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Search Results: 1 - 10 of 2024 matches for " Sala Arnaldo "
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Perfil de indicadores da aten??o primária à saúde no estado de S?o Paulo: retrospectiva de 10 anos
Sala, Arnaldo;Mendes, José Dínio Vaz;
Saúde e Sociedade , 2011, DOI: 10.1590/S0104-12902011000400009
Abstract: more than 20 years after the creation of sistema único de saúde (sus - brazil's national health system) and after a long period of improvements in primary health care (phc) in the state of s?o paulo, brazil, one of the most important tasks is to evaluate their processes and their health outcomes. the aim of this study is to analyze the profile of indicators related to phc in the state of s?o paulo during the last decade (2000 to 2009). fourteen indicators related to phc structure, sus performance and to health conditions were selected. these indicators were analyzed considering the entire state of s?o paulo and by groups of municipalities defined by their population (small: less than 20 thousand inhabitants; medium: between 20 and 100 thousand inhabitants; large: more than 100 thousand inhabitants) and by their wealth (low; high). almost all the 14 selected indicators improved along the period. the phc structure-related indicators had a global improvement, and the groups of small municipalities showed better levels along the entire period. the sus performance-related indicators showed differences among groups of municipalities. the group of large municipalities obtained lower hospitalization rates in conditions preventable by phc. nevertheless, this same group had the lowest rates of pap smear tests. the group of small and high wealth municipalities presented better trends in health condition indicators. the group of large municipalities presented the highest rates of mortality caused by cervical cancer and cardiovascular disease. in conclusion, there is a clear improvement in phc in terms of structure, health care performance and health conditions.
Metodologia de avalia??o do trabalho na aten??o primária à saúde
Sala, Arnaldo;Nemes, Maria Ines Baptistella;Cohen, Diane Dede;
Cadernos de Saúde Pública , 1998, DOI: 10.1590/S0102-311X1998000400016
Abstract: a case study assessed health care activities in a primary health care facility to help develop methodologies of care work assessment and of the proposal of leading categories for the said processes, based on the work process. this study was developed at the centro de saúde escola of the faculdade de medicina of the universidade de s?o paulo, using as empirical material the assessment of the care activities aimed at the emergency care and programmed care of 'chronic' patients (patients suffering from hypertension and diabetes). the analysis of these assessments which considered different moments of the work process (working objects, activity of agents, analysis of the working means and result of the work) suggest the need of creating analytical categories that will make workable the understanding of this process, inserting each moment to the work as a whole. the analytical categories proposed are: 1) workability as a means of making effective the proposed actions; 2) strategic effectiveness as a measure of the scope of the results that have been observed among patients and/or the population and that can be the result of the actions performed.
Avalia??o da efetividade do controle da hipertens?o arterial em unidade básica de saúde
Sala,Arnaldo; Nemes Filho,Alexandre; Eluf-Neto,José;
Revista de Saúde Pública , 1996, DOI: 10.1590/S0034-89101996000200008
Abstract: the present study is part of a performance evaluation of the aging health care program carried out at a primary health care clinic. activities for arterial hypertension (ah), control oriented accorging to a risk assessment, in conformity with ministry of health norms, are included in the program mentioned. the effectiveness of the reduction of blood pressure (bp) levels in hypertensive individuals subjected to programmatic activities for disease control, in an attempt to identify conditions associated with that reduction, is evaluated. of the 396 patients with ah registered under the program between 01/01/92 and 06/30/93, 250 cases were included for this evaluation. these patients had, in addition to high blood pressure levels (bp 3 160/95 mm hg) on the first attendances at the health center (before registration in the programme), at least two medical consultations during program follow-up. the differences in blood pressure levels between measurements taken during consultations before the beginning of attendance at the program and those taken