Mestrado em Saúde Coletiva
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Navegando Mestrado em Saúde Coletiva por Assunto "Access to health services"
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- ItemAbsenteísmo dos usuários aos serviços de saúde no município de Vila Velha no Estado do Espírito Santo(Universidade Federal do Espírito Santo, 2016-08-04) Tristão, Flavio Ignes; Andrade, Maria Angelica Carvalho; Lima, Rita de Cássia Duarte; Lima, Eliane de Fátima AlmeidaThe access to health services is a major challenge for the care guarantee based on the principles of universality, comprehensiveness and equity. As a central component to achieve this purpose, the Primary Care is recognized as the main access to the realization of care and organizes the Health Care Networks, implicated in comprehensiveness of health actions at different levels of complexity. Parallel to this, is the paradox of evident occurrence of non-access, ie, absenteeism users to health services. This study aimed to analyze the access, use and absenteeism users to health services in the municipal health network from Vila Velha - ES. The specific objectives included: analyzing the amount of scheduled clinic visits and the occurrence of absenteeism in the Basic Attention municipality in the years 2014 and 2015; analyze the amount of scheduled clinic visits and the occurrence of absenteeism in the Specialized Care of Vila Velha in 2015; analyze the queries marking process in the two levels of care and; analyze the causal factors related to absenteeism users to health services mentioned by health professionals and by the users. For this we used quantitative methodologies (descriptive statistical analysis of secondary data) and qualitative (thematic analysis of interviews), which was supplemented to provide a thorough understanding of the studied aspects. The results indicated that users' access to services of Primary Care and Specialized is performed not focused manner on the user, and that absenteeism is related to employee care model and way of organizing access two levels of attention, and consider related factors ace dimensions of access and availability of services, the payment power, the degree of information and acceptability. The study pointed out the importance of valuing the subjective aspects of the relationship between professionals and users, which can directly affect the quality of the understanding of the health conditions of users and also to build mutual respect of bonds and trust between those involved in the production process for care.
- ItemAvaliação da assistência pré-natal na microrregião de São Mateus-ES(Universidade Federal do Espírito Santo, 2013-07-10) Martinelli, Katrini Guidolini; Santos Neto, Edson Theodoro dos; Oliveira, Adauto Emmerich de; Gama, Silvana Granado Nogueira; Amorim, Maria Helena CostaPrenatal care is one of the factors that contributes to the persistence of adverse perinatal outcomes and maternal death at high levels. Thus, the evaluation of access and the process of prenatal care is of high importance in the detection of the issues who remain in the offered service. The objectives of this study are to evaluate the adequacy of the process of prenatal care according to the parameters of the Program for the Humanization of Prenatal and Birth plus procedures provided by Stork Network , as well as access to prenatal care, according to the dimensions of availability, acceptability and ability to pay, on the SUS of the region of São Mateus - ES. It is a cross-sectional study that selected 742 postpartum women in seven hospitals in the region chosen for the research. Data were collected through interviews and analysis of records from prenatal care and newborn records. Subsequently, these data were processed and subjected to chi-square test, the Fisher exact test and the nonparametric Spearman with p-value less than 5%. Although the SUS constitutionally guarantee universal access to health care, it is noted that there are still inequalities between pregnant women in accessing health services. Only 7.4% and 0.4% of the mothers received adequate prenatal care according to the parameters PHPN and Stork Network , respectively. It is recommended that the location of health facilities, transport resources and financing of health services are reorganized, the same way the prenatal care needs to be systematized, more humane and focused on attention to the most vulnerable women.
