Made available in DSpace on 2015-12-04T11:45:36Z (GMT). No. of bitstreams: 1 Florinda_Roque.pdf: 390806 bytes, checksum: b1a602cdf4e3deed9823cc46d23386e6 (MD5) Previous issue date: 2004-04-02 / The Brazilian people can get no satisfaction about the public attendance o healthy sector. It means that the Government politic has been inefficient to maintain a universal healthy system for population. So, the persons who have some better financial conditions, are looking for alternatives on private enterprise to protect themselves, as well as their dependents. Also, the private companies have adopted these strategic fringe benefits to offers to their employees. In Brazil, the healthy plans operators are responsible to attending about thirty five millions of users, considering that this number was bigger in the past. Actually, there are more than hundred operators, which are the following types: Group Medicine, Insurance Company, Self Management and Co-operative of doctors. The insolvency and financial problems of some companies in that sector had as consequence the stop on attendance of users, after contributing for many years. So the society began making pressure to quick the process of regulation on this area, and in 1998 it was approved the law 9656/98, after this it was included many provisory measures and norms, as the creation of a regulatory agency with many regulatory norms. With the sector regulation, it was necessary the juridical orderings of the operator's accounting standards. These juridical orderings brings the obligation of publishing the financial statements and models for this publication. This research analyzed some aspects of the financial statements and the quality of disclosures in the years 2001 and 2002, with intention of reflects if the ways of disclosure presentation helps the users to realize a complete analysis before decide for purchasing healthy plan. / O atendimento insatisfat??rio ?? popula????o na ??rea da sa??de mostra que o Estado ?? ineficiente para manter um sistema universal para atender satisfatoriamente toda a popula????o nessa importante ??rea. Como conseq????ncia, as pessoas de melhor poder aquisitivo buscam na iniciativa privada as alternativas para prote????o da sua sa??de e de seus dependentes. Tamb??m as empresas se valem dessas op????es para oferecer aos seus colaboradores um benef??cio adicional e importante, para a maioria dos trabalhadores, que ?? a assist??ncia m??dica em grupo. No Brasil, as operadoras de planos de sa??de s??o respons??veis pelo atendimento de aproximadamente trinta e cinco milh??es de usu??rios, sendo que este n??mero j?? foi maior. Existem atualmente mais de mil operadoras, classificadas nos tipos Medicina de Grupo, Seguradora, Auto Gest??o e Cooperativa de Trabalho M??dico. A fal??ncia de v??rias empresas deixou muitos usu??rios sem atendimento, mesmo depois de v??rios anos de contribui????o. Tais acontecimentos originaram uma press??o por parte da comunidade de usu??rios, no sentido de agilizar o processo de regulamenta????o dessas atividades, que resultou na aprova????o, em 1998, da Lei n?? 9656/98. Depois disto surgiram outras medidas provis??rias e normas, como a cria????o de uma ag??ncia reguladora, a qual emitiu v??rias normas reguladoras. A regulamenta????o do setor provocou, por sua vez, o ordenamento jur??dico e a normatiza????o dos procedimentos cont??beis das operadoras, os quais, entre outras exig??ncias, determina a obrigatoriedade de publicar as demonstra????es cont??beis, de acordo com os modelos contidos nas normas divulgadas. Esta pesquisa analisou a qualidade das evidencia????es, as pr??ticas cont??beis que as Operadoras de Plano de Sa??de foram obrigadas a seguir de acordo com a Lei n?? 9656/98 e alguns aspectos econ??micos-financeiros, analisados atrav??s do ??ndice de giro operacional das operadoras de plano de sa??de modalidade medicina de grupo no Estado de S??o Paulo, nos anos de 2001 e 2002 no intuito de refletir sobre as exig??ncias de uma sociedade globalizada.

Qualification work is focused on problematic of injuries, occurring in the population, and their influence regarding amount of costs covered by the public health care. The aim of this thesis is to determine, based on available information, expenses trends in health care and also costs, related to health care, of individual health insurance companies. Identification of injuries occurrence throughout the population and determination of their costs and complexity is furthermore important segment of the thesis. Based on these data, the objective of this thesis is to identify the portion of this amount contributing to the overall costs of public health care. The practical part of the thesis also contains analysis of recommendations, which might influence or cause change from current situation.

Thesis (LLM ( Labour law)) --University of Limpopo, 2013 / Refer to document

Source: Masters Abstracts International, Volume: 46-05, page: 2674. Adviser: Carl Hacker. Includes bibliographical references.