on the first attendances to the programme were analysed according to initial blood pressure level, age, sex, registering diagnosis and absences during the program follow-up. reductions of 3 5 mm hg in diastolic blood pressure (dbp) and/or 3 10 mm hg in systolic blood pressure (sbp) were obtained in 197 (78.8%) patients. the mean reduction was 8.8 mm hg (sd = 11.4) for dbp and 17.7 mm hg (sd = 18.6) for sbp. results of several epidemiological studies allow the inference that a decrease in the mortality risk from cardiovascular disease can be achieved in a significant proportion of the individuals registered in the program. blood pressure normalization according to program norms occurred in 111 (44.4%) individuals. multiple linear regression analysis demonstrated that initial blood pressure and percentages of absenteeism during the follow-up were independently associated with the reductions in sbp and dbp. age was independently a
Avalia o da efetividade do controle da hipertens o arterial em unidade básica de saúde
Sala Arnaldo,Nemes Filho Alexandre,Eluf-Neto José
Revista de Saúde Pública , 1996,
Abstract: Como parte integrante da avalia o de desempenho do Programa de Aten o à Saúde no Envelhecimento, desenvolvido em uma unidade básica de saúde, foi mensurada a efetividade da hipertens o arterial, segundo a redu o dos níveis de press o arterial em indivíduos hipertensos submetidos a a es programáticas para controle da doen a, procurando identificar condi es associadas com tal redu o. Dos 396 pacientes portadores de hipertens o arterial sistêmica inscritos no Programa, no período de 01/01/92 a 30/06/93, foram considerados para esta avalia o 250 casos que apresentavam, além de níveis pressóricos elevados (PA superscript three 160/95 mmHg) em atendimentos iniciais no servi o (anteriores à inscri o no programa), pelo menos duas consultas médicas no seguimento programático. As diferen as de níveis pressóricos entre as medidas realizadas nas consultas anteriores ao início do atendimento programático, e as realizadas a partir do início destes atendimentos foram analisadas segundo o nível pressórico inicial, idade, sexo, diagnósticos na inscri o e faltas ao agendamento programático. Obteve-se redu o na press o arterial diastólica (PAD) de 5 mmHg ou mais, e/ou redu o de 10 mmHg ou mais na press o arterial sistólica (PAS) em l97 (78,8%) pacientes. A média da redu o da PAD foi 8,8 mmHg (d.p. = 11,4), e da PAS foi 17,7 mmHg (d.p. = 18,6). Resultados de diversos estudos epidemiológicos permitem inferir redu o do risco de mortalidade por doen a cardiovascular em propor o considerável de indivíduos inscritos no Programa. Em 111 (44,4%) indivíduos ocorreu normaliza o da press o aos níveis preconizados pelo Programa. A análise por meio de regress o linear múltipla demonstrou que, entre as variáveis estudadas, a press o inicial e a percentagem de faltas no seguimento programático estiveram associadas de modo independente com a redu o da PAS e da PAD. A idade esteve associada independentemente apenas com a redu o da PAS. A participa o da idade e da percentagem de faltas no seguimento programático revelam que o resultado final do trabalho programático n o é insensível aos diferentes modos com que as pessoas assumem o cuidado com a própria saúde.
Metodologia de avalia o do trabalho na aten o primária à saúde
Sala Arnaldo,Nemes Maria Ines Baptistella,Cohen Diane Dede
Cadernos de Saúde Pública , 1998,
Abstract: No presente trabalho, realiza-se um estudo de caso, no qual se analisa o processo de avalia o de a es assistenciais em uma unidade básica de saúde, no sentido de contribuir para o desenvolvimento de metodologias de avalia o do trabalho assistencial e de proposi o de categorias orientadoras desses processos de avalia o, tendo como base o processo de trabalho. Este estudo foi desenvolvido no Centro de Saúde Escola da Faculdade de Medicina da Universidade de S o Paulo, tomando como seu material empírico as avalia es das a es assistenciais dirigidas ao pronto-atendimento e ao atendimento programático de pacientes cr nicos (hipertensos e diabéticos). A análise dessas avalia es, que apreenderam diferentes momentos constituintes do processo de trabalho (objetos do trabalho, atua o dos agentes, análise dos meios de trabalho, produto do trabalho), sugerem a necessidade da elabora o de categorias analíticas que operacionalizem a apreens o desse processo, articulando cada momento à sua totalidade. As categorias analíticas propostas s o: 1) operacionalidade, como medida da efetiva o das a es propostas; 2) efetividade estratégica, como medida do alcance dos resultados apreensíveis nos usuários e/ou na popula o, atribuíveis às a es realizadas.
