Paulette Cavalcanti de Albuquerque

Do normativo à realidade do Sistema Único de Saúde: revelando barreiras de acesso na rede de cuidados assistenciais

This article analyzes the conditions of comprehensive access to health care in Recife in the state of Pernambuco based on the trajectory experienced by users from primary health services through to specialist care. Quantitative and qualitative approaches were combined with triangulation of methods as the research technique. Systemic Arterial Hypertension was chosen as a core condition, as it is an ailment that requires attention at various levels of the citys health network. The research revealed various barriers of access in primary health care becoming more accentuated at other levels of care resulting in delays in timely care and consequently prolonging the suffering of the population. Structural problems such as a shortage of medical professionals in primary care, insufficient access to specialized consultations and exams, together with the inherent dynamics of the health services, are real obstacles that the user faces in the quest for continuous and comprehensive care in the Unified Health System (SUS). In addition to broadening and enhancing the availability of services, especially complementary exams, it is necessary to ensure communication between the departments of the SUS, in order to consolidate an articulated network, thereby improving health care.

Bases de dados orçamentários e qualidade da informação: uma avaliação do Finanças do Brasil (Finbra) e do Sistema de Informações sobre Orçamentos Públicos em Saúde (Siops)

El articulo caracteriza y evalua el sistema de Finanzas de Brasil (Finbra) y el sistema de informaciones referido a presupuestos publicos en salud (Siops) en las dimensiones de cualidad de accesibilidad, oportunidad y claridad metodologica. Se hace una investigacion descriptiva con abordaje cuantitativo y cualitativo, mediante fuentes bibliograficas y documentales. Se comprobo que Finbra y Siops surgen en el contexto de la descentralizacion de las politicas publicas brasilenas que exigio, ademas del acceso a las informaciones, mayor control de las cuentas publicas. Los sistemas presentaron ventajas similares en lo referido a accesibilidad y oportunidad, pero el SIOPS se mostro con mayor claridad metodologica. Se resalta que hay necesidad de ampliar el conocimiento acerca de esas importantes fuentes de registro contable de las instituciones sub nacionales, en vista a su mejoramiento y perfeccionamiento.The article describes and assesses Finances of Brazil (Finbra) and Information System on Public Health Budgets (Siops) in the dimensions accessibility quality, opportunity and methodological clarity. It was made a descriptive research with quantitative and qualitative approach through bibliographical and documentary sources. It was found that Finbra and Siops arouse in the context of the decentralization of Brazilian public policies, which required, besides the access to information, more control of public accounts. The systems show similar advantages concerning accessibility and opportunity, but Siops proved to have better methodological clarity. It is pointed out that it is necessary to expand the knowledge about these important sources of the accounting register of subnational entities, intending to their improvement and refinement.

Sistema de informações hospitalares fonte complementar na vigilância e monitoramento das doenças de transmissão vetorial

The objective of this paper was to explore the potentialities of the Hospital Information System - SIH/SUS for epidemiologic surveillance and monitoring of vector-borne diseases (dengue, leishmaniasis, and yellow fever). Hospital admittance data from the SIH, during the period from 1984 to 1998, and from the case reporting system of the National Center of Epidemiology – CENEPI, during the period from 1980 to 1997 were used. The data demonstrate that there was resurgence of dengue in 1982, with small amount of hospital admittances up to 1997. In the latter year the frequency of admittances increased, mainly in the Southeast, Northeast and North regions, indicating the occurrence of severe dengue cases. Already for yellow fever, incoherence between the clinical aspects of the disease and the large number of admittances reported was observed, suggesting systematic errors in the hospital information system. For leishmaniasis, coherence was observed between SIH and CENEPI data, which showed the recurrent character described for this disease. In a general way, SIH demonstrated quality as a complementary source of information for surveillance of hemorrhagic dengue and leishmaniasis however, problems were detected for monitoring yellow fever, suggesting the need for system adjustments.

