Base de dados : MEDLINE
Pesquisa : N02.278.216 [Categoria DeCS]
Referências encontradas : 1774 [refinar]
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[PMID]:29359902
[Au] Autor:Raduege TJ; Thomson Reuters Accelus.
[Ti] Título:Healthcare facilities.
[So] Source:Issue Brief Health Policy Track Serv;2017:1-61, 2017 Dec 26.
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Instalações de Saúde
Administração de Instituições de Saúde
Administração Hospitalar
Hospitais
[Mh] Termos MeSH secundário: Organizações de Assistência Responsáveis
Prestação Integrada de Cuidados de Saúde
Governo Federal
Reforma dos Serviços de Saúde
Seres Humanos
Reembolso de Seguro de Saúde
Medicaid
Medicare
Administração dos Cuidados ao Paciente
Equipe de Assistência ao Paciente
Patient Protection and Affordable Care Act
Atenção Primária à Saúde
Qualidade da Assistência à Saúde
Reembolso de Incentivo
Serviços de Saúde Rural
Governo Estadual
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE


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[PMID]:28464850
[Au] Autor:Vermandere H; Galle A; Griffin S; de Melo M; Machaieie L; Van Braeckel D; Degomme O
[Ad] Endereço:International Centre for Reproductive Health, Ghent University, De Pintelaan 185, Post: UZP114, 9000, Gent, Belgium. Heleen.vermandere@ugent.be.
[Ti] Título:The impact of facility audits, evaluation reports and incentives on motivation and supply management among family planning service providers: an interventional study in two districts in Maputo Province, Mozambique.
[So] Source:BMC Health Serv Res;17(1):313, 2017 05 02.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKRGOUND: Good progress is being made towards universal access to contraceptives, however stock-outs still jeopardize progress. A seldom considered but important building block in optimizing supply management is the degree to which health workers feel motivated and responsible for monitoring supply. We explored how and to what extent motivation can be improved, and the impact this can have on avoiding stock-outs. METHODS: Fifteen health facilities in Maputo Province, Mozambique, were divided into 3 groups (2 intervention groups and 1 control), and 10 monthly audits were implemented in each of these 15 facilities to collect data through examination of stock cards and stock-counts of 6 contraceptives. Based on these audits, the 2 intervention groups received a monthly evaluation report reflecting the quality of their supply management. One of these 2 groups was also awarded material incentives conditional on their performance. A Wilcoxon-Mann Whitney test was used to detect differences between the groups in the average number of stocked-out centres, while changes over time were verified through applying a Friedman test. Additionally, staff motivation was measured through interviewing health care providers of all centres at baseline, and after 5 and 10 months. To detect differences between the groups and changes over time, a Kruskal Wallis and a Wilcoxon signed-rank test were applied, respectively. RESULTS: Motivation reported by providers (n = 55, n = 40 and n = 39 at baseline, 1st and 2nd follow-up respectively) was high in all groups, during all rounds, and did not change over time. Facilities in the intervention groups had better supply management results (including less stock-outs) during the entire intervention period compared with those in the control group, but the difference was only significant for the group receiving both material incentives and a monthly evaluation. However, our data also suggest that supply management also improved in control facilities, receiving only a monthly audit. During this study, more stock-outs occurred for family planning methods with lower demand, but the number of stock-outs per family planning method in the intervention groups was only significantly lower, compared with the control group, for female condoms. CONCLUSIONS: While a rise in motivation was not measurable, stock management was enhanced possibly as a result of the monthly audits. This activity was primarily for data collection, but was described as motivating and supportive, indicating the importance of feedback on health workers' accomplishments. More research is needed to quantify the additional impact of the interventions (distribution of evaluation reports and material incentives) on staff motivation and supply management. Special attention should be paid to supply management of less frequently used contraceptive methods.
[Mh] Termos MeSH primário: Auditoria Clínica
Anticoncepcionais/provisão & distribuição
Serviços de Planejamento Familiar/organização & administração
Administração de Instituições de Saúde
Pessoal de Saúde
Motivação
[Mh] Termos MeSH secundário: Equipamentos e Provisões
Estudos de Avaliação como Assunto
Feminino
Pesquisa sobre Serviços de Saúde
Seres Humanos
Moçambique
Qualidade da Assistência à Saúde
Estatísticas não Paramétricas
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Contraceptive Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180117
[Lr] Data última revisão:
180117
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-017-2222-3


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[PMID]:28973129
[Au] Autor:Hauptman PJ; Bookman RJ; Heinig S
[Ad] Endereço:Department of Medicine, Saint Louis University School of Medicine, St Louis, Missouri.
[Ti] Título:Advancing the Research Mission in a Time of Mergers and Acquisitions.
[So] Source:JAMA;318(14):1321-1322, 2017 Oct 10.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Centros Médicos Acadêmicos/organização & administração
Pesquisa Biomédica/organização & administração
Administração de Instituições de Saúde
Instituições Associadas de Saúde
[Mh] Termos MeSH secundário: Docentes de Medicina
Propriedade
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171004
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.11812


