Cássia Kely Favoretto Costa

Eficiência dos estados brasileiros e do Distrito Federal no sistema público de transplante renal: uma análise usando método DEA (Análise Envoltória de Dados) e índice de Malmquist

The objective of this study was to evaluate the efficiency of Brazilian States and the Federal District in the public kidney transplant system and their productivity trends from 2006 to 2011. The authors used Data Envelopment Analysis (DEA) with slack and the Malmquist index with slack. Inputs included spending on hospital services and health professionals in the system. The output was the number of kidney transplants performed in each State. The data showed a significant discrepancy between States in the number of kidney transplants. The transplant systems inefficiency may result from inadequate management, failure to comply with national guidelines, inactive hospital transplant committees, and overburdened hospital staff. Institutional changes promoted by the Brazilian Ministry of Health (procedures improvement and standardization) failed to increase productivity in most States during this period.O objetivo foi avaliar a eficiencia dos estados brasileiros e do Distrito Federal no sistema publico de transplante renal e a mudanca de produtividade deles entre 2006 e 2011. Utilizou-se a Analise Envoltoria de Dados (DEA) baseada em folgas e o indice de Malmquist com folgas. Os inputs usados foram os gastos dos servicos hospitalares e dos profissionais no sistema. Como output, o numero de transplantes renais realizados por cada estado. Existe uma discrepância significativa em relacao a captacao e ao numero de transplantes renais entre os estados. Evidencia-se uma ineficiencia nesse sistema, que poder ser causada por sua gestao inadequada; nao seguimento de regras nacionais; comissoes intra-hospitalares nao ativas e equipes hospitalares sobrecarregadas. As mudancas institucionais promovidas pelo Ministerio da Saude (aperfeicoamento e padronizacao dos processos) nao geraram aumento de produtividade na maioria dos estados nesse periodo.

Efficiency of Brazilian States and the Federal District in the public kidney transplant system based on DEA (Data Envelopment Analysis) and the Malmquist index

The objective of this study was to evaluate the efficiency of Brazilian States and the Federal District in the public kidney transplant system and their productivity trends from 2006 to 2011. The authors used Data Envelopment Analysis (DEA) with slack and the Malmquist index with slack. Inputs included spending on hospital services and health professionals in the system. The output was the number of kidney transplants performed in each State. The data showed a significant discrepancy between States in the number of kidney transplants. The transplant systems inefficiency may result from inadequate management, failure to comply with national guidelines, inactive hospital transplant committees, and overburdened hospital staff. Institutional changes promoted by the Brazilian Ministry of Health (procedures improvement and standardization) failed to increase productivity in most States during this period.O objetivo foi avaliar a eficiencia dos estados brasileiros e do Distrito Federal no sistema publico de transplante renal e a mudanca de produtividade deles entre 2006 e 2011. Utilizou-se a Analise Envoltoria de Dados (DEA) baseada em folgas e o indice de Malmquist com folgas. Os inputs usados foram os gastos dos servicos hospitalares e dos profissionais no sistema. Como output, o numero de transplantes renais realizados por cada estado. Existe uma discrepância significativa em relacao a captacao e ao numero de transplantes renais entre os estados. Evidencia-se uma ineficiencia nesse sistema, que poder ser causada por sua gestao inadequada; nao seguimento de regras nacionais; comissoes intra-hospitalares nao ativas e equipes hospitalares sobrecarregadas. As mudancas institucionais promovidas pelo Ministerio da Saude (aperfeicoamento e padronizacao dos processos) nao geraram aumento de produtividade na maioria dos estados nesse periodo.

Índice de Qualidade de Vida: Aspectos Objetivos e Subjetivos

Este artigo descreve e analisa as principais fontes de satisfacao e insatisfacao presentes no trabalho de auxiliares e assistentes que atuam em uma cooperativa operadora de saude suplementar localizada no interior de Minas Gerais. Foi realizado um estudo de caso quantitativo e qualitativo, utilizando-se uma versao reduzida do JDS (Job Diagnostic Survey), a partir de uma concepcao classica de QVT. Os resultados mais significativos do ponto de vista da satisfacao associaram-se ao inter-relacionamento e ao significado da tarefa, ao passo que os indicadores de insatisfacao relacionaram-se a autonomia e ao feedback recebido quanto ao desempenho das tarefas. Associacoes significativas foram evidenciadas entre variaveis de conteudo (variedade de habilidade, autonomia e feedback extrinseco) e de contexto da tarefa (sistema de compensacao) com o tempo de trabalho no cargo atual. A qualidade de vida no trabalho, no geral, mostrou haver associacao com a faixa etaria, tendo os empregados administrativos mais jovens demonstrado maior satisfacao neste cruzamento quando comparados aos empregados mais velhos.This paper presents a study on the concept of Environmental Management. Its inclusion in the organizational guidelines demonstrates the concern of companies to develop sustainable practices, ensuring their survival and other generations’. Although its introduction in business was due to legal requirements, the introduction of this new model of organization resulted in improvement in productivity and public image. Accordingly, the purpose of being green shows the need to raise awareness over the character and behavior of the involved team. In organizations, people are the ones who plan, monitor and implement activities. Therefore, there is a dependency on the human factor in achieving the companys green. Sustainable practices, gradually implemented, are being perceived by the target audience of organizations – they are getting favorable responses regarding the increasing competitiveness in the market. The green image has become a requirement of preference for customers. Organizations, staff and consumers are realizing how beneficial it is to change the model to keep themselves alive, maintaining the healthy environment as a source of productive resources.

