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1.
PLoS One ; 15(6): e0233572, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32502156

RESUMO

EstomatoNet was created in the south of Brazil to provides specialist support over a web-based platform to primary care dentists for diagnosis of oral lesions. To evaluate the usability of EstomatoNet and to identify user perceptions regarding their expectations and difficulties with the system; and to compare the perceptions of regular users of the service to those of first-time users. Sixteen dentists were selected for the study: 8 were frequent users of EstomatoNet and 8 were residents who had never used the Platform. To assess usability, participants were required to request telediagnosis support for a fictional case provided by the research team. During the process of uploading the information and sending the request, users were asked to "think out loud," expressing their perceptions. The session was observed by an examiner with remote access to the user's screen (via Skype). After the simulation, users completed the System Usability Scale (SyUS), a validated tool with scores ranging from 0 to 100. The mean SyUS score assigned by frequent users was 84.7±6.6, vs. 82.2±9.3 for residents (satisfactory usability: score above 68). The difference between the groups was not statistically significant (Student t test, P = .55). The residents group took longer (347.1±101.1s) to complete the task than frequent users (252.8±80.3s); however, the difference between the groups was not statistically significant (Student t test, P = .06). In their subjective evaluation, users suggested the inclusion of a field to add further information on outcomes and resolution of the case and changes in the position of the "Send" button to improve workflow. The present results indicate satisfactory usability of EstomatoNet. The Platform seems to meet the needs of users regardless of how experienced they are; nevertheless, a few minor changes in some steps would improve the tool.


Assuntos
Serviços de Saúde Bucal , Doenças da Boca/diagnóstico , Mucosa Bucal/patologia , Telemedicina , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Boca/patologia , Doenças da Boca/terapia , Comunicação por Videoconferência
2.
Cien Saude Colet ; 25(suppl 1): 2493-2497, 2020 Jun.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32520294

RESUMO

The Ministry of Health, through the Primary Health Care Secretariat and in partnership with the Secretariat of Health Surveillance, built and implemented Primary Health Care (PHC) strategies within the scope of support to local managers and in partnership with the National Health Secretaries Council (CONASS) and the National Municipal Health Secretariats Council (CONASEMS) to combat COVID-19. These actions have PHC as the main responsible for several areas and physical, human, and financial resources, as well as allow boosting national progress towards the use of information and communication technologies and new partnerships for conducting research.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Atenção Primária à Saúde/organização & administração , Brasil , Infecções por Coronavirus/diagnóstico , Bases de Dados Factuais , Governo Federal , Humanos , Influenza Humana/diagnóstico , Pneumonia Viral/diagnóstico , Telemedicina
4.
Cien Saude Colet ; 25(4): 1313-1326, 2020 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32267434

RESUMO

More than 30 years into the anniversary of the Unified Health System (SUS), 40 years after Alma-Ata, and soon after the Astana Conference, the Brazilian Ministry of Health proposes several strategies to strengthen PHC with the creation of the Primary Health Care Secretariat (SAPS). This paper presents the process of developing the national PHC service portfolio, one of the strategies developed by SAPS to strengthen the PHC clinic, and the challenges for the expansion of comprehensive care in the actions developed by the Family Health and Oral Health teams. After the public consultation, from a total of 209 initially listed actions and procedures, including incorporations and exclusions, 210 items were defined, including the actions planned for the integration between primary care and health surveillance. We emphasize that the national portfolio model can be adapted to the reality and municipal context in each of the federation units, including considering the availability of the local care network.

5.
Cien Saude Colet ; 25(4): 1361-1374, 2020 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32267438

RESUMO

This paper aims to present a debate on the new Brazilian Primary Health Care (PHC) funding policy. We consulted the national and international literature, and we involved municipal, state, and federal PHC managers to develop the payment method. The proposed final model is based on weighted capitation, payment-for-performance, and incentive for strategic actions. Capitation is weighted by the socioeconomic vulnerability, demographic aspects, and municipal adjustment, the payment-for-performance consists of an entire set of 21 indicators, and incentives for strategic actions were facilitated from the maintenance of some specific programs. The results of the simulations pointed to low registration (90 million Brazilians) for the currently estimated coverage (148,674,300 Brazilians). Moreover, they showed an immediate increase in financial resources for 4,200 Brazilian municipalities. We observed that the funding proposal brings Brazilian PHC into the 21st century, points to the strengthening of PHC attributes, and materializes the principles of universality and equity of the Unified Health System.

