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Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Resumen Este artículo pretende analizar los aportes de Mouffe y Laclau desde el posmarxismo, la democracia agonista y la lógica populista que innovaron sobre los modos de construir identidades colectivas y viabilidad política. Se indaga sobre la potencia de estas teorías para el desarrollo micropolítico de la gestión en salud. Las contribuciones teóricas ubican a las pasiones como la fuerza motora de la política; proponen sublimar los conflictos en acción por medio de canales institucionales; establecen a las prácticas hegemónicas como la capacidad de articular demandas heterogéneas; y explican la capacidad de configurar una identidad colectiva con un liderazgo contingente. Las particularidades del trabajo en salud, como la condición artesanal, los márgenes de autonomía, el ejercicio micropolítico para su desarrollo y la organización como una burocracia profesional, habilitan que las propuestas puedan ser llevadas a la práctica. Se señala que la experiencia de construir identidades al interior de la organización desde un lazo afectivo y la vehiculización de las demandas insatisfechas invitan a reducir el malestar en los servicios y a promover un posicionamiento de transformación.

Copyright of Enfermería Neonatal is the property of Fundacion para la Salud Materno Infantil (FUNDASAMIN) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: transformational leadership creates a satisfactory and motivational work environment that drives the processes of change and innovation in an organization, which was also evidenced during the COVID-19 pandemic; it was the health personnel who bravely faced and assumed this role and challenge. Objectives: to know the importance of transformational leadership in hospital management, to analyze the organization's response capacity according to the requirements of its hospital management and to diagnose the satisfaction of health personnel in their work area. Methods: systematic review of papers published between 2016 and 2021, the search was performed in articles with indexing in Scielo, Scopus, Science Direct, Latindex and others. Exclusion and inclusion criteria were applied. Conclusions: the analysis of the selected articles allowed finding different approaches and determining that leadership is of importance in management and decision making in a strategic way for hospital improvement both for the staff and for those who receive the care service. [ABSTRACT FROM AUTHOR]

El objetivo fue identificar los resultados de la investigación sobre gestión de centros de atención primaria de salud en la literatura científica, desde 2015 hasta 2020. Se trata de una Revisión Integradora de literatura en las bases de datos Biblioteca Virtual de Salud, PubMed, Scopus y Web of Science, con los descriptores: Gestión en Salud, Administración de los Servicios de Salud y Atención Primaria de Salud. Fueron incluidos trabajos que tratan del objetivo de esta investigación, publicados de 2015 hasta 2020, en cualquier idioma. Para análisis del material se utilizó el Análisis de Contenido. El corpus del trabajo está formado por 36 artículos. Resultaron siete categorías: caracterización de los profesionales, planeamiento del trabajo, gestión de cambios, gestión basada en el desempeño, democracia institucional, participación y control social, y formación. Se concluye que la literatura seleccionada indica que los encargados de la gestión de esos centros de salud presentan una baja cualificación técnica. A ello se suma una creciente influencia del mercado y del modelo de gestión empresarial sobre la administración de esos servicios, además de los contratos del sector público con proveedores privados que imponen desafíos a la participación social y a la atención de las necesidades locales de salud.

Copyright of Revista Venezolana de Gerencia (RVG) is the property of Revista de Filosofia-Universidad del Zulia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Management & Health / Revista Gestão & Saúde is the property of Revista Gestao e Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La gestión de instituciones hospitalarias cada vez es más compleja. La situación actual exige la eliminación de los modelos de gestión funcionales por operativos que integren de manera simultánea las funciones preventivas, curativas y directivas de manera eficiente con el fin de elevar la calidad asistencial. El objetivo del presente artículo es analizar la evolución de las prácticas en gerencia de procesos en la administración de servicios hospitalarios. Entre los métodos de investigación utilizados se encuentran a revisión bibliográfica y documental, la observación científica participativa, las entrevistas y la observación de los procesos que permiten determinar variables clave para el análisis de modelos. Todo ello se complementa con un análisis bibliométrico cuantitativo-descriptivo de las principales aplicaciones de las funciones de administración de operaciones en los sistemas hospitalarios. Se determinan las funciones más utilizadas en los modelos hospitalarios y su influencia en la calidad de los procesos asistenciales.

Objective: To realize the value stream mapping proposing improvements of the intensive care unit discharge process. Methods: A descriptive, prospective and exploratory study that compared two moments of a process. The value stream mapping tool was used in an intensive care unit of a hospital located in the city of São Paulo with the purpose of identifying critical points and proposing improvement actions. Results: The unit's care team carried out the mapping of the initial value flow, identifying opportunities for improvement such as the implementation of actions to change flows, training and task review. With the elaboration of the current value flow map, a reduction in the time of discharge from the intensive care unit of 97 minutes can be highlighted, which represented approximately 26.7% of the total time. Conclusion: The use of the Value Stream Map tool had positive implications for process management due to the possibility of a systemic view of all stages, identification of opportunities and improvement in care practice. [ABSTRACT FROM AUTHOR]

Copyright of Revista Eletrônica de Enfermagem is the property of Revista Eletronica de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: presentar la concepción e implementación del Modelo de Gestión de Alta del Complejo Hospitalario de Clínicas de la Universidad Federal de Paraná. Método: informe de experiencia ocurrida entre 2017 y 2020, sobre el diseño e implementación del modelo de Gestión del Alta con apoyo del modelo lógico. Resultados: la continuidad de los cuidados y la gestión de los casos son operados por un equipo exclusivo de enfermeras de enlace que gestionan y contra revierten los cuidados a la atención primaria y a otros puntos de la red sanitaria. Conclusión: la gestión de altas se consolida como una estrategia gerencial que integra la red de atención a la salud, evita las discontinuidades de la asistencia, promueve la seguridad de los pacientes y los familiares, además de la optimización de las camas, y aún inserta en la agenda de la atención primaria a los pacientes complejos. Contribuye a la continuidad de los cuidados y representa la evidencia de un nuevo campo de trabajo para las enfermeras.

Copyright of Investigacion & Educacion en Enfermeria is the property of Universidad de Antioquia, Facultad de Enfermeria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Los servicios de enfermería en las instituciones públicas son fundamentales, debido a la importancia que este profesional tiene dentro del proceso de atención de la salud de la población, sin embargo, el servicio no solo conlleva al aprendizaje de elementos técnicos propios de su profesión, también involucra el aprendizaje y aplicación de conceptos gerenciales y de organización que le permitirán un mejor desempeño en sus labores. El objetivo de este artículo es describir los elementos que favorecen u obstaculizan la dinámica gerencial de enfermería para el cuidado solidario en un hospital de ESSALUD, Perú. El abordaje fue cualitativo descriptivo usando la dialéctica y aplicando entrevistas semiestructuradas a cuatro enfermeras de los servicios de consulta externa y hospitalización que desempeñaron cargos administrativos, cuatro enfermeras asistenciales y cuatro usuarios en el Hospital Víctor Lazarte Echegaray de Trujillo, Perú. Se observó como las subcategorías estudiadas, a saber, estructura organizativa, trabajo solidario y docencia asistencial se constituyen como elementos que obstaculizan la dinámica gerencial del personal del área de enfermería. Se concluyó que La gerencia de enfermería precisa de un plan de reingeniería con capacitación en nuevas competencias, de un sistema de evaluación interna y externa innovador, de un programa efectivo de coordinación intra e interinstitucional, de fortalecimiento de la articulación docente asistencial y de un plan de incentivos y reconocimiento, lo que asegurara una gerencia solidaria en bien de los enfermeros y de los usuarios de la institución.

Copyright of Revista Família, Ciclos de Vida e Saúde no Contexto Social (REFACS) is the property of Universidade Federal do Triangulo Mineiro, Instituto de Ciencias da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The quality of management and adaptation of admission of patients to the internal medicine services is a relevant topic in the health environment, as it is an indicator of the existing balance between primary health care, the emergency hospital service and the functioning of the internal medicine service itself. However, there are irregularities in this balance due to certain problems linked to a scarce theoretical level of the providers and to scarcities in the practical and organizational skills to carry out hospitalization. Some of the deficiencies damaging the quality of management during admission in this service, which require the projection of a strategy based on a health, formative, and social-humanistic model are presented in this work, with the aim of achieving significant advances in the hospital context.

Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Pesquisa: Cuidado é Fundamental is the property of Revista de Pesquisa: Cuidado e Fundamental Online and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Salud, Ciencia y Tecnología is the property of Fundacion Salud, Ciencia y Tecnologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermagem Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Telos is the property of Revista Telos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Se presenta un recuento histórico de los 30 años de la especialidad médica de Gestión en Salud en la Universidad Nacional Mayor de San Marcos. La especialidad fue creada en 1988 como Medicina General Integral en respuesta a la escasez de médicos especialistas en gestión. El nombre de la especialidad se mantuvo hasta 1994, cuando cambia a Medicina Integral y Gestión en Salud para enfatizar su orientación gerencial. En 2002, se modifica el plan curricular considerando la importancia de tener una especialización médica exclusiva de gestión para el sector salud. La especialidad es pionera en una formación gradual en tres niveles: microgestión, mesogestión y macrogestión. El nuevo plan curricular permitió a los residentes la posibilidad de mejores rotaciones en instituciones públicas y privadas. A partir del 2007, la especialidad es denominada Gestión en Salud, cuyos médicos especialistas mantienen su sólida formación para desempeñarse en los procesos de decisión, conducción, dirección y operatividad de los sistemas de salud. La visión de los creadores de la especialidad se encuentra vigente, los especialistas de Gestión en Salud se desempeñan en las diferentes instituciones del sistema de salud, aportando sus conocimientos y habilidades, y generando un impacto en la salud de la población peruana.

Foundation: Orthopedics is one of the specialties with high risk of demands due to professional responsibility; this is, among other reasons, because traffic, industrial and domestic accidents have noticeably increased lately.Objective: to describe the application of a methodology with a multi-criteria approach to the management of technological risks in an orthopedic service.Methods: a descriptive study was realized at the Orthopedics service Vladimir Ilinch Lenin Hospital in Holguín during 2016. A methodology with a multi-criteria approach was applied which had four stages: risk setting, identification, evaluation and control. Some of the instruments used were Petri network, Software for the analysis of social network and the multi-criteria entropy method.Results: as high priority and more influential risks in the specialty of orthopedics there were identified the copy and paste of old information when writing new reports, deficiencies in internal communication means and loss of information by the high as well as the orthopedics area. With the implementation of the Plan for preventing risks it was possible to increase risk detection and there updating so as decreasing the relationship risk-evaluation.Conclusion: the methodology used allows solving deficiencies in risk management in hospitals since it allows a higher accuracy in each of the process stages and therefore a more effective control.

The quality of management and adaptation of admission of patients to the internal medicine services is a relevant topic in the health environment, as it is an indicator of the existing balance between primary health care, the emergency hospital service and the functioning of the internal medicine service itself. However, there are irregularities in this balance due to certain problems linked to a scarce theoretical level of the providers and to scarcities in the practical and organizational skills to carry out hospitalization. Some of the deficiencies damaging the quality of management during admission in this service, which require the projection of a strategy based on a health, formative, and social-humanistic model are presented in this work, with the aim of achieving significant advances in the hospital context. [ABSTRACT FROM AUTHOR]

Emergency medical service (EMS) systems play a fundamental role in society by providing a vital service in initial emergency care. The purpose of this research is to present the first literature review of hospital selection operational decision within the context of the EMS system. The main findings were the following: The hospital selection problem is integrated with the location, dispatch, routing, and size of the ambulance fleet. The main selection criteria were closeness, hospital care capacities and the shortest queue or greatest number of free beds. The most used performance measures were the shortest transport and waiting time. Solution techniques include discrete event simulation, queuing models, mixed linear integer programming, and CPLEX and Arena software. The application of metaheuristics is scarce; mobile applications and Internet information systems have been implemented for real-time decision making. It is recommended that the design of hospital selection methods be implemented as well as the technological developments, considering the participation of the actors of the EMS system. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The creation of an institution as large as the Instituto Mexicano del Seguro Social (IMSS) required a lot of planning to manage all the benefits provided to the population. Thus, it is necessary to have health personnel with knowledge and experience in health services administration. This manuscript is an acknowledgment to doctors Manuel Barquín Calderón, Antonio Ríos Vargas and Carlos Zamarripa Torres, pioneers and recognized protagonists in the planning and organization (administration) of the IMSS medical services between 1945 and 1955, who also had rational initiatives and constructive, doing their duty. On the other hand, the Institute exposed and projected that medical-administrative activities were a complex task, and that its practice required specialized knowledge that could not be left to chance, empiricism, good will, beliefs or nonobjective imagination. [ABSTRACT FROM AUTHOR]

Noncommunicable diseases (NCD) cause more than 41 million deaths each year, equivalent to 71% of all deaths globally. The main types of NCD are: cardiovascular diseases (heart attack or cerebrovascular infarction), diabetes, cancer and chronic respiratory diseases (chronic obstructive pulmonary disease and asthma). In Mexico, NCD are responsible of more than three-quarters of deaths. This supplement describes a novel strategy by the Instituto Mexicano del Seguro Social (IMSS) to confront chronic diseases, known as Comprehensive Care Protocols, which aim to be a simple and easy-to-interpret reference document, but at the forefront of national and international knowledge, based on scientific evidence and normative documents. In addition, they specify the indispensable, optional actions and those that have to be avoided by the expanded health team. Therefore, this tool will guide our actions according to scientific advances and social needs. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing & Health is the property of Journal of Nursing & Health (JONAH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to analyze the attendances performed at the Emergency Mobile Care Service of the State of Rio Grande do Sul in 2016 and 2017, focusing in response time. Method: observational, descriptive and retrospective study with quantitative approach. Data were collected on user profile, day of the week, risk classification, type of grievance, average time to respond to requests, amount of withdrawal and number of calls not regulated due to lack of teams or vehicles. Results: The number of requests for clinical reasons was 53.8%, of these 51.6% were medium severity. The prevalence was male and aged between 18 and 29 years. In 84.7% of the calls, basic support was requested. The total response time was between 30 minutes and 1 hour, longer than recommended according to the national average, whether in urban or rural areas. Conclusion: After analyzing the calls, it is clear that the worst problem with the calls is the response time, and it is necessary to decrease the same of the requests. [ABSTRACT FROM AUTHOR]

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of the study was to estimate the prevalence of non-use of health services (NUHS) and its associated factors using the National Household Survey (ENAHO 2015). The participants were defined as NUHS if they have presented any symptoms, discomfort, illness, relapse of chronic illness or accident during the last month and did not go to the health services. 35036 participants were analyzed; the prevalence of NUHS was 53,9%. NUHS was higher in the coastal region (adjusted Prevalence Ratio [aPR]=1.24;95%CI:1.17-1.31), highlands (aPR=1.38;95%CI:1.31-1.46) and jungle (aPR=1.25,95%CI:1.18-1.33) compared to Lima. Likewise, there were a higher prevalence of NUHS in participants without health insurance (aPR=1.59;95%CI:1.52-1.66) and those affiliated to Ministry of Health insurance (aPR=1.16;95%CI:1.11-1.22) compared to those affiliated to Social Security. More than half of the participants suffered from NUHS, which was associated with geographical and health system conditions. It is required evidenced-informed public policies to improve this situation.

Copyright of Ciencia, Cuidado e Saude is the property of Universidade Estadual de Maringa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tuberculosis (TB) is the first cause of death by an infectious agent in the world, the incidence in the population is declining very slowly and drug resistance is currently considered an international crisis. In Peru, the recent TB Prevention and Control Act in Peru (Law 30287) declares the fight against TB of national interest. In recent years, the Ministry of Health’s (MINSA) National Health Strategy for the Prevention and Control of Tuberculosis (ESNPCT) has achieved significant progress in the control of this disease; however, challenges still remain to be addressed. This article reviews the epidemiological situation of TB in Peru, systematizes the progress achieved during the management of the ESNPCT team between the years 2011 and 2015 from the biomedical approach, public management and social determinants of health, also posing challenges to achieving TB control under law 30287 and the “End of TB” strategy of the World Health Organization (WHO).

Introduction: Colombian pharmaceutical policy established the adequate prescription of drugs, as a strategy to counteract the inequitable access to drugs and the deficient quality of health care. Objective: establish restrictions on the use of drugs in a highly complex hospital and measure the economic impact, without affecting the safety of care. Materials and methods: each drug were evaluated according to the inclusion of the health benefits plan (PBS), use in emergencies and alternatives of use. Then, they were classified according to prescription restrictions: 1) no restriction, 2) urgent and prescription with restriction by specialty, 3) non-urgent and prescription with restriction by specialty, 4) restricted prescription, and 5) prescription forbidden. The comparison between 12 months before restriction and 33 months afterwards. Results: 1217 medications were included. 56.5% included in the PBS of prescription without restriction, 22.4% not included in the PBS of prescription with restriction by specialty, 11.6% forbidden and 6.0% restricted. After the restriction, there was a statistically significant monthly decrease of at least 58,274 pharmaceutical units and USD $275,446. The greatest impact was obtained with PBS drugs, followed by no urgent PBS. Conclusion: The establishment of clear prescribing criteria allows a reduction in the cost associated with the drug's use, as well as a rational use of them, without affecting the patients' safety. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Enfermagem e Atenção à Saúde (REAS) is the property of Revista de Enfermagem e Atencao a Saude - Reas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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This article presents a historical account of 30 years of the medical specialty of Health Management of the Universidad Nacional de San Marcos (UNMSM). The specialty was created in 1988 as Integral General Medicine in response to the small numbers of doctors specialized in management. The name of the specialty was kept until 1994, when it was then changed to Integral Medicine and Health Management to emphasize on the managerial aspect of it. In 2002, the curriculum is modified taking into consideration the importance of having an exclusive medical management specialization for the healthcare sector. The specialty is pioneer in a gradual education style in three levels: micromanagement, mesomanagement and macromanagement. The new curriculum opened the possibility of better clinical rotations for residents in public and private institutions. As of 2007, the specialty is named Health Management, its specialists maintain their solid training to perform in the processes of decision making, leading, directing and operability of the healthcare system. The vision of the founders of the specialty is still standing, specialists in Health Management work in different institutions of the healthcare system, contributing with their knowledge and skills, creating an impact on the Peruvian public health. [ABSTRACT FROM AUTHOR]

Objective. To describe the characteristics of the management process in primary health care units as well as the profile of managers, and to discuss the implications of these elements for the attainment of Unified Health System principles in Brazil in accordance with the propositions of the Alma-Ata Declaration. Method. This descriptive, cross-sectional study used data collected with the Primary Care Service Quality Assessment tool (QualiAB), a self-administered, web-based instrument. QualiAB was voluntarily answered by 157 unit managers from 41 municipalities in the state of São Paulo from October to December 2014. Results. Of 157 units, 67 (42.7%) were family health care units and 58 (36.9%) were 'traditional' units; 95 (60.5%) were located in urban peripheries. At the time of the study, eight (5.0%) units did not have a manager and eight (5.0%) were managed by the city health secretary. Almost 80% of the managers were nurses and performed multiple tasks in addition to management. Multidisciplinary support (technical supervision as a means of continuing education) was available in 75 (47.7%) units; 60 (38.2%) units did not have any kind of multidisciplinary support. Participation in evaluative processes was mentioned in 130 (82.8%) units. The main results of evaluations were planning and reprogramming of activities with the engagement of the multiprofessional team in 40 units (25.5%) and definition of an annual activity plan in 38 (24.2%). Twenty-nine units (17.8%) did not have access to the results of evaluations. Conclusion. The study supports the importance of work process management and the need to (re)invest in training and recognition of local management as a strategy to produce primary health care that is capable of promoting health as a right and a condition of citizenship. [ABSTRACT FROM AUTHOR]

Visando compreender como as dimensões organizacional, política e relacional afetam o cotidiano do trabalho gerencial em Unidades Básicas de Saúde de municípios de pequeno porte do norte do Paraná, realizou-se estudo qualitativo cujos dados foram obtidos por meio de grupos focais. O enfermeiro é o que mais desenvolve a função gerencial, porém, informalmente. O modelo gerencial verticalizado e autoritário predomina, e há fragilidade no exercício frente à autonomia e ao corporativismo de profissionais. Na dimensão política, interesses político-partidários sobrepõem-se às decisões gerenciais; e, na dimensão relacional, há manifestação de conflito, com desrespeito e disputas, mas, também, colaboração, com diálogo e trabalho em equipe. Nesses municípios, os processos gerenciais são pouco desenvolvidos, necessitando de profissionalização e oficialização do cargo, além do desenvolvimento de educação permanente.