Exigência do código da CID em atestado: embasamento legal e análise da jurisprudência atual / ICD code requirement in medical statement: legal basis and analysis of current jurisprudence

A Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID) é uma forma globalmente padronizada para fornecer informações cruciais sobre as doenças, suas causas e consequências, colaborando para criar políticas de saúde e laborais. Porém, sua divulgação compulsória por parte de profissionais da saúde pode expor o empregado e sua privacidade. Neste contexto, o objetivo desse trabalho é analisar as decisões publicadas nos últimos dez anos, julgadas em última instância pelo Tribunal Superior do Trabalho (TST) e o entendimento dos magistrados sobre o assunto, as leis utilizadas no embasamento e a distribuição dos processos com esse teor. Foi realizada uma pesquisa no site do TST com os termos "exigência" "CID" "atestado" "médico" entre os anos de 2012 e 2022. Foram encontradas 18 decisões, 94% delas das regiões Sul e Sudeste do país. Quase 70% são desfavoráveis à exigência da CID em atestados, tendo como base a Constituição Federal (CF), resoluções do Conselho Federal de Medicina (CFM) e o Código Civil (CC). Conclui-se que as decisões relacionadas à exigência do código da CID estão concentradas em tribunais do Sul e do Sudeste, sendo os anos entre 2015 e 2019 com o maior número de ocorrências. Há uma predominância pela não exigência do código da CID em 12 das 18 decisões, sendo o argumento mais utilizado o sigilo e privacidade garantidos pela CF e Códigos de Ética Médica e de Ética Odontológica. As que se mostraram a favor predominantemente citam a súmula 122 do TST

International Statistical Classification of Diseases and Health Related Problems (ICD) is the global standard for diagnostic health information, providing key information about diseases, their causes, and consequences, leading to improvement on public and labor health. Its disclosure may expose employers when required by employers. Based on this context, the aim of this study is to analyze decisions law decisions and judgments reports from the Federal Labor Court between 2012 and 2022, the understanding of judges on the subject, the basis and distribution of decisions in this matter. Research was conducted on Superior Labor Court of Brazil website, using the keywords in Portuguese "requirement", "ICD", "statement" and "medical" between 2012 and 2022. It was found 18 judgments, 94% from South and Southeast of Brazil. Almost 70% of them were against the requirement of ICD code in medical statement, basing their decisions on our Federal Constitution (FC), resolutions of the Federal Medical Council (FMC) and Civil Code (CC). In conclusion, the Brazilian Law understands that the employee's privacy when seeking for medical help is above the employer's requirement. It is believed the new General Data Protection Law (GDPL) may reinforce this common Legal Knowledge and help footing new orders

Atestado odontológico falso e seu real enquadramento no Código Penal brasileiro / False certificate in Dentistry and its real framework in the Brazilian Penal Code

O atestado odontológico compreende um tipo de documento emitido pelo profissional que expressa a veracidade de um fato relacionado ao paciente constatado durante a prática clínica. O objetivo deste artigo foi apontar e analisar o tipo de crime que incorre o cirurgião-dentista que emite atestado falso. Trata-se de uma pesquisa transversal com abordagem descritiva realizada por meio do levantamento das provas de concursos públicos realizados no Brasil para o cargo de Perito Odontolegista ou nomenclatura correspondente. Foram considerados os concursos realizados nas unidades federativas do Brasil sem distinção quanto ao ano, sendo que a coleta das informações se deu nos meses de janeiro a abril de 2023. Conclui-se que, apesar de ocorrerem discrepâncias de interpretação muito pontuais na literatura odontológica quanto ao condizer entre os Artigos 299 e 302 do Código Penal Brasileiro, não há possibilidade legal de o cirurgião-dentista ser sujeito ativo do crime de falsidade de atestado médico, por ser crime próprio do profissional médico

The dental certificate comprises a kind of document issued by the professional that expresses the veracity of a fact related to the patient verified during clinical practice. The aim of this article was to point out and analyze the type of crime incurred by dentists who issue false certificates. This is a cross-sectional research with a descriptive approach carried out through the survey of public tenders held in Brazil for the position of Forensic Odontologist or corresponding nomenclature. It was considered the contests held in the Brazilian Federative Units without distinction to the year, and the information collection was performed from January to April 2023. It can be concluded that, although there are few interpretation discrepancies in the dental literature regarding articles 299 and 302 of the Brazilian Penal Code, there is no legal possibility for the dentist to be an active subject of the crime of falsity of medical certificate, as it is a crime specific to the professional medical doctor

Public views on the Covid-19 immunity certificate: A scoping review.

