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5.
Rev Saude Publica ; 53: 110, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31826176

RESUMO

OBJECTIVE: To evaluate the influence of the Mais Médicos (More Doctors) Program on the performance of primary health care by quantifying health services access and use in Northeast Brazil, based on the population size of the municipalities, on the financial investment in health, and on the number of physicians in the family health teams. METHOD: Evaluative research of quantitative nature. Access was evaluated by the population coverage ratio of the Family Health Strategy and use of health services, which were measured by medical appointments conducted between April 2013 and September 2015. We defined processes for database selection, adjustment, and validation, including explanatory variables for a sample of 896 municipalities. The analysis was based on the time periods before and after the implementation of the program. The Wilcoxon signed-rank test and non-parametric alternatives constituted statistical tests in the comparative analysis of the data. RESULTS: A 19.2% increase was observed in the number of medical appointments between the first six months and the final six months of the data series. In this period, the median appointments in municipalities with up to 5,000 inhabitants increased from 701.0 to 768.0; while in those with more than 100,000 inhabitants it decreased from 285.5 to 280.0 (p < 0.05). Between April 2013 and September 2015, the median coverage ratio of the family health teams increased from 89.2% to 95.3%, approaching 100% in the municipalities with up to 20,000 inhabitants. CONCLUSIONS: The study highlights the expansion of access and use of primary health care services in the northeast region after the implementation of the Mais Médicos (More Doctors) Program. Between April 2013 and September 2015, the coverage of family health teams and the production of medical appointments increased, constituting important achievements for SUS.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Programas Governamentais , Médicos/provisão & distribução , Atenção Primária à Saúde/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Brasil , Assistência à Saúde/economia , Saúde da Família , Alocação de Recursos para a Atenção à Saúde , Humanos , Atenção Primária à Saúde/economia , Avaliação de Programas e Projetos de Saúde , Recursos Humanos
7.
J R Soc Med ; 112(11): 462-471, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31710823

RESUMO

Locum doctors are often perceived to present greater risks of causing harm to patients than permanent doctors. After eligibility and quality assessment, eight empirical and 34 non-empirical papers were included in a narrative synthesis to establish what was known about the quality and safety of locum medical practice. Empirical literature was limited and weak methodologically. Locums enabled healthcare organisations to maintain appropriate staffing levels and allowed staffing flexibility, but they also gave rise to concerns about continuity of care, patient safety, team function and cost. There was some evidence to suggest that the way locum doctors are recruited, employed and used by organisations, may result in a higher risk of harm to patients. A better understanding of the quality and safety of locum working is needed to improve the use of locum doctors and the quality and safety of patient care that they provide.


Assuntos
Escolha da Profissão , Medicina de Família e Comunidade/organização & administração , Satisfação no Emprego , Segurança do Paciente/normas , Admissão e Escalonamento de Pessoal/organização & administração , Médicos/provisão & distribução , Humanos
10.
Bull World Health Organ ; 97(9): 631-636, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31474776

RESUMO

Japan's universal health-care system means that it is a very safe country in which to give birth. Perinatal outcomes in Japan are excellent, with low infant mortality and neonatal mortality. However, childbirth remains a challenge for many Japanese women, who are faced with a scarcity of places to give birth, limited availability of analgesia and social norms that favour natural birth. The number of birth facilities in Japan continues to decrease as fewer children are born. The numbers of qualified medical staff remain inadequate, with a continuing lack of female physicians, perpetuated by a pervasive negative gender bias. Recruitment efforts are underway, but few doctors want to specialize in obstetrics or gynaecology. Furthermore, around half of female obstetricians and gynaecologists in Japan's male-dominated medical system stop practising when they have their own children. The difficulty of obtaining analgesia during labour is another problem. Although low uptake of labour pain relief in Japan is said to be due to cultural influences, the root of the problem is a lack of qualified anaesthesiologists and the inflexibility of a system that will not allow other staff to be trained to administer labour analgesia. Problems with labour anaesthesia have been linked to 14 maternal deaths since 2010. Japanese policy-makers need to act to renovate the nation's obstetric facilities, reorganize regional perinatal care systems, train more obstetricians and anaesthesiologists, promote task-shifting and better integrate biomedical and traditional, non-medical care for pregnant women.