6.
Cien Saude Colet ; 25(4): 1401-1412, 2020 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32267441

RESUMO

Five new challenges were brought to the federal management of SUS from the establishment of the Primary Health Care Secretariat (SAPS) in May 2019, as follows: a) to expand people's access to health facilities; b) to define a new financing model from health outcomes and efficiency; c) to define a new model of provision and training of family and community doctors for remote areas; d) to strengthen clinic and multi-professional teamwork; e) to expand computerization of health facilities and use of electronic medical records. This essay discusses these elements in light of a new evaluation model that also guides a new process of financing the Brazilian Primary Health Care (PHC). It builds on the correction of distributive distortions, and also seeks to guide greater effectiveness and efficiency in public investment and quality of service provided to the population. The proposal for a new PHC evaluation and financing model was elaborated through studies of the best international examples and discussion with representatives of the National Council of State Health Secretaries (CONASS) and the National Council of Municipal Health Secretaries (CONASEMS), and with technical support from the World Bank.

7.
Ciênc. Saúde Colet ; 25(4): 1401-1412, abr. 2020. tab
Artigo em Português | LILACS | ID: biblio-1089525

RESUMO

Resumo A partir da criação de uma Secretaria de Atenção Primária à Saúde (SAPS) no Ministério da Saúde em maio de 2019, cinco novos desafios foram trazidos para a gestão federal do SUS: a) ampliação do acesso da população às unidades de saúde da família, b) definição de um novo modelo de financiamento baseado em resultados em saúde e eficiência, c) definição de um novo modelo de provimento e formação de médicos de família e comunidade para áreas remotas, d) fortalecimento da clínica e do trabalho em equipe multiprofissional, e) ampliação da informatização das unidades de saúde e uso de prontuário eletrônico. Esse ensaio discute esses elementos à luz de um novo modelo avaliativo que, ao mesmo tempo, seja capaz de orientar o novo processo de financiamento da Atenção Primária à Saúde (APS) no Brasil. Este baseia-se na correção de distorções distributivas e também busca orientar maior efetividade e eficiência no investimento público e qualidade do serviço prestado à população. Através de estudos dos melhores exemplos internacionais e discussão com os representantes do Conselho Nacional de Secretários Estaduais de Saúde (CONASS) e do Conselho Nacional dos Secretários Municipais de Saúde (CONASEMS) e com apoio técnico do Banco Mundial, foi elaborada a proposta de novo modelo avaliativo e de financiamento da APS.


Abstract Five new challenges were brought to the federal management of SUS from the establishment of the Primary Health Care Secretariat (SAPS) in May 2019, as follows: a) to expand people's access to health facilities; b) to define a new financing model from health outcomes and efficiency; c) to define a new model of provision and training of family and community doctors for remote areas; d) to strengthen clinic and multi-professional teamwork; e) to expand computerization of health facilities and use of electronic medical records. This essay discusses these elements in light of a new evaluation model that also guides a new process of financing the Brazilian Primary Health Care (PHC). It builds on the correction of distributive distortions, and also seeks to guide greater effectiveness and efficiency in public investment and quality of service provided to the population. The proposal for a new PHC evaluation and financing model was elaborated through studies of the best international examples and discussion with representatives of the National Council of State Health Secretaries (CONASS) and the National Council of Municipal Health Secretaries (CONASEMS), and with technical support from the World Bank.


