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Search Results: 1 - 10 of 61256 matches for " outcome and process assessment (health care) "
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Avalia??o da qualidade de assistência primária à saúde em localidade urbana da regi?o sul do Brasil
Halal,Iná S.; Sparrenberger,Felipe; Bertoni,Anete M.; Ciacomet,Carla; Seibel,Carlos E.; Lahude,Flávia M.; Magalh?es,Gilson A.; Barreto,Lirio; Lira,Rita C.A.;
Revista de Saúde Pública , 1994, DOI: 10.1590/S0034-89101994000200007
Abstract: a 10% sample of patients who attended two primary health care units (phcu) in pelotas, rs (brazil) was studied cross-sectinonally for the purpose of measuring qualitatively the attention being offered to the population. according to domiciliar interviews, 15 days after their appointments, a solution (cure or improvement) was achieved in 87.9% of the patients. patients or parents satisfaction (in the case of pediatric patients) was observed in nearly 90% of the sample. patient satisfaction and solution were statistically associated (p=0.04). association between the solution and the availability of medicines in the phcu was observed. patients who had received the whole or a part of their treatment had 33% greater probability of solving their problem. professional satisfaction was linearly associated with both perception of a better professional-patient relationship (pr=3.48; ci95%2.17-5.59) and the expectation of a better patient prognosis (pr=1.99; ci95% 1.36-2.91).
Avalia??o da aten??o pré-natal em uma institui??o filantrópica da cidade de S?o Paulo
Koffman, Márcia Duarte;Bonadio, Isabel Cristina;
Revista Brasileira de Saúde Materno Infantil , 2005, DOI: 10.1590/S1519-38292005000500003
Abstract: objectives: to assess prenatal healthcare in a philanthropic institution in the city of s?o paulo according to the donabedian proposal. methods: to assess indicators pregnancy age in the beginning of prenatal care; number, procedures and consultation intervals and laboratory exams, the kessner index as adapted by takeda was applied. data were obtained through auditing of 635 medical files from july 2000 to june, 2001. the significance level of statistical exams was of 5%. results: prenatal medical visits median was of 6.5 (dp=2.7) and pregnancy age at the beginning of prenatal care was of 20.7 weeks (dp=7.7). medical visits procedures adequacy varied from 92.6% a 97.8% and medical visits interval was 53,7% to 100%. the application of the kessner index rated prenatal care as being adequate for 38.4% of pregnant women, inadequate for 24.7% and intermediary for 36.9%. the kessner index compounded by exams results rated prenatal care as being adequate for 35,7% of pregnant women, inadequate for 28.3% and intermediate for 35.9%. conclusions: the type of assessment adopted is viable is allows for periodical applications aiming at adequacy improvement of the care offered.
Evolu??o da mortalidade por causas evitáveis e expans?o dos recursos municipais de saúde em Maringá, Paraná
Scochi,Maria José;
Revista de Saúde Pública , 1999, DOI: 10.1590/S0034-89101999000200004
Abstract: objective: an assessment of the evolution of the profile of mortality from avoidable diseases, in the municipality of maringá, pr (brazil), 1980 through 1993, as related to the quality of health attendance. methods: based on the proposal to study caregiving results, eleven causes of avoidable deaths were selected. the evolution of resources available, level of schooling and sanitation were associated with the evolution of mortality. results and discussion: the data revealed that the mortality rates for most of the avoidable causes tended to decline faster than those for other causes (a reduction of 39% as against 16%). a significant improvement in schooling and sanitary conditions was also observed over the same period. the positive evolution of the general health status of the population makes it difficult to credit the decline of avoidable deaths directly to the health services, but the difference between the mortality rates from avoidable causes and others allows one to infer that if despite the satisfactory living conditions there were an outbreak of avoidable deaths it would indicate a lack of efficiency on the part of the health services. under the circumstances verified, the decrease in the rate of mortality from avoidable causes can be partly attributed to the expansion of the health services.
