Thesis (D.P.A.)--University of La Verne, 2003. / Includes bibliographical references (p. 216-227).

Thesis (D.P.A.)--University of La Verne, 2003. / Includes bibliographical references (leaves 216-227).

Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services. Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.

Diss. (sammanfattning) Umeå : Univ., 2007. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

Thesis (M.P.H.M. (Primary Health Care Management))--Mahidol University, 2005.

Thesis (M.S.)--University of Michigan, 1992.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Oct. 30, 2007). Includes bibliographical references (p. 72-73).

A proposta de Reforma Psiquiátrica vem modificando a assistência ao portador de transtorno mental nas últimas décadas. Com a desinstitucionalização do doente mental, emergem novos paradigmas com grandes desafios a todos os atores sociais envolvidos na construção da cidadania e na busca da reabilitação psicossocial. Surgem novos conceitos do processo saúde-doença, novas redes de assistência, alocação de recursos como também a implantação de Centros de Atenção Psicossocial CAPS e ainda diretrizes do Ministério da Saúde determinando que as ações, no campo da saúde mental, sejam realizadas na atenção básica, ou seja, nas Unidades Básicas de Saúde (UBS) e por meio da Estratégia Saúde da Família (ESF). A ESF passa a ser uma importante ferramenta no processo saúde-doença no que diz respeito ao cuidado integral do ser humano visando à promoção, prevenção, proteção e recuperação tanto das doenças físicas, sociais quanto mentais. Assim, o objetivo deste trabalho é compreender as necessidades da ESF para desenvolver as ações de saúde mental na comunidade e identificar as ações desenvolvidas pelas equipes da ESF frente aos portadores de transtornos mentais e seus familiares. Trata-se de uma pesquisa qualitativa, que foi desenvolvida por meio de entrevista semiestruturada realizada com os membros das equipes da ESF, as entrevistas foram gravadas e transcritas na íntegra para análise. O material foi analisado por meio da Análise Discurso sob a ótica do referencial teórico do materialismo histórico e dialético. Emergiram das entrevistas três categorias: Processo Saúde Doença-Mental; Família; Processo de Trabalho. Os discursos dos informantes revelaram que os profissionais ESF mantêm a prática da psiquiatria tradicional centrado nas consultas, na medicação e nos exames, sendo esse o principal instrumento para a produção de saúde, e exercício das práticas destes profissionais está baseado no diagnóstico psiquiátrico; é incipiente o numero de profissionais que se mobiliza a desenvolver ações voltas ao acolhimento e a escuta; realizam atividades grupais e relatam que existe a necessidade de ampliar seus conhecimentos na área de saúde mental. / The proposed Psychiatric Reform has changed how mental health patients have been assisted in recent decades. With the deinstitutionalization of mental health patients, new paradigms have emerged offering great challenges to all social actors involved in constructing citizenship and to the search for psychosocial rehabilitation. New concepts of the health-disease process have appeared, along with new assistance networks, allocation of resources, as well as the creation of Psychosocial Care Centers CAPS, and Health Ministry guidelines stipulating that actions in the mental health field be undertaken at the basic care level at Basic Health Units (UBS) and through the Family Health Strategy (ESF). ESF has become an important tool in the health-disease process with regard to integral care aiming for the promotion, prevention, protection and recovery of physical, social and mental illness. Thus, the objective of this work is to comprehend the needs of ESF to develop mental health actions in the community and identify the actions developed by ESF teams with regard to mental health patients and their relatives. It is a qualitative research, to be developed through semi-structured interviews with members of the ESF teams; the interviews were recorded and fully transcribed for analysis. O material foi analisado por meio da Análise Discurso sob a ótica do referencial teórico do materialismo histórico e dialético. The material was analyzed through discourse analysis under the theoretical framework of historical and dialectical materialism. Three categories emerged from the interviews: Health-Mental Illness process; Family; Work Process. The discourses of the informants revealed that ESF professionals keep traditional psychiatric practice centered on consultations, medication and exams, making it the main tool for health production, with the exercise of these professionals practice based on psychiatric diagnosis; the number of professionals who mobilize to develop actions focusing on welcoming and listening is still incipient; they perform group activities and report the need to broaden their knowledge on the field of mental health.