Assuntos
Humanos , Atenção Primária à Saúde/economia , Atenção Primária à Saúde/legislação & jurisprudência , Atenção Primária à Saúde/organização & administração , Programas Governamentais/economia , Programas Governamentais/legislação & jurisprudência , Implementação de Plano de Saúde/economia , Implementação de Plano de Saúde/legislação & jurisprudência , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/legislação & jurisprudência , Acesso aos Serviços de Saúde/organização & administração , Reembolso de Incentivo , Brasil , Cobertura Universal do Seguro de Saúde
8.
Ciênc. Saúde Colet ; 25(4): 1313-1326, abr. 2020. tab
Artigo em Português | LILACS | ID: biblio-1089509

RESUMO

Resumo Ao ultrapassarmos os 30 anos do Sistema Único de Saúde (SUS), após 40 anos de Alma-Ata e logo após a Conferência de Astana, o Ministério da Saúde do Brasil propõe diversas estratégias de fortalecimento da APS com a criação da Secretaria de Atenção Primária à Saúde (SAPS). Este artigo apresenta o processo de desenvolvimento da carteira nacional de serviços para a APS, uma das estratégias desenvolvidas pela SAPS para fortalecimento da clínica na APS, e os desafios para a ampliação da integralidade do cuidado nas ações desenvolvidas pelas equipes de Saúde da Família e Saúde Bucal. Após a consulta pública, de um total de 209 ações e procedimentos inicialmente listados, entre incorporações e exclusões, foram definidos 210 itens, incluindo as ações previstas para a integração entre atenção primária e vigilância em saúde. Ressaltamos que o modelo da carteira nacional pode ser adaptado à realidade e contexto municipal em cada uma das unidades da federação, inclusive considerando a disponibilidade da rede de atenção local.


Abstract More than 30 years into the anniversary of the Unified Health System (SUS), 40 years after Alma-Ata, and soon after the Astana Conference, the Brazilian Ministry of Health proposes several strategies to strengthen PHC with the creation of the Primary Health Care Secretariat (SAPS). This paper presents the process of developing the national PHC service portfolio, one of the strategies developed by SAPS to strengthen the PHC clinic, and the challenges for the expansion of comprehensive care in the actions developed by the Family Health and Oral Health teams. After the public consultation, from a total of 209 initially listed actions and procedures, including incorporations and exclusions, 210 items were defined, including the actions planned for the integration between primary care and health surveillance. We emphasize that the national portfolio model can be adapted to the reality and municipal context in each of the federation units, including considering the availability of the local care network.


Assuntos
Humanos , Atenção Primária à Saúde/organização & administração , Saúde Bucal , Saúde da Família , Acesso aos Serviços de Saúde/organização & administração , Brasil , Guias como Assunto , Assistência Centrada no Paciente/organização & administração , Pesquisa sobre Serviços de Saúde/organização & administração
9.
Ciênc. Saúde Colet ; 25(4): 1361-1374, abr. 2020. tab, graf
Artigo em Português | LILACS | ID: biblio-1089507

RESUMO

Resumo O objetivo desse artigo é apresentar um debate sobre a nova política de financiamento para Atenção Primária à Saúde (APS) no Brasil. Para desenvolvimento do método de pagamento foi realizado consulta da literatura nacional e internacional, além do envolvimento de gestores municipais, estaduais e federais da APS. O modelo final proposto é baseado em Capitação ponderada; Pagamento por desempenho; Incentivo para Ações Estratégicas. A capitação é ponderada por vulnerabilidade socioeconômica, aspectos demográficos e ajuste municipal, o pagamento por desempenho composto por um conjunto total de 21 indicadores e incentivos a ações estratégicas foi possível a partir da manutenção de alguns programas específicos. Os resultados das simulações apontaram para um baixo cadastro (90 milhões de brasileiros) para a cobertura estimada atual (148.674.300 milhões de brasileiros). Além disso, demonstraram um incremento imediato de recursos financeiros para 4.200 municípios brasileiros. Observa-se que a proposta do financiamento traz a APS brasileira para o século XXI, aponta para o fortalecimento dos atributos da APS e torna concreto os princípios de universalidade e equidade do Sistema Único de Saúde.


