Claudia Affonso Silva Araujo

Efficiency determinants and capacity issues in Brazilian for-profit hospitals

This paper reports on the use of different approaches for assessing efficiency of a sample of major Brazilian for-profit hospitals. Starting out with the bootstrapping technique, several DEA estimates were generated, allowing the use of confidence intervals and bias correction in central estimates to test for significant differences in efficiency levels and input-decreasing/output-increasing potentials. The findings indicate that efficiency is mixed in Brazilian for-profit hospitals. Opportunities for accommodating future demand appear to be scarce and strongly dependent on particular conditions related to the accreditation and specialization of a given hospital.

Developing learning capabilities through a quality management program

This study examines the development of learning capabilities through the implementation of a quality management program in services, based on a case study of transplantation management. The findings show how the introduction of an online system, based on a quality management program, underpinned the knowledge-building capacity of the organization. The results contribute to service literature by addressing how a quality management program links to organizational learning process directly and through building-up organizational knowledge. The implementation of a quality management program allows knowledge building through identification and socialization of tacit knowledge and combination of explicit knowledge. The development of learning capabilities fostered by the introduction of this program occurs under conditions that contribute to the building-up of organizational knowledge. Organizational learning is enhanced during this implementation through an incremental process that detects errors and corrects behavior and/or alters organizations premises, standards and values. This organizational learning helps to upgrade the overall process.

Brazilian nursing professionals: leadership to generate positive attitudes and behaviours

PURPOSE This paper aims to identify the kind of work environment that should be offered by hospital leaders to their nursing staff in Brazil to generate job satisfaction, organizational commitment and organizational citizenship behaviour within their field of expertise. DESIGN/METHODOLOGY/APPROACH A survey was applied to 171 nurses and 274 nursing technicians who work at five private hospitals in Brazil. Both factor analysis and regression analysis were used to analyse the study model. FINDINGS The results indicate that to stimulate positive behaviours and attitudes among nursing staff, managers should mainly be concerned about establishing a clear and effective communication with their professionals to ensure role clarity, promote a good working environment and encourage relationships based on trust. RESEARCH LIMITATIONS/IMPLICATIONS The limitations of the study are absence of the researcher while the questionnaires were filled out and the fact that the sample comprised respondents who made themselves available to participate in the research. PRACTICAL IMPLICATIONS This study contributes to elucidate the factors that can promote a good internal climate for nursing staff, assisting hospital leaders to face the huge managerial challenges of managing, retaining and advancing these professionals. ORIGINALITY/VALUE The findings contribute to the body of knowledge in leadership among nursing professionals in developing countries. Hospital leaders in Brazil should encourage trusting relationships with nursing professionals through clear, effective and respectful communications, besides investing in team development and promoting a good working environment.

Efficiency of Brazilian public services of kidney transplantation: Benchmarking Brazilian states via data envelopment analysis

The Brazilian Public Health System, facing a national economic and political crisis, operates with tight budgets and poor physical infrastructure. Among the services it delivers, organ transplantation represents a complex process wherein inefficient resource allocation is a relevant issue. This study examines the technical and scale efficiency of the Brazilian public services in kidney transplantation, assessing the conversion of physical and labor inputs into kidney transplants using data envelopment analysis. This longitudinal analysis used a secondary database from the Brazilian Registry of Transplants having, as a unit of analysis, 23 Brazilian states that performed kidney transplants from 2013 to 2015. The Malmquist index is applied to examine productivity changes. Data were adjusted per million of population, and factors were extracted by principal component analysis. The results indicate that most states operate in a technically inefficient manner, resulting in a low mean efficiency score. Overall efficiency worsened during the analyzed period, and there was a significant disparity in performance between states, with higher scores in the South and Southeast—the most developed and wealthiest regions—than in the North and Northeast. The results provide managerial insights into the delivery of organ transplantation by the Brazilian public services on both the national and state levels, helping to identify opportunities for better resource allocation in this activity. Given the scarcity of studies that systematically assess and benchmark organ donation and transplantation, this work represents an innovative context of application and may be useful for the community of relevant policymakers, academics, and health professionals.