INTRODUCTION: Already in its first implementation, the introduction of the Covid-19 immunity certificate has generated some debate among the public. This debate might be a hindrance to the effective realization of this policy. This study aimed to systematically review published research evaluating public feeling of the Covid-19 immunity certificate policy measure and to find which factors might influence its acceptance. METHODS: We followed the scoping review methods manual by the Joanna Briggs Institute. We included studies with no time limits that presented novel data, and no exclusions have been made based on study design. We excluded articles that presented just expert opinions. RESULTS: We found and reviewed 17 articles. The included studies were conducted in two main countries (the United Kingdom and Switzerland), with the rest from Israel, Italy, Spain, Germany, Australia, Taiwan and China. Both qualitative and quantitative studies were included, and nonrepresentative samples were mostly used to explore the public feeling about the Covid-19 immunity certification. The included studies showed that public views on immunity certification are quite contradictory and influenced by age, gender, ethnicity, political orientation and attitudes towards Covid-19 vaccination. The topic more often addressed by the included studies was the public's views on the positive and negative implications of the Covid-19 immunity certificate in terms of ethical, legal and behavioural consequences of this measure. CONCLUSION: The varying acceptance rates are notable and may partly be linked to differences in demographics, Covid-19 concerns and ideological beliefs, as seen in other health-related tracking policies. Moreover, dominant factors behind the (un)success of this policy are complex and entangled with the cultural and political dimensions rather than being just technical. For this reason, it is important to expand psychosocial research to better understand the concerns behind health certifications and allow planning of culturally based and ethically sound suitable strategies. This would be very relevant to increasing public approval and compliance with this public health measure. PATIENT OR PUBLIC CONTRIBUTION: This does not apply to our work as it was a review paper.

Public Perceptions of Harms and Benefit of COVID-19 Immunity Certificate: A Cross-Sectional Study in the Italian Setting.

A cross-sectional survey between 29 January 2022 and 3 February 2022 was conducted to understand the public rationale for accepting or rejecting the use of COVID-19 immunity certificates and to identify the psychosocial factors that mostly predict the positive/negative individuals' perceptions of this measure. One thousand twenty-two Italian adults were recruited by a professional panel provider by employing a stratified sampling strategy controlled for gender, age, geographical area of residence, size of the urban centre of residence, employment, and wage. Eight Welch's ANOVAs were then carried out to compare the perception of benefits and the perception of harms among different population groups. Multiple linear regression was carried out to measure the explained variance of benefits perception and harms perception by age, trust in institutions, and concern for health emergencies. The results shows that age, trust in institution, and concern for the COVID-19 emergency explain more variance of perceived benefits than of perceived harms of COVID-19 immunity certificates but the opposite regarding political orientation which explains perceived harms better than perceived benefits. The need for policy improvements is pressing because a large share of the world's population remains unvaccinated. Moreover, our results can serve as vital information for similar health crises that may occur in the future. In addition, our results are expected to offer useful insights into public feelings around the use of digital health information tools.

Blockchain-based governance models for COVID-19 digital health certificates: A legal, technical, ethical and security requirements analysis.

This paper analyses the requirements of a blockchain-based data governance model for COVID-19 digital health certificates. Recognizing a gap in the existing literature, this paper aims to answer the research question "To what extent does a blockchain-based governance model for COVID-19 digital health certificates in the EU meet the relevant legal, technical, ethical and security requirements?" This paper identifies the required standards and develops a novel framework to determine the viability of blockchain as a governance model. The results of our evaluation indicate that while a private permissioned blockchain can meet the requirements to some degree, the governance element is key to legal compliance; legal risks and ethical implications remain unresolved with the use of blockchain. The paper also found that this model comes with the loss of the main advantages of blockchain - decentralization and anonymity. This evaluation framework may be used in other contexts and for assessing other technologies.

NovidChain: Blockchain-based privacy-preserving platform for COVID-19 test/vaccine certificates.