Abstract This paper aims to present a debate on the new Brazilian Primary Health Care (PHC) funding policy. We consulted the national and international literature, and we involved municipal, state, and federal PHC managers to develop the payment method. The proposed final model is based on weighted capitation, payment-for-performance, and incentive for strategic actions. Capitation is weighted by the socioeconomic vulnerability, demographic aspects, and municipal adjustment, the payment-for-performance consists of an entire set of 21 indicators, and incentives for strategic actions were facilitated from the maintenance of some specific programs. The results of the simulations pointed to low registration (90 million Brazilians) for the currently estimated coverage (148,674,300 Brazilians). Moreover, they showed an immediate increase in financial resources for 4,200 Brazilian municipalities. We observed that the funding proposal brings Brazilian PHC into the 21st century, points to the strengthening of PHC attributes, and materializes the principles of universality and equity of the Unified Health System.


Assuntos
Humanos , Atenção Primária à Saúde/economia , Reembolso de Incentivo , Capitação , Financiamento Governamental/legislação & jurisprudência , Programas Nacionais de Saúde/economia , Brasil , Programas Nacionais de Saúde/legislação & jurisprudência
10.
Can Fam Physician ; 66(2): 104-111, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32060190

RESUMO

OBJECTIVE: To contrast how Brazil's and Canada's different jurisdictional and judicial realities have led to different types of telemedicine and how further scale and improvement can be achieved. COMPOSITION OF THE COMMITTEE: A subgroup of the Besrour Centre of the College of Family Physicians of Canada and Canadian telemedicine experts developed connections with colleagues in Porto Alegre, Brazil, and collaborated to undertake a between-country comparison of their respective telemedicine programs. METHODS: Following a literature review, the authors collectively reflected on their experiences in an attempt to explore the past and current state of telemedicine in Canada and Brazil. REPORT: Both Brazil and Canada share expansive geographies, creating substantial barriers to health for rural patients. Telemedicine is an important part of a universal health system. Both countries have achieved telemedicine programs that have scaled up across large regions and are showing important effects on health care costs and outcomes. However, each system is unique in design and implementation and faces unique challenges for further scale and improvement. Addressing regional differences, the normalization of telemedicine, and potential alignment of telemedicine and artificial intelligence technologies for health care are seen as promising approaches to scaling up and improving telemedicine in both countries.

11.
Rev. bras. med. fam. comunidade ; 15(42): 2346, 20200210.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1053087

RESUMO

O Programa Médicos pelo Brasil (PMPB) foi lançado em 2019 pelo Ministério da Saúde com objetivo de ampliar a oferta de serviços médicos em locais de difícil provimento ou alta vulnerabilidade. As principais mudanças propostas no PMPB são: obrigatoriedade de registro no Conselho Federal de Medicina; alocação de vagas com prioridade para as pequenas e distantes cidades, contratação dos profissionais via CLT e formação qualificada em Medicina de Família e Comunidade (MFC), permitindo a titulação dos médicos após dois anos. Com essas mudanças, espera-se um aprofundamento na interiorização dos profissionais, com possibilidade efetiva de fixação, além da formação em larga escala de MFCs. A formação através da residência também será impulsionada, com incentivo financeiro municipal para esse fim, em consonância com as ações do novo financiamento federal da Atenção Primária à Saúde (APS), o Programa Previne Brasil. O PMPB será executado pela Agência para o Desenvolvimento da Atenção Primária à Saúde (Adaps), um modelo inovador de gestão pública, que trará eficiência ao programa. Com essas características, o PMPB pretende oferecer um solução perene para a oferta de serviços médicos no âmbito da APS do Sistema Único de Saúde.