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[PMID]:28535978
[Au] Autor:Kagan A; Simmons-Mackie N; Victor JC; Chan MT
[Ad] Endereço:Aphasia Institute, Toronto, Ontario, Canada. Electronic address: akagan@aphasia.ca.
[Ti] Título:Communicative Access Measures for Stroke: Development and Evaluation of a Quality Improvement Tool.
[So] Source:Arch Phys Med Rehabil;98(11):2228-2236.e5, 2017 Nov.
[Is] ISSN:1532-821X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To (1) develop a systems-level quality improvement tool targeting communicative access to information and decision-making for stroke patients with language disorders; and (2) evaluate the resulting tool-the Communicative Access Measures for Stroke (CAMS). DESIGN: Survey development and evaluation was in line with accepted guidelines and included item generation and reduction, survey formatting and composition, pretesting, pilot testing, and reliability assessment. SETTING: Development and evaluation were carried out in hospital and community agency settings. PARTICIPANTS: The project used a convenience sample of 31 participants for the survey development, and 63 participants for the CAMS reliability study (broken down into 6 administrators/managers, 32 frontline staff, 25 participants with aphasia). Eligible participants invited to the reliability study included individuals from 45 community-based organizations in Ontario as well as 4400 individuals from communities of practice. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Data were analyzed using kappa statistics and intraclass correlations for each item score on all surveys. RESULTS: A tool, the CAMS, comprising 3 surveys, was developed for health facilities from the perspectives of (1) administrators/policymakers, (2) staff/frontline health care providers, and (3) patients with aphasia (using a communicatively accessible version). Reliability for items on the CAMS-Administrator and CAMS-Staff surveys was moderate to high (kappa/intraclass correlation coefficients [ICCs], .54-1.00). As expected, reliability was lower for the CAMS-Patient survey, with most items having ICCs between 0.4 and 0.6. CONCLUSIONS: These findings suggest that CAMS may provide useful quality improvement information for health care facilities with an interest in improving care for patients with stroke and aphasia.
[Mh] Termos MeSH primário: Afasia/reabilitação
Administração de Instituições de Saúde/normas
Melhoria de Qualidade/organização & administração
Reabilitação do Acidente Vascular Cerebral/normas
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Melhoria de Qualidade/normas
Reprodutibilidade dos Testes
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170525
[St] Status:MEDLINE


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[PMID]:28318606
[Au] Autor:Cavalieri M; Guccio C; Rizzo I
[Ad] Endereço:Department of Economics and Business, University of Catania, Italy.
[Ti] Título:On the role of environmental corruption in healthcare infrastructures: An empirical assessment for Italy using DEA with truncated regression approach.
[So] Source:Health Policy;121(5):515-524, 2017 May.
[Is] ISSN:1872-6054
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: This paper investigates empirically whether the institutional features of the contracting authority as well as the level of 'environmental' corruption in the area where the work is localised affect the efficient execution of public contracts for healthcare infrastructures. METHODS: A two-stage Data Envelopment Analysis (DEA) is carried out based on a sample of Italian public contracts for healthcare infrastructures during the period 2000-2005. First, a smoothed bootstrapped DEA estimator is used to assess the relative efficiency in the implementation of each single infrastructure contract. Second, the determinants of the efficiency scores variability are considered, paying special attention to the effect exerted by 'environmental' corruption on different types of contracting authorities. RESULTS: Our results show that the performance of the contracts for healthcare infrastructures is significantly affected by 'environmental' corruption. Furthermore, healthcare contracting authorities are, on average, less efficient and the negative effect of corruption on efficiency is greater for this type of public procurers. CONCLUSIONS: The policy recommendation coming out of the study is to rely on 'qualified' contracting authorities since not all the public bodies have the necessary expertise to carry on public contracts for healthcare infrastructures efficiently.
[Mh] Termos MeSH primário: Arquitetura de Instituições de Saúde/economia
Arquitetura de Instituições de Saúde/legislação & jurisprudência
Instalações de Saúde/economia
[Mh] Termos MeSH secundário: Proposta de Concorrência/estatística & dados numéricos
Arquitetura de Instituições de Saúde/estatística & dados numéricos
Fraude
Instalações de Saúde/estatística & dados numéricos
Administração de Instituições de Saúde/economia
Administração de Instituições de Saúde/estatística & dados numéricos
Itália
Modelos Estatísticos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:170321
[St] Status:MEDLINE