The COVID-19 pandemic has emerged as a highly transmissible disease which has caused a disastrous impact worldwide by adversely affecting the global economy, health, and human lives. This sudden explosion and uncontrolled worldwide spread of COVID-19 has revealed the limitations of existing healthcare systems regarding handling public health emergencies. As governments seek to effectively re-establish their economies, open workplaces, ensure safe travels and progressively return to normal life, there is an urgent need for technologies that may alleviate the severity of the losses. This article explores a promising solution for secure Digital Health Certificate, called NovidChain, a Blockchain-based privacy-preserving platform for COVID-19 test/vaccine certificates issuing and verifying. More precisely, NovidChain incorporates several emergent concepts: (i) Blockchain technology to ensure data integrity and immutability, (ii) self-sovereign identity to allow users to have complete control over their data, (iii) encryption of Personally Identifiable Information to enhance privacy, (iv) W3C verifiable credentials standard to facilitate instant verification of COVID-19 proof, and (v) selective disclosure concept to permit user to share selected pieces of information with trusted parties. Therefore, NovidChain is designed to meet a high level of protection of personal data, in compliant with the GDPR and KYC requirements, and guarantees the user's self-sovereignty, while ensuring both the safety of populations and the user's right to privacy. To prove the security and efficiency of the proposed NovidChain platform, this article also provides a detailed technical description, a proof-of-concept implementation, different experiments, and a comparative evaluation. The evaluation shows that NovidChain provides better financial cost and scalability results compared to other solutions. More precisely, we note a high difference in time between operations (i.e., between 46% and 56%). Furthermore, the evaluation confirms that NovidChain ensures security properties, particularly data integrity, forge, binding, uniqueness, peer-indistinguishability, and revocation.

Commentary: mobile laboratories for SARS-CoV-2 diagnostics: what Europe could learn from the East African Community to assure trade in times of border closures.

BACKGROUND: The emergence of SARS-CoV-2 mutants might lead to European border closures, which impact on trade and result in serious economic losses. In April 2020, similar border closures were observed during the first SARS-CoV-2 wave in East Africa. MAIN BODY: Since 2017 the East African Community EAC together with the Bernhard-Nocht-Institute for Tropical Medicine BNITM established a mobile laboratory network integrated into the National Public Health Laboratories of the six Partner States for molecular diagnosis of viral haemorrhagic fevers and SARS-CoV-2. Since May 2020, the National Public Health Laboratories of Kenya, Rwanda, Burundi, Uganda and South Sudan deployed these mobile laboratories to their respective borders, issuing a newly developed "Electronic EAC COVID-19 Digital Certificate" to SARS-CoV-2 PCR-negative truck drivers, thus assuring regional trade. CONCLUSION: Considering the large financial damages of border closures, such a mobile laboratory network as demonstrated in East Africa is cost-effective, easy to implement and feasible. The East African Community mobile laboratory network could serve as a blueprint for Europe and other countries around the globe.

Incapacidad como acto médico y ley estatutaria de salud / The Inability as a Medical Act

Con el avance de la Seguridad Social en Salud en Colombia y la protección del derecho fundamental a la salud, se ha consolidado la autonomía médica con la expedición de la Ley Estatutaria de Salud, expedida en 2015. En el artículo se presentan conceptos inherentes a dicho ejercicio en Colombia y la actualización de un artículo publicado con anterioridad.

With the advancement of Social Security in Health in Colombia and the protection of the fundamental right to Health, medical autonomy is Consolidated with the Statutory Health Law issued in 2015. The arricie presents inherent concepts to this exercise in Colombia and the update of an arricie published previously.

Análisis de la cumplimentación de certificados médicos por estudiantes y profesionales de odontología / Analysis of filling out dental certificates by dental students and professionals

Resumen: Este estudio tuvo el objetivo de analizar y comparar la cumplimentación de certificados médicos por estudiantes del cuarto año del curso de Odontología de una universidad pública brasileña y por profesionales de cursos de especialización específicos del área. Entre 2014 y 2016, se dejó a los encuestados una hoja de papel en blanco en cuyo encabezamiento sólo constaba la palabra "Certificado", a fin de que se lo elaboraran de la manera que juzgaran más adecuada. Se utilizó test para comparación de dos proporciones y Test de Chi- Cuadrado con nivel de significación del 5%. Participaron de la inves tigación 336 individuos, de los cuales 167 (49,7%) eran estudiantes y 169 (50,3%), profesionales de cursos de especialización de la Facultad de Odontología de Araçatuba. Solamente 73 (21,7%) individuos ela boraron el certificado correctamente. Entre los errores de los estu diantes se destaca la inserción de la Clasificación Estadística Interna cional de Enfermedades sin el consentimiento del paciente, y, de los profesionales, la falta del Documento Nacional de Identidad. Hubo diferencia estadística significativa entre las categorías respecto a la correcta cumplimentación del certificado (p=0). Se concluyó que una parte considerable de los encuestados rellena los certificados odonto lógicos incorrectamente, con menores errores entre los estudiantes de Odontología.

