Made available in DSpace on 2015-04-14T13:54:07Z (GMT). No. of bitstreams: 1 457202.pdf: 1618194 bytes, checksum: d607b65d131e6da9ab8169e51d5b048b (MD5) Previous issue date: 2014-03-05 / The growing population aging has led to several changes in the needs of the society where we live, requiring a better understanding on topics ranging from epidemiological transition to financial issues related to how to defray the expenses of this longevity. It is known that changes in age structure and the consequences of population aging increase the prevalence of chronic degenerative diseases, a process that leads to an increase in costs for health systems. The main purpose of this study was to associate costs of elderly hospitalizations with mean per capita household income in elderly's municipality of residence. The method was a cross-sectional study that assessed hospitalizations of elderly people living in the municipalities of Alvorada, Ivoti and Porto Alegre, Southern Brazil, and admitted at hospitals in the state of Rio Grande do Sul in 2011, based on data collected from SIH/SUS-DATASUS, a database created by the Brazilian Ministry of Health. These municipalities were selected for this study because they showed the greatest disparity in mean per capita household income among the municipalities belonging to their Regional Health Department. Using the tabulation tool named TABWIN, the following analysis parameters were selected: total number, frequency and length of hospitalizations. Such data were associated with socioeconomic and demographic data of the municipalities under study. Considering the overall amount of hospitalizations of elderly people living in the three municipalities analyzed, it was observed that inhabitants of Porto Alegre showed the lowest frequency of hospitalizations (11.15%), whereas their hospitalizations had the highest mean cost (1.896,19 BRL [Brazilian reais]). Inhabitants of Ivoti showed the highest frequency of hospitalizations (18.53%), with the lowest mean cost (R$ 1,001.10 BRL), whereas inhabitants of Alvorada had an intermediate frequency of hospitalizations (16.57%), with a mean cost of R$ 1,483.66 BRL. As for the association between healthcare costs and mean household income, Porto Alegre showed the highest income (1,722.37 BRL) and the highest per capita gross internal product (GDP), Ivoti had intermediate income (1,019.75 BRL) and per capita GDP, and Alvorada presented a significantly lower income (587.84 BRL). However, although Porto Alegre showed the highest per capita cost with hospitalization of its inhabitants (31.78 BRL), it assigned only 0.1% of its GDP to cover these expenses, whereas Alvorada had a per capita cost of 22.08 BRL, assigning 0.29% of its per capita GDP, and Ivoti showed the lower cost per capita (18.94 BRL) for covering elderly hospitalizations and also the lowest portion of its GDP per capita for this purpose (0.08%). The combination of demographic, socioeconomic, epidemiological, and morbidity and mortality data provides a more solid, critical and endorsed view for the construction of favorable or unfavorable opinions regarding health actions and the use of public resources. Additionally, it is important to develop data analysis and collection skills among health professionals and managers, in order to potentiate care so that it meets the actual needs of each municipality or region during decision making processes. / O crescente envelhecimento da popula??o vem trazendo consigo modifica??es das necessidades na organiza??o social em que vivemos, exigindo desde uma melhor compreens?o desta transi??o epidemiol?gica at? as quest?es financeiras que envolvem o custeio desta longevidade. Entende-se que as mudan?as na estrutura et?ria e as consequ?ncias do envelhecimento populacional tornam mais significativa a preval?ncia de doen?as cr?nico-degenerativas, processo esse que desencadeia crescentes custos para os sistemas de sa?de. Este trabalho teve como objetivo relacionar custos de interna??es hospitalares de idosos com a renda m?dia domiciliar per capita de seus munic?pios de resid?ncia. Trata-se de um estudo transversal com an?lise a partir dos elementos colhidos no banco de dados