Impacto de un programa de atención domiciliaria al enfermo crónico en ancianos: calidad de vida y reingresos hospitalarios
Espinel-Bermúdez,María Claudia; Sánchez-García,Sergio; Juárez-Cedillo,Teresa; García-González,José Juan; Viveros-Pérez,álvaro; García-Pe?a,Carmen;
Salud Pública de México , 2011, DOI: 10.1590/S0036-36342011000100004
Abstract: objective: to evaluate the impact of the adec program (acronym in spanish) as compared with the typical care provided to disabled elderly affiliated with the mexican institute of social security (imss). material and methods: prospective cohort at three months after discharge from two general hospitals in mexico city. a total of 130 patients with functional dependency were studied, 70 in the adec program and 60 with typical care. impact was measured using hospital readmissions and quality of life based on the sickness impact profile (sip). results: average age was 74 (61/103) years and 60% were women. the main diagnosis was cerebrovascular disease (30.77%). the quality of life in the psychosocial dimension improved for the adec group (from 46.26 (±13.85) to 29.45(±16.48) as compared with 47.03 (±16.47) to 42.36 (±16.35) for those receiving typical care (p<0.05). no differences were found regarding hospital readmissions. (p>0.05). conclusions: hc program improved the psychosocial dimension of quality of life.
Measuring the performance of health care services: a review of international experiences and their application to urban contexts
García-Altés,Anna; Zonco,Lauriane; Borrell,Carme; Plasència,Antoni; ,;
Gaceta Sanitaria , 2006, DOI: 10.1590/S0213-91112006000400011
Abstract: background: the objective of performance assessment is to provide governments and populations with appropriate information about the state of their health care system. the objective of this paper is to present the most recent developments in performance assessment and their application in urban contexts. methods: literature review in pubmed (1970-2004). we identified additional papers and grey literature from retrieved references. results: performance assessment initiatives were identified in australia, canada, the united kingdom, and new zealand. the world health report 2000 is one of the best known examples of a transnational approach to performance assessment. conclusion: the best developed initiatives to date are those that define precise categories, criteria and indicators with which to analyse and assess health care systems, based on a solid conceptual framework. performance assessment fits perfectly in urban contexts, as it is a useful tool for designing and monitoring policies, assessing the quality of the services provided, and measuring the health status of city dwellers. barcelona and montreal are currently collaborating together on a project to assess the performance assessment of their respective health care services.
Resultados imediatos e tardios da valvoplastia mitral percutanea em pacientes com estenose mitral
Cardoso, Luiz Francisco;Ayres, Carlos Vinetou;Bento, André Moreira;Tarasoutchi, Flávio;Vieira, Marcelo Luiz;Grinberg, Max;
Arquivos Brasileiros de Cardiologia , 2010, DOI: 10.1590/S0066-782X2010000300020
Abstract: background: the analysis of immediate and long-term results of mitral valvoplasty by balloon catheter (mvrbc) are still lacking in literature, mainly in the national context. objective: to assess the immediate and late results of patients submitted to mitral valve repair by balloon catheter. method: a total of 330 consecutive patients were followed-up by 47 ± 36 months (up to 126 months). univariate and multivariate analyses assessed the factors associated with the success of the procedure, restenosis and late events (death or necessity of new intervention on mitral valve). kaplan-meier method estimated survival without events. results: the procedure was successful in 305 cases (92.4%). the mitral valve anatomy was the main predictor for immediate success for the procedure. during the procedure, restenosis occurred in 77 (23.3%) patients and was associated with smaller mitral valve area and with larger calcification before the process. in a mean period of 38 ± 26-month follow-up, 67 events occurred. the probability of survival without events was of 95% in one year, 75% in five years and 61% in ten years. the predictors of survival without events were: age, echocardiography score and immediate result of the procedure. conclusion: mitral valve repair by balloon catheter is an effective procedure, as 60% patients did not present events after the follow-up. the anatomical condition of the mitral valve and the patient's age were the best predictors of survival without events, and should be taken into account when selecting patients for the mentioned procedure. (arq bras cardiol 2010; 94(3):383-390)
Avalia??o do processo da aten??o médica: adequa??o do tratamento de pacientes com diabetes mellitus, Pelotas, Rio Grande do Sul, Brasil
Assun??o, Maria Cecília Formoso;Santos, Iná da Silva dos;Costa, Juvenal Soares Dias da;
Cadernos de Saúde Pública , 2002, DOI: 10.1590/S0102-311X2002000100021
Abstract: a study was conducted in 1998 with the aim of assessing adequacy of clinical management of diabetic patients attending public health services in pelotas, brazil. patients were interviewed to gather data on medical consultation, disease, and treatment. data analysis focused on the "type of treatment" variable with three categories: diet, physical activity, and drug treatment. seventy-six percent of the patients reported having received nutritional orientation. only 50% of them reported having followed their diet during the preceding 15 days. also, 75% of patients reported having received recommendations to perform physical activity. however, only one third had practiced some exercise in the previous month. among 377 interviewed, 289 (77%) were on medication, and among the patients taking oral hypoglycemic agents many had at least one contraindication. the article discusses the need to enhance physicians' adherence to scientific guidelines for diabetes management.
