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Search Results: 1 - 10 of 9505 matches for " Travassos Cláudia "
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Estudo da desigualdade na utiliza??o de servi?os de saúde por idosos em três regi?es da cidade do Rio de Janeiro
Pinheiro, Rejane Sobrino;Travassos, Cláudia;
Cadernos de Saúde Pública , 1999, DOI: 10.1590/S0102-311X1999000300005
Abstract: this article analyzes social inequalities in health care services utilization by the elderly and tests the influence of place of residence. the study was based on a sample survey of residents 60 years of age and older from three different areas in the city of rio de janeiro. the multi-stage sampling method led to violations of the logistic regression assumptions which were considered in the data analysis stage. need was the most important factor related to utilization. however, gender, type of service, income, and place of residence also showed positive impact on health care utilization. moreover, the effect of the income was modified by place of residence. the area with the best living conditions (copacabana) did not show inequalities in health care services utilization. the income gradient was more important in middle and lower-income areas, i.e., méier and santa cruz, respectively.
Estudo da desigualdade na utiliza o de servi os de saúde por idosos em três regi es da cidade do Rio de Janeiro
Pinheiro Rejane Sobrino,Travassos Cláudia
Cadernos de Saúde Pública , 1999,
Abstract: Neste trabalho, foi analisada a desigualdade social na utiliza o de servi os de saúde e a influência que a área de residência exerce nessas desigualdades. Com informa es baseadas em um questionário multidimensional aplicado a uma amostra de idosos da cidade do Rio de Janeiro, foi estudada a associa o do uso de servi os de saúde com fatores sócio-demográficos, condi o social, necessidade e oferta de servi os médicos. O desenho amostral complexo levou a viola es de pressupostos do modelo de regress o logística, que foram tratadas na fase de análise dos dados, com base no cálculo do efeito do desenho. O fator mais importante na explica o da varia o no uso de servi os de saúde por idosos foi necessidade. Porém, ser do sexo feminino, renda, área de moradia e ter direito de usar servi o privado também mostraram efeito positivo no consumo de servi os de saúde. O modelo apontou ainda para a existência de intera o entre área de residência e renda. A área de alto padr o de vida, representada neste estudo por Copacabana, n o apresentou desigualdades internas no uso de servi os de saúde, sendo o efeito da renda mais importante em locais classificados em níveis de padr o de vida médio e menor (Méier e Santa Cruz, respectivamente).
O erro médico e a viola??o às normas e prescri??es em saúde: uma discuss?o teórica na área de seguran?a do paciente
Nascimento, Nadia Bomfim do;Travassos, Cláudia Maria de Rezende;
Physis: Revista de Saúde Coletiva , 2010, DOI: 10.1590/S0103-73312010000200016
Abstract: in 1999, the report by the institute of medicine (iom), pointed that there are significant adverse events and that more than half of these occurrences were caused by medical errors, provoking numerous actions and research on patient safety. infections related to health care (iras), one of the problems faced in the area, are the subject of research that attempt to create procedures and strategies to prevent such events. hand hygiene, because it is the simplest measure of control in iras and, paradoxically, the one with the lowest compliance rate among physicians, is the target of numerous programs and campaigns. the need to reverse this state has generated extensive literature that, among other things, indicates and identifies barriers and risk factors for poor adherence to standards and procedures for hands hygiene, but also seeks to understand the behavioral aspects concerned. this paper presents some theoretical models aimed at understanding the behavioral dynamics which involves the achievement of error and violation and carries out an analysis with the possibilities of apprehension of the process. finally, it is considered that the explanatory models jointly presented bring contributions that can be applied in practice and that identifying and understanding the mechanisms of collective defense would lead to factors that are at stake in the low adherence to procedures, sanitation of hands among physicians, despite the existing evidence.