[Analysis of contractual incentives for kidney transplants in Brazil using the principal-agent model].

The aim of this article was to analyze contractual incentives for kidney transplants in Brazil based on the principal-agent model. The approach assumes that the Brazilian Ministry of Health is the principal and the public hospitals accredited by the National Transplant System are the agent. The Ministry of Healths welfare depends on measures taken by hospitals in kidney uptake. Hospitals allocate administrative, financial, and management efforts to conduct measures in kidney donation, removal, uptake, and transplantation. Hospitals may choose the levels of effort that are consistent with the payments and incentives received in relation to transplantation costs. The solution to this type of problem lies in structuring an optimal incentives contract, which requires aligning the interests of both parties involved in the transplantation system.The aim of this article was to analyze contractual incentives for kidney transplants in Brazil based on the principal-agent model. The approach assumes that the Brazilian Ministry of Health is the principal and the public hospitals accredited by the National Transplant System are the agent. The Ministry of Healths welfare depends on measures taken by hospitals in kidney uptake. Hospitals allocate administrative, financial, and management efforts to conduct measures in kidney donation, removal, uptake, and transplantation. Hospitals may choose the levels of effort that are consistent with the payments and incentives received in relation to transplantation costs. The solution to this type of problem lies in structuring an optimal incentives contract, which requires aligning the interests of both parties involved in the transplantation system.

Análisis de los incentivos contractuales de trasplantes de riñón en Brasil mediante el modelo agente-principal

The aim of this article was to analyze contractual incentives for kidney transplants in Brazil based on the principal-agent model. The approach assumes that the Brazilian Ministry of Health is the principal and the public hospitals accredited by the National Transplant System are the agent. The Ministry of Healths welfare depends on measures taken by hospitals in kidney uptake. Hospitals allocate administrative, financial, and management efforts to conduct measures in kidney donation, removal, uptake, and transplantation. Hospitals may choose the levels of effort that are consistent with the payments and incentives received in relation to transplantation costs. The solution to this type of problem lies in structuring an optimal incentives contract, which requires aligning the interests of both parties involved in the transplantation system.The aim of this article was to analyze contractual incentives for kidney transplants in Brazil based on the principal-agent model. The approach assumes that the Brazilian Ministry of Health is the principal and the public hospitals accredited by the National Transplant System are the agent. The Ministry of Healths welfare depends on measures taken by hospitals in kidney uptake. Hospitals allocate administrative, financial, and management efforts to conduct measures in kidney donation, removal, uptake, and transplantation. Hospitals may choose the levels of effort that are consistent with the payments and incentives received in relation to transplantation costs. The solution to this type of problem lies in structuring an optimal incentives contract, which requires aligning the interests of both parties involved in the transplantation system.

Análise dos incentivos contratuais de transplantes de rins no Brasil pelo modelo agente-principal

The aim of this article was to analyze contractual incentives for kidney transplants in Brazil based on the principal-agent model. The approach assumes that the Brazilian Ministry of Health is the principal and the public hospitals accredited by the National Transplant System are the agent. The Ministry of Healths welfare depends on measures taken by hospitals in kidney uptake. Hospitals allocate administrative, financial, and management efforts to conduct measures in kidney donation, removal, uptake, and transplantation. Hospitals may choose the levels of effort that are consistent with the payments and incentives received in relation to transplantation costs. The solution to this type of problem lies in structuring an optimal incentives contract, which requires aligning the interests of both parties involved in the transplantation system.The aim of this article was to analyze contractual incentives for kidney transplants in Brazil based on the principal-agent model. The approach assumes that the Brazilian Ministry of Health is the principal and the public hospitals accredited by the National Transplant System are the agent. The Ministry of Healths welfare depends on measures taken by hospitals in kidney uptake. Hospitals allocate administrative, financial, and management efforts to conduct measures in kidney donation, removal, uptake, and transplantation. Hospitals may choose the levels of effort that are consistent with the payments and incentives received in relation to transplantation costs. The solution to this type of problem lies in structuring an optimal incentives contract, which requires aligning the interests of both parties involved in the transplantation system.