The Médicos pelo Brasil Program (PMPB) was launched in 2019 by the Ministry of Health with the objective to expand the supply of medical services in places of difficult provision or high vulnerability. The main changes proposed in the PMPB are: mandatory registration with the Federal Council of Medicine; allocation of vacancies with priority for small and distant cities, hiring of professionals via national labor legislation and qualified training in Family Medicine (FM), allowing the doctor's speciality certification after two years. With these changes, it is expected to deepen the internalization of professionals, with effective possibility of fixation, in addition to training in scale in FM. Training through residency will also be promoted, with municipal financial incentives for this purpose, aligned with the actions of the new federal financing of Primary Health Care (PHC), the Previne Brasil Program. The PMPB will be executed by the Agency for the Development of Primary Health Care (Adaps), an innovative management model that will bring efficiency to the program. With these characteristics, the PMPB intends to offer a solution for the provision of medical services within the PHC of the Brazilian Public Health System


El Programa de Médicos pelo Brasil (PMPB) fue lanzado en 2019 por el Ministerio de Salud con el bjetivo expandir la oferta de servicios médicos en lugares de difícil provisión o alta vulnerabilidad. Los rincipales cambios propuestos en el PMPB son: registro obligatorio en el Consejo Federal de Medicina; designación de vacantes con prioridad para ciudades pequeñas y distantes, contratación de profesionales a través de las leyes laborales nacionales y capacitación calificada en medicina familiar y comunitaria (MFC), lo que permite la certificación de especialidad después de dos años. Con estos cambios, se espera profundizar la internalización de profesionales, con posibilidad efectiva de fijación, además de capacitación a gran escala de los MFC. La capacitación a través de la residencia también será promovida, con incentivos financieros municipales para este propósito, en línea con las acciones del nuevo financiamiento federal de Atención Primaria de Salud (APS), el Programa Previne Brasil. El PMPB será ejecutado por la Agencia para el desarrollo de la atención primaria de salud (Adaps), un modelo de gestión innovador. Eso traerá eficiencia al programa. Con estas características, el PMPB pretende ofrecer un solución perenne para la prestación de servicios médicos dentro de la APS del Sistema Único de Salud.

12.
Rev. bras. med. fam. comunidade ; 15(42): 2354, 20200210.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1095706

RESUMO

Rev Bras Med Fam Comunidade. Rio de Janeiro, 2020 Jan-Dez; 15(42):23541Bases para a reforma da Atenção Primária à Saúde no Brasil em 2019: mudanças estruturantes após 25 anos do Programa de Saúde da FamíliaErno Harzheim1, Caroline Martins José dos Santos2, Otávio Pereira D'Avila3, Lucas Wollmann4, Luiz Felipe Pinto5Bases for Brazilian Primary Health Care Reform in 2019: structural changes after 25 years of the Family Health ProgramComo citar: Harzheim E, Santos CMJ, D'Avila OP, Wollmann L, Pinto LF. Bases para a reforma da Atenção Primária à Saúde no Brasil em 2019: mudanças estruturantes após 25 anos do Programa de Saúde da Família. Rev Bras Med Fam Comunidade. 2020;15(42):2354. https://doi.org/10.5712/rbmfc15(2)2354www.rbmfc.org.brPerspectivasBases para la Reforma de la Atención Primaria de Salud en Brasil en 2019: cambios estructurales después de 25 años del Programa de Salud FamiliarO ano de 2019 marcou a estruturação das bases para uma profunda reforma na Atenção Primária à Saúde (APS) do Brasil. Os desafios enfrentados através dessa reforma foram a falta de priorização política real da APS, o financiamento insuficiente da APS e focado na estrutura de serviços, os obstáculos ao acesso de primeiro contato, a escassez de profissionais qualificados, a necessidade de maior informatização da APS e a ausência de integração de dados clínicos, a fragilidade clínica e necessidade de ampliação do escopo profissional e a falta de informação de qualidade para tomada de decisão clínica e gerencial. Com ações direcionadas a cada um desses desafios, a Secretaria de Atenção Primária à Saúde do Ministério da Saúde criou estratégias sistêmicas e integradas entre si que representam mudanças estruturantes e investimentos em governança clínica para transformar a APS brasileira, garantindo mais e melhor saúde para a população, com mecanismos transparentes e técnicos para seu financiamento, organização, oferta, monitoramento e avaliação.