Cadastro ampliado em saúde da família como instrumento gerencial para diagnóstico de condi??es de vida e saúde
Sala, Arnaldo;Sim?es, Oziris;Luppi, Carla Gianna;Mazziero, Miryan Cristina;
Cadernos de Saúde Pública , 2004, DOI: 10.1590/S0102-311X2004000600013
Abstract: as a consequence of the introduction of the family health program in the city of s?o paulo, brazil, a pilot experiment was conducted with an expanded enrolment form for gathering information on families at two school health services. the aim of the study was to analyze this enrolment form as a management tool capable of identifying differences and inequities in each area. the collected data provided the basis for generating six related indicators: time of residence in the area, family members per bedroom, per capita family income, number of children as a percentage of total family members, schooling, and health insurance coverage. a compound indicator was constructed, called the mean living standard score, in addition to another indicator - mean score/ basic health care information system - from the three indicators existing in form a of the basic health care information system. the results identified contiguous geographic areas with different living standards. the two scores showed similar discriminatory power. in conclusion, it is possible to differentiate and discriminate sub-areas, thereby highlighting the need to organize different health actions for each sub-area.
Licen?as médicas entre trabalhadores da Secretaria de Estado da Saúde de S?o Paulo no ano de 2004
Sala, Arnaldo;Carro, Adriana Rosa Linhares;Correa, Aniara Nascimento;Seixas, Paulo Henrique D'?ngelo;
Cadernos de Saúde Pública , 2009, DOI: 10.1590/S0102-311X2009001000008
Abstract: workers' illness and the resulting absenteeism is a relevant issue for the public sector, due to the high sick leave rates. the current study focused on the characteristics of sick leaves among employees of the s?o paulo state health department in brazil. data from 2004 were collected for 58,196 public employees of the state health department, including the respective episodes of sick leave. the overall absenteeism rate due to illness was 2.8%, with differences between the department's various divisions and job descriptions. the highest absenteeism rates were among hospital workers in operational (3.4%) and patient care jobs (3.3%). total number of sick leave days per worker was associated with job, age bracket, and gender. the findings highlight the need to establish policies to influence work organization with innovative interventions in the various work areas.
Avalia??o do processo de atendimento a pacientes portadores de doen?a cr?nico-degenerativa em uma unidade básica de saúde
Sala,Arnaldo; Cohen,Diane D.; Dalmaso,Ana S. W.; Lima,?ngela M. M.; Teixeira,Ricardo R.;
Revista de Saúde Pública , 1993, DOI: 10.1590/S0034-89101993000600009
Abstract: the efficacy of health actions, related to arterial hypertension and used as a strategy to decrease morbi-mortality due to cardiovascular diseases, in accordance with the "risk approach" and carried out in a primary health care clinic is assessed. these actions are based on the detection of arterial hypertension in the adult population attended at the clinic and on the control of blood pressure levels in hypertensive individuals in which other known risk factors continue to be controlled, as well as on further treatment of eventual complications. data relating to the 3,793 patients who were attended at least once by doctors of the adult sector of a training health-center located in s. paulo county (brazil) during the period from june 1990 to may 1991, inclusive, were evaluated. this evaluation was made according to each diagnosis undertaken as well as to the concentration of each type of consultation whether occasional, or follow-up. of these 3,793 patients analysed, 839 presented arterial hypertension and/or diabetes, and were grouped into four categories: the exclusively hypertensive, the hipertensive with other associated chronic diseases (except diabetes), the diabetic and the diabetic with arterial hypertension. the results of this study brougth the following aspects to light: 1) the low coverage of hypertensive individuals and diabetics being attended by the health service when only the population attended by the health service is taken into consideration. 2) the incidence of patients diagnosed as hypertensive in occasional consultations who did not return to the health service for medical follow-up indicates the difficulties involved in attracting such individuals permanently. this loss is due to both the non-appearance of patients at the consultations programmed for their follow-up as well the lack of the follow-up program on the part of the health service. 3) with regard to these that fulfilled the follow-up program, the concentration of medical consultatio