Desigualdade no tratamento à fratura proximal de fêmur no Rio de Janeiro
Pinheiro, Rejane Sobrino;Travassos, Cláudia;Gamerman, Dani;
Revista Brasileira de Epidemiologia , 2006, DOI: 10.1590/S1415-790X2006000300011
Abstract: objective: the aim of this study was to analyze the variations in the surgical use of healthcare services for hip fracture patients, and the occurrence of inequity in the rio de janeiro public health sector. methods: the unified health system hospital information system data from hospital records of rio de janeiro health services between 1994 and 1995 were analyzed. results: multivariate analysis showed that women had a greater chance of surgery (or=1.53, ci95%1.18-199). the chances of surgery were lower in federal hospitals (or=0.21, ci95% 0.10-0.41), state hospitals (or =0.07, ci95% 0.04-0.12), and city hospitals (or=0.11, ci95% 0.07-0.18), compared with private hospitals hired by the sus. the chances of surgery were lower in emergency departments (or=0.31, ci95% 0.19-0.48) and in hospitals located in less deprived areas (or=1.68, ci95% 1.52-1.86). conclusion: the variation in the hospital market was related to patient and hospital profiles, and the surgical treatment for hip fracture was associated with factors unrelated to need, showing differences in access.
Utiliza??o dos servi?os de saúde no Brasil: gênero, características familiares e condi??o social
Travassos,Cláudia; Viacava,Francisco; Pinheiro,Rejane; Brito,Alexandre;
Revista Panamericana de Salud Pública , 2002, DOI: 10.1590/S1020-49892002000500011
Abstract: objective. to investigate the pattern of utilization of health care services by men and by women in brazil. methods. we used data from the brazilian national household sample survey (pesquisa nacional por amostra de domicílios) carried out in 1998. logistic regression models were developed to analyze information concerning men and women who had and who did not have restrictions in their routine activities due to health problems during the 15 days before the survey. the individual variables considered were: labor market position (type of employment), amount of schooling completed, and race. also analyzed were family-related variables: per capita family income, size of the family, and, for the head of the family, the amount of schooling and labor market position. the two-level models (with family and individual variables) showed an effect from family characteristics, but the variables analyzed did not explain that effect. results. women used health services more often than did men, even after controlling for restrictions in routine activities due to health reasons. the use of health services by men and women was dependent on family income and on the social status of the individual, indicating a pattern of social inequality. in both the group with restrictions in their activities and in the group without such restrictions, the men and women differed from each other in their utilization of health care services. family variables were more important in explaining the utilization of health services among people without restrictions in their activities. conclusions. policies aimed at reducing inequalities in access to health care services must take into consideration the differences between women and men as well as the importance of family characteristics. it is also important to stress the need to include the dimensions of gender and family in the design of health service utilization models.
Utiliza o dos servi os de saúde no Brasil: gênero, características familiares e condi o social
Travassos Cláudia,Viacava Francisco,Pinheiro Rejane,Brito Alexandre
Revista Panamericana de Salud Pública , 2002,
Abstract: Objetivo. Investigar o perfil de utiliza o de servi os de saúde por homens e mulheres no Brasil. Métodos. Utilizaram-se os dados da Pesquisa Nacional por Amostra de Domicílios realizada em 1998. Foram desenvolvidos modelos de regress o logística para analisar as informa es relativas a homens e mulheres com e sem restri o de atividades por motivos de saúde nos 15 dias que antecederam a pesquisa. As variáveis individuais foram: posi o no mercado de trabalho, escolaridade e ra a. Também foram analisadas variáveis relativas à família: renda familiar per capita, tamanho da família e escolaridade e posi o do chefe da família no mercado de trabalho. Nos modelos em dois níveis (variáveis individuais e familiares) evidenciou-se um efeito de família que, entretanto, n o foi captado pelas variáveis analisadas. Resultados. As mulheres utilizaram mais os servi os de saúde, mesmo quando controlado o efeito da restri o de atividades por motivo de saúde. O uso de servi os de saúde por homens e mulheres dependeu do poder aquisitivo das famílias e das características sociais do próprio indivíduo, definindo um perfil de desigualdades sociais. Observaram-se diferen as no perfil de desigualdade nos gêneros entre pessoas que referiram e n o referiram restri o de atividades. As variáveis familiares tiveram maior importancia na explica o do consumo de servi os por pessoas sem restri o de atividade. Conclus es. A formula o de políticas voltadas para a redu o das desigualdades no consumo de servi os de saúde deve considerar as diferen as entre mulheres e homens, além da importancia das características familiares. Ressalta-se a necessidade de incluir as dimens es gênero e família na especifica o dos modelos de uso de servi os de saúde.