Orientador: Mauro Antonio Pires Dias da Silva / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-05T20:55:02Z (GMT). No. of bitstreams: 1 Santos_DeboradeSouza_M.pdf: 379854 bytes, checksum: ab9f6b9ff913e9b4fc015e02a2a14e5a (MD5) Previous issue date: 2005 / Resumo: O trabalho centrou-se no estudo de um projeto intersetorial desenvolvido por uma Escola e uma UBS da cidade de Campinas, em 2004, tendo como desafio fundamental analisar, a partir dos discursos dos atores sociais envolvidos, as aproximações e limitações de suas práticas com as respectivas propostas políticas oficiais de Educação e Saúde. Utilizou-se como referencial metodológico para análise dos discursos a noção de representação social de Moscovici, como forma de saber construído a partir das relações cotidianas individuais e sociais inseridas no coletivo. Assim, resgatamos nas falas dos sujeitos (profissionais de saúde e de educação) as percepções, conceitos e vivências relacionados às práticas intersetoriais, buscando correlacioná-las ao discurso formal das políticas a este respeito. A partir do estudo do discurso institucional das políticas de saúde e educação foi possível identificar que, no Brasil, ambos são constitucionalmente tidos como direitos fundamentais do cidadão, sendo de responsabilidade do Estado a criação e desenvolvimento de políticas que visem à promoção da saúde e a educação orientada para o exercício pleno da cidadania dos brasileiros. Além disto, o discurso formal evidencia a proposição de parcerias entre esses setores para alcance destas metas, conforme análise dos princípios fundamentais do SUS e do programa Paidéia de Saúde da Família da cidade de Campinas. O estudo empírico, realizado mediante entrevistas semi-estruturadas com profissionais de saúde e educação, buscou contrapor teoria e prática, a fim de levantar os principais avanços, perspectivas e limitações referentes a intersetorialidade. Ao estudar as falas dos sujeitos evidenciou-se que ainda prevalece entre eles uma explicação unicausal do processo saúde-doença, bem como a priorização de atendimentos médicos e individuais. Identificou-se ainda a prática cotidiana de ações educativas verticalizadas e fragmentadas, baseadas na transmissão ¿acabada¿ de conhecimentos. Houve também a conclusão de que os professores, pais e crianças não participaram de todo o processo do trabalho, ocupando duas funções centrais: apontar os problemas e receber as ações educativas do ¿pessoal do posto¿. No entanto, o trabalho multidisciplinar de saúde, a preocupação com a realidade escolar na construção do projeto e a busca por desenvolver um trabalho intersetorial sistematizado e contínuo entre Escola e UBS demonstraram significativos avanços no desenvolvimento do referido trabalho intersetorial, visando à promoção da saúde / Abstract: This paper has focused on the study of an intersectorial project developed by a school and a UBS (Primary Service's Health) in the city of Campinas, and has as its fundamental challenge to analyse, from the speeches of the social actors involved (professionals of health and education), which are the limitations and policies of their practices with the respective official political proposals of Health and Education. The notion for social representation of Moscovici, as a form of know-how built on the daily individual and social relations inserted in the collectivity, was used as a methodological referential to analyse the speeches. Thus, the perceptions, concepts and life experiences linked to intersectorial practices were drawn from the subjects¿ speeches, trying to correlate them to the speeches related to the formal policies in this respect. It was possible to identify, from the study of institutuional policies regarding the conceptions of health and education, that in Brazil both are constitutionally seen as fundamental rights of the citizen, being the responsibility of the State the creation and development of policies that aim to promote health and education oriented to the full exercise of Brazilian citizenship. Besides, the formal speech shows the proposition of partnerships between sectors to achieve these goals, according to the analysis of fundamental principles of the SUS (United Health System) and from the Family Health program Paidéia, from the city of Campinas. The empirical study, made through semi-structured interviews with the actors, tried show the differences between theory and practice, in order to find the main advances, perspectives and limitations regarding intesectoriality. As the subjects¿s speeches were studied, it was shown that there still prevails, among them, an explanation based on a single cause of the health-sickness process, as well as the priorization of individual and medical treatments. It was identified the daily practice of educational verticalized an fragmented actions, based on the ¿finished¿ transmission of knowledge. There was also the conclusion that teachers, parents and children do not take part in the whole work process, occupying two main functions: to show the problems and receive the educational actions from the ¿people from the station¿. However, the multidisciplinary health work, the preocupation with school reality in the building of the project and the search to develop a systematize and continuous intersectorial work between Scholl and UBS (Primary Service's Health) have shown significative advances in the development of the aforesaid intersectorial work, aiming the promotion of health / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem