabetes ◽  
Health Initiatives ◽  
Specialized Care ◽  
Development Support ◽  
Brazilian Health System

Chronic non-communicable diseases (NCD) account for 72% of the causes of death in Brazil. In 2013, 54 million Brazilians reported having at least one NCD. The implementation of e-Health in the Unified Health System (SUS) could fill gaps in access to health in primary health care (PHC). Objective: to demonstrate telehealth strategies carried out within the scope of the Institutional Development Support Program of the Unified Health System (PROADI-SUS) and developed by Hospital Alemão Oswaldo Cruz, between 2018 and 2021, on evaluation, supply, and problem-solving capacity for patients with NCDs. Methodology: a prospective and descriptive study of three projects in the telehealth areas, using document analysis. The Brasil Redes project used availability, implementation, and cost-effectiveness analysis, TELEconsulta Diabetes is a randomized clinical trial, and Regula Mais Brasil is focused on the waiting list for regulation of specialties. All those strategies were developed within the scope of the SUS. Results: 161 patients were attended by endocrinology teleconsultation in one project and another two research projects, one evaluating Brazil’s Telehealth Network Program, and another evaluating effectiveness and safety of teleconsultation in patients with diabetes mellitus referred from primary care to specialized care in SUS. Despite the discrepancy in the provision of telehealth services in the country, there was an increase in access to specialized care on the three projects and especially on the Regula Mais Brasil Collaborative project; we observed a reduction on waiting time and favored distance education processes. Conclusion: the three projects offered subsidies for decision-making by the Ministry of Health in e-Health and two developed technologies that could be incorporated into SUS.

scholarly journals Health regulation in Brazilian municipalities

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Bastos ◽  
D Bastos ◽  
M Barbosa
Keyword(s):  
Health System ◽  
Health Management ◽  
Limiting Factors ◽  
Structured Interviews ◽  
Education Professionals ◽  
Unified Health System ◽  
Primary Health ◽  
Access To Health ◽  
Higher Education Professionals ◽  
Brazilian Health System

Abstract The regulatory structures can become determinants in the organizational process of health management, as it has the possibility of giving more effective responses to the user who seeks the Brazilian health system. The objective of the study is to analyze the regulation of health services in Brazilian municipalities, considering the regulation centers, recommended by the legislation of the Unified Health System (SUS). This is a descriptive exploratory study with a qualitative focus, developed in municipal regulatory centers in Brazilian states, through semi-structured interviews. The sample consisted of eighteen managers and seventy regulation professionals, from September / 2017 to January 2018. As limiting factors in regulation, the following stand out: great demand for people; unavailability of beds; systemic difficulties in relation to the agreed services; procedures that are difficult to schedule and execute; problems in information flows between primary care and regulation. The main potentialities are: increased financial resources for health; reorganization of internal regulatory procedures; meeting users' needs; health training for regulatory professionals; and strengthening primary health care. The study showed that it is difficult to concentrate higher education professionals to perform the tasks of regulators of medium and high complexity procedures; there are obstacles to operationalize the regulatory process, since the regulatory structures created coexist with insufficient resources, agreements that are inconsistent with the country's reality; there is recognition of the need for a strong regulatory component in guaranteeing qualified access to health, and one of the greatest challenges is to understand the multiplicity of scenarios, subjects and interests, and to implement user-centered strategies. Key messages Health regulation in Brazilian municipalities.

scholarly journals A model for drug dispensing service based on the care process in the Brazilian health system

2013 ◽  
Vol 49 (1) ◽  
pp. 107-116 ◽  
Author(s):  
Luciano Soares ◽  
Eliana Elisabeth Diehl ◽  
Silvana Nair Leite ◽  
Mareni Rocha Farias
Keyword(s):  
Theoretical Model ◽  
Health System ◽  
Care Process ◽  
Rational Use ◽  
Drug Dispensing ◽  
Unified Health System ◽  
Proposed Model ◽  
Analytical Research ◽  
Accountability Management ◽  
Brazilian Health System

