Introduction: Characteristics of primary health care and emergency services may hamper their inte... more Introduction: Characteristics of primary health care and emergency services may hamper their integration and, therefore, reduce the quality of care and the effectiveness of health systems. This study aims to identify and analyse policy, structural and organizational aspects of healthcare services that may affect the integration between primary health and emergency care networks. Theory and Methods: We conducted a qualitative research study based on grounded theory that included: (1) interviews with 30 health care leaders; and (2) documental analysis of the summaries of Regional Interagency Committee meetings from two regions in the state of Sao Paulo, Brazil. Results: The integration between primary health and emergency care network is inefficient. The barriers that contributed to this situation are as follows: (1) policy: the municipal health department is responsible for providing primary health care and the regional health department provides emergency care, but there is a lack of space for the integration of services; (2) structural: distinct criteria for planning mechanisms; and (3) organizational: ineffective point of interaction between different levels of the health system. Conclusions and discussion: Our findings have implications for health management and planning in low-and middle-income countries (LMICs) with suggestions for interventions for overcoming the aforementioned barriers.
This is an observational quantitative and analytical study aimed at verifying the knowledge, acce... more This is an observational quantitative and analytical study aimed at verifying the knowledge, acceptability and use of natural family planning (NFP) by patients in a university hospital from July to November, 2008. The data were collected using a structured questionnaire and analyzed with the softwares Excel and Statistica 8.0. Of the 113s women interviewed, 70 (62%) accepted the method and 1 (0.9%) used it routinely. Acceptance was higher among those who wished to become pregnant in the future compared to those who did not wish it. Acceptability was statistically significant (p = 0.0147) among the 28 (80%) non-contraceptive users compared to 42 (53.8%) who used some contraceptive method. Factors such as age, education, number of living children and religion were not statiscally associated with the acceptability of NFP. The Billings ovulation method has an adequate acceptability, but has a low actual use because of the lack of information by health professionals of its real effective...
To assess the association between conservative management of high-grade cervical squamous intraep... more To assess the association between conservative management of high-grade cervical squamous intraepithelial lesions and recurrence rates and age groups. Cross-sectional, retrospective, analytical observational study of 509 women (aged 15 to 76) with abnormal Pap smears attending a public reference center in the city of Maringá, southern Brazil, from 1996 to 2006. Data was collected from medical records, and the variables definitive diagnosis, type of treatment provided, occurrence of high-grade cervical squamous intraepithelial lesions and recurrence were studied. Pearson's chi-square test and Fisher's exact test were used in the statistical analyses. There were 168 cases of cervical high-grade cervical squamous intraepithelial lesions, of these, 31 were treated with cold-knife conization, 104 loop electrosurgical excision procedure, 9 hysterectomy and 24 conservative treatment (i.e., clinical and cytological follow-up or cervical electrocoagulation). A total of 8 (33.3%) wome...
O presente capítulo apresenta e discute os resultados da pesquisa Rede de Atenção às Urgências e ... more O presente capítulo apresenta e discute os resultados da pesquisa Rede de Atenção às Urgências e Emergências: Avaliação da Implantação e Desempenho das Unidades de Pronto Atendimento (UPAs) no estado do Paraná. Os métodos incluíram pesquisa documental e entrevistas (n=65) com gestores e profissionais de sete unidades visitadas no período de de dezembro de 2012 a março de 2013. São apresentados resultados relativos ao processo de implantação das UPAs no Paraná, ao perfil dos coordenadores, médicos e enfermeiros que trabalham nas unidades, à assistência prestada, à coordenação e continuidade do cuidado, aos sistemas de informação e à resolutividade da UPA.
Introduction: Characteristics of primary health care and emergency services may hamper their inte... more Introduction: Characteristics of primary health care and emergency services may hamper their integration and, therefore, reduce the quality of care and the effectiveness of health systems. This study aims to identify and analyse policy, structural and organizational aspects of healthcare services that may affect the integration between primary health and emergency care networks. Theory and Methods: We conducted a qualitative research study based on grounded theory that included: (1) interviews with 30 health care leaders; and (2) documental analysis of the summaries of Regional Interagency Committee meetings from two regions in the state of Sao Paulo, Brazil. Results: The integration between primary health and emergency care network is inefficient. The barriers that contributed to this situation are as follows: (1) policy: the municipal health department is responsible for providing primary health care and the regional health department provides emergency care, but there is a lack of space for the integration of services; (2) structural: distinct criteria for planning mechanisms; and (3) organizational: ineffective point of interaction between different levels of the health system. Conclusions and discussion: Our findings have implications for health management and planning in low-and middle-income countries (LMICs) with suggestions for interventions for overcoming the aforementioned barriers.
This is an observational quantitative and analytical study aimed at verifying the knowledge, acce... more This is an observational quantitative and analytical study aimed at verifying the knowledge, acceptability and use of natural family planning (NFP) by patients in a university hospital from July to November, 2008. The data were collected using a structured questionnaire and analyzed with the softwares Excel and Statistica 8.0. Of the 113s women interviewed, 70 (62%) accepted the method and 1 (0.9%) used it routinely. Acceptance was higher among those who wished to become pregnant in the future compared to those who did not wish it. Acceptability was statistically significant (p = 0.0147) among the 28 (80%) non-contraceptive users compared to 42 (53.8%) who used some contraceptive method. Factors such as age, education, number of living children and religion were not statiscally associated with the acceptability of NFP. The Billings ovulation method has an adequate acceptability, but has a low actual use because of the lack of information by health professionals of its real effective...
To assess the association between conservative management of high-grade cervical squamous intraep... more To assess the association between conservative management of high-grade cervical squamous intraepithelial lesions and recurrence rates and age groups. Cross-sectional, retrospective, analytical observational study of 509 women (aged 15 to 76) with abnormal Pap smears attending a public reference center in the city of Maringá, southern Brazil, from 1996 to 2006. Data was collected from medical records, and the variables definitive diagnosis, type of treatment provided, occurrence of high-grade cervical squamous intraepithelial lesions and recurrence were studied. Pearson's chi-square test and Fisher's exact test were used in the statistical analyses. There were 168 cases of cervical high-grade cervical squamous intraepithelial lesions, of these, 31 were treated with cold-knife conization, 104 loop electrosurgical excision procedure, 9 hysterectomy and 24 conservative treatment (i.e., clinical and cytological follow-up or cervical electrocoagulation). A total of 8 (33.3%) wome...
O presente capítulo apresenta e discute os resultados da pesquisa Rede de Atenção às Urgências e ... more O presente capítulo apresenta e discute os resultados da pesquisa Rede de Atenção às Urgências e Emergências: Avaliação da Implantação e Desempenho das Unidades de Pronto Atendimento (UPAs) no estado do Paraná. Os métodos incluíram pesquisa documental e entrevistas (n=65) com gestores e profissionais de sete unidades visitadas no período de de dezembro de 2012 a março de 2013. São apresentados resultados relativos ao processo de implantação das UPAs no Paraná, ao perfil dos coordenadores, médicos e enfermeiros que trabalham nas unidades, à assistência prestada, à coordenação e continuidade do cuidado, aos sistemas de informação e à resolutividade da UPA.
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