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[PMID]:28249578
[Au] Autor:Oyekale AS
[Ad] Endereço:Department of Agricultural Economics and Extension, North-West University Mafikeng Campus, Mmabatho, 2735, South Africa. asoyekale@gmail.com.
[Ti] Título:Assessment of primary health care facilities' service readiness in Nigeria.
[So] Source:BMC Health Serv Res;17(1):172, 2017 Mar 01.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Effective delivery of healthcare services requires availability of adequate infrastructure, diagnostic medical equipment, drugs and well-trained medical personnel. In Nigeria, poor funding and mismanagement often characterize healthcare service delivery thereby affecting coverage and quality of healthcare services. Therefore, the state of service delivery in Nigeria's health sector has come under some persistent criticisms. This paper analyzed service readiness of Primary Health Care (PHC) facilities in Nigeria with focus on availability of some essential drugs and medical equipment. METHODS: Service Delivery Indicator (SDI) data for PHC in Nigeria were used. The data were collected from 2480 healthcare facilities from 12 states in the Nigeria's 6 geopolitical zones between 2013 and 2014. Data were analyzed with descriptive statistics, Principal Component Analysis (PCA) and Ordinary Least Square regression. RESULTS: Medical disposables such as hand gloves and male condoms were reported to be available in 77.18 and 44.03% of all the healthcare facilities respectively, while immunization services were provided by 86.57%. Functional stethoscopes were reported by 77.22% of the healthcare facilities, while only 68.10% had sphygmomanometers. In the combined healthcare facilities, availability of some basic drugs such as Azithromycin, Nifedipine, Dexamethasone and Misoprostol was low with 10.48, 25.20, 21.94 and 17.06%, respectively, while paracetamol and folic acid both had high availability with 74.31%. Regression results showed that indices of drug and medical equipment availability increased significantly (p < 0.05) among states in southern Nigeria and with presence of some power sources (electricity, generators, batteries and solar), but decreased among dispensaries/health posts. Travel time to headquarters and rural facilities significantly reduced indices of equipment availability (p < 0.05). CONCLUSION: It was concluded that for Nigeria to ensure better equity in access to healthcare facilities, which would facilitate achievement of some health-related sustainable development goals (SDGs), quality of services at its healthcare facilities should be improved. Given some differences between availability of basic medical equipment and their functionality, and lack of some basic drugs, proper inventory of medical services should be taken with effort put in place to increase funding and ensure proper management of healthcare resources.
[Mh] Termos MeSH primário: Instalações de Saúde
Acesso aos Serviços de Saúde
Atenção Primária à Saúde/organização & administração
[Mh] Termos MeSH secundário: Medicamentos Essenciais
Instalações de Saúde/recursos humanos
Instalações de Saúde/normas
Instalações de Saúde/estatística & dados numéricos
Administração de Instituições de Saúde
Recursos Humanos em Saúde/estatística & dados numéricos
Seres Humanos
Nigéria
Qualidade da Assistência à Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Drugs, Essential)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-017-2112-8


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[PMID]:28160839
[Au] Autor:Muller C
[Ad] Endereço:Centre hospitalier de Sarrebourg, 25 avenue du Général de Gaulle, 57 402 Sarrebourg Cedex, France. Electronic address: catherine.muller@laposte.net.
[Ti] Título:Le directeur, le directoire et le conseil de surveillance..
[So] Source:Rev Infirm;66(228):49-50, 2017 Feb.
[Is] ISSN:1293-8505
[Cp] País de publicação:France
[La] Idioma:fre
[Mh] Termos MeSH primário: Instalações de Saúde/legislação & jurisprudência
Administração de Instituições de Saúde
Liderança
[Mh] Termos MeSH secundário: Comitês Consultivos/legislação & jurisprudência
Comitês Consultivos/organização & administração
Comitês Consultivos/normas
Tomada de Decisões Gerenciais
Instalações de Saúde/recursos humanos
Administração de Instituições de Saúde/legislação & jurisprudência
Administração de Instituições de Saúde/recursos humanos
Hospitais Universitários/legislação & jurisprudência
Hospitais Universitários/recursos humanos
Hospitais Universitários/organização & administração
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170706
[Lr] Data última revisão:
170706
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170206
[St] Status:MEDLINE


