Estrutura do atendimento à saúde da criança no Brasil / Structure of the child health assistance in Brazil

O atendimento à saúde da criança no Brasil se caracteriza pelo enfoque no atendimento por intercorrências, centrado no médico. Há pouca participaçäo de outros profissionais, principalmente de enfermeiros. A força de trabalho está polarizada entre médicos e atendentes de baixo nível de escolaridade. Os recursos humanos se concentram nas regiöes mais desenvolvidas, em prejuízo das populaçöes rurais e periféricas que ainda enfrentam dificuldade de acesso. É pequena a oferta de consultórios de pediatria pelo setor privado lucrativo, que investe mais no atendimento hospitalar. O grande prestador de assistência pediátrica säo as entidades filantrópicas, sem fins lucrativos. A oferta total de consultas para crianças de 0 a 14 anos está em média em 1,3 consultas/criança/ano, sendo muito insuficiente para acompanhamento da saúde. O atendimento domiciliar por agentes de saúde tem sido uma via alternativa para melhoria da cobertura das açöes de promoçäo e prevençäo. Considerando a capacidade instalada total evidencia-se uma baixa produtividade dos consultórios públicos de pediatria, que poderia ser até triplicada se houvesse adequaçäo de recursos humanos.

Oferta y demanda de recursos humanos en salud / Supply and demand of human resources in health

Este documento constituye el informe preliminar de una investigación realizada por la Subcomisión de Recursos Humanos, con la finalidad de disponer de información actualizada y tomar decisiones más adecuadas para el diseño del Sistema Nacional de Salud. La investigación tuvo como objetivos determinar el número de profesionales y técnicos de salud que en los próximos años egresarán de las distintas universidades e institutos tecnológicos superiores del país; así como determinar el número de profesionales y técnicos en salud que actualmente están laborando en los diversos organismos del Sector. Conociendo la oferta y demanda actual se estimó la demanda futura que de ellos harán las distintas instituciones de salud; se perfilará una política de recursos humanos en el Perú que contribuya a establecer un equilibrio entre oferta y demanda, asegurando el pleno empleo y mejorando las expectativas de los mismos

Capacidade instalada na rede de serviços do SUDS/SP / Installed capacity of the SUDS/SP health services net

A rede de serviços de saúde, na década dos 80, no Estado de Säo Paulo, foi analisada levando-se em conta os dados da pesquisa AMS/IBGE sobre estabelecimentos existentes no Brasil, na regiäo Sudeste e no Estado de Säo Paulo, em 1985 e 1987. No entanto, no decorrer da década outros eventos determinaram alteraçöes na rede, como, por exemplo, a municipalizaçäo ocorrida principalmente a partir de 1987. Assim, o crescimento da rede ambulatorial e hospitalar será apreendido näo apenas pela análise dos dados de pesquisa AMS/IBGE, mas também pela análise de outros dados fornecidos pelo Centro de Informaçöes de Saúde (CIS), da Secretaria de Estado da Saúde de Säo Paulo

Establishment of criteria for determining priorities among designated health professional shortage areas--HRA. Notice.

In accordance with the requirement of section 333A(c) of the Public Health Service Act, as amended by Public Law 101-597 (the National Health Service Corps Revitalization Amendments of 1990), this Notice establishes the criteria which the Secretary will use to make determinations under section 333A(a)(1)(A) of the health professional shortage areas (HPSAs) with the greatest shortages, using the exclusive factors specified in section 333A(b).

Draft registration of health care personnel.

A chronic shortage of health care personnel in the active and reserve forces continues to be of concern, particularly in planning for national emergencies or war. Congress has authorized the Selective Service System to establish a system to register and classify health care personnel rapidly in the event a national emergency requires implementation of a draft for the armed services. This paper describes the creation of the Health Care Personnel Delivery System. It provides a brief history of previous military drafts for health care personnel and describes the principal differences in the way a draft registration program may operate in the future.

Israel's expenditure on health services.

In 1986, the State of Israel utilized 7.6% of its gross national product (GNP) for health care. At first glance this seems to be a reasonable level of expenditure when compared with the percentage of GNP devoted to health care in eight selected industrialized non-communist nations. However, Israel devoted fewer dollars per citizen on health care than any of the eight other nations. We investigate the role of three factors that contributed to this relatively low expenditure level: a) health personnel and bed supply levels, b) operations and procedure rates, and c) relative wage costs of health personnel. If Israel had the same level of per capita GNP as the USA, its annual health service per capita expenditure would increase from $472 to $1,328. If, in addition, its health personnel received the same wage differentials (in relation to the average wage levels) as those received by health personnel in the USA, it is estimated that Israel would spend around $1,842 annually per capita on health care (representing 10.7% of its GNP). This figure is only $98 less than what the USA spends, and creates a vastly different impression concerning the efficiency of the health system than does the original unadjusted expenditure of only $472 per head, which is $1,468 less than that spent by the USA. The Israeli health system can be said to be characterized by adequate manpower inputs, high bed occupancy rates, low surgery rates relative to the USA (not necessarily a negative phenomenon), and low relative wage inputs. The relatively limited available output indicators lead us to believe that productivity per person employed in the health services could be raised. The low absolute levels of health expenditures in Israel are mainly due to a combination of a low GNP per head and relatively low wage differentials between health service staff and other income earners.

Medical manpower--South African situation models for planning and recommendations.

Imbalances in medical manpower in South Africa are outlined. Theoretical publications on health manpower development are reviewed, with particular reference to factors and problems to be considered when estimating health manpower needs. Four models (health demand, health needs, service target and manpower/population ratio) of health manpower planning are described and their applicability to the South African situation is discussed. Recommendations for health manpower development in South Africa, especially for primary health care, are made.

Wages & benefits of nursing personnel in nursing homes: correcting the inequities.

The nursing home industry is an increasingly important component of long-term care. Yet major problems in access and quality are evident. Correcting the inadequate wages and benefits of nursing home personnel is a necessary first step in addressing this issue.