Thesis (Ph.D. in Nursing) -- University of Colorado at Denver and Health Sciences Center, 2006. / Typescript. Includes bibliographical references (leaves 188-199). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;

Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Dissertation Abstracts International, Volume: 69-02, Section: B, page: 0969. Adviser: Charles E. Begley. Includes bibliographical references.

Orientador: Aarão Mendes Pinto Neto / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T22:16:57Z (GMT). No. of bitstreams: 1 Baccaro_LuizFranciscoCintra_D.pdf: 2072530 bytes, checksum: 31649568918c18e7bd2825dac90d7e60 (MD5) Previous issue date: 2013 / Resumo: Objetivos: Conhecer a prevalência e os fatores associados à ocorrência de osteoporose, quedas e fraturas por fragilidade óssea em mulheres brasileiras com 50 anos ou mais. Identificar os fatores associados ao desenvolvimento precoce de osteoporose. Método: inquérito populacional transversal que incluiu mulheres com 50 anos ou mais, conduzido na cidade de Campinas, São Paulo, Brasil de 10/05/2011 a 31/10/2011. As mulheres foram entrevistadas por assistentes de pesquisa treinadas, após o sorteio de 66 setores censitários do município. As mulheres que não responderam ao questionário por problemas pessoais e aquelas com incapacidade cognitiva ou demência foram excluídas do estudo. A variável dependente osteoporose foi classificada como osteoporose autorrelatada, independente da realização de exame de densitometria óssea, ou como osteoporose diagnosticada através de densitometria óssea. As demais variáveis dependentes foram ocorrências de quedas no último ano e de fraturas por fragilidade óssea após os 50 anos de idade. As variáveis independentes foram às características sociodemográficas, hábitos pessoais, problemas de sáude, autopercepção de saúde e avaliação da capacidade funcional. A análise estatística foi realizada através do teste qui-quadrado, regressão de Cox e regressão de Poisson com critério de seleção de variáveis backward. Resultados: Seiscentas e vinte e duas mulheres responderam ao questionário e constituíram a amostra final. A média etária das mulheres foi de 64,1 anos. A prevalência de osteoporose autorrelatada, independente da realização da densitometria óssea foi de 21,3%, e a prevalência de osteoporose diagnosticada através da densitometria óssea foi de 16,7%. A prevalência de quedas no último ano foi de 24,6% e a de fraturas por fragilidade óssea de 10,8%. No modelo estatístico final, os fatores associados à maior prevalência de osteoporose, independente da realização de densitometria óssea, foram ter maior tempo de menopausa (RP 1,04; 95% IC 1,03 - 1,05; p<0,001), autopercepção de saúde regular/ruim/péssima (RP 1,73; 95% IC 1,29 - 2,33; p<0,001), artrose (RP 1,83; 95% IC 1,30 - 2,59; p<0,002) e ter problemas para manter o equilíbrio quando toma banho ou desce escadas (RP 1,52; 95% IC 1,07 - 2,14; p=0,02). Os fatores associados com maior prevalência de osteoporose diagnosticada por densitometria óssea foram possuir maior tempo de menopausa (RP 1,04; 95% IC 1,03 - 1,05; p < 0,001), apresentar artrose (RP 1,80; 95% IC 1,20 - 2,68; p = 0,005), ter problemas para correr / levantar peso / fazer esportes / trabalho pesado (RP 1,82; 95% IC 1,14 - 2,90; p = 0,012) e possuir problemas para manter o equilíbrio quando se está tomando banho ou descendo escadas (RP 1,52; 95% IC 1,04 - 2,23; p = 0,031). As variáveis associadas ao desenvolvimento precoce de osteoporose foram autopercepção de saúde regular/ruim/péssima (coeficiente 0,77; p<0,001), tratamento para menopausa com medicamentos naturais (coeficiente 1,01; p<0,001), fumar atualmente ou no passado mais de vinte cigarros por dia (coeficiente 1,02; p=0,003) e ter problemas para correr / levantar peso / fazer esportes / trabalho pesado (coeficiente 0,60; p=0,029). Os fatores relacionados com maior prevalência de quedas foram ter problemas de equilíbrio quando anda (RP 1,87; 95% IC 1,33 - 2,63; P < 0,001), consumo de álcool (RP 1,69; 95% IC 1,25-2,28; P < 0,002), ter sido internada no último ano (RP 1,46; 95% CI 1,09 - 1,96; P = 0,012), e apresentar catarata (RP 1,40; 95% IC 1,05 - 1,87; P = 0.021). Os fatores relacionados à menor prevalência de quedas foram ter convênio médico (RP 0,67; 95% IC 0,50 - 0,89; P = 0,007) e realizar algum tipo de tratamento para os sintomas da menopausa (RP 0,42; 95% IC 0,19 - 0,92; P = 0,031). Os fatores relacionados à maior prevalência de fraturas foram apresentar maior tempo de menopausa (RP 1,03; 95% IC 1,01-1,05; P=0,003) e apresentar osteoporose (RP 1,97; 95% IC 1,27-3,08; P=0,003). Conclusões: a prevalência de osteoporose e fraturas por fragilidade óssea na população estudada foi semelhante à relatada pelos últimos estudos nacionais. A prevalência de quedas foi discretamente menor do que a relatada pelos últimos estudos nacionais e internacionais. Os fatores associados à osteoporose foram ter maior tempo de menopausa, autopercepção de saúde regular/ruim/péssima, relatar artrose, ter problemas para manter o equilíbrio e apresentar diminuição da capacidade funcional. Os fatores associados ao desenvolvimento precoce da osteoporose foram autopercepção de saúde regular/ruim/péssima, tratamento com medicamentos naturais para a menopausa, fumar mais de vinte cigarros (atualmente ou no passado) e apresentar diminuição da capacidade funcional. Os fatores associados à maior prevalência de quedas foram problemas de equilíbrio, consumir bebidas alcoólicas, ter sido internada nos últimos doze meses e referir catarata. Realizar algum tipo de tratamento para a menopausa e possuir convênio médico se associaram a menor prevalência de quedas. Os fatores clínicos associados à maior prevalência de