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Custeio dos gastos no serviço público de saúde: estudo de caso no Hospital Nelson Salles / Costing spending on public health care: a case study in Nelson Hospital SallesWarley Francisco de Araújo Pereira 11 March 2014 (has links)
A dissertação tem como objetivo aplicar um método de custeio aos gastos atribuídos, pelo Hospital Nelson Salles, na execução do serviço público de saúde, em apoio ao Município Engenheiro Paulo de Frontin. Para a realização deste trabalho, o estudo utilizou-se da pesquisa bibliográfica para fundamentar e ilustrar o tema proposto, bem como, do método exploratório descritivo para reconhecer a situação da instituição e identificar uma metodologia de controle dos custos adequada à realidade da organização estudada. A apuração de custos em organizações hospitalares justifica-se: pelo aumento na demanda de clientes; pelo crescimento dos gastos na área da saúde e pelas limitações decorrentes dos orçamentos das entidades públicas, onde as organizações necessitam adotar um sistema que forneça informações úteis referentes aos custos, em especial ao hospital, objeto de estudo, por não dispor de um sistema de custos. Um sistema de apuração de custos pode trazer aos gestores hospitalares informações relevantes ao planejamento, controle e tomada de decisão com vistas à otimizar os recursos limitados e a manutenção da qualidade no atendimento ao paciente. Neste contexto, foram apresentados os principais métodos de custeio utilizados para a implementação do sistema de gestão de custos hospitalares, que são custeio por absorção; com apropriação por centro de custos, o custeio variado e o custeio baseado em atividades (ABC).Como resultado alcançado foi aplicado o tradicional método de custeio adotado para implementar um sistema de gestão de custos hospitalar, que é o custeio por absorção, pois o hospital em estudo não apresenta controle de custos e, portanto, o sistema tradicional é o mais adequado para uma primeira avaliação dos custos; para melhor visualização dos custos executados na atividade de saúde foi aplicado o critério de rateio por departamentalização dos custos indireto. Depende de cada hospital identificar qual o método mais adequado a sua estrutura organizacional. Em relação às considerações finais, sugeriu-se a utilização da departamentalização, que proporcionará ao Hospital Nelson Salles importantes informações gerenciais. No atual contexto organizacional, identificou-se que o recomendável é o método de custeio por absorção, por ser o mais tradicional, atender a legislação fiscal e demanda menores investimentos para sua implementação. / The dissertation aims to apply a method of funding allocated to spending at Nelson Salles Hospital, in the implementation of public health services support of the Country Engineer Paulo de Frontin. For this work, the study used the literature to substantiate and illustrate the theme, as well as a descriptive exploratory method to recognize the institutions situation and identify a control methodology appropriate to the reality of the studied organization costs. The calculation of costs for hospital organizations is justified: the increase in customer demand, the growth in spending on health and the limitations arising from the budgets of public entities, where organizations need to adopt a system that provides useful information regarding costs in particular the hospital object of study due to lack system cost. A system of calculation of costs for hospital managers can bring relevant information to the planning, control and decision making in order to optimize the limited resources and the maintenance of quality in patient care. With ownership cost center, costing the varied and activity-based costing (ABC), in this context, the main costing methods used for the implementation of the management system the hospital costs, which are absorption costing were presented. As a result achieved was applied the traditional costing method adopted to implement a management system for hospital cost, which is the absorption costing, because the study hospital has no cost control and therefore, the traditional system is the most suitable for a first assessment of the costs, for better visualization of the costs carried on the activity of the health assessment criteria for departmentalization of indirect costs was applied. It depends on each hospital to identify the most appropriate method to its organizational structure. Regarding the final considerations it was suggested that the use of departmentalization, which will give the Nelson SallesHospital important management information. In the current organizational context, it was identified that the recommended method is the absorption costing, to be the most traditional, meet the tax laws and lower investment demand for its implementation.