Abstract: The objective of this study was to analyze and compare the filling of the dental certificates by the students of the fourth year of the den tistry course of a Brazilian public university and professionals of specialization courses in the area. The respondents were given a blank sheet written "Certificate", for them to fill out. The period analyzed was from 2014 to 2016. The test was used to compare two proportions and the chi-square test, with a significance level of 5%. A total of 336 individuals participated in the study, of which 167 (49.7%) were fourth year students of the Dentistry course and 169 (50.3%) professionals of specialization courses of the School of Dentistry of Araçatuba. Only 73 (21.7%) correctly filled the certificate. Among the errors, we emphasize the students' insertion of the International Statistical Clas sification of Diseases without the patient's consent and among profes sionals the lack of the General Registry. There was a significant statis tical difference between the categories regarding the correct filling of the certificate (p = 0). We concluded that the dental certificates are filled incorrectly by a considerable portion of the respondents, with minor errors among dentistry students.

Entendimento dos julgados do Tribunal de Justiça do Estado de São Paulo sobre a emissão de atestado médico falso: uma análise jurisprudencial / Understanding of tried cases at the Court of Justice of the State of São Paulo relative to issuing false medical certificates: jurisprudence analysis

Contexto: O atestado médico é um documento de emissão corriqueira na prática médica. O uso desse documento com alterações ou com conteúdo que não seja verdadeiro é tipificado como crime no art. 302 do Código Penal brasileiro, denominado "Falsidade de atestado médico". O Brasil, no entanto, tem uma escassez de dados estatísticos sobre esse crime. Objetivos: Realizar um levantamento de dados acerca da temática dos processos sobre atestado falso na esfera penal no Tribunal de Justiça do Estado de São Paulo. Métodos: Foi realizada uma pesquisa por palavra-chave na área de consulta de julgados de 1ª instância do site do Tribunal de Justiça do Estado de São Paulo, com o descritor "atestado", de julgados sem data determinada. Resultados: Nos anos analisados, apesar do número pequeno de casos, houve uma tendência de crescimento no número de julgados. A maior parte dos réus era de não médicos, do sexo masculino e com infração relacionada ao ambiente de trabalho. Houve um grande quantitativo de condenações em 1ª instância. Conclusão: O estudo apontou para a necessidade de coibição desse crime, sendo a certificação digital uma boa forma de alcançar esse objetivo.

Introduction: Medical certificates are commonly issued in medical practice. Use of medical certificates with alterations or false content is characterized as a crime, denominated "Falsification of medical certificates", by the Brazilian Penal Code article 302. Data on this type of crime are scarce in Brazil. Objective: To collect data relative to criminal lawsuits for falsification of medical certificates filed at the Court of Justice of the State of São Paulo. Methods: A keyword-based search of tried cases with no time limitation was conducted on the trial court database available at the Court of Justice of the State of São Paulo website using the search term "certificate". Results: Although small, the number of tried cases increased along the analyzed years. Most defendants were non-physicians and male and offences had relationship with the workplace. The number of trial court convictions was high. Conclusion: The results point to the need to prevent this type of crime; digital certificates represent a good means to achieve this goal.

Absenteismo-doença em trabalhadores de higienização: o que dizem os registros oficiais / Absenteeism-disease in sanitation workers: what the official records say

Introdução. No Brasil, é grande a preocupação com o absenteísmo em muitos setores produtivos. Objetivo. Traçar o perfil de absenteísmo-doença em trabalhadores de higienização em uma instituição de ensino superior. Método. Estudo descritivo e retrospectivo com dados do Programa de Prevenção de Riscos Ambientais (PPRA), de 196 prontuários médicos e 2.880 atestados das estatísticas de absenteísmo-doença de 486 trabalhadores entre 2010 e 2014. Os dados foram tratados pelo IBM SPSS Statistics 20.0. Resultados. Houve predomínio do sexo feminino (92,9%), baixa escolaridade (51,5%), faixa etária de 31 a 45 anos (46%). As causas de absenteísmo-doença foram relacionadas com o capítulo Z da CID-10 (57,5%), correspondente aos Fatores que Influenciam o Estado de Saúde e o Contato com os Serviços de Saúde. Os riscos apurados pelo PPRA para os auxiliares de limpeza foram físico, químico e ergonômico. Conclusão. O perfil de absenteísmo-doença obtido apontou as doenças osteo-musculares e do tecido conjuntivo como as principais relacionadas às faltas com diagnóstico médico.