A Estratégia Saúde da Família no estado de Pernambuco: avaliação da estrutura das equipes por porte populacional

O estudo teve como objetivo avaliar a estrutura das Equipes de Saude da Familia do estado de Pernambuco por porte populacional, no ano de 2009. Foram aplicados questionarios estruturados a 154 equipes, de 24 municipios, e avaliados itens referentes a instrumentos, materiais educativos, espaco fisico, medicamentos, vacinas, alem dos recursos humanos disponiveis. Os resultados mostraram que os espacos fisicos das equipes foram mais bem avaliados nos municipios de pequeno porte (p=0,032). Somente 5,6% das equipes cumprem todos os requisitos de estrutura, e o componente recursos humanos apontou a precariedade do vinculo dos profissionais, principalmente nos municipios de medio porte do estado.

A atenção em saúde bucal no estado de Pernambuco: analisando a estrutura e as ações preventivas e curativas, segundo porte populacional

The aim of this study was to analyze the oral health care in Pernambuco state, Brazil, from the available structure and the preventive and curative actions offered by oral health teams, according to population size. For this, structured questionnaires were applied to a sample of 121 oral health teams, which reported on the structure and work process, being used for data analysis using the χ2 and Fisher exact tests. Regarding vocational training, the results showed a higher percentage of dental surgeons with introductory course formation (57.2%) or expertise in family health (46.3%) in big cities, when compared to medium and small size cities (p<0.05). In addition, only 25.4% of the units had a room with sink and mirror for supervised brushing and 48% of teams reported having insufficient amount of educational materials for prevention efforts. It was also noted that collective actions outside school were less often developed by small municipalities. Thus, investments in the team structure and continuous encouraging on education may reduce the differences in oral health care in the cities of Pernambuco.

O papel do Núcleo de Apoio à Saúde da Família na coordenação assistencial da Atenção Básica: limites e possibilidades

RESUMO O objetivo deste estudo foi o de analisar como o Nucleo de Apoio a Saude da Familia tem colaborado com as Equipes de Saude da Familia na sua funcao de coordenacao assistencial. Realizou-se um estudo qualitativo do tipo estudo de caso no municipio de Camaragibe, Pernambuco. A coleta de dados cobriu o periodo de janeiro a maio de 2015 e aplicou grupos focais, analise documental e observacao participante. Os resultados evidenciam que o Nucleo de Apoio a Saude da Familia, atuando segundo a logica do apoio matricial, pode colaborar com o fortalecimento da funcao de coordenacao assistencial da Atencao Basica.

Bases de datos presupuestarios y calidad de la información: una evaluación de las Finanzas de Brasil (Finbra) y del sistema de informaciones referido a presupuestos públicos en salud (Siops)

El articulo caracteriza y evalua el sistema de Finanzas de Brasil (Finbra) y el sistema de informaciones referido a presupuestos publicos en salud (Siops) en las dimensiones de cualidad de accesibilidad, oportunidad y claridad metodologica. Se hace una investigacion descriptiva con abordaje cuantitativo y cualitativo, mediante fuentes bibliograficas y documentales. Se comprobo que Finbra y Siops surgen en el contexto de la descentralizacion de las politicas publicas brasilenas que exigio, ademas del acceso a las informaciones, mayor control de las cuentas publicas. Los sistemas presentaron ventajas similares en lo referido a accesibilidad y oportunidad, pero el SIOPS se mostro con mayor claridad metodologica. Se resalta que hay necesidad de ampliar el conocimiento acerca de esas importantes fuentes de registro contable de las instituciones sub nacionales, en vista a su mejoramiento y perfeccionamiento.The article describes and assesses Finances of Brazil (Finbra) and Information System on Public Health Budgets (Siops) in the dimensions accessibility quality, opportunity and methodological clarity. It was made a descriptive research with quantitative and qualitative approach through bibliographical and documentary sources. It was found that Finbra and Siops arouse in the context of the decentralization of Brazilian public policies, which required, besides the access to information, more control of public accounts. The systems show similar advantages concerning accessibility and opportunity, but Siops proved to have better methodological clarity. It is pointed out that it is necessary to expand the knowledge about these important sources of the accounting register of subnational entities, intending to their improvement and refinement.