- ItemEstudo dos tempos entre o diagnóstico e tratamento do câncer de mama em uma instituição de referência no Espírito Santo(Universidade Federal do Espírito Santo, 2016-09-12) Simião, Luana de Jesus; Zandonade, Eliana; Amorim, Maria Helena Costa; Thuler, Luiz Claudio Santos; Andrade, Maria Angélica CarvalhoIntroduction: The time intervals related to the treatment of breast cancer are essential to the therapeutic success of patients. Objectives: To analyze the time between the diagnosis and the beginning of treatment for patients diagnosed with breast cancer between the years of 2010-2011 and 2013-2014, to know the sociodemographic and clinical profile, linking them to Law nº12732, in order to identify the risk factors that contributed to the delay in treatment. There were two longitudinal analytical studies of primary and secondary data covering 1016 cases of women who were diagnosed with breast cancer and treated at the Santa Rita de Cássia Hospital, in Vitoria, Espírito Santo state. Methods: The results were analyzed by using calculations of frequency and mean, median, and standard deviation. The crude odds ratios were calculated and adjusted by using the Logistic Regression Model for the variables with statistical significance, considering the significance level of 0.10. Results: The median between diagnosis and treatment corresponded to 44 days, and that between the first consultation and treatment corresponded to 50 days. After the law went into effect an increase was identified in the quantitiveness of white women (26%); of those who were originally sent by the Brazilian public health system (SUS) (81%); of patients who did not present diagnosis and treatment (71%); patients who received treatment originating from their diagnosis in a period not exceeding 60 days (74%); from the account of family history (53%) and a decrease in metastasis (18%). As risk factors, those items identified include age, years of education, Law nº12732 and earlier diagnosis and treatment. In the years 2010 to 2011, 38% of women started treatment within 60 days. In 2013 to 2014 this figure became 62%.Patients diagnosed in 2010 and 2011 (OR = 1.74, CI = 1.30 to 2.33) and those who entered the hospital with a diagnosis and no treatment (OR = 1.89, CI = 1.40 to 2.54) initiated therapy for a period longer than 61 days. Conclusion: The institution that was researched has performed its activities in line with those that are recommended by the legal provisions; however, it is necessary that there be careful analysis of risk factors, aiming to adopt strategies that provide cancer care that is in keeping with the principles of SUS.
- ItemO cotidiano como promotor de vínculos : o caso da USF Santa Martha, Vitória-ES(Universidade Federal do Espírito Santo, 2009-06-18) Silva, Rachel Cristine Diniz da; Araújo, Maristela Dalbello de; Franco, Túlio Batista; Silva, Marta Zorzal eThis study had as objective to analyze the relations, constructed throughout last the three years, among the professionals of the USF St. Martha (USF-Family Health Units), Vitória-ES and the population it belongs to its territory that is delimited, aiming at to identify if the available services meet the needs of health of this population, and if this service is configured as a gateway to the health system. For achievement of the objectives it adopts the qualitative approach, therefore it values the opinion and it catches the particularities of the relations constructed between the different characters who constitute this plot. It uses interview with haltf-structured script, individual and collective, analyzed through the technique of the Collective Subject Discourse (DSC), allowing evidence of thinking expressed in a discourse of a set of citizens on a particular subject. It composes the DSC five professionals, seven communitarian health agents and fourteen users of that service. The analysis showed that the unit has been configured as a gateway for access to services of the health system; even so the net of services is not yet articulated in a way to guarantee integrally the take care of to the necessities of health of this population, when these require a higher level of complexity. The presence of the ESF in this territory, though initially has generated conflicts with the population, that desired in the truth an soon-attendance service, currently has received a good evaluation by the users, who report that the connection established by the daily relation, the knowledge about the family and the environment in which they live, favors one better understanding on the part of the professionals on its necessities of health and consequently in the resolution of the same ones. Still speaking of connection, users mention the ACS (Community Health Agents) as an important link with the health unit; therefore with the ESF (Strategy for Family Health) they started to have 'someone' to talk on its necessities. The process of shelter instituted in this unit, covering all its schedule of functioning, also comes facilitating the access of the users, mainly in the take care of the urgencies, although its current configuration not yet to be adequate, causing certain dissatisfaction such a way on the part of the professionals as of the population, who also make improvement proposals. Finishing, its is observed that the ESF (Strategy for Family Health) they started to have 'someone' to talk on its necessities. The process of shelter instituted in this unit, covering all its schedule of functioning, also comes facilitating the access of the users, mainly in the take care of the urgencies, although its current configuration not yet to be adequate, causing certain dissatisfaction such a way on the part of the professionals as of the population, who also make improvement proposals. Finighing, it is observed that the ESF, through its principles, has a new look on the population of a territory, so that people also feel safer to have a professional reference that can appeal, however, as all that is new, it is required some adjustments, mainly in the processes of work and joint of the service nets, so that effectively it has on the part of the ESF contribution for the improvement of the quality of life of the population.