Introduction. In Brazil, there is great concern about absenteeism in many productive sectors. Aim. To determine the absenteeism-disease profile of sanitation workers in a higher education institution. Methods. Descriptive and retrospective study. Collected data of the Environmental Risk Prevention Program (PPRA), from 196 medical records of 2,880 medical certificates of absenteeism and illness statistics referring to 486 workers between 2010-14. Data were analyzed by the SPSS Statistics 20.0 software. Results. There was a predominance of female (92.9%), low education (51.5%) and average group between 31-45 years (46%). Absenteeism and illness were related to the Chapter Z of ICD-10 (57,5%) that corresponds to the Factors Influencing Health Status and Contact with Health Services. The risks identified by the PPRA for cleaning workers were physical, chemical and ergonomic. Conclusion. The profile of absenteeism-disease obtained showed the osteo-muscular and connective tissue diseases as the main ones related to absences from work with medical diagnosis.

Programa de ginástica laboral e a redução de atestados médicos / Labor gymnastics program and reduction of medical certificates

Estudos recentes têm apontado a ginástica laboral como uma importante ferramenta para amenizar alguns malefícios ocasionados pelo ritmo de trabalho da vida moderna. Portanto, o presente estudo objetivou analisar a influência de um programa de ginástica laboral (PGL) na redução da quantidade de atestados de uma empresa de tratamento de resíduos industriais da cidade de Chapecó-SC. A amostra foi composta por 31 sujeitos, sendo 22 do sexo masculino e 9 do sexo feminino com idade média de 32,48±8,28. Todos os dados foram coletados a partir dos prontuários dos funcionários. O PGL foi desenvolvido duas vezes na semana durante 12 meses contínuos. Os resultados apontam uma diminuição na quantidade total de atestados (51,52%), por doenças sistêmicas (43,48%) e por doenças osteomusculares (55,56%) no período de desenvolvimento do PGL. Conclui-se portanto, que com a diminuição no número de atestados, houve também melhoria na saúde e qualidade de vida de seus praticantes.

Recent studies have pointed the labor gymnastics as an important tool to alleviate some caused by the working in the modern life. Therefore, the present study aimed to analyze the influence of a labor gymnastics program (LGP) in reduction the amount of certificates of industrial in the city of Chapecó-SC. The sample consisted of 31 subjects, 22 males and 9 females with an average age of 32.48 ± 8.28. All data were collected from the medical records of employees. The LGP was developed two times a week for 12 months continuous. The results show a decrease in the total amount of certificates (51.52%), for systemic diseases (43.48%) and musculoskeletal diseases (55.56%) in the period of development on the LGP. In conclusion, with the decrease in the number of certificates, there was also improvement in health and quality of life of its practitioners.

Prevalência de absenteísmo odontológico em funcionários públicos de um município do interior do Estado de São Paulo / Prevalence of dental absenteeism in public employees of a city in São Paulo state, Brazil

Contexto: O estudo do absenteísmo através dos atestados odontológicos se faz necessário para promover a redução de sua ocorrência, contribuindo com a produtividade e reduzindo os custos na administração pública/privada. Objetivos: Avaliar as características do absenteísmo odontológico e as suas causas, por meio da CID-10 presente nas atestações de funcionários públicos municipais do interior do Estado de São Paulo. Métodos: Estudo observacional secccional, realizado no município de Santa Cruz do Rio Pardo (SP), utilizando os prontuários funcionais dos servidores, no período de 2001 a 2012. Foram incluídos 343 prontuários, selecionados de forma randomizada. Quantificaram-se as causas de afastamentos odontológicos utilizando-se a CID-10. Os testes Mann-Whitney e Correlação de Spearman foram aplicados (p<0,05). Resultados: Foram identificados 337 afastamentos por motivos odontológicos, sendo que 75,3% eram pertencentes ao gênero feminino (p=0,015), o tempo no serviço foi de 83,29 meses de trabalho (r=0,16; p=0,003), 44,6% pertencentes a trabalhadores com nível superior de escolaridade (r=0,10; p=0,077) e faixa salarial de 1 a 3 salários mínimos (61,5%) (r=0,01; p=0,83). Identificou-se taxa de absenteísmo de 26,7%, sendo 43,62% não codificados, 11,28% doenças da polpa e dos tecidos periapicais, 9,79% dentes inclusos e impactados, 9,49% gengivite e doenças periodontais e 8,30% cárie dentária. Conclusões: A alta taxa de absenteísmo observada evidenciou a necessidade de adoção de políticas de promoção e prevenção à saúde do trabalhador, reforçando a importância da Odontologia como fonte reguladora das questões relacionadas ao absenteísmo.