Perfil de morbilidad y gastos hospitalarios con ancianos en Paraná, Brasil, entre 2008 y 2012

Growth in the elderly population has increased both the demand for health services and healthcare expenses, with relevant consequences for economic stability. The current study aimed to analyze the morbidity profile and hospital expenses with elderly patients in relation to socioeconomic and demographic conditions in Paraná State, Brazil, from 2008 to 2012, applying principal components analysis and groupings. Regions with higher and lower economic and human development showed high prevalence of hospitalizations and costs pertaining to the circulatory and respiratory systems and cardiac diseases for males and females. In regions with intermediary development, diseases of the nervous system in men and of the circulatory system in women had the highest morbidity and hospital expenses. Thus, measures for prevention and health promotion in this elderly population should be targeted to regional investigations.Growth in the elderly population has increased both the demand for health services and healthcare expenses, with relevant consequences for economic stability. The current study aimed to analyze the morbidity profile and hospital expenses with elderly patients in relation to socioeconomic and demographic conditions in Parana State, Brazil, from 2008 to 2012, applying principal components analysis and groupings. Regions with higher and lower economic and human development showed high prevalence of hospitalizations and costs pertaining to the circulatory and respiratory systems and cardiac diseases for males and females. In regions with intermediary development, diseases of the nervous system in men and of the circulatory system in women had the highest morbidity and hospital expenses. Thus, measures for prevention and health promotion in this elderly population should be targeted to regional investigations.

Perfil de morbidade e gastos hospitalares com idosos no Paraná, Brasil, entre 2008 e 2012

Growth in the elderly population has increased both the demand for health services and healthcare expenses, with relevant consequences for economic stability. The current study aimed to analyze the morbidity profile and hospital expenses with elderly patients in relation to socioeconomic and demographic conditions in Paraná State, Brazil, from 2008 to 2012, applying principal components analysis and groupings. Regions with higher and lower economic and human development showed high prevalence of hospitalizations and costs pertaining to the circulatory and respiratory systems and cardiac diseases for males and females. In regions with intermediary development, diseases of the nervous system in men and of the circulatory system in women had the highest morbidity and hospital expenses. Thus, measures for prevention and health promotion in this elderly population should be targeted to regional investigations.Growth in the elderly population has increased both the demand for health services and healthcare expenses, with relevant consequences for economic stability. The current study aimed to analyze the morbidity profile and hospital expenses with elderly patients in relation to socioeconomic and demographic conditions in Parana State, Brazil, from 2008 to 2012, applying principal components analysis and groupings. Regions with higher and lower economic and human development showed high prevalence of hospitalizations and costs pertaining to the circulatory and respiratory systems and cardiac diseases for males and females. In regions with intermediary development, diseases of the nervous system in men and of the circulatory system in women had the highest morbidity and hospital expenses. Thus, measures for prevention and health promotion in this elderly population should be targeted to regional investigations.

[Morbidity profile and hospital expenses with elderly patients in Paraná State, Brazil, 2008-2012].

Growth in the elderly population has increased both the demand for health services and healthcare expenses, with relevant consequences for economic stability. The current study aimed to analyze the morbidity profile and hospital expenses with elderly patients in relation to socioeconomic and demographic conditions in Paraná State, Brazil, from 2008 to 2012, applying principal components analysis and groupings. Regions with higher and lower economic and human development showed high prevalence of hospitalizations and costs pertaining to the circulatory and respiratory systems and cardiac diseases for males and females. In regions with intermediary development, diseases of the nervous system in men and of the circulatory system in women had the highest morbidity and hospital expenses. Thus, measures for prevention and health promotion in this elderly population should be targeted to regional investigations.Growth in the elderly population has increased both the demand for health services and healthcare expenses, with relevant consequences for economic stability. The current study aimed to analyze the morbidity profile and hospital expenses with elderly patients in relation to socioeconomic and demographic conditions in Parana State, Brazil, from 2008 to 2012, applying principal components analysis and groupings. Regions with higher and lower economic and human development showed high prevalence of hospitalizations and costs pertaining to the circulatory and respiratory systems and cardiac diseases for males and females. In regions with intermediary development, diseases of the nervous system in men and of the circulatory system in women had the highest morbidity and hospital expenses. Thus, measures for prevention and health promotion in this elderly population should be targeted to regional investigations.

Morbidity and hospitalization costs of chronic diseases for the Unified National Health System

Objetivo: caracterizar as morbidades e os custos das internacoes hospitalares do Sistema Unico de Saude por doencas cronicas (cardiovasculares, respiratorias, diabetes e neoplasias). Metodos: estudo analitico e retrospectivo, utilizou dados secundarios do sistema de informacao hospitalar de pessoas com idade ≥ 25 anos. Resultados: dentre as quatro morbidades avaliadas, as neoplasias e as doencas cardiovasculares se mostraram mais prevalentes. Para as neoplasias, houve predominância do sexo feminino, com idade entre 45 e 49 anos. O sexo masculino teve maior participacao para as doencas cardiovasculares, na faixa de 55 a 59 anos. Estas duas doencas foram mais dispendiosas para o sistema. Para ambos os sexos, a frequencia de doencas respiratorias segue comportamento de queda, enquanto o diabetes se mantem estavel no periodo. Conclusao: a maior prevalencia de intervencao foi de neoplasias entre as mulheres e nos homens predominou as doencas cardiovasculares.