fraturas por fragilidade óssea foram ter osteoporose e maior tempo de menopausa. Os resultados deste estudo indicam a necessidade da realização de programas de saúde pública que incentivem hábitos saudáveis, como a prática de exercícios físicos regulares, de programas contra o tabagismo e o alcoolismo, além do acompanhamento médico de rotina de mulheres com 50 anos ou mais / Abstract: Objectives: This study was performed to determine the prevalence and factors associated with the occurrence of osteoporosis, falls, and fragility fractures in Brazilian women aged 50 years or older and obtain information on factors related to the early onset of osteoporosis. Methods: A cross-sectional population survey that included women aged 50 years or older was conducted in the city of Campinas, São Paulo, Brazil from 10 May 2011 to 31 October 2011. Women were interviewed by trained research assistants after a draw of 66 census sectors in the city. Women who did not respond to the questionnaire for personal reasons and those with cognitive impairment or dementia were excluded. The dependent variable osteoporosis was classified either as self-reported regardless of bone densitometry, or as osteoporosis diagnosed by bone densitometry. The other dependent variables were the occurrence of falls in the last year and the occurrence of fragility fractures after 50 years of age. The independent variables were sociodemographic data, health-related habits and problems, self-perception of health, and evaluation of functional capacity. Statistical analysis was carried out by the chi-square test, Cox multiple regression model, and Poisson regression analysis using backward selection criteria. Results: A total of 622 women completed the questionnaire and constituted the final sample. The mean age of the women was 64.1 years. The prevalence of self-reported osteoporosis regardless of bone densitometry was 21.3%, and the prevalence of osteoporosis diagnosed by bone densitometry was 16.7%. The prevalence of falls in the last year was 24.6%, and the prevalence of fragility fractures was 10.8%. In the final statistical model, the factors associated with a higher prevalence of osteoporosis regardless of bone densitometry were a longer period of time since menopause (PR, 1.04; 95% CI, 1.03-1.05; p < 0.001), self-perception of health as fair/poor/very poor (PR, 1.73; 95% CI, 1.29-2.33; p < 0.001), arthrosis (PR, 1.83; 95% CI, 1.30-2.59; p < 0.002), and problems maintaining balance when taking a bath or going down stairs (PR, 1.52; 95% CI, 1.07-2.14; p = 0.02). The factors associated with a higher prevalence of osteoporosis diagnosed by bone densitometry were a longer period of time since menopause (PR, 1.04; 95% CI, 1.03-1.05; p < 0.001), arthrosis (PR, 1.80; 95% CI, 1.20-2.68; p = 0.005), problems running/lifting something heavy/practicing sports/doing heavy work (PR, 1.82; 95% CI, 1.14-2.90; p = 0.012), and problems maintaining balance when taking a bath or going down stairs (PR, 1.52; 95% CI, 1.04-2.23; p = 0.031). The variables associated with early onset of the disease were self-perception of health as fair/poor/very poor (coefficient, 0.77; p < 0.001), menopausal treatment with natural remedies (coefficient, 1.01; p < 0.001), smoking or having smoked >20 cigarettes/day (coefficient, 1.02; p = 0.003), and problems running/lifting something heavy/practicing sports/doing heavy work (coefficient, 0.60; p = 0.029). The factors associated with a higher prevalence of falls were trouble maintaining balance when walking (PR, 1.87; 95% CI, 1.33-2.63; p < 0.001), alcohol consumption (PR, 1.69; 95% CI, 1.25-2.28; p < 0.002), admission to a hospital in the last 12 months (PR, 1.46; 95% CI, 1.09-1.96; p = 0.012), and cataracts (PR, 1.40; 95% CI, 1.05-1.87; p = 0.021). Having health insurance (PR, 0.67; 95% CI, 0.50-0.89; p = 0.007) and using some form of medication to treat menopausal symptoms (PR, 0.42; 95% CI, 0.19-0.92; p = 0.031) were associated with a lower prevalence of falls. A longer period of time since menopause (PR, 1.03; 95% CI, 1.01-1.05; p = 0.003) and having osteoporosis (PR, 1.97; 95% CI, 1.27-3.08; p = 0.003) were associated with a higher prevalence of fragility fractures. Conclusions: The prevalence of osteoporosis and fragility fractures in this study population was similar to that reported by recent national studies. The prevalence of falls was slightly lower than that reported by recent national and international studies. The factors associated with osteoporosis were a longer period of time since menopause, self-perception of health as fair/poor/very poor, arthrosis, trouble maintaining balance, and reduced functional capacity. Factors associated with early onset of the disease were self-perception of health as fair/poor/very poor, treatment with natural remedies for menopause, smoking >20 cigarettes/day (currently or in the past), and reduced functional capacity. The factors associated with a higher prevalence of falls were trouble maintaining balance when walking, alcohol consumption, admission to a hospital in the last 12 months, and cataracts. Administration of some type of treatment for menopause and having health insurance were associated with a lower prevalence of falls. The clinical factors associated with a higher prevalence of fragility fractures were osteoporosis and a longer period of time since menopause. The results of this study indicate the need to carry out public health programs that encourage healthy habits such as regular physical exercise, programs that discourage smoking and alcoholism, and the performance of routine medical monitoring of women aged 50 years or older / Doutorado / Fisiopatologia Ginecológica / Doutor em Ciências da Saúde