Background: The study of absenteeism through dental attestations is necessary to promote the reduction of its occurrence, contributing to productivity and reducing costs in the public/private management. Objectives: To evaluate the characteristics of dental absenteeism and its causes through the ICD-10 present in the claims of municipal government workers in the state of São Paulo, Brazil. Methods: Seccional observational study, conducted in the city of Santa Cruz do Rio Pardo, São Paulo, Brazil, using functional records of the servers, in the period of 2001-2012. Three hundred and forty-three records, randomly selected, were included. The causes of dental clearances were quantified using ICD-10. Mann-Whitney test and Spearman correlation were used (p<0.05). Results: There were identified 337 absences by dental reasons, with 75.3% belonged to the female gender (p=0.015), time in service was 83.29 months of work (r=0.16; p=0.003), 44.6% belonging to workers with higher education levels (r=0.10; p=0.077) and salary range of 1-3 minimum salaries (61.5%) (r=0.01; p=0.83). It was identified absenteeism rate of 26.7%, with 43.62% uncoded, 11.28% diseases of pulp and periapical tissues, 9.79% impacted and included teeth, 9.49% gingivitis and periodontal diseases and 8.30% dental caries. Conclusions: The high rate of absenteeism observed highlighted the need of adopting policies for the promotion and prevention on occupational health, reinforcing the importance of the Dentistry as a source of regulatory issues related to absenteeism.

Design and Realization of the Health Certificate Management Information System Based on Two-dimensional Code Technology / 医学信息学杂志

The paper analyzes problems existed in health certificate issuing management among employees in the service industries in Xi'an and points out the necessity of using informatization means to assist health certificate data management.It proposes the scheme of u-sing the management system based on two-dimensional code technology to manage health certificate information and makes detailed de-scription of design and realization of the system.

Estudo de coorte prospectivo das características do absenteísmo na administração pública: atestação médico-odontológica na saúde do servidor / Prospective cohort study of the characteristics of absenteeism public administration: medical-dental certification of the server health

O absenteísmo médico-odontológico é relatado como sendo responsável pela perda de dias e horas de trabalho, refletindo-se em prejuízos econômicos nos setores público e privado, não obstante a sua essência nos remeta a uma reflexão muito mais profunda, no que diz respeito à Saúde e aos seus agravos, enquanto fatores causais desta condição, muitas vezes impostos ao trabalhador pelo próprio ambiente de trabalho. O presente estudo teve por objetivo avaliar as características e o perfil do Absenteísmo na Administração Pública, o envolvimento e a atestação médico - odontológica relacionados ao afastamento do servidor do seu trabalho, além da relação entre Patologias Médicas e odontológicas, sob uma óptica baseada em evidências de uma pesquisa pautada na Incidência. Além disto, como objetivo secundário, foi conduzida uma atualização da revista da literatura com fulcro nos aspectos legais, éticos, normativos e científicos, no que tange às atestações de estados de saúde. A partir de um estudo preliminar do tipo exploratório retrospectivo, transversal, descritivo e analítico, realizado anteriormente com o propósito de se estabelecer a relação entre absenteísmo e doenças, tanto de origem médica, como odontológica; traçou-se assim um perfil do Absenteísmo na Administração Pública. Também assim, estabeleceu-se uma estratégia que envolveu uma amostra de 340 prontuários funcionais de servidores públicos municipais de uma cidade do interior do Estado de São Paulo, Brasil, do universo de 973 servidores ativos, que foi submetida a uma avaliação transversal retrospectiva de 11 anos e 5 meses, no período de 01 de janeiro de 2001 a 31 de maio de 2012, através da análise da História Médico-Odontológica Pregressa colhida dos atestados médicos e odontológicos juntados e justificantes de faltas ou afastamentos, documentos legais estes comprovantes do motivo do absenteísmo. Subsequentemente a este levantamento epidemiológico, com base na Prevalência, deu-se...

Medical and dental absenteeism is reported to be responsible for the lost of days and hours of work, reflecting in economic losses in the public and private sectors, nevertheless its essence refers us to a much deeper reflection, with regard to Health and their grievances, as causal factors of this condition often imposed by the employee's own work environment. The present study aimed to evaluate the characteristics and profile of Absenteeism in Public Administration, the involvement and the medical - dental attestation related to the staf absence from work, besides the relationship between Medical and Dental Pathologies, under a view based on evidence from a survey based in the Incidence. Furthermore, as a secondary objective, we conducted a literature review of the update with the fulcrum in the legal, ethical, normative and scientific aspects, in relation of health states. From a preliminary study of the retrospective exploratory, cross-sectional, descriptive study was previously conducted with the purpose of establishing the relationship between absenteeism and illnesses, both medical and dental origin; thus drew up a profile of Absenteeism in Public Administration. Thus, it was established a strategy that involved a sample of 340 medical records of functional employees of a city in the state of São Paulo, Brazil, from the universe of 973 active servers, which was subjected to a retrospective cross-sectional assessment of 11 years and 5 months in the period from January 1, 2001 to May 31, 2012, by analyzing the History of Medical and Dental harvested from past medical and dental certificates and documents gathered in proof of absences these ones legal documents showing why the absenteeism. Subsequently to this epidemiological survey, based on the Prevalence, was continued the process through a prospective cohort study of 1 year and 6 months, with the same parameters and sample, but with a loss of 11.37%, which analyzed the end...