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Representações sociais da saúde mental por psicólogos do Sistema de Saúde da Cidade de Diadema - São Paulo: concepções e repercurçõesRocha, Rogério Fortunato da [UNESP] 29 August 2008 (has links) (PDF)
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rocha_rf_me_botfm.pdf: 939882 bytes, checksum: d70c45e8c8d77da4f3097a21e19550fb (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Esta pesquisa buscou investigar as representações sociais sobre a Saúde Mental por psicólogos atuantes no sistema de saúde da cidade de Diadema, São Paulo. O trabalho utilizou como referência o método de análise das Representações Sociais proposto por Moscovici (1961). O procedimento foi realizado a partir de seis (6) entrevistas semi dirigidas; objetivando conhecer as formas como o tema Saúde Mental é apreendido por profissionais ligados diretamente à Saúde Coletiva. / This research aimed to investigate social representations about Mental Health by psychologists who work in the health system in the city of Diadema-SP-Brasil. The research used as reference the concept of Social Representation advanced by Moscovici (1961). The research was made by means of six semi-structural interviews, with the objective of knowing how the concept of mental health is apprehended by professionals who are active in the Public health service.
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Custeio dos gastos no serviço público de saúde: estudo de caso no Hospital Nelson Salles / Costing spending on public health care: a case study in Nelson Hospital SallesWarley Francisco de Araújo Pereira 11 March 2014 (has links)
A dissertação tem como objetivo aplicar um método de custeio aos gastos atribuídos, pelo Hospital Nelson Salles, na execução do serviço público de saúde, em apoio ao Município Engenheiro Paulo de Frontin. Para a realização deste trabalho, o estudo utilizou-se da pesquisa bibliográfica para fundamentar e ilustrar o tema proposto, bem como, do método exploratório descritivo para reconhecer a situação da instituição e identificar uma metodologia de controle dos custos adequada à realidade da organização estudada. A apuração de custos em organizações hospitalares justifica-se: pelo aumento na demanda de clientes; pelo crescimento dos gastos na área da saúde e pelas limitações decorrentes dos orçamentos das entidades públicas, onde as organizações necessitam adotar um sistema que forneça informações úteis referentes aos custos, em especial ao hospital, objeto de estudo, por não dispor de um sistema de custos. Um sistema de apuração de custos pode trazer aos gestores hospitalares informações relevantes ao planejamento, controle e tomada de decisão com vistas à otimizar os recursos limitados e a manutenção da qualidade no atendimento ao paciente. Neste contexto, foram apresentados os principais métodos de custeio utilizados para a implementação do sistema de gestão de custos hospitalares, que são custeio por absorção; com apropriação por centro de custos, o custeio variado e o custeio baseado em atividades (ABC).Como resultado alcançado foi aplicado o tradicional método de custeio adotado para implementar um sistema de gestão de custos hospitalar, que é o custeio por absorção, pois o hospital em estudo não apresenta controle de custos e, portanto, o sistema tradicional é o mais adequado para uma primeira avaliação dos custos; para melhor visualização dos custos executados na atividade de saúde foi aplicado o critério de rateio por departamentalização dos custos indireto. Depende de cada hospital identificar qual o método mais adequado a sua estrutura organizacional. Em relação às considerações finais, sugeriu-se a utilização da departamentalização, que proporcionará ao Hospital Nelson Salles importantes informações gerenciais. No atual contexto organizacional, identificou-se que o recomendável é o método de custeio por absorção, por ser o mais tradicional, atender a legislação fiscal e demanda menores investimentos para sua implementação. / The dissertation aims to apply a method of funding allocated to spending at Nelson Salles Hospital, in the implementation of public health services support of the Country Engineer Paulo de Frontin. For this work, the study used the literature to substantiate and illustrate the theme, as well as a descriptive exploratory method to recognize the institutions situation and identify a control methodology appropriate to the reality of the studied organization costs. The calculation of costs for hospital organizations is justified: the increase in customer demand, the growth in spending on health and the limitations arising from the budgets of public entities, where organizations need to adopt a system that provides useful information regarding costs in particular the hospital object of study due to lack system cost. A system of calculation of costs for hospital managers can bring relevant information to the planning, control and decision making in order to optimize the limited resources and the maintenance of quality in patient care. With ownership cost center, costing the varied and activity-based costing (ABC), in this context, the main costing methods used for the implementation of the management system the hospital costs, which are absorption costing were presented. As a result achieved was applied the traditional costing method adopted to implement a management system for hospital cost, which is the absorption costing, because the study hospital has no cost control and therefore, the traditional system is the most suitable for a first assessment of the costs, for better visualization of the costs carried on the activity of the health assessment criteria for departmentalization of indirect costs was applied. It depends on each hospital to identify the most appropriate method to its organizational structure. Regarding the final considerations it was suggested that the use of departmentalization, which will give the Nelson SallesHospital important management information. In the current organizational context, it was identified that the recommended method is the absorption costing, to be the most traditional, meet the tax laws and lower investment demand for its implementation.