do SIH/SUS-DATASUS, de interna??es hospitalares de idosos residentes dos munic?pios de Alvorada, Ivoti e Porto Alegre, internados no ano de 2011 em hospitais do Rio Grande do Sul, selecionados por representarem a maior disparidade de renda m?dia domiciliar per capita, dentre os munic?pios de sua Coordenadoria Regional de Sa?de. Atrav?s do TABWIN foram selecionados como par?metros para as an?lises o valor total, frequ?ncia e tempo de perman?ncia das interna??es hospitalares. Tais dados foram relacionados aos dados socioecon?micos e demogr?ficos dos munic?pios em estudo. Considerando o montante global de todas as interna??es dos idosos residentes dos tr?s munic?pios em an?lise, verificou-se que os mun?cipes de Porto Alegre apresentaram a menor frequ?ncia de interna??es (11,15%), ao passo que suas interna??es obtiveram o maior custo m?dio (R$ 1.896,19). Os mun?cipes de Ivoti apresentaram a maior frequ?ncia de interna??es, no valor de 18,53%, com o menor custo m?dio, de R$ 1.001,10, enquanto que os de Alvorada apresentaram interna??es em frequ?ncia intermedi?ria (16,57%), com custo m?dio de R$ 1.483,66. Quanto ? rela??o de custos em sa?de com renda m?dia domiciliar per capita, Porto Alegre apresentou a maior renda (R$ 1.722,37) e o maior PIB per capita, Ivoti apresentou renda R$ 1.019,75 e PIB intermedi?rios e Alvorada apresentou a renda significativamente menor (R$ 587,84). Entretanto, apesar de Porto Alegre ter apresentado o maior custo per capita com as interna??es de seus mun?cipes (R$ 31,78), empenhou apenas 0,1% de seu PIB para suprir estes custos, enquanto o munic?pio de Alvorada apresentou custo per capita de R$ 22,08, empenhando 0,29% de seu PIB per capita, e Ivoti apresentou o menor custo per capita (R$ 18,94) para a cobertura de interna??es de seus idosos e tamb?m teve o menor consumo de seu PIB per capita com este objetivo (0,08%). O cruzamento de dados demogr?ficos, socioecon?micos, epidemiol?gicos e de morbimortalidade proporciona uma vis?o mais s?lida, cr?tica e respaldada para a constru??o de pareceres favor?veis ou desfavor?veis ?s a??es de sa?de e ? utiliza??o dos recursos p?blicos. Tamb?m o maior desenvolvimento da habilidade de coleta e an?lise desses dados ? algo que merece ser disseminado entre os profissionais e gestores em sa?de, em prol da potencializa??o do atendimento ?s reais necessidades de cada munic?pio ou regi?o durante processos decis?rios.

Made available in DSpace on 2015-04-14T14:46:09Z (GMT). No. of bitstreams: 1 438860.pdf: 4536324 bytes, checksum: d5e05c95e76176145bd305204487a283 (MD5) Previous issue date: 2012-02-29 / This dissertation analyses in a sociological prospect the disconfessionalization of the religious places in the public hospitals of Porto Alegre and its transformation into interreligious places. It shows that this process relies on the principle of equality between religions. The work tries to check and analyze the state mechanisms that enable this phenomenon. It shows that Federal Constitution of 1988 and some national policies of Ministry oh Healt are used as instruments of public agents for disconfessionalize the religious places, that were exclusively catholic until the beginning of the 21st century. On the other hand, it shows the resistance of the catholic religious agents to this process. It shows that disconfessionalization is also done by people of religious minorities interested to dissolve the hegemonic presence of catholic religion in the hospitals. The work also analyses how the religious assistance is done in public and private hospitals, comparing this service in both kind of hospitals. It shows that this kind of assistance try to adapt to the modernization of the institutions and the growing religious pluralism of the Brazilian society. To understand the change of the religious places and the religious assistance, the work appeal to the sociological and theoretical analyses of phenomenon like secularization, secularism, and the constitution of the secular state, and it shows an historical approach of the relation between religion and state in Brazil. / Essa disserta??o analisa, numa perspectiva sociol?gica, a desconfessionaliza??o dos espa?os religiosos dos