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[PMID]:28640326
[Au] Autor:Siqueira CE
[Ad] Endereço:College of Public and Community Service, University of Massachusetts Boston, Boston, U.S.A.
[Ti] Título:Bill of Law 4,302: outsourcing, albeit late.
[Ti] Título:O Projeto de Lei nº 4.302: terceirização quae sera tamen..
[So] Source:Cad Saude Publica;33(5):e00061317, 2017 06 05.
[Is] ISSN:1678-4464
[Cp] País de publicação:Brazil
[La] Idioma:eng; por; spa
[Mh] Termos MeSH primário: Serviços Terceirizados
[Mh] Termos MeSH secundário: Brasil
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE


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[PMID]:28574865
[Au] Autor:Atherton DS; Reilly S
[Ad] Endereço:From the *Department of Anatomic Pathology, University of Alabama at Birmingham, Cooper Green Hospital; and †Department of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL.
[Ti] Título:The Regional Autopsy Center: The University of Alabama at Birmingham Experience.
[So] Source:Am J Forensic Med Pathol;38(3):189-192, 2017 Sep.
[Is] ISSN:1533-404X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Rates of autopsied deaths have decreased significantly for the last several decades. It may not be practical for some institutions to maintain the facilities and staffing required to perform autopsies. In recent years, the University of Alabama at Birmingham (UAB) has established contracts to perform autopsies for several regional institutions including the Alabama Department of Forensic Sciences (ADFS), the United States Veterans Affairs, the local prison system, local community hospitals, and with families for private autopsy services. Contracts and autopsy data from 2004 to 2015 were obtained and reviewed. Since 2004, the number of UAB hospital autopsies trended slightly downward. On average, UAB hospital cases comprised most yearly cases, and the ADFS was the second largest contributor of cases. Income generated from outside autopsies performed from 2006 to 2015 totaled just more than 2 million dollars, and most of the income was generated from referred ADFS cases. This study provides evidence that a centralized institution (regional autopsy center [RAC]) can provide regional autopsy service in a practical, feasible, and economically viable manner, and a RAC can benefit both the referring institutions as well as the RAC itself.
[Mh] Termos MeSH primário: Autopsia/estatística & dados numéricos
Serviços Terceirizados
Universidades
[Mh] Termos MeSH secundário: Alabama
Hospitais Comunitários/estatística & dados numéricos
Seres Humanos
Prisões/estatística & dados numéricos
Setor Privado/estatística & dados numéricos
Programas Médicos Regionais
Estados Unidos
United States Department of Veterans Affairs
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE
[do] DOI:10.1097/PAF.0000000000000316


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[PMID]:28183562
[Au] Autor:Jelacic S; Craddick K; Nair BG; Bounthavong M; Yeung K; Kusulos D; Knutson JA; Somani S; Bowdle A
[Ad] Endereço:Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA. Electronic address: sjelacic@uw.edu.
[Ti] Título:Relative costs of anesthesiologist prepared, hospital pharmacy prepared and outsourced anesthesia drugs.
[So] Source:J Clin Anesth;36:178-183, 2017 Feb.
[Is] ISSN:1873-4529
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Anesthesia drugs can be prepared by anesthesia providers, hospital pharmacies or outsourcing facilities. The decision whether to outsource all or some anesthesia drugs is challenging since the costs associated with different anesthesia drug preparation methods remain poorly described. METHODS: The costs associated with preparation of 8 commonly used anesthesia drugs were analyzed using a budget impact analysis for 4 different syringe preparation strategies: (1) all drugs prepared by anesthesiologist, (2) drugs prepared by anesthesiologist and hospital pharmacy, (3) drugs prepared by anesthesiologist and outsourcing facility, and (4) all drugs prepared by outsourcing facility. MAIN RESULTS: A strategy combining anesthesiologist and hospital pharmacy prepared drugs was associated with the lowest estimated annual cost in the base-case budget impact analysis with an annual cost of $225 592, which was lower than other strategies by a margin of greater than $86 000. CONCLUSION: A combination of anesthesiologist and hospital pharmacy prepared drugs resulted in the lowest annual cost in the budget impact analysis. However, the cost of drugs prepared by an outsourcing facility maybe lower if the capital investment needed for the establishment and maintenance of the US Pharmacopeial Convention Chapter <797> compliant facility is included in the budget impact analysis.
[Mh] Termos MeSH primário: Anestesia/economia
Anestésicos/economia
Custos de Medicamentos/estatística & dados numéricos
Serviços Terceirizados/economia
Serviço de Farmácia Hospitalar/economia
[Mh] Termos MeSH secundário: Anestesiologistas
District of Columbia
Composição de Medicamentos/economia
Composição de Medicamentos/métodos
Seres Humanos
Modelos Econométricos
Fármacos Neuromusculares Despolarizantes/economia
Seringas
Vasoconstritores/economia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics); 0 (Neuromuscular Depolarizing Agents); 0 (Vasoconstrictor Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170211
[St] Status:MEDLINE


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[PMID]:28129362
[Au] Autor:Ji C; Guo H; Jin S; Yang J
[Ad] Endereço:China Academy of Rural Development, Zhejiang University, Hangzhou, Zhejiang, China.
[Ti] Título:Outsourcing Agricultural Production: Evidence from Rice Farmers in Zhejiang Province.
[So] Source:PLoS One;12(1):e0170861, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:China has recorded positive growth rates of grain production for the past eleven consecutive years. This is a remarkable accomplishment given that China's rapid industrialization and urbanization has led to a vast reduction of arable land and agricultural labor to non-agricultural sectors. While there are many factors contributing to this happy outcome, one potential contributing factor that has received increasing attention is the emergence of agricultural production outsourcing, a new rural institution that has emerged in recent years. This study aims to contribute to the limited but growing literature on agricultural production outsourcing in China. Specifically, this study analyzes factors affecting farmers' decisions to outsource any or some production tasks using data from rice farmers in Zhejiang province. Results from a logistic model show that farm size and government subsidy encourages farmers to outsource while ownership of agricultural machines and land fragmentation have negative effects on farmers' decisions to outsource production tasks. Results also showed that determinants of outsourcing decisions vary with the production tasks that farmers outsourced.
[Mh] Termos MeSH primário: Agricultura
Oryza/crescimento & desenvolvimento
Serviços Terceirizados
[Mh] Termos MeSH secundário: China
Conservação dos Recursos Naturais
Fazendeiros
Seres Humanos
População Rural
Urbanização
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170128
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0170861


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[PMID]:27874190
[Au] Autor:McCleskey BC; Reilly SD; Atherton D
[Ad] Endereço:Department of Pathology, University of Alabama at Birmingham, 619 South 19th Street, Birmingham, AL, 35233.
[Ti] Título:The Value of Outsourcing Selected Cases in a Medical Examiner Population: A 10-Year Experience.
[So] Source:J Forensic Sci;62(1):99-102, 2017 01.
[Is] ISSN:1556-4029
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Due to increasing caseloads and inadequate staffing, the burden on Coroner/Medical Examiner Offices to comply with recommended autopsy limits for forensic pathologists (FPs) has been difficult. Since 2006, pathologists at the University of Alabama at Birmingham have performed select autopsies for the Alabama Department of Forensic Sciences. Each case was reviewed by a state FP and scene investigator to determine appropriateness for referral. All referred cases received full postmortem examination including microscopic examination and collection of toxicological samples, and toxicology was ordered by the referring FP as appropriate. The final cause and manner of death were determined by the referring state FP after review of all findings. A majority of the 421 cases were ruled accidental deaths (233), most due to drug toxicity. Of the 178 natural deaths, 118 were attributed to cardiovascular disease. Outsourcing select forensic cases can be educational and an effective tool to manage workflow without compromising quality.
[Mh] Termos MeSH primário: Autopsia
Médicos Legistas
Serviços Terceirizados
Universidades
[Mh] Termos MeSH secundário: Alabama
Causas de Morte
Patologia Legal
Seres Humanos
Carga de Trabalho
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161123
[St] Status:MEDLINE
[do] DOI:10.1111/1556-4029.13269


