This study showed different frequencies of intestinal parasitosis (giardiasis and helminthiasis) among children in day-care centers and junior and high schools (public and private). The survey involved 199 individuals, 96 belonging to public schools and 103 to private institutions. The frequency of giardiasis in public institutions was shown to be greater than in private institutions. Regarding helminthiasis, frequencies were similar among day-care centers, but greater for public schools in comparison to private institutions. When levels of socio-economic status, education, basic sanitary conditions and hygiene were analyzed as determinants of intestinal parasitosis, it became evident that greater frequency of giardiasis and helminthiasis occurred among children from low-income families and those whose parents had low levels of education. The source of vegetables was also a significant factor in determining such parasitosis.
INTRODUCTION: The importance of evaluating health systems and services: increased expenditures, technological advances, aging of the population, deficiencies with assistance practices, iniquities in resource allocation, accountability to controlling organs and society, improvements and reforms in the health system and services. The performance evaluation of health services demonstrates an important part of the performance of the health system, allowing comparisons of performance of processes and results, as the services evaluated have articulations among them, and that the outcome has relations with all levels of attention evaluated. OBJECTIVE: to evaluate the performance of public health services in a mediumsized São Paulo municipality, from 2008 to 2015, in terms of quality, access, effectiveness and adequacy of services. MATERIAL AND METHOD: exploratory study, with descriptive analysis of quantitative data. Health indicators of the information systems of the Ministry of Health and of the IBGE population were used. They were distributed in the dimensions of access, effectiveness and adequacy, according to the model of the PROADESS-Methodology for Evaluation of Health System Performance; for the interpretation of the performance was carried out comparison between the municipal level and other three levels (state of São Paulo, Southeast region and Brazil). RESULTS: access: hospitalization rate, revascularization surgery, angioplasty and tetra / pentavalent immunization demonstrated better performance of the municipal health services in relation to the other levels; coverage Family Health Strategy and vaccination of the elderly against influenza showed worse performance, but with a tendency to improve over time. Adequacy: prenatal consultations of the municipality with better performance in relation to the other levels, and closer to that recommended; hysterectomy and cesarean delivery with worse performance. Effectiveness: deaths in hospitalizations due to acute myocardial infarction with better performance for the municipality; hospitalizations for conditions sensitive to primary care, congenital syphilis in less than one year and amputation of lower limbs in diabetics with worse municipal performance in relation to the other three levels of the study. CONCLUSION: with regard to access, in the set of indicators, performance was positive, with a better result for hospital care in relation to primary care; in terms of adequacy, the performance was unfavorable to the municipality in comparison to the other levels, as well as in the effectiveness, the municipal performance was also inferior to the other three levels surveyed, showing weakness in the basic assistance care.
O indicador de saúde das condições sensíveis à atenção primária é um instrumento de avaliação importante, podendo indicar indiretamente a falta de atenção básica oportuna e efetiva. O objetivo deste estudo é analisar os coeficientes de internações por condições sensíveis à atenção primária (CSAP) das doenças crônicas não transmissíveis, em dois municípios de grande porte localizados em regiões brasileiras distintas. Estudo ecológico, que analisou as internações por condições sensíveis à atenção primária das doenças crônicas não transmissíveis (DCNT) segundo sexo, faixa etária, diagnósticos específicos e cobertura populacional por equipes de saúde da família, em Londrina (PR) e Ribeirão Preto (SP), entre 2011 e 2015. A tendência observada das DCNT foi de coeficientes de hipertensão arterial, insuficiência cardíaca e diabetes semelhantes nos dois locais. A gestão, cobertura populacional e processo de trabalho das equipes multiprofissionais são aspectos que podem explicar os coeficientes de internações das DCNT observados nas duas cidades, entre 2011 e 2015.
Os resultados mostraram que as metas quantitativas foram atingidas em todos os quadrimestres analisados e as metas qualitativas não foram atingidas em apenas três quadrimestres dentre os sete anos analisados.Demonstrou ser um modelo promissor de alocação de recursos para compra de serviços, apesar de fragilidades no cumprimento de metas de qualidade, acompanhamento e revisão destas metas. PALAVRAS-CHAVE:
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