Access to medication emphasizes the availability of the product at the expense of providing a service. The goal of this paper is to propose a theoretical model for a drug dispensing service, beginning with a reflection on the current realities of the Unified Health System and drug dispensation in Brazil. A conceptual analytical research made by a methodological course called disciplined imagination was mainly the approach applied to develop the model. The drug dispensing service is part of the care process, which considers access as an attribute; reception, connection and accountability, management, and clinical pharmaceutical aspects as components; and the rational use of drugs as the purpose. The proposed model addresses access to the dispensing service and demands a reorientation of routines, instruments, and practices.

scholarly journals The Idealized Brazilian Health System versus the real one: contributions from the nursing field

2014 ◽  
Vol 22 (6) ◽  
pp. 1026-1033 ◽  
Author(s):  
Dirce Stein Backes ◽  
Martha Helena Teixeira de Souza ◽  
Mara Teixeira Caino Marchiori ◽  
Juliana Silveira Colomé ◽  
Marli Terezinha Stein Backes ◽  
...  
Keyword(s):  
Public Health ◽  
Content Analysis ◽  
Health System ◽  
Linear Model ◽  
Descriptive Study ◽  
Thematic Content Analysis ◽  
Unified Health System ◽  
System Versus ◽  
Qualitative Nature ◽  
Brazilian Health System

OBJECTIVE: to identify the perceptions of professionals working in a facility connected with the Brazilian Unified Health System - SUS in regard to what they know, think and talk about public health policy.METHOD: this exploratory-descriptive study with a qualitative nature was conducted with 28 professionals working in a facility connected with the SUS. Data were collected through interviews with guiding questions and analyzed through the thematic content analysis technique.RESULTS: coded and interpreted data resulted in three thematic axes: The SUS - perfect web that does not work in practice; The recurrent habit of complaining about the SUS; The need to rethink the way of thinking about, acting in and managing the SUS.CONCLUSION: the professionals working for the SUS are aware of the principles and guidelines that govern the Brazilian health system, however, they reproduce a dichotomous and linear model of conception and practice strongly linked to the thinking of society in general.

scholarly journals Brazilian especialized care: challenges and proposals to provide integrality on health assistance

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E de Moura Ferraz ◽  
J F Marques da Silva ◽  
F Hisatugo ◽  
F de Freitas Mendonça ◽  
B G Carvalho ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Planning ◽  
Regulatory System ◽  
Structured Interviews ◽  
Public And Private ◽  
Regional Health Planning ◽  
Specialized Care ◽  
Great Relevance ◽  
Brazilian Health System

Abstract The Brazilian health system has as principles the integrality of assistance and the regional health planning of services, organized through attention networks. In the constitution of this network, specialized care fraction, even though it concentrates a significant importance in citizens right of health guarantee, has represented a problem of great relevance, constituting a challenge for the organization of health care, whether in the field of management or assistance, in Brazil, as well as in other countries. In this perspective, this study aims to identify the challenges and propose strategies to effectuate the provision of specialized care fraction in the Brazilian health system. This is a qualitative and exploratory study, developed in the northern macro-region of the State of Paraná in Brazil. The data collection took place through semi-structured interviews, with the participation of public and private managers and other subjects that compose the assistance and management network of this region, between 2016 and 2017. The data were organized through discourse analysis, supported by policy analysis referential. The results show an expressive demand for this fraction of assistance in the analyzed territory, mostly offered by private institutions. The high demand is linked to the low resoluteness of primary health care and an ineffective communication system between different points of care. Other challenges highlighted in this phenomenon are: the lack of solidarity and the sharing of responsibilities between federal entities; the weakness of the counties; asymmetries of power between public and private managers; the fragile integrated and regionalized planning; the underfunding of the system; the fledgling regulatory system; the conflicts between governance actors; and political interferences. Key messages In order to overcome challenges to provise the specialized care fraction, is necessary to strength the cooperation between entities, making viable health policies coherent to collective needles. With the objective of organize the provision of integrality of health, one of the essential requirements would be qualify the assistance on the different points of care that compose the health network.

scholarly journals Access to medicines for chronic diseases in Brazil: a multidimensional approach