This dissertation considers the issue of equivalence and the related matter of solidarity in the health insurance sector. The used methodology is an analysis on the basis of which the specific causes of the current state of the healthcare system are investigated. The initial chapters focus on the theoretical basis and insurance principles in general, and then health insurance in more detail. The individual systems (models) of healthcare, which are compared with the aim of finding the optimum method of financing the healthcare sector, are then described. The analytical section looks at the current state of healthcare in the Czech Republic and the main problems it faces: an ageing population and constantly rising healthcare costs, which are slowly becoming uncontrollable. Healthcare reform, which began on 1 January 2008 with the introduction of regulation fees, is also evaluated. A great deal of attention is paid to fees because the legality of their introduction is being settled by the Constitutional Court of the Czech Republic. In conclusion, the author outlines a healthcare system that would be, in his opinion, more financially manageable, and just more equitable and fair.

The main theme of the thesis is managed care system description and definition. The first part is focused on managed care history, development in this system, and types of organizations providing this medical and hospital services. There is also chapter concerned with problems of resource management and managed care quality. The next chapter describes medical and health services and managed care in the USA, the only country offering these services in free mareket economy. For comparison in the next chapter there are presented someEuropean states, which try to introduce managed care as a tool for reduction of redundant and duplicate health services costs, include Czech Republic. At the conclusion, the comparison of some economic indicator of medical and health services among some European contries and the USA has been done.

The aim of my thesis is to review current and approchable types of insurance in Czech republic with an emphasis on the health insurance. The thesis should result in a summary of possible reform or stabilization arrangements that are solving unfavourable prognosis in Czech republic in the long term.