Abstract
Viacava Francisco,Leite Iúri da Costa,Travassos Cláudia
Ciência & Saúde Coletiva , 2002,
Abstract:
Acesso à interna??o hospitalar nos municípios brasileiros em 2000: territórios do Sistema único de Saúde
Oliveira, Evangelina X. G. de;Travassos, Cláudia;Carvalho, Marilia Sá;
Cadernos de Saúde Pública , 2004, DOI: 10.1590/S0102-311X2004000800023
Abstract: this article investigates the effect of external factors on hospitalization patterns in brazilian municipalities (or counties): supply, spatial configuration, socioeconomic aspects, and political context. inpatient data from 2000 for individuals 15 years and over and most frequent hospital procedures, obtained from the national hospital information system (sih-sus), were aggregated by place of residence at the municipal level. nested generalized additive mixed models were fitted using bayesian inference. probability of hospitalization is shown to increase with hospital bed supply and with primary care and local capacity, and to decrease with increasing distances and in larger and wealthier municipalities. inclusion of random, state, and spatial patterns effects reveals regional differences in the probability of hospitalization and the main factors explaining such different patterns.
Factors associated with readmission to a general hospital in Brazil
Castro, M?nica Silva Monteiro de;Carvalho, Marilia Sá;Travassos, Cláudia;
Cadernos de Saúde Pública , 2005, DOI: 10.1590/S0102-311X2005000400021
Abstract: the objective of this study was to compare different modeling strategies to identify individual and admissions characteristics associated with readmission to a general hospital. routine data recorded in the hospital information system on all admissions to the regional public hospital of betim, minas gerais state, brazil, from july 1996 to june 2000 were analyzed. cox proportional hazards model and variants designed to deal with multiple-events data, like andersen-gill (ag), prentice, williams and peterson (pwp), and random effects models were fitted to time between hospital admissions or censoring. for comparison purposes, a poisson model was fitted to the total number of readmissions, using the same covariates. we analyzed 31,648 admissions of 26,198 patients, including 17,096 adults and 9,102 children. estimates for the pwp and frailty models were very similar, and both approaches should be fitted and compared. if clinical characteristics are available, the pwp model should be used. otherwise the random effects model can account for unmeasured differences, particularly some related to severity of the disease. these methodologies can help focus on various related readmission aspects such as diagnostic groups or medical specialties.
Territórios do Sistema único de Saúde: mapeamento das redes de aten??o hospitalar
Oliveira, Evangelina X. G. de;Carvalho, Marilia Sá;Travassos, Cláudia;
Cadernos de Saúde Pública , 2004, DOI: 10.1590/S0102-311X2004000200006
Abstract: this article presents two types of networks organized according to patient caseload in health services, concerning both primary hospital care (most frequent hospital procedures) and tertiary care (high-cost procedures). data on inpatient care in brazil in 2000 obtained from the hospital information system of the unified national health system were aggregated by place of residence and hospital location at the municipal level. both the network structure and the node (municipality) hierarchy were established using the dominant flow approach. in addition, a typology of flows was applied to indicate the degree of connection across the networks. primary hospital care networks reach most of the country, and few municipalities are not connected to the network. relatively few cities provide higher-level services, and almost half of the municipalities are unconnected. the ministry of health aims to provide access to frequently used health services near the users' place of residence, and this goal appears to be feasible in the short run. on the other hand, much remains to be done to ensure widespread access to tertiary care.
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