2016 ◽  
Vol 50 (suppl 2) ◽  
Author(s):  
Maria Auxiliadora Oliveira ◽  
Vera Lucia Luiza ◽  
Noemia Urruth Leão Tavares ◽  
Sotero Serrate Mengue ◽  
Paulo Sergio Dourado Arrais ◽  
...  
Keyword(s):  
Health System ◽  
Communicable Disease ◽  
Statistical Significance ◽  
Household Survey ◽  
Access To Medicines ◽  
Communicable Diseases ◽  
Related Factors ◽  
Non Communicable Diseases ◽  
Geographic Accessibility ◽  
Unified Health System

ABSTRACT OBJECTIVE To analyze the access to medicines to treat non-communicable diseases in Brazil according to socioeconomic, demographic, and health-related factors, from a multidimensional perspective. METHODS Analysis of data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), household survey, sampling plan by conglomerates with representativeness of the Brazilian population and large areas of the country, according to sex and age domains. Data collected in 2013–2014 with sample of adults (≥ 20 years) who reported having non-communicable diseases and medical indication for use of medicines (n = 12,725). We assessed the prevalence of access to medicines for self-reported non-communicable diseases, considering four dimensions: availability, geographic accessibility, acceptability, and affordability. We applied Pearson’s Chi-square test to assess the statistical significance of the differences between strata, considering the level of significance of 5%. We found prevalence of 94.3%, 5.2%, and 0.5% for full, partial, and null access, respectively. Higher prevalence was observed among seniors in the South compared to the Northeast; for those who reported having one non-communicable disease compared to those who reported having two or more; for those who needed one medicine compared to those who needed three or more; and for those who self-assessed their health as good or very good. Geographic accessibility was similar in the Unified Health System and in the private pharmacies (72.0%). Total availability of medicines was 45.2% in the Unified Health System, 67.4% in the Popular Pharmacy Program, and 88.5% in private pharmacies. Acceptability was 92.5% in the Unified Health System, 97.8% in the Popular Pharmacy Program, and 98.7% in private pharmacies. As to affordability, 2.6% of the individuals failed to take the medicines they should in the 30-day period prior to the interview due to financial difficulty. Prevalence of full access to medicines for non-communicable diseases in Brazil is high and presents significant differences for age group, region of the country, number of non-communicable diseases, and for medicines prescribed and self-assessment of health. The major barriers to access to medicines were identified in the dimensions analyzed.

scholarly journals Practices and challenges on coordinating the Brazilian Unified Health System

2020 ◽  
Vol 54 ◽  
pp. 25
Author(s):  
Luzia Beatriz Rodrigues Basto ◽  
Maria Alves Barbosa ◽  
Claci Fátima Weirich Rosso ◽  
Lizete Malagoni de Almeida Cavalcante Oliveira ◽  
Ilma Pastana Ferreira ◽  
...  
Keyword(s):  
Primary Care ◽  
Health System ◽  
Limiting Factors ◽  
Access To Health Services ◽  
Structured Interviews ◽  
High Demand ◽  
Training And Education ◽  
Unified Health System ◽  
Access To Health ◽  
Flow Of Information

OBJECTIVE: To analyze the obstacles and challenges faced by managers and coordination professionals in their practices in municipal coordinating centers. METHODS: An exploratory descriptive study with a qualitative focus, applied in 40 managers and coordination professionals, from September 2017 to November 2018, with semi-structured interviews, resulting in two categories of analysis: limiting factors and factors that facilitate the management and operationalization of the Brazilian Unified Health System (SUS) coordinating sector. RESULTS: Analyzing the statements, we found evidence of the following limiting factors: failure in the criteria of referral, unavailability of beds, high demand, systemic difficulties in relation to the coordinating system, procedures of difficult scheduling and execution, increased repressed demand for elective procedures and difficulties in the flow of information between primary care and coordination. In the category of facilitating factors, the most significant possibilities were: expansion of the capability to know the user’s reality, improvement in primary care and increase in health financial resources, health training and education and restructuring, in addition to reorganizing internal coordinating procedures. CONCLUSION: The limiting factors of coordination show the need to promote actions that offer all SUS users full access to health services.

scholarly journals Presence and extent of the primary health care attributes among children hospitalized for pneumonia