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Direito à saúde, integralidade e participação: um estudo sobre as entre sociedade e Ministério Público na experiência de Porto Alegre / Right to health, wholeness and participation: a study of society and among prosecutors in Porto Alegre experienceFelipe Rangel de Souza Machado 06 March 2006 (has links)
Conselho Nacional de Desenvolvimento Científico e Tecnológico / Em 1988, a Assembleia Constituinte, no rastro do processo de redemocratização do país, finalmente apontava para a transformação das políticas sociais no Brasil, cujo resultado foi lavrado na Carta Magna. A partir desse momento, os brasileiros obtiveram o direito de cidadania como estatuto fundamental de nacionalidade, e o direito à saúde como princípio de cidadania. Neste sentido, o setor saúde foi pioneiro nas práticas das políticas sociais no Brasil. A adoção de seus princípios doutrinários e operacionais por lei destacando-se aqui a integralidade significou a afirmação do direito à saúde como caminho de supressão da estrutura fragmentada de organização dos serviços de saúde no Brasil. Integralidade emerge como eixo de organização da defesa do direito à saúde, a partir das propostas de mudanças das práticas no cotidiano dos serviços. O objetivo deste estudo foi analisar as relações existentes entre os usuários do Sistema Único de Saúde (SUS), a partir dos Conselhos de Saúde, e o Ministério Público (MP) desenvolvida no município de Porto Alegre, no estado do Rio Grande do Sul, no que concerne à utilização de dispositivos institucionais e jurídico legais no cumprimento do direito à saúde. O foco deste estudo esteve voltado para a experiência desenvolvida entre os anos de 2000 e 2004, no município de Porto Alegre. Historicamente, os Conselhos de Saúde naquele estado têm desempenhado papel de destaque na formulação e acompanhamento das políticas públicas de saúde. O avanço desses conselhos
permitiu-lhes desenvolver novas estratégias na luta pela garantia do direito à saúde, e o MP vem sendo importante parceiro nessa disputa. Nesse cenário, pudemos observar a utilização, cada vez mais freqüente, do princípio da integralidade como recurso legal na discussão encaminhada pelos usuários junto ao MP, no intuito de garantir o direito à saúde. O princípio da integralidade tem sido utilizado como proposta de transformação da própria lógica da gestão de oferta de serviços. O MP tem propiciado uma interlocução cada vez maior entre a gestão dos serviços e os conselhos de saúde, a fim de encontrar melhores saídas para os principais problemas de saúde do município. Esse espaço de diálogo criado pelo MP constitui avanço substancial na compreensão das formas de solução de conflitos, fundando um novo
campo de práticas de aprimoramento do Estado democrático. A atuação conjunta do MP com os Conselhos de Saúde tem levado a instituir novas formas e mecanismos de negociação e
pactuação entre as diferentes esferas dos poderes públicos e sua relação com a sociedade, no que diz respeito à institucionalização de uma gramática civil de direito à saúde. / In 1988, the Constituent Assembly, following Brazils return to democracy, finally pointed to the transformations of Brazilian social policies, whose results were expressed in the
Constitution. From that moment on, for Brazilians citizenship became the fundamental statute of nationality, and health rights became a citizenship principle. In this sense, the health sector pioneered in Brazilian social policies practices. The adoption of such doctrinaire and operational elements by law where the principle of integrality stands out confirmed the