The year was 2019. It marked the foundations for a profound Primary Health Care (PHC) Reform in Brazil. The challenges faced through this were the lack of real PHC political prioritization, insufficient PHC funding and focused on the service structure, obstacles to first contact access, the shortage of qualified professionals, the need for greater PHC computerization and the lack of integration of clinical data. Also, the clinical fragility and the need to expand the professional scope and the lack of quality information for clinical and managerial decision making. Actions were directed to each of these challenges, and the Ministry of Health's Secretariat of Primary Health Care created systemic and integrated strategies which represented structural changes and investments in clinical governance to transform Brazilian PHC, ensuring more and better health for the population, with transparent and technical mechanisms for its financing, organization, provision, monitoring and evaluation.


El año era 2019. Marcó la estructuración de las bases para una reforma profunda en la Atención Primaria de Salud (APS) en Brasil. Los desafíos enfrentados a través de esta reforma fueron la falta de una priorización política real de APS, fondos insuficientes de APS y centrados en la estructura del servicio, obstáculos para el acceso de primer contacto, la escasez de profesionales calificados, la necesidad de una mayor informatización de APS y la falta de integración de datos clínicos, la fragilidad clínica y la necesidad de ampliar el alcance profesional y la falta de información de calidad para la toma de decisiones clínicas y gerenciales. Con acciones dirigidas a cada uno de estos desafíos, la Secretaría de Atención Primaria de Salud del Ministerio de Salud creó estrategias sistémicas e integradas que representan cambios estructurales e inversiones en la gobernanza clínica para transformar la APS brasileña, garantizando más y mejor salud para la población, con mecanismos transparentes y técnicos para su financiación, organización, provisión, seguimiento y evaluación.

14.
Ciênc. Saúde Colet ; 25(supl.1): 2493-2497, Mar. 2020. tab
Artigo em Português | LILACS | ID: biblio-1101068

RESUMO

Resumo O Ministério da Saúde, por intermédio da Secretaria de Atenção Primária à Saúde e em parceria com a Secretaria de Vigilância em Saúde construiu e implementou estratégias da Atenção Primária à Saúde (APS) no âmbito do apoio aos gestores locais e em articulação com o Conselho Nacional de Secretários Estaduais (CONASS) e Municipais de Saúde (CONASEMS) para o combate ao COVID-19. Essas ações têm a APS como a grande responsável por diversas áreas e recursos físicos, humanos e financeiros, assim como permite impulsionar o avanço nacional para o uso de tecnologias de informação e comunicação e novas parcerias para realização de pesquisas.


Abstract The Ministry of Health, through the Primary Health Care Secretariat and in partnership with the Secretariat of Health Surveillance, built and implemented Primary Health Care (PHC) strategies within the scope of support to local managers and in partnership with the National Health Secretaries Council (CONASS) and the National Municipal Health Secretariats Council (CONASEMS) to combat COVID-19. These actions have PHC as the main responsible for several areas and physical, human, and financial resources, as well as allow boosting national progress towards the use of information and communication technologies and new partnerships for conducting research.


Assuntos
Humanos , Pneumonia Viral/prevenção & controle , Atenção Primária à Saúde/organização & administração , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Betacoronavirus , Pneumonia Viral/diagnóstico , Brasil , Bases de Dados Factuais , Telemedicina , Infecções por Coronavirus , Infecções por Coronavirus/diagnóstico , Governo Federal , Influenza Humana/diagnóstico
16.
Int J Equity Health ; 18(1): 176, 2019 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-31730005

RESUMO

We present to the scientific community the pioneering of Brazilian National Institute of Geography and Statistics (IBGE, the Brazilian Census Bureau) in partnership with the Ministry of Health, the largest fieldwork ever conducted in a single country in the world, using the PCAT in a national household sample survey, visiting more than 100,000 households and 40% of the country's municipalities. In Brazil, PCAT is being consolidated as an instrument to support public policy for the evaluation of primary health care. We believe that it represents a virtuous example of dialogue between scientific community and health management, following the legacy of Professors Barbara Starfield and Leiyu Shi.