2015 ◽  
Vol 23 (3) ◽  
pp. 512-519 ◽  
Author(s):  
Juliana Coelho Pina ◽  
Suzana Alves de Moraes ◽  
Maria Cândida de Carvalho Furtado ◽  
Débora Falleiros de Mello
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Family Counseling ◽  
Coordination Of Care ◽  
Access To Health Services ◽  
Unified Health System ◽  
Primary Health ◽  
Access To Health

OBJECTIVE: to analyze the presence and extent of the primary health care attributes among children hospitalized for pneumonia.METHOD: observational and retrospective study with hospital-based case-control design, developed in three hospitals associated to the Brazilian Unified Health System, located in a city of the State of São Paulo, Brazil. The study included 690 children under five years old, with 345 cases and 345 controls.RESULTS: both groups scored high for access to health services. In contrast, high scores for attributes such as longitudinality and coordination of care were observed for the controls. Despite low scores, integrality and family counseling were also high for the controls.CONCLUSION: knowledge of the aspects involving the primary health care attributes and its provision for child care are very important because they have the potential to support professionals and managers of the Brazilian Unified Health System in the organization of health services.

scholarly journals Children with special needs in health: challenges of the single health system in the 21st century

2020 ◽  
Vol 73 (suppl 4) ◽  
Author(s):  
Camilla Ferreira Catarino Barreiros ◽  
Maria Auxiliadora de Souza Mendes Gomes ◽  
Saint Clair do Santos Mendes Júnior
Keyword(s):  
Health System ◽  
Special Needs ◽  
Clinical Care ◽  
Medical Knowledge ◽  
Children With Special Needs ◽  
Health It ◽  
Access To Health Services ◽  
Technological Support ◽  
Unified Health System ◽  
Access To Health

ABSTRACT Objective: Reflect on the gaps in the care of Children with Special Needs in Health that demand complex clinical care with dependence on technological support for the maintenance of life, in the Unified Health System. Methods: This is a reflection study based on recent policies and literature related to the theme. Discussion: Despite the advances achieved with the Unified Health System with regard to access to health services and the expansion of Primary Care, with the aim of reorienting health, it can be said that the health care model for CSHCN in Brazil is still centered on the hospital and medical knowledge. Final considerations: There are gaps in the policies for children aimed at the new paediatric profile, and little is discussed about its implications for the Unified Health System.

Right to health, autonomy, and access to prenatal services

2021 ◽  
pp. 096973302199604
Author(s):  
Tatianne dos Santos Perez Both ◽  
Laís Alves de Souza ◽  
Elen Ferraz Teston ◽  
Antonio Rodrigues Ferreira Júnior ◽  
Maria Elizabeth Araújo Ajalla ◽  
...  
Keyword(s):  
Health Services ◽  
Health System ◽  
Right To Health ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Mato Grosso ◽  
Unified Health System ◽  
Informed Consent Form ◽  
Access To Health ◽  
The Right

Background: The concept of the right to health includes decent conditions of work, housing, and leisure. It can be assessed through the evaluation of access to health services and programs. The creation of the Brazilian Unified Health System expanded access to healthcare for the entire Brazilian population. Aim: This study aimed to understand the use of the Brazilian Unified Health System by pregnant women who live on the Brazil–Paraguay border, whose residents are known as Braziguayans. Methods: We conducted 16 semi-structured interviews with users of prenatal services at Unified Health System units located at the border of the municipalities of Ponta Porã and Pedro Juan Caballero. Ethical considerations: The Research Ethics Committee of the Federal University of Mato Grosso do Sul approved of this research. All participants were provided with project information and signed an informed consent form. Findings: Through content analysis of the interviews, “right to health” and “autonomy, pathways, and access” were two recurrent themes that have arisen. These suggested that Braziguayan women live in conditions of social vulnerability. They do not fully experience the right to healthcare, despite sufficient knowledge about the Brazilian and Paraguayan healthcare systems from which to choose prenatal care. The interviewees acknowledged that Unified Health System use is a right of Brazilian citizens and considered its units to be safe environments. These women also understand the structuring of Unified Health System and the mechanisms of accessing healthcare programs. Conclusion: We can conclude that, despite widely known difficulties, Unified Health System represents, for Braziguayan women, potential access to reliable health services for adequate prenatal and childbirth assistance.

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