Assuntos
Analgesia/psicologia , Atitude do Pessoal de Saúde , Dor do Parto/tratamento farmacológico , Dor do Parto/psicologia , Médicos/psicologia , Anestesiologistas/provisão & distribução , Parto Obstétrico , Feminino , Humanos , Japão , Trabalho de Parto , Serviços de Saúde Materna , Área Carente de Assistência Médica , Obstetrícia , Parto , Médicos/provisão & distribução , Gravidez , Sexismo
11.
Tex Med ; 115(8): 21, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31369141

RESUMO

Medical education made some gains in the 2019 legislative session, including the statutory approval of two new medical schools.


Assuntos
Educação de Pós-Graduação em Medicina/economia , Médicos/provisão & distribução , Faculdades de Medicina/tendências , Humanos , Texas
14.
Orv Hetil ; 160(31): 1223-1230, 2019 Aug.
Artigo em Húngaro | MEDLINE | ID: mdl-31352809

RESUMO

Introduction: The Human Resources for Health (HRH) mobility and migration are considered as global phenomena. The European Union often faces the mobility of health professionals on a system level. Hungary is recognised among the sending countries, therefore both international and national level health workforce monitoring, planning, and forecasting are inevitable. Aim: The purpose of this research was to investigate the national demographical profiles of the medical professions affected most significantly by the Hungarian HRH mobility process. Method: Age and regional distribution analyses of the requests for degree certificate issued by the National Healthcare Services Centre were carried out between the years of 2010 and 2017. Results: In Hungary, the rate of mobility - the number of requests for degree certificate among the licensed to practice professionals - resulted in the following: the highest rate was detected in anaesthesiology and intensive therapy with 23.5%, in surgery 17.9%, then internal medicine 7.9%, paediatrics 7.4%, and in general practice 6.4%. According to the results, in the 5 above mentioned professions, the physicians most affected by mobility are mostly from the age cohort of 50+. Furthermore, the results also highlight the territorial inequalities: the region of the capital as well as the medical university towns and counties are in the most favourable situation in terms of professional care and supply. Conclusion: Therefore, it can be concluded that in the case of the 5 investigated subspecialties, not only the overall age of the physicians is higher in the disadvantaged areas, but these regions also have to face a more severe shortage of specialists. Orv Hetil. 2019; 160(31): 1223-1230.


Assuntos
Pessoal de Saúde , Mão de Obra em Saúde/organização & administração , Médicos/provisão & distribução , Especialização/estatística & dados numéricos , Adulto , Emigração e Imigração , Mão de Obra em Saúde/tendências , Humanos , Hungria , Pessoa de Meia-Idade
16.
Australas Psychiatry ; 27(5): 528-531, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31267760

RESUMO

OBJECTIVE: To describe the workforce of career medical officers (CMOs) working in psychiatry and addiction medicine across New South Wales (NSW) and to explore their training and education needs, and experience of their role. METHOD: A cross-sectional survey of CMOs in NSW working in psychiatry or addiction medicine. The survey consisted of quantitative data and free-text responses, and was conducted online in late 2017. RESULTS: Of the 41 CMOs identified and sent the survey link, 25 CMOs completed the survey (61% RR). Almost half had worked as a CMO for 11 years or longer. Only six respondents held a recognised senior CMO position. Common areas of expertise were clozapine, metabolic health, and electroconvulsive therapy (ECT). One-quarter of respondents did not receive supervision. Suggested education and training improvements included an annual 1-day training symposium and monthly peer review group for CMOs. CONCLUSION: CMOs are an often senior group of clinicians working in important areas of service provision. Ongoing educational support for this group of medical practitioners is prudent to ensure the delivery of best practice mental health and drug health care.


Assuntos
Educação Médica Continuada/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , Transtornos Mentais/terapia , Médicos/provisão & distribução , Psiquiatria/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales , Transtornos Relacionados ao Uso de Substâncias/terapia
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