health rights as an approach to suppress the fragmented structure of health services organization in Brazil. This study aims to analyze the relation between patients of the Brazilian Unified Health System (SUS) and the Public Prosecution Service (PPS), in Porto Alegre city, State of Rio Grande do Sul, Brazil, concerning the use of institutional, juridical and legal instruments to guarantee health rights, mainly from 2000 to 2004. The Health Councils in that city play an important historical role in formulating and supervising the health public policies. The growth of these councils has permitted them to develop new strategies (with the aid of the PPS) in the struggle for health rights. In this context, we could notice that both patients and prosecutors have been often applyed the integrality principle as a legal source to guarantee health rights. As a result, the principle of integrality has changed the
logic of services offer. The PPS has propitiated more and more dialog between services managers and representatives of the Health Councils, in order to find better solutions for the
citizens health problems. This space for dialog, created by the PPS, more than an advanced way to solve conflicts, contributes to the increment of democratic practices, as well of the democratic State. The synchronized action of the PPS and the Health Councils has produced new ways and mechanisms of negotiation and agreement between different fields of public government and society, institutionalizing a new civil grammar of health rights.
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AvaliaÃÃo da qualidade do atendimento do serviÃo de saÃde do doente renal crÃnico: diferencial entre pÃblico e privado / Assessment of quality of care from the health service of chronic kidney disease: differential between public and privateRicardo Josà Marinho Castelo 28 February 2014 (has links)
nÃo hà / O setor da saÃde à um dos segmentos da administraÃÃo pÃblica em que a insatisfaÃÃo do usuÃrio pode adquirir um desfecho vital. Particularmente para pacientes acometidos de insuficiÃncia renal crÃnica (IRC), doenÃa que leva à perda de funÃÃo dos rins, fazendo com que deixem de executar plenamente sua atividade bÃsica, a qualidade dos serviÃos deve sempre manter a excelÃncia. O presente trabalho destina-se a analisar e comparar o grau de satisfaÃÃo destes pacientes quanto aos serviÃos de consultas e de hemodiÃlise prestados pelos setores pÃblico e privado. Para isso, foi utilizado um modelo logit multivariado com informaÃÃes advindas dos suplementos de saÃde das PNADs (Pesquisa Nacional de Amostras de DomicÃlio) de 2003 e 2008. Os resultados mostraram que as pessoas atendidas na rede particular possuem um grau de satisfaÃÃo maior em relaÃÃo à pÃblica. No entanto, este diferencial nÃo aumentou entre 2003 e 2008 e nÃo se mostra significativo em relaÃÃo ao serviÃo de diÃlise. / The health sector is one of the public administration segments where the user dissatisfaction can acquire a vital outcome. Particularly for patients suffering from chronic renal failure (CRF), a disease in which the kidneys loose functioning and no longer perform in totality its basic functions, the quality of services should always maintain excellence. The present work aims to analyze and compare the degree of satisfaction of these patients at consultation and dialysis services provided by public and private sectors. For this, it was used a multivariate logit model with 2003 and 2008 information of PNADâs (National Household Sample Survey) health supplements. The results showed that people in private service have a higher degree of satisfaction than those in public. However, this difference did not increase between 2003 and 2008 and not shown to be significant in relation to the dialysis service.
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Rapportering och kontroll i fokus : En studie av Arbetsförmedlingens utvärderingsverksamhetZovko, Davor January 2017 (has links)
The aim of this study was to explore evaluation in the Swedish Public Employment Service, with particular focus on how the use of evaluations looks like. The study consists of two studies. The first one is an analysis of the Employment Service’s all policy documents that describe or mention evaluation as well as an interview-study with all the management staff in one of the Employment Service’s local labor market units. The second study is a comparative study with analysis of the Employment Service’s entire evaluation production for the years 2010 and 2015. The results show that the Swedish Public Employment Service is a hierarchically controlled governmental organization with routines for effective communication of management's messages to all levels in the organization. Employment Service's evaluation is governed and implemented centrally and communicated from the top, down through the organization. Evaluations are mainly used as a routine for checking and reporting, as well as accounting to the government. Managers on a middle and local level find that much of the evaluation is about control, and that control is not adapted to needs of the everyday business on the local level. Evaluation activities are extensive. Evaluations seems to have become an end in itself, used in legitimizing purposes rather than as a tool for developing of the service to the clients. Half of the evaluations that the Employment Service carried out by their own, is regular evaluations. Almost all evaluations carried out by the European Social Fund Council in Sweden and “Samordningsförbund” (associations for coordination of social projects) are single occasion-evaluations. Legitimizing dominates the use of evaluation, both 2010 and 2015 in evaluating production. Evaluation for improving of the service to the clients is mentioned only in a small number of policy documents. Evaluations that includes the client’s perspective as well as proposals for change occurs to a limited extent in both 2010 and 2015. The Organization of the Employment Service's evaluation activities are heavily influenced by New Public Management's management philosophy.
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eGovernment SR z pohľadu občana / eGovernment from the Slovak citizen's point of viewZákutný, Peter January 2017 (has links)
This thesis is specifically concerned with the assessment of eGovernment from the Slovak citizens point of view. There are three major objectives of this thesis: to familiarize the reader with the concept of eGovrnment, to investigate into the past of the eGovrnment in Slovakia and to analyze the present state of the services concerning their use. These objectives are achieved by the extensive research of the data on the digitalization of public administration. Based on the results of the questionnaire survey, the study demonstrates the citizens' evaluation of the current situation in Slovakia. Namely, the questionnaire serves to assess the respondents level of satisfaction with the particular services, as well as the extent to which are these services used. Furthermore, it investigates users attitude towards the potential changes and new possibilities in the field of eGovernment. The theoretical part of this study includes the overview of the services available, here, in Slovakia, along with those available in the foreign countries and the key terms and pillars of the digitalization of public administration. The questionnaire survey, the evaluation and the analysis of the utilization of services are the main focus points included in the empirical part.
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Citizen's Perspectives on Municipalities' E-Services : A Study about how a Municipality works with their E-Services and how they involve the CitizensHedlund, Elin January 2020 (has links)
Digitalization and e-services are a hot topic within the Swedish municipalities today. There are a lot of discussions about how the municipalities can improve their services with the help of digital tools. However, the one thing that is often missed is what the citizens or end users' needs and want from a service. Through a mixed method approach, this research is looking into how one municipality in the western part of Sweden are working with their e-services and what the citizens think about them. In the study, the results show that the municipality needs a general strategic position in relation to digitalization. The research also show that it is more about the process and journey for both the employees and citizens rather than a question about which digital tool or service that they should use. The municipality is in the initial phase of digitalization and they need to have both the employees and the citizens on board to be able to succeed.
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Možnosti a meze využití metody mystery shoppingu při měření kvality veřejných služeb / The possibilities and limits of using the method of mystery shopping in the measurement of the public services qualityHankovský, Jakub January 2016 (has links)
Thesis on the topic of the possibilities and limits of using the method of mystery shopping in the measurement of the public services quality is intended to introduce the method of mystery shopping and to evaluate the possibility of its use in the public services quality measurement through its application. Quality is a broad term which is associated with many definitions. Public services have many specifics compared to the private ones, dominated by the lack of profit and focus on meeting the public interest. Even the definition of quality and performance standards in the public sector differs from those in the private sector. Mystery shopping, which is heavily used in measuring the level of service quality in the private sector occurs rarely in the common practice of public services. The public sector is declaratively for several decades focused on the quality of its services. We can identify a clear commitment to achieving quality perceived from the perspective of actual customer which is represented by the approach of good governance, promoted by the UN, to the National Quality Policy and Strategy of national policy to quality strategy Smart administration. Strategy and objectives are accompanied by a number of methods to standardize, manage and measure the quality of public services, which are...