hospitais p?blicos de Porto Alegre e as suas transforma??es em espa?os inter-religiosos. Mostra que esse processo se baseia no princ?pio laico de igualdade entre as religi?es. O trabalho busca verificar e analisar os mecanismos estatais que possibilitam esse fen?meno. Mostra que a Constitui??o Federal de 1988 e algumas pol?ticas nacionais do Minist?rio da Sa?de servem como instrumentos de agentes p?blicos para desconfessionalizar os locais de culto, que at? a entrada do s?culo XXI eram exclusivamente cat?licos. Por outro lado, apresenta a resist?ncia de agentes religiosos cat?licos a esse processo. Mostra que a desconfessionaliza??o tamb?m foi feita por membros de minorias religiosas interessadas em dissolver a presen?a hegem?nica da religi?o cat?lica no meio hospitalar. O trabalho tamb?m analisa como ocorre a assist?ncia religiosa nos hospitais p?blicos e privados, comparando o servi?o nos dois tipos de hospitais. Mostra que essa assist?ncia procura adaptar-se ? moderniza??o das institui??es e ao crescente pluralismo religioso da sociedade brasileira, tornando-se ela mesma plural. Para compreender as mudan?as nos espa?os religiosos e a assist?ncia religiosa, o trabalho recorre ? an?lise sociol?gica e te?rica de fen?menos como a seculariza??o, a laicidade e a constitui??o do Estado laico, e faz uma abordagem hist?rica da rela??o entre religi?o e Estado no Brasil.

Made available in DSpace on 2015-04-14T13:20:25Z (GMT). No. of bitstreams: 1 437427.pdf: 1769374 bytes, checksum: 288684c39a2f0f0cb45fda6d8cd88ec1 (MD5) Previous issue date: 2012-01-11 / This thesis constitutes a qualitative study about the work involved in the social worker in the hospital, and is anchored in research that is based on the theory and historical-dialectical materialist method. The problem part of the following research question: "how the social workers to the hospital system develop its work in teams where they live?" In order to analyze the work of the social worker of the hospital network, from the perspective of teamwork in order to qualify the integral and humanized care to the user. The research subjects were nine (09) professionals who work in health teams in hospitals, in Porto Alegre, including: social workers, doctors, nurse, psychologist and speech therapist. In the process of data collection, we used a semi-structured interview technique with application form consisting of open questions. The data collected were subjected to content analysis of crop-based thematic Bardin (1977), identifying thematic topics and frequency of communications professionals, according to summaries of the themes or explanatory of reality: the social worker the health teams, team work, comprehensiveness and humanization that support for the discussion and propositions woven. / Esta disserta??o se constitui em um estudo de abordagem qualitativa sobre o trabalho em que participa o assistente social no contexto hospitalar, e se encontra ancorada em uma pesquisa que se baseia na teoria e no m?todo materialista hist?rico-dial?tico. O problema de pesquisa parte da seguinte interroga??o: de que forma os assistentes sociais que atuam na rede hospitalar desenvolvem seu trabalho nas equipes em que est?o inseridos? ; com o objetivo de analisar o trabalho do assistente social da rede hospitalar, na perspectiva do trabalho em equipe, a fim de qualificar a aten??o integral e humanizada do atendimento ao usu?rio. Os sujeitos da pesquisa s?o nove (09) profissionais que atuam em equipes de sa?de, em institui??es hospitalares, em Porto Alegre, entre eles: assistentes sociais, m?dicos, enfermeiro, psic?logo e fonoaudi?logo. No processo de coleta de dados, utilizou-se a t?cnica de entrevista semiestruturada com aplica??o de formul?rio composto de quest?es abertas. Os dados coletados foram submetidos ? an?lise de conte?do de recorte tem?tico com base em Bardin (1977), identificando-se n?cleos tem?ticos e frequ?ncia dos temas nas comunica??es dos profissionais, de acordo com as s?nteses das categorias tem?ticas ou explicativas da realidade: o assistente social nas equipes de sa?de, trabalho em equipe, integralidade e humaniza??o que d?o suporte para a discuss?o e as proposi??es tecidas.