Significancia clínica de mudan?a em processo de psicoterapia psicodinamica breve
Yoshida, Elisa Medici Piz?o;
Paidéia (Ribeir?o Preto) , 2008, DOI: 10.1590/S0103-863X2008000200008
Abstract: the current investigation is part of a work in progress aimed to analyze the process of change and the outcome of brief psychotherapies in patients of brazilian communitarian health units. specifically, the current work aimed to explore a method to determine clinically meaningful change of symptoms evaluated by self-report measures, when normative data are not available. it consists in the specific use of the well-known jacobson and truax's method to determine the clinical significance of a treatment. to calculate the change scores and cutoffs of symptomatic measures, data from a sample of college students were used as representative of a functional population. changes of one psychotherapeutic process were analyzed. results suggest that clinical significance of change can be reliably determined by self-report measures. some limitations of this method are considered.
Resultados da implementa??o de modelo organizacional de um servi?o de cirurgia cardiovascular
Atik, Fernando A.;Garcia, Maria Fernanda M. A;Santos, Linda Maria;Chaves, Renato B;Faber, Cristiano N.;Corso, Ricardo B.;Vieira, Nubia W.;Caneo, Luiz Fernando;
Revista Brasileira de Cirurgia Cardiovascular , 2009, DOI: 10.1590/S0102-76382009000200005
Abstract: objective: increasing complexity of patients referred to cardiac surgery demands more effective heart centers, in order to maintain the same quality. the aim of this study is to examine the short-term effect of adoption of an organizational model on surgical outcomes. methods: from january 2006 to june 2007, 367 consecutive adult patients underwent cardiovascular surgery. pre-, intra- and postoperative data were prospectively collected and transferred to an institutional database. organizational model was established in august 2006, and based on integrated multiprofessional team work patient-centered, evidence-based medicine with standardized patient care and personal conflict management. the outcomes studied were hospital mortality and combined adverse events (death, stroke, acute myocardial infarction and acute renal failure), by using multivariate logistic regression analysis. results: after establishment of such model, there was reduction of hospital mortality (from 12% to 3.6%, relative risk= 0.3; p=0.003) and combined events (from 22% to 15%, relative risk=0.68; p=0.11). operations performed previously to the model were independently associated with higher mortality (or=2.5; p=0.04), adjusted to preoperative characteristics and euroscore risk stratification system. other predictors of mortality were age > 65 years (or=6.36; 95%ci 2.57 - 17.21; p<0.0001) and cardiopulmonary bypass time > 145 minutes (or=8.57; 95%ci 3.55 - 21.99; p<0.0001). conclusion: marked improvements in surgical outcomes depend on development of cardiac surgery centers based on organizational models similar to the model proposed in this study.
Avalia??o dos servi?os de enfermagem: identifica??o dos critérios de processo dos programas de acredita??o hospitalar
Cunha, Isabel Cristina Kowal Olm;Feldman, Liliane Bauer;
Revista Brasileira de Enfermagem , 2005, DOI: 10.1590/S0034-71672005000100012
Abstract: efforts to ensure quality in healthcare, to elaborate patterns and criteria have been a challenge in brazil. this study aimed to identify the process of evaluation criteria applied to the nursing services adopted by accreditation programs, and classify them in administrative, assistential and teaching research attributions. the study was exploratory, descriptive and quantitative. collected data from 7 companies accredited by the national accrediting organization leaded into 8 models, which were divided into a, b and c groups. seventy-nine criteria were identified; 32 from assistential, 32 administrative and 15 teaching-research processes. the nursing service was evaluated with focus in the c group. a small amount of assistential and learning research in a and b groups, showing that an increase in criteria would be necessary in order to obtain more accurate measuring.
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