Assuntos
Censos , Política de Saúde , Inquéritos Epidemiológicos/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Brasil , Humanos
17.
Int J Med Inform ; 129: 296-302, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31445270

RESUMO

OBJECTIVE: Children are an important portion of the population of the territories covered by Primary Health Care (PHC), with needs and characteristics that can be managed at this level of care. Therefore, it is essential that professionals working in PHC be capable of providing child care. The aim of this study was to evaluate the performance of dentists working in primary healthcare (PHC) in a pediatric dentistry distance learning (DL) course, and to investigate the relationship between the grades earned on questionnaires applied after each course module and features of their personal and professional profile. METHOD: The study used a convenience sample of 201 dentists working in PHC, who enrolled in a DL course offered by a telehealth center in the state of Rio Grande do Sul, Brazil. The course consisted of video classes on restorative dentistry, endodontics, dental trauma, and clinical management in pediatric dentistry. After completing each module, each participant was asked to answer a questionnaire to assess their acquisition of immediate knowledge. Student's t-test and the ANOVA test were used to assess the relationship between the mean grade earned and the variables of sex, age, type of training institution, time since graduation, and years working in PHC. RESULTS: A significant relationship was observed between type of training institution (public) and the grade earned on the restorative dentistry questionnaire, and also between time since graduation and the grade earned on the dental trauma questionnaire (p < 0.05). No relationship was observed between the personal/professional variables and the grades earned on the endodontics and clinical management questionnaires. Grades were significantly lower on the endodontics questionnaire (p < 0.05). DISCUSSION: The large number of dentists enrolled in this DL course is a demonstration that there is great interest in pediatric dentistry contents. Improvement of DL courses may lead to the enhancement of professionals and their skills, and to a significant improvement in the quality of care provided to children in public health networks. CONCLUSION: It was concluded that training in a public institution and a longer time since graduation positively influenced the grades earned on the restorative dentistry and dental trauma questionnaires, respectively.


Assuntos
Educação a Distância , Atenção Primária à Saúde , Adulto , Brasil , Criança , Odontólogos , Endodontia , Feminino , Humanos , Masculino , Odontopediatria , Inquéritos e Questionários , Adulto Jovem
18.
Oral Dis ; 25(8): 1897-1905, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31332880

RESUMO

OBJECTIVES: YouTube™ has become a widely used source of health information. This cross-sectional study aimed to analyze the quality of English language videos on oral leukoplakia available on YouTube™. MATERIALS AND METHODS: A YouTube™ search for oral leukoplakia was performed, leading to 1,690 videos. The first 100 results were examined for exclusion criteria, yielding 28 videos. The source, duration, views, likes, and dislikes of each video were recorded. Two oral medicine residents scored the videos for visibility, popularity, quality, utility, and reliability. RESULTS: Videos were categorized into two groups: independent users or company advertisements (n = 21) and professional organizations or government agencies (n = 5). Analysis showed that, in general, videos were of low quality, usefulness, and reliability. Higher quality videos had more likes (p < .05, Mann-Whitney test). More reliable videos received more likes and presented a higher viewing rate and interaction index (p < .05, Mann-Whitney test). CONCLUSIONS: There are few high-quality videos about oral leukoplakia on YouTube™. Oral medicine professionals and students should attempt to correct this deficit, as they are the holders of evidence-based knowledge and clinical experience.