Redes sociais e práticas em saúde: influência de uma comunidade online de diabetes na adesão ao tratamento

Resumo Este estudo visa compreender como as comunidades online podem contribuir, no Brasil, para aumentar a adesao de pacientes cronicos ao tratamento prescrito pelo medico. Para tanto, realizou-se a netnografia da comunidade Diabetes: vivendo e aprendendo – troca de informacoes, considerando como arcabouco teorico as dimensoes da adesao propostas pela Organizacao Mundial de Saude – OMS. A analise evidencia os impactos da Cibercultura sobre os processos de saude e doenca, provocando mudancas nas relacoes medico-paciente, no empoderamento do paciente e na gestao individual de sua condicao cronica. Os resultados mostraram tambem uma influencia positiva das interacoes estabelecidas na comunidade sobre os fatores multidimensionais do modelo de adesao proposto pela OMS, conduzindo ainda a possibilidade de inclusao de uma sexta dimensao referente a conectividade. As principais motivacoes identificadas para participacao na comunidade foram o acesso a informacoes sobre a doenca e o tratamento, o compartilhamento de experiencias e o suporte social. Assim, a proposicao de politicas de saude que auxiliem os doentes cronicos a atenderem tais necessidades tende a contribuir para aumentar a adesao ao tratamento.

Factors influencig software migration decision: Case studies of Acerlormittal Tubarão and the city government of Serra, Espirito Santo

The objective of this research is to identify the factors that influence the migration of free software to proprietary software, or vice-versa. The theoretical framework was developed in light of the Diffusion of Innovations Theory (DIT) proposed by Rogers (1976, 1995), and the Unified Theory of Acceptance and Use of Technology (UTAUT) proposed by Venkatesh, Morris, Davis and Davis (2003). The research was structured in two phases: the first phase was exploratory, characterized by adjustments of the revised theory to fit Brazilian reality and the identification of companies that could be the subject of investigation; and the second phase was qualitative, in which case studies were conducted at ArcelorMittal Tubarao (AMT), a private company that migrated from proprietary software (Unix) to free software (Linux), and the city government of Serra, in Espirito Santo state, a public organization that migrated from free software (OpenOffice) to proprietary (MS Office). The results show that software migration decision takes into account factors that go beyond issues involving technical or cost aspects, such as cultural barriers, user rejection and resistance to change. These results underscore the importance of social aspects, which can play a decisive role in the decision regarding software migration and its successful implementation.

Cost comparison of kidney transplant versus dialysis in Brazil

O objetivo do presente estudo foi comparar os custos medicos diretos do transplante renal e das terapias renais substitutivas, especificamente a hemodialise e a dialise peritoneal, sob a perspectiva do Sistema Unico de Saude (SUS). Os custos das terapias renais substitutivas foram extraidos de informacoes publicadas na literatura. Os itens de custo previstos do transplante renal foram identificados em um hospital privado mediante coleta dos codigos dos procedimentos utilizados para a cobranca do SUS e os demais itens extraidos da literatura. O resultado desta pesquisa indica que, no periodo dos quatro anos coberto por este estudo, o transplante renal de doador falecido gera uma economia, por paciente, de R

TECNOLOGIAS DE AUTOATENDIMENTO: SATISFAÇÃO E COMPORTAMENTO FUTURO DO USUÁRIO

37 mil e R

The Influence of Banking Service Customers' Satisfaction Level on the Perception of Switching Costs and on Behavioural Loyalty

74 mil em relacao a hemodialise e a dialise peritoneal, respectivamente. Quanto ao transplante renal de doador vivo, as economias sao ainda maiores: R

Indicadores de eficiência no processo de doação e transplante de órgãos: revisão sistemática da literatura

46 mil e R