Estudo de coorte prospectivo das características do absenteísmo na administração pública: atestação médico-odontológica na saúde do servidor / Prospective cohort study of the characteristics of absenteeism public administration: medical-dental certification of the server health

O absenteísmo médico-odontológico é relatado como sendo responsável pela perda de dias e horas de trabalho, refletindo-se em prejuízos econômicos nos setores público e privado, não obstante a sua essência nos remeta a uma reflexão muito mais profunda, no que diz respeito à Saúde e aos seus agravos, enquanto fatores causais desta condição, muitas vezes impostos ao trabalhador pelo próprio ambiente de trabalho. O presente estudo teve por objetivo avaliar as características e o perfil do Absenteísmo na Administração Pública, o envolvimento e a atestação médico - odontológica relacionados ao afastamento do servidor do seu trabalho, além da relação entre Patologias Médicas e odontológicas, sob uma óptica baseada em evidências de uma pesquisa pautada na Incidência. Além disto, como objetivo secundário, foi conduzida uma atualização da revista da literatura com fulcro nos aspectos legais, éticos, normativos e científicos, no que tange às atestações de estados de saúde. A partir de um estudo preliminar do tipo exploratório retrospectivo, transversal, descritivo e analítico, realizado anteriormente com o propósito de se estabelecer a relação entre absenteísmo e doenças, tanto de origem médica, como odontológica; traçou-se assim um perfil do Absenteísmo na Administração Pública. Também assim, estabeleceu-se uma estratégia que envolveu uma amostra de 340 prontuários funcionais de servidores públicos municipais de uma cidade do interior do Estado de São Paulo, Brasil, do universo de 973 servidores ativos, que foi submetida a uma avaliação transversal retrospectiva de 11 anos e 5 meses, no período de 01 de janeiro de 2001 a 31 de maio de 2012, através da análise da História Médico-Odontológica Pregressa colhida dos atestados médicos e odontológicos juntados e justificantes de faltas ou afastamentos, documentos legais estes comprovantes do motivo do absenteísmo. Subsequentemente a este levantamento epidemiológico, com base na Prevalência, deu-se...

Medical and dental absenteeism is reported to be responsible for the lost of days and hours of work, reflecting in economic losses in the public and private sectors, nevertheless its essence refers us to a much deeper reflection, with regard to Health and their grievances, as causal factors of this condition often imposed by the employee's own work environment. The present study aimed to evaluate the characteristics and profile of Absenteeism in Public Administration, the involvement and the medical - dental attestation related to the staf absence from work, besides the relationship between Medical and Dental Pathologies, under a view based on evidence from a survey based in the Incidence. Furthermore, as a secondary objective, we conducted a literature review of the update with the fulcrum in the legal, ethical, normative and scientific aspects, in relation of health states. From a preliminary study of the retrospective exploratory, cross-sectional, descriptive study was previously conducted with the purpose of establishing the relationship between absenteeism and illnesses, both medical and dental origin; thus drew up a profile of Absenteeism in Public Administration. Thus, it was established a strategy that involved a sample of 340 medical records of functional employees of a city in the state of São Paulo, Brazil, from the universe of 973 active servers, which was subjected to a retrospective cross-sectional assessment of 11 years and 5 months in the period from January 1, 2001 to May 31, 2012, by analyzing the History of Medical and Dental harvested from past medical and dental certificates and documents gathered in proof of absences these ones legal documents showing why the absenteeism. Subsequently to this epidemiological survey, based on the Prevalence, was continued the process through a prospective cohort study of 1 year and 6 months, with the same parameters and sample, but with a loss of 11.37%, which analyzed the end...

[Record linkage of hospital discharge data and first health certificates: a test in the Val d'Oise]. / Chaînage d'enregistrements de séjours PMSI aux premiers certificats de santé: un test dans le Val d'Oise.