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[PMID]:27696988
[Au] Autor:Siganporia P; Astrakianakis G; Alamgir H; Ostry A; Nicol AM; Koehoorn M
[Ad] Endereço:a School of Population and Public Health , University of British Columbia , Vancouver , Canada.
[Ti] Título:Hospital support services and the impacts of outsourcing on occupational health and safety.
[So] Source:Int J Occup Environ Health;22(4):274-282, 2016 10.
[Is] ISSN:2049-3967
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Outsourcing labor is linked to negative impacts on occupational health and safety (OHS). In British Columbia, Canada, provincial health care service providers outsource support services such as cleaners and food service workers (CFSWs) to external contractors. OBJECTIVES: This study investigates the impact of outsourcing on the occupational health safety of hospital CFSWs through a mixed methods approach. METHODS: Worker's compensation data for hospital CFSWs were analyzed by negative binomial and multiple linear regressions supplemented by iterative thematic analysis of telephone interviews of the same job groups. RESULTS: Non-significant decreases in injury rates and days lost per injury were observed in outsourced CFSWs post outsourcing. Significant decreases (P < 0.05) were observed in average costs per injury for cleaners post outsourcing. Outsourced workers interviewed implied instances of underreporting workplace injuries. CONCLUSIONS: This mixed methods study describes the impact of outsourcing on OHS of healthcare workers in British Columbia. Results will be helpful for policy-makers and workplace regulators to assess program effectiveness for outsourced workers.
[Mh] Termos MeSH primário: Serviço Hospitalar de Nutrição/estatística & dados numéricos
Hospitais/estatística & dados numéricos
Traumatismos Ocupacionais/epidemiologia
Serviços Terceirizados/estatística & dados numéricos
[Mh] Termos MeSH secundário: Colúmbia Britânica
Seres Humanos
Saúde do Trabalhador
Percepção
Indenização aos Trabalhadores/estatística & dados numéricos
Local de Trabalho
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171121
[Lr] Data última revisão:
171121
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161005
[St] Status:MEDLINE


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[PMID]:27416917
[Au] Autor:Rago B; Negahban A
[Ad] Endereço:Pharmacokinetics, Dynamics & Metabolism, Pfizer Inc., Eastern Point Road, Groton, CT 06340, USA.
[Ti] Título:Outsource-ability of high-resolution MS-based DMPK assays.
[So] Source:Bioanalysis;8(16):1641-4, 2016 Aug.
[Is] ISSN:1757-6199
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Descoberta de Drogas
Espectrometria de Massas
Serviços Terceirizados
Preparações Farmacêuticas/metabolismo
Farmacocinética
[Mh] Termos MeSH secundário: Animais
Cromatografia Líquida/métodos
Descoberta de Drogas/métodos
Seres Humanos
Espectrometria de Massas/métodos
Serviços Terceirizados/métodos
Espectrometria de Massas em Tandem/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Pharmaceutical Preparations)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170112
[Lr] Data última revisão:
170112
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160716
[St] Status:MEDLINE
[do] DOI:10.4155/bio-2016-0163


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[PMID]:27384209
[Au] Autor:Souza HS; Mendes ÁN
[Ad] Endereço:Universidade de São Paulo, Faculdade de Saúde Pública, São Paulo, SP, Brazil.
[Ti] Título:Outsourcing and "dismantling" of steady jobs at hospitals.
[So] Source:Rev Esc Enferm USP;50(2):286-94, 2016 Apr.
[Is] ISSN:0080-6234
[Cp] País de publicação:Brazil
[La] Idioma:eng; por
[Ab] Resumo:OBJECTIVE: To relate hospitals' organizational structure as the core of a web of outsourced services and flexible employment bonds among healthcare professionals in the context of finance capitalism, analyzing work arrangements based mainly on the type of employment bond. METHOD: Qualitative research through ethnography, interviews, data analysis, and case studies. The case studies were concentrated in 3 hospitals located in the São Paulo metropolitan region under different management types: public administration; outsourced administration via a healthcare social organization (HSO); and private administration. RESULTS: This study highlights a trend in outsourcing, dismantling of steady jobs, and shaping working relations asymmetrically in terms of healthcare professions. CONCLUSION: These aspects are characteristic of contemporary capitalism and post-Fordist work organization. In this context, the state under sponsorship cripples the very existence of an effective human resources policy, creating a favorable environment for outsourcing and flexibility of employment bonds among healthcare workers. OBJETIVO: Relacionar a estrutura organizativa dos hospitais como núcleo de uma rede de serviços subcontratados e a flexibilização dos vínculos contratuais dos profissionais de saúde no contexto de capitalismo financeirizado, analisando os regimes de trabalho condicionados centralmente pelo vínculo empregatício. MÉTODO: Pesquisa qualitativa através de etnografia, realização de entrevistas, análise de dados e utilização de estudo de caso. Os estudos de caso concentram-se em três hospitais localizados Região Metropolitana de São Paulo com gestões distintas: administração pública; administração terceirizada para Organização Social de Saúde (OSS); e administração privada. RESULTADOS: Destacamos a tendência da terceirização, do desmonte do emprego estável e a conformação de relações trabalhistas assimétricas para as profissões em saúde. CONCLUSÃO: Esses aspectos são característicos do período do capitalismo contemporâneo e da organização pós-fordista do trabalho. Nesse contexto, o subfinanciamento do Estado inviabiliza uma política de recursos humanos efetiva, configurando o ambiente propício para as terceirizações e flexibilidade do vínculo empregatício para os trabalhadores de saúde.
[Mh] Termos MeSH primário: Pessoal de Saúde
Hospitais/recursos humanos
Serviços Terceirizados
[Mh] Termos MeSH secundário: Brasil
Administração Hospitalar
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170214
[Lr] Data última revisão:
170214
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:160708
[St] Status:MEDLINE