Integralidade e Aten??o Primária à Saúde: avalia??o na perspectiva dos usuários de unidades de saúde do município de S?o Paulo
Sala, Arnaldo;Luppi, Carla Gianna;Sim?es, Oziris;Marsiglia, Regina Giffoni;
Saúde e Sociedade , 2011, DOI: 10.1590/S0104-12902011000400012
Abstract: in the city of s?o paulo, the primary health care (phc) outpatient clinics function based on the models of the family health program (fhp) and health program. both models involve integrality issues. the aim of this study is to assess the integrality achievement in phc outpatient clinics located in the city of s?o paulo, based on users' opinion. the categories were: access to first contact, continuity, coordination, services catalogue, community orientation and family orientation. the two models of services organization at the phc outpatient clinics in the city were compared using the portuguese translated version of the primary care assessment tool (pcatool). the adapted pcatool was administered to a sample of users of the two phc models. the main results indicated good performance in the categories of first contact, services catalogue and coordination. family orientation, community orientation and accessibility received the worst evaluation. significant differences between the two models involve better medical records, better community-oriented activities, lower number of referrals to specialized care and more adequate working hours in the fhp model. the integrality issues that were best evaluated were those closely related to individual health care, while the issues concerned with services' organization and culture received the worst scores.
Avalia o do processo de atendimento a pacientes portadores de doen a cr nico-degenerativa em uma unidade básica de saúde
Sala Arnaldo,Cohen Diane D.,Dalmaso Ana S. W.,Lima ?ngela M. M.
Revista de Saúde Pública , 1993,
Abstract: Avalia-se o desempenho de a es de saúde desenvolvidas em uma unidade básica de saúde, relativas ao controle da hipertens o arterial sistêmica (HAS) enquanto estratégia de redu o de morbi-mortalidadc por doen a cardiovascular baseada no "enfoque de risco". Estas a es estruturam-se a partir da detec o da hipertens o arterial na popula o adulta atendida no servi o e do controle dos níveis pressóricos nos indivíduos portadores de HAS, incluindo outros fatores de risco conhecidos, bem como tratamento de eventuais complica es. Analisaram-se 3.793 usuários que compareceram pelo menos uma vez à consulta médica no servi o de Assistência ao Adulto de um Centro de Saúde-Escola, do Município de S o Paulo (Brasil), no período de 1o de junho de 1990 a 31 de maio de 1991. Para cada um dos usuários foram considerados os diagnósticos realizados, bem como a concentra o de cada modalidade de consulta realizada (pronto-atendimento e consulta agendada). Destes, 839 eram portadores de hipertens o arterial e/ou diabete e foram agrupados em quatro categorias: os exclusivamente hipertensos, os hipertensos com outra doen a cr nica associada (exceto diabete), os diabéticos e os diabéticos com hipertens o arterial. Os resultados deste estudo mostraram: 1) baixa cobertura de indivíduos hipertensos e diabéticos em atendimento no servi o, quando se considera a popula o atendida pelo Centro de Saúde; 2) a existência de pacientes diagnosticados como hipertensos em consultas de pronto-atendimento, que n o retornaram ao Centro de Saúde para seguimento médico programático, apontando para dificuldades na capta o efetiva destes indivíduos. Esta "perda" deveu-se tanto a faltas dos pacientes às consultas agendadas para seu seguimento quanto ao n o agendamento de consultas de seguimento por parte do servi o; 3) para os pacientes que aderiram ao seguimento, a concentra o de consultas médicas e a concentra o de faltas apresentaram números compatíveis com a proposta de agendamento trimestral; 4) a categoria dos exclusivamente hipertensos apresentou, quando comparada com as demais, menor concentra o de consultas e maior propor o de faltas por consulta agendada. Discutem-se os limites das a es baseadas no "enfoque de risco" para controle de doen as crónico-degenerativas em popula o.
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