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[PMID]:28130950
[Au] Autor:Lorv B; Horodyski R; Welton C; Vail J; Simonetto L; Jokanovic D; Sharma R; Mahoney AR; Savoy-Bird S; Bains S
[Ad] Endereço:Senior analyst within the Strategy Management and Project Management Office at Trillium Health Partners (THP) in Mississauga, Ontario.
[Ti] Título:The Development of a Quality Management Framework for Evaluating Medical Device Reprocessing Practice in Healthcare Facilities.
[So] Source:Healthc Q;19(4):37-43, 2017.
[Is] ISSN:1710-2774
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:There is increasing awareness of the importance of medical device reprocessing (MDR) for the provision of safe patient care. Although industry service standards are available to guide MDR practices, there remains a lack of published key performance indicators (KPIs) and targets that are necessary to evaluate MDR quality for feedback and improvement. This article outlines the development of an initial framework that builds on established guidelines and includes service standards, KPIs and targets for evaluating MDR operations. This framework can support healthcare facilities in strengthening existing practices and enables a platform for collaboration towards better MDR performance management.
[Mh] Termos MeSH primário: Desinfecção/normas
Contaminação de Equipamentos/prevenção & controle
Equipamentos e Provisões/normas
Controle de Infecções/normas
Garantia da Qualidade dos Cuidados de Saúde/organização & administração
[Mh] Termos MeSH secundário: Desinfecção/métodos
Equipamentos e Provisões/microbiologia
Administração de Instituições de Saúde
Seres Humanos
Controle de Infecções/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:170129
[St] Status:MEDLINE


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[PMID]:28122552
[Au] Autor:Gurung G; Derrett S; Gauld R; Hill PC
[Ad] Endereço:Department of Preventive and Social Medicine, Dunedin School of Medicine, PO Box 56, Ground Floor, Adams Building, 18 Frederick Street, Dunedin, 9016, New Zealand. aakashtamu@gmail.com.
[Ti] Título:Why service users do not complain or have 'voice': a mixed-methods study from Nepal's rural primary health care system.
[So] Source:BMC Health Serv Res;17(1):81, 2017 Jan 25.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Despite abundant literature on the different aspects of health care complaint management systems in high-income countries, little is known about this area in less developed health care systems and most research to date has been conducted in hospital settings. This article seeks to address this gap by reporting on research into complaint systems in primary health care (PHC) settings in Nepal. METHODS: Using a mixed-methods design, qualitative interviews were conducted with key informants (n = 39) and six community focus groups (n = 56), in the Dang District of Nepal. In addition, interviewer-administered structured questionnaire interviews were held with 400 service users, health facility operation and management committee (HFMC) members and service providers from 22 of the 39 public health facilities. Qualitative data were transcribed, organized and then analyzed using the framework method in QSR NVivo 10, while quantitative data were analyzed using IBM SPSS 22. RESULTS: Despite service users having grievances with the health system, they did not complain frequently: 9% (n = 20) reported ever making complaints about the PHC services. Complaints made were about medicines, health facility opening hours, health facility physical environment, and service providers, and were categorized into environment/equipment, accessibility/availability, level of empathy in the care process and care/safety. Generally, complaints were made verbally to health providers or to HFMC members or female community health volunteers. Use of formal channels such as suggestion boxes or written complaints was almost non-existent. Reasons reported for not complaining included: a lack of complaint channels; lack of knowledge of service entitlements; power asymmetry between service providers and service users; lack of opportunity to choose alternative providers, lack of an established culture of complaining, and a perceived lack of responsiveness to complaints. CONCLUSION: Very few service users made complaints to PHC services in Nepal. Several contextual factors related to the community and the health system were identified as the reasons for not complaining. We recommend continuing efforts to establish proper complaints mechanisms with an increased emphasis on the existing community health system networks. Furthermore, awareness among service users about service entitlements and complaint mechanisms should be increased.
[Mh] Termos MeSH primário: Satisfação do Paciente
Atenção Primária à Saúde
Serviços de Saúde Rural
[Mh] Termos MeSH secundário: Assistência à Saúde/organização & administração
Feminino
Grupos Focais
Administração de Instituições de Saúde
Seres Humanos
Entrevistas como Assunto
Masculino
Nepal
Atenção Primária à Saúde/organização & administração
Serviços de Saúde Rural/organização & administração
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170127
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-017-2034-5


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[PMID]:28004992
[Au] Autor:Ince B; Necioglu D; Turkish Stroke Study Group
[Ad] Endereço:1 Division of Cerebrovascular Disease, Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
[Ti] Título:Organization of stroke care in Turkey.
[So] Source:Int J Stroke;12(1):105-107, 2017 Jan.
[Is] ISSN:1747-4949
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Stroke is one of the major health problems in Turkey. Since cerebrovascular disease is the second leading cause of death, institutional organizations are important to decrease the burden of stroke in our country. Although the number of comprehensive stroke centers has been increasing constantly and many significant improvements have been realized in last years, there are still some regions without a comprehensive stroke center in Turkey.
[Mh] Termos MeSH primário: Assistência à Saúde/organização & administração
Acidente Vascular Cerebral/terapia
[Mh] Termos MeSH secundário: Geografia Médica
Administração de Instituições de Saúde
Hospitais
Seres Humanos
Acidente Vascular Cerebral/diagnóstico
Acidente Vascular Cerebral/epidemiologia
Turquia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161223
[St] Status:MEDLINE
[do] DOI:10.1177/1747493016672084



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