Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / O monitoramento e a avaliaÃÃo nos serviÃos de saÃde sÃo etapas imprescindÃveis na implantaÃÃo das polÃticas de saÃde. InformaÃÃes em saÃde fidedignas sÃo relevantes para subsidiar o planejamento e a tomada de decisÃes. A EstratÃgia SaÃde da FamÃlia, entendida como o mecanismo de acesso primÃrio dos usuÃrios Ãs aÃÃes de saÃde, fornece, por meio dos Sistemas de InformaÃÃo, dados relativos à execuÃÃo de atividades em seu Ãmbito de atuaÃÃo. Este estudo objetivou analisar os indicadores de SaÃde Bucal do Pacto da AtenÃÃo BÃsica no Estado do CearÃ, verificando o percentual de cobertura populacional por equipes de SaÃde da FamÃlia (ESF) e SaÃde Bucal (ESB), a apresentaÃÃo dos indicadores de SaÃde Bucal na sÃrie histÃrica proposta e o modo como as informaÃÃes, que ensejam os indicadores, sÃo fornecidas pelos profissionais responsÃveis. O trabalho constituiu-se de duas fases. Na fase 1 compilou-se dados referentes à cobertura populacional das aÃÃes de SaÃde da FamÃlia e SaÃde Bucal e os indicadores de SaÃde Bucal do Pacto da AtenÃÃo BÃsica preconizados pelo MinistÃrio da SaÃde, no Ãmbito do Estado do CearÃ. Utilizou-se de informaÃÃes relativas à sÃrie histÃrica entre os anos de 2001 e 2007; no ano de 2001 o MinistÃrio da SaÃde iniciou repasse financeiro para os municÃpios, como incentivo para inserÃÃo de cirurgiÃes-dentistas nas equipes de SaÃde da FamÃlia no Brasil. Estes dados foram obtidos em sÃtio eletrÃnico do MinistÃrio da SaÃde e complementados pelos relatÃrios do NÃcleo de AtenÃÃo à SaÃde Bucal da Secretaria da SaÃde do Estado do CearÃ. Foram dispostos em tabelas do Programa Excel, sendo consideradas estatisticamente significantes as anÃlises cujo valor de p fosse menor do que 0,05. Tais dados foram processados no Programa SPSS. Na fase 2, utilizou-se um instrumento (questionÃrio) aplicado aos cirurgiÃes-dentistas atuantes na EstratÃgia SaÃde da FamÃlia do Estado, onde se indagou a respeito do conhecimento deles sobre os indicadores de SaÃde Bucal e como costumavam informar as aÃÃes de SaÃde Bucal que realizavam diariamente nas Unidades BÃsicas de SaÃde da FamÃlia (UBASF) e nos demais espaÃos sociais em que atuavam. Os dados da fase 1 foram analisados por intermÃdio de regressÃo linear e associaÃÃo entre variÃveis, cuja anÃlise demonstrou que houve crescimento percentual estatisticamente significante de cobertura populacional por equipes de SaÃde da FamÃlia e SaÃde Bucal.NÃo houve melhoria significante nos indicadores de SaÃde Bucal, evidenciando-se sua estagnaÃÃo no decorrer da sÃrie histÃrica. Observou-se que hà divergÃncias entre a interpretaÃÃo dos objetivos dos indicadores e o registro dos dados relativos Ãs aÃÃes de SaÃde Bucal pelos cirurgiÃes-dentistas atuantes na EstratÃgia SaÃde da FamÃlia e as orientaÃÃes do MinistÃrio da SaÃde, havendo a necessidade de serem implementadas medidas de capacitaÃÃo permanente para esclarecer aspectos relacionados aos indicadores de SaÃde Bucal. / Monitoring and evaluation of health services are indispensable steps in the process of implementation of health policies. Trustworthy health information is relevant to subsidize the planning and the decision-making. Familyâs Health Strategy, understood as the primary access mechanism of the users to health actions, provides data related to the implementation of activities within its scope through the information systems. This study aimed to analyze the Oral Health Indicators of the Primary Attention Pact within the State of CearÃ, checking the percentage of the population assisted by the Familyâs Health Strategy and Oral Health Program, the presentation of Oral Health Indicators in the historical series proposed and how the information, which generates indicators, is provided by the professionals in charge. This work consisted of two stages. In stage 1 it was compiled data on the populationâs coverage of the actions of the Familyâs Health Strategy and Oral Health Program and the Oral Health Indicators of the Primary Care recommended by the Ministry of Health within the State of CearÃ. It was used information concerning the historical series between the years 2001 and 2007, when the Ministry of Health began to fund cities, as an incentive for inserting dentist surgeons in the Familyâs Health teams in Brazil. These data were obtained through the website of the Ministry of Health and complemented by the Oral Health Care Department of the Secretary of Health of the State of CearÃ. They were arranged in Excel charts and it was considered statistically significant the differential analyses whose p-value was less than 0.05. The data were processed in the program so-called SPSS (Statistical Package for the Social Sciences). In stage 2, it was used an instrument (questionnaire) applied to dentist surgeons who participate in the Familyâs Health Strategy in CearÃ, where they were asked about their knowledge about the Oral Health Indicators and how they used to inform the Oral Health actions that they carried out daily in the Basic Units of Health Family and some other social spaces where they worked in. The stage 1 data were analyzed using linear regression and association between variables. It was verified that there was percentage growth of populationâs coverage of the historical series of the Familyâs Health Teams and Oral Health was statistically relevant. There was no statistically significant improvement in the Oral Health indicators, giving evidence of the stagnation of the members during the historical series. It was noticed that there are misunderstandings about the interpretation of the indicators and in the registry of the data related to the Oral Health actions by dentist surgeons operating in the Familyâs Health Strategy and orientation of Ministry of Health, with the necessity of implementation of measures of permanent training to clarify aspects concerning the Oral Health Indicators.

The increasing costs of health care is becoming one of the main problems of Czech health care. The state has become a constant tendency to enter the health system as a result and its interventions (regulations) influence the behavior of its actors. The regulation is in the eyes of the state solution that can cope with so-called market failures, but the result is damage to the entire health care system. Therefore health care could inspire in animal health care, where almost no government regulation (except law) and the system is based on market behavior.

The graduation thesis is focused on the health of the economy . The aim of this work is to identify and evaluate regional differences in the availability of health care in the regions of the Czech Republic , which was achieved by using the data obtained from ÚZIS institute. Attention was focused on the availability of outpatient doctors, hospital doctors and hospital beds . This availability was evaluate on the basis of the density of the phenomenon in the every region. The thesis used the methods of statistical data analysis , comparison , synthesis of acquired knowledge and literature search and resources. In the area of outpatient care, there was found that the Czech Republic is from the 90s to increase of specialists at the expense of primary care. There were no significant regional differences in access to outpatient care. However, we find large disparities in hospital care. For districts with disturbing the availability of hospital care can mark the border counties Tachov and Jeseník.

This thesis investigates the treatment quality of medical services in the hospital sector from different angles: theory, measures and application in China. This thesis includes three essays. The first essay (Chapter 2) is a critical review about the quality assessment. It shows that the environmental performance index is suitable for measuring treatment quality. The second essay (Chapter 3) introduces alternative approaches to environmental performance indices to solve the infeasibility problem of current measures. Environmental performance indices are measures to evaluate the production of undesirable outputs relative to desirable outputs. My new measures are more accurate using the sequential frontier and various reference vectors. The last essay (Chapter 4) is an empirical case study in the Chinese hospital sector that examines how the degree of government involvement and the degree of market competition affect the performance of treatment quality. Using the environmental performance indices of Essay 2 to evaluate treatment quality, I find that the performance of treatment quality of Chinese hospitals improved during the 2009-2014 period. Therefore, the marketisation of hospitals and government subsidies contribute to this sustained improvement

Entrepreneurs in integrated care face some of the same challenges in empirically demonstrating impact, regardless of the model of care they espouse. In this editorial, 2 leading model developers reflect on the state of the science in primary care integration, including research gaps and promising research underway. We asked these leaders to discuss conceptual areas of shared concern, and we present those with reference to the metaphor of the translational research bridge. Their insights resonate with one another and suggest a role for collaboration to advance empirical support for the implementation of integrated care.

A barrier cited by primary care administrators in integrating behavioral health is financial risk. Fee-for-service billing mechanisms remain complex and there is little empirical guidance on cost-effective models. This study was an economic evaluation of an integrated care model in a pediatric private practice clinic. The study evaluated cost benefits by examining specific delivery indices such as concerns presented, time spent, billing codes used, and reimbursement received in regards to pediatric primary care visits by comparing days when an on-site Behavioral Health Consultant (BHC) was available versus Non-BHC Days. All 3 hypotheses were supported: 1) more patients were seen in clinic on BHC Days; 2) more revenue was generated on BHC Days; and 3) incorporation of the BHC was cost-effective. Findings showed that time saved by having a BHC onsite increased provider productivity, resulting in an additional $1,142 in revenue generated on a BHC Day when compared to a Non-BHC Day.

The Primary Care Behavioral Health (PCBH) model of service delivery is being used increasingly as an effective way to integrate behavioral health services into primary care. Despite its growing popularity, scientifically robust research on the model is lacking. In this article, we provide a qualitative review of published PCBH model research on patient and implementation outcomes. We review common barriers and potential solutions for improving the quantity and quality of PCBH model research, the vital data that need to be collected over the next 10 years, and how to collect those data.

Thesis (Ph. D.)--University of Wisconsin--Madison, 2001. / Includes bibliographical references (p. 517-547). Also available on the Internet.

Thesis (Ph. D.)--University of Wisconsin--Madison, 2001. / Includes bibliographical references (p. 517-547).

Philosophiae Doctor - PhD (School of Public Health) / South Africa has an estimated two million documented and undocumented immigrants. In addition, Statistics South Africa (2014) notes very significant internal migration. This mobile population is affected by chronic communicable and non-communicable diseases such as TB, HIV, and diabetes, although it has a Constitutional right to health and healthcare. Their quality of healthcare and disease control also affects the general population and the burden on the health system can be increased by inadequately managed chronic conditions as well as acute health care needs. Access to healthcare and continuity of care reflect both patient agency and the health system. Community Health Workers (CHWs) play an important role in linking communities and patients to health services and vice versa. The aim of this study was to understand how agricultural migrants in the Cape Winelands District of Western Cape Province of South Africa navigated the healthcare system to access healthcare services including securing continuity of care, and in particular the role of CHWs in this process, in order to inform policy and practice.