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Public Self Service Technology (SST): Designing for Trust : Factors enhancing user’s trust towards a public SSTDipesh Dugar, Deepika January 2018 (has links)
Public Self Service Technology (SST) has become an important part of our daily life. Advancement in technology and reduced hardware costs have motivated service providers to deploy public a SST for various important and complex tasks. Examples of such tasks include editing and printing confidential documents, performing monetary transactions, etc. These tasks requires a user to reveal his/her personal information to a public SST. The major problem while performing these tasks using a public SST is that the user has to deal with many surrounding factors like social density, privacy and security, which might affect his/her trust towards the SST and in turn the user might refrain from using it. This study aims to find different factors that can enhance user’s trust towards a public SST, encourage to use it and complete the task even if it requires user’s personal information.The in-depth interview method was adopted for the study to learn twelve interviewees’ experience with varied public SSTs that specifically handles personal information, in an urge to understand interviewees’ behaviour, underlying motivations and desires to use those public SSTs. Analysing the data collected from interviews, ten trust factors were found that emerge at various stages of interaction with a public SST. They were categorized into pre-interaction, on-interaction and post-interaction factors based on their time of interaction. Beyond the trust factors, three additional important factors have emerged from interview data, which motivates users to adopt public SSTs. They are usefulness, convenience and personality-based trust. The results may be valuable for researchers who are focusing on different aspects of trust and any public artefact as well as for service providers and designers to design a trustworthy public SST. Based on the results, some practical implications for designing public SSTs are also presented. / Offentlig självbetjäningsteknik (eng. Public Self Service Technology) har blivit en viktig del av vårt dagliga liv. Förbättring i teknik och minskade hårdvarukostnader har motiverat tjänsteleverantörer att distribuera offentliga SST för olika viktiga och komplexa uppgifter. Exempel på sådana uppgifter är att redigera och skriva ut konfidentiella dokument, utföra monetära transaktioner etc. Dessa uppgifter kräver att en användare delar med sig av personlig information till en offentlig SST. Det stora problemet med att utföra dessa uppgifter med hjälp av SST är att användaren måste hantera många omgivande faktorer som social täthet, integritet och säkerhet, vilket kan påverka personens förtroende mot SST och i sin tur kananvändaren avstå från att använda den. Följaktligen syftar denna studie till atthitta olika faktorer som kan öka användarnas förtroende mot offentliga SST, uppmuntra att använda dem och slutföra uppgifter även om det kräver användarens personuppgifter.En djupintervjumetod användes i studien för att lära sig om tolv testdeltagares erfarenhet av olika offentliga SST, specifikt de som hanterar privat information, i en strävan att förstå deltagarnas beteende, underliggande motivation och önskemål att använda dessa offentliga SST. Analys av de uppgifter som samlats in från intervjuer, upptäckte tolv förtroendefaktorer som uppstår vid olika stadier av interaktion med en offentlig SST. De var därför uppdelade i pre-interaktion, interaktionsoch post-interaktionsfaktorer. Från intervjuerna har ytterligare tre viktiga faktorer upptäckts som motiverar användarna att använda offentliga SST. De är användbarhet, bekvämlighet och personlighetsbaserat förtroende. Resultaten är värde-fulla för forskare som fokuserar på olika aspekter av förtroende och offentligaartefakter samt för tjänsteleverantörer och designers för att utforma en pålitlig offentlig SST. Baserat på resultaten presenteras också några praktiska konsekvenser för utformningen av offentliga SST.
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