BACKGROUND: Our objective was to test the feasibility of an indirect linkage of data on births from health certificates (HC) with hospital discharge (HD) data. METHODS: The linkage was carried out for live births between April 1st and June 30th, 2011 in six of the nine maternity units in the district of Val d'Oise. The HC and HD had 3284 and 3550 births registered during this period, respectively. Linkage was conducted using variables available in both sources: number of fetuses, baby's birth date, gender, maternity unit of birth, maternal age, municipality of residence, gestational age and birth-weight. Two linkage methods were tested: a deterministic and a semi-deterministic method and a probabilistic approach. The latter method calculates a probability estimate for the strength of the relationship between two linked observations related to the discriminatory power and the error rate of the matched variables. For cases that were linked despite discordance on some of the matching variables, random samples of observations were checked against both HC and HD records to compute rates of false matches. RESULTS: The deterministic and semi-deterministic method linked 92.5% and 85.6% of observations in the HC and HD, respectively. The probabilistic method achieved a linkage rate of 99.6% for HC and 92.7% for HD. Cases only linked by the probabilistic method were more often preterm and had low birth-weight. Cases matched using the probabilistic method only had an error rate of 0.4% with 95% CI [0.2-0.6%]. CONCLUSION: Common items in the HC and HD make it possible to achieve a high rate of linkage. The probabilistic method links more births and, in particular, those at higher risk, and error rates were low.

Registro Sanitario, logros, debilidades y proyecciones al cierre del 2013 / The Health Registry, achievements, weaknesses and projections at the close of 2013

Se presenta un breve comentario acerca del trabajo desarrollado por el Registro Sanitario en el año 2013, con la finalidad de informar a los interesados en este tema sobre los logros, debilidades y proyecciones de trabajo que se ha trazado este colectivo de especialistas para los próximos años(AU)

A brief commentary is presented about the work done by the Health Registry in the year 2013, with the purpose of informing those interested in the topic about the achievements, weaknesses and work projections set by this team of specialists for the coming years(AU)

Registro Sanitario, logros, debilidades y proyecciones al cierre del 2013 / The Health Registry, achievements, weaknesses and projections at the close of 2013

Se presenta un breve comentario acerca del trabajo desarrollado por el Registro Sanitario en el año 2013, con la finalidad de informar a los interesados en este tema sobre los logros, debilidades y proyecciones de trabajo que se ha trazado este colectivo de especialistas para los próximos años.(AU)

A brief commentary is presented about the work done by the Health Registry in the year 2013, with the purpose of informing those interested in the topic about the achievements, weaknesses and work projections set by this team of specialists for the coming years.(AU)

Análisis de la confección del certificado de asistencia de primera intención a un lesionado / Analysis of the Completion of the Certificate of First Medical Assistance to an Injured Person

Fundamento: El certificado de asistencia de primera intención a un lesionado, es un documento médico legal que todo profesional médico debe saber elaborar. Cualquier dificultad en los datos requeridos en este documento, puede causar una serie de limitaciones en el proceso judicial de los delitos de lesiones. Objetivo: analizar el proceso de confección del certificado de asistencia de primera intención a un lesionado. Métodos: se realizó un estudio descriptivo, de corte transversal, en la consulta de sanidad del lesionado en la provincia de Cienfuegos, durante el año 2012. Se revisaron 2189 certificados, los cuales fueron analizados en cuanto a: especialidad médica, nivel de atención y datos requeridos en el documento. Resultados: más del 50 % de los certificados expedidos presentaron alguna dificultad en su confección, de las cuales, la de mayor frecuencia fue la no descripción detallada de las lesiones, presente en 329 certificados (27,7 %), seguida del pronóstico médico legal inadecuado en 298 certificados (25,1 %). Los especialistas en Medicina General Integral expidieron la mayor cantidad de certificados y el 100 % de ellos presentó dificultades. Conclusión: los médicos actuantes carecen de criterios científicos metodológicos para la confección adecuada de los certificados de asistencia de primera intención de un lesionado.

Background: the certificate of first medical assistance to an injured person is a medicolegal document that every medical professional should know how to complete. Any problem with the data requested in this form can cause a number of limitations on the prosecution of injury-related offenses. Objective: to characterize the process for completing the certificate of first medical assistance to an injured person. Methods: A descriptive cross-sectional study was conducted at the consultation for injured patients in the province of Cienfuegos, in the year 2012. A total of 2189 certificates were analyzed considering: medical specialty, level of care and data required in the document. Results: over 50% of the certificates issued had problems in their completion; the most frequent was non-detailed description of the lesions, present in 329 certificates (27.7%), followed by inaccurate medicolegal prognosis in 298 certificates (25.1%). Specialists in General Medicine issued the largest number of certificates and 100% of them had problems. Conclusion: attending physicians lack scientific and methodological criteria for accurately completing the certificates of first medical assistance to an injured person.