Assuntos
Informação de Saúde ao Consumidor , Disseminação de Informação/métodos , Leucoplasia Oral , Mídias Sociais , Estudos Transversais , Humanos , Reprodutibilidade dos Testes , Gravação em Vídeo
19.
Rev. bras. med. fam. comunidade ; 14(41): e1881, fev. 2019. ilus
Artigo em Português | LILACS, Coleciona SUS | ID: biblio-981952

RESUMO

Novos desafios epidemiológicos e demográficos demandam novas formas de organizar os sistemas de saúde. O presente ensaio propõe a telessaúde como ferramenta organizativa, capaz de suavizar o triângulo de ferro da atenção à saúde e de facilitar a busca pelo triple aim, pelo seu potencial de aumento do acesso e qualidade com redução de custo. A integração da telessaúde ao processo de referência e transição entre serviços assistenciais aumenta a resolutividade da Atenção Primária à Saúde (APS), favorece a coordenação do cuidado, promove adesão terapêutica, diminui reinternações e estimula a prevenção quaternária. Este ensaio propõe a telessaúde como metasserviço que confere densidade tecnológica à APS e permite que ela se torne coordenadora efetiva do cuidado, passando a organizar o fluxo de informações, pessoas e insumos. Frente às inovações propostas, é essencial avaliar o impacto de ações já existentes de telessaúde para viabilizar a sua aplicação como metasserviço de saúde.


New epidemiological and demographic challenges require new ways of organizing healthcare systems. This essay proposes telehealth as an organizational tool, capable of smoothing the iron triangle of health care and facilitating achievement of the triple aim, namely greater access and quality with cost reduction. The integration of telehealth into the referral process and the transition between care services increases the resolvability of primary health care (PHC), facilitates the coordination of care, promotes treatment adherence, decreases readmissions, and stimulates quaternary prevention. This essay introduces the notion of telehealth as a meta-service that confers technological density to PHC and allows it to become an effective coordinator of care, organizing the flow of information, people and supplies. In view of the innovations proposed, it is essential to evaluate the impact of existing telehealth initiatives so as to extend their applicability as meta-service.


Nuevos desafíos epidemiológicos y demográficos demandan nuevas formas de organizar los sistemas de salud. El presente ensayo propone la telesalud como herramienta organizacional, capaz de suavizar el triángulo de hierro de la atención a la salud y de facilitar la búsqueda por el triple aim, por su potencial de aumento del acceso y calidad con reducción de costo. La integración de la telesalud al proceso de referencia y transición entre servicios asistenciales aumenta la capacidad resolutiva de la Atención Primaria a la Salud (APS), favorece la coordinación del cuidado, promueve la adhesión terapéutica, disminuye reinternaciones y estimula la prevención cuaternaria. Este ensayo propone la telesalud como metaservicio que confiere densidad tecnológica a la APS y permite que ella se convierta en coordinadora efectiva del cuidado, pasando a organizar el flujo de informaciones, personas e insumos. Frente a las innovaciones propuestas, es esencial evaluar el impacto de acciones ya existentes de telesalud para viabilizar su aplicación como metaservicio de salud.


Assuntos
Sistemas de Saúde , Telemedicina , Inovação
20.
Iran J Public Health ; 48(8): 1439-1444, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32292726

RESUMO

Background: The aim of the present study was to assess the level of satisfaction of dentists working in primary healthcare (PHC) with a Distance learning (DL) course in pediatric dentistry offered by the TeleHealthRS center, and to the investigate possible associations between the variables indicative of their satisfaction and their performance on the questionnaires applied before and after the course. Methods: The course was offered in 2015 by the Federal University of Rio Grande do Sul (UFRGS) together with the TeleHealthRS center in Brazil. Data were collected on the participants' personal and professional profile, their pre- and post-course knowledge about pediatric dentistry, and their satisfaction with the course. Student's t-test and the ANOVA test were used to assess the possible associations between the variables indicative of their satisfaction and their performance on the questionnaires applied before and after the course. Results: Overall, the participants were satisfied with the course, however, no statistically significant association was found between the variables indicative of their satisfaction and the grades they earned on the pre- and post-course questionnaires. Conclusion: The available pediatric dentistry course received positive evaluations from the participants, constituting a possible strategy for the qualification of primary care dentists. Future studies are warranted to further investigate the expectations of DL course participants, aiming to enhance the quality of future editions of this learning modality for pediatric dentistry contents.

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