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[PMID]:27336585
[Au] Autor:Homedes N; Ugalde A
[Ad] Endereço:Management Policy and Community Health, School of Public Health, University of Texas, El Paso, Texas, United States of America.
[Ti] Título:Health and Ethical Consequences of Outsourcing Pivotal Clinical Trials to Latin America: A Cross-Sectional, Descriptive Study.
[So] Source:PLoS One;11(6):e0157756, 2016.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The implications of conducting clinical trials in low and middle income countries on the financial accessibility and safety of the pharmaceutical products available in those markets have not been studied. Regulatory practices and ethical declarations lead to the commercialization of the new products, referred to as New Molecular Entities (NMEs), in the countries where tested as soon as they are approved in high surveillance countries. Patients and patients' associations use the Latin American courts to access new and expensive treatments, regardless of their safety profile and therapeutic value. DESIGN AND OBJECTIVES: Cross-sectional, descriptive study. To determine the therapeutic value and safety profile of the NMEs approved by the Food and Drug Administration (FDA) in 2011 and 2012 that had been tested in Latin America, and the implications of their market approval for the pharmaceutical budgets in the countries where tested. SETTING: Latin America. MEASURES: To assess the therapeutic value and safety of the NMEs commercialized in the different countries we used f independent drug bulletins. The prices of the NMEs for the consumers were obtained from the pharmaceutical price observatories of the countries were the medicines had been tested. If the price was not available in the observatories, it was obtained from pharmaceutical distributors. We used the countries' minimum wage and per capita income to calculate the financial accessibility of a course of treatment with the NMEs. RESULTS: We found that 33 NMEs approved by the FDA in 2011 and 2012 have been tested in Latin America. Of these, 26 had been evaluated by independent drug bulletins and only five were found to add some value to a subset of patients and had significant side-effects. The pharmaceutical prices were very high, varied widely across countries and were unrelated to the countries' income per capita or minimum wage. CONCLUSION: The implementation of clinical trials in Latin America results in the commercialization of medicines with questionable safety profiles and limited therapeutic value, putting patients at risk and causing budgetary strains in pharmaceutical budgets.
[Mh] Termos MeSH primário: Ensaios Clínicos como Assunto
Tratamento Farmacológico
Serviços Terceirizados
[Mh] Termos MeSH secundário: Temas Bioéticos
Ensaios Clínicos como Assunto/economia
Ensaios Clínicos como Assunto/ética
Estudos Transversais
Países em Desenvolvimento
Tratamento Farmacológico/economia
Tratamento Farmacológico/ética
Seres Humanos
América Latina
Serviços Terceirizados/economia
Serviços Terceirizados/ética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160624
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0157756


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[PMID]:27333140
[Au] Autor:Martins MI
[Ad] Endereço:Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro , Brazil.
[Ti] Título:Precarious employment, precarious work, outsourcing, inequity, and risks from the workers' health perspective: a dialogue with the authors.
[So] Source:Cad Saude Publica;32(6), 2016 06 20.
[Is] ISSN:1678-4464
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Mh] Termos MeSH primário: Saúde do Trabalhador
Serviços Terceirizados
[Mh] Termos MeSH secundário: Brasil
Emprego
Seres Humanos
Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160623
[St] Status:MEDLINE



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