Budgetary databases and information quality: an assessment of Brazil's Finance (Finbra) and Information System on Public Health Budgets (Siops)

El articulo caracteriza y evalua el sistema de Finanzas de Brasil (Finbra) y el sistema de informaciones referido a presupuestos publicos en salud (Siops) en las dimensiones de cualidad de accesibilidad, oportunidad y claridad metodologica. Se hace una investigacion descriptiva con abordaje cuantitativo y cualitativo, mediante fuentes bibliograficas y documentales. Se comprobo que Finbra y Siops surgen en el contexto de la descentralizacion de las politicas publicas brasilenas que exigio, ademas del acceso a las informaciones, mayor control de las cuentas publicas. Los sistemas presentaron ventajas similares en lo referido a accesibilidad y oportunidad, pero el SIOPS se mostro con mayor claridad metodologica. Se resalta que hay necesidad de ampliar el conocimiento acerca de esas importantes fuentes de registro contable de las instituciones sub nacionales, en vista a su mejoramiento y perfeccionamiento.The article describes and assesses Finances of Brazil (Finbra) and Information System on Public Health Budgets (Siops) in the dimensions accessibility quality, opportunity and methodological clarity. It was made a descriptive research with quantitative and qualitative approach through bibliographical and documentary sources. It was found that Finbra and Siops arouse in the context of the decentralization of Brazilian public policies, which required, besides the access to information, more control of public accounts. The systems show similar advantages concerning accessibility and opportunity, but Siops proved to have better methodological clarity. It is pointed out that it is necessary to expand the knowledge about these important sources of the accounting register of subnational entities, intending to their improvement and refinement.

Analysis of oral health indicators of Pernambuco: performance of cities according to size population, population enrolled in the Information System for Primary Care and proportion in the Family Health Strategy

Este estudo teve como objetivo analisar a assistencia a saude bucal no Estado de Pernambuco, com base em seus indicadores, segundo as variaveis porte populacional, proporcao da populacao cadastrada e relacao entre as equipes de saude da familia e equipes de saude bucal. Para isso, foram utilizados dados secundarios obtidos do Sistema de Informacao Ambulatorial (SIA/SUS), Cadastro Nacional de Estabelecimentos de Saude (CNES) e Sistema de Informacoes da Atencao Basica (SIAB), utilizando os testes estatisticos ANOVA e Kruskal-Wallis para analise dos dados. Os resultados mostraram que o porte populacional dos municipios demonstrou estar relacionado com o desempenho de alguns indicadores: municipios de grande porte apresentaram menores valores para proporcao de exodontias (p=0,0006). A organizacao das equipes de saude bucal foi outro aspecto discutido neste estudo, observando-se que quanto maior a cobertura e quando a relacao entre as equipes era 1:1, mais favoraveis eram os indicadores de primeira consulta odontologica, escovacao supervisionada, media de procedimentos odontologicos individuais e proporcao de exodontias, todos apresentando diferencas estatisticamente significantes (p<0,05). Dessa forma, pode-se concluir que aspectos demograficos, de cobertura da estrategia e de relacao proporcional das equipes influenciam o desempenho de indicadores em saude bucal em municipios do Estado de Pernambuco.

Análise do processo de trabalho dos agentes de vigilância ambiental do município de Olinda, Pernambuco

This work aimed to analyze the coverage of the Program of Environmental Surveillance in Health in the city of Olinda, Pernambuco State and the factors that interfered in not achieving the number of properties established by the National Program of Dengues Control to be visited by the environmental surveillance agents, among them the number of absences and the number of properties worked daily. For the accomplishment of the study, a database was prepared with a list of agents that worked in the year of 2006, considering the number of absences, medical licenses, vacations and the number of worked properties. The results showed that the number of properties worked by the agents per day had a larger influence in the low income presented in the year of 2006 when compared to the number of their absences. The high number of closed properties and refusals, lack of materials, constant training courses and agent demands for other health actions were some factors that contributed to the low productivity of the agents. Therefore, it is necessary a change in the work process of the environmental surveillance agents, as well as a more discerning and constant evaluation of their activities so that it is possible to reach the established goals.