A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica

Detalhes bibliográficos
Autor(a) principal: Pissinato, Adriana Vieira da Silva
Data de Publicação: 2014
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da Uninove
Texto Completo: http://bibliotecatede.uninove.br/handle/tede/1120
Resumo: Medical Assistance Ambulatory (AMA) was the strategy created by the city of S??o Paulo to fix the problem from the spontaneous demand coming from basic health units (UBS) and emergency rooms (PS). AMA routine from 2005 to 2013 has been the target of discussions that leave its work proposal questionable, which leads to the need of study and understanding of its impact on demand and Health Care net. The aim of this research was to conduct an analysis of the distribution of demand for medical care provided in the AMA, UBS and PS in S??o Paulo; especially in Freguesia do ?? and Brasil??ndia Regional Administration of Health. This exploratory and descriptive study using the data from SIA ??? Datasus, medical records and medical reports about the distribution of demand through the number of medical consultations of AMA Services to analyze the profile of patients using the AMA and how they are inserted in the Health Care net. It was observed that from 2002 to 2013 there was a reduction of 30% of visits made by UBS (Basic Health Unit), increase and subsequent stabilization of medical care provided by the AMA and initial reduction (2005) and subsequent increase (2011) in the number of assistance in PS (emergency room). This was also observed in the STS Freguesia do ?? / Brasil??ndia. Were analyzed 156 medical records, it was notice that 91.7% of patients were treated at the AMA conform the objectives of this device. However, 81.4% of these patients require medical monitoring, and 22% are not accompanied. Considering the ordinance 1101 / MS 2011, 85% of patients had access to more than 2 visits / year in AMA and 71.2% of patients at 1 medical consultation / year at UBS. It was concluded that the AMA increased the supply of consultations in S??o Paulo and favored the patient's access to the health system. However, the poor articulation of health care net associated with lack of knowledge of the patients about the health devices affects the promotion and health monitoring. This study subsidied the analysis of health system in S??o Paulo city before and after Ama inclusion in the Health Care net and encourage new studies to be conducted on this topic.
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spelling Motta, Lara Jansiskihttp://lattes.cnpq.br/6750462252900819Assis, S??nia Francisca Monken dehttp://lattes.cnpq.br/4648925294194872Akerman, Marcohttp://lattes.cnpq.br/9206528078547920Novaretti, M??rcia Cristina Zagohttp://lattes.cnpq.br/7914282268625215Seoane, Antonio Ferreirahttp://lattes.cnpq.br/282539053778732728176140899http://lattes.cnpq.br/3165532765828447Pissinato, Adriana Vieira da Silva2015-07-17T14:42:37Z2014-11-24Pissinato, Adriana Vieira da Silva. A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica. 2014. 107 f. Disserta????o( Programa de Mestrado Profissional em Administra????o - Gest??o em Sistemas de Sa??de) - Universidade Nove de Julho, S??o Paulo .http://bibliotecatede.uninove.br/handle/tede/1120Medical Assistance Ambulatory (AMA) was the strategy created by the city of S??o Paulo to fix the problem from the spontaneous demand coming from basic health units (UBS) and emergency rooms (PS). AMA routine from 2005 to 2013 has been the target of discussions that leave its work proposal questionable, which leads to the need of study and understanding of its impact on demand and Health Care net. The aim of this research was to conduct an analysis of the distribution of demand for medical care provided in the AMA, UBS and PS in S??o Paulo; especially in Freguesia do ?? and Brasil??ndia Regional Administration of Health. This exploratory and descriptive study using the data from SIA ??? Datasus, medical records and medical reports about the distribution of demand through the number of medical consultations of AMA Services to analyze the profile of patients using the AMA and how they are inserted in the Health Care net. It was observed that from 2002 to 2013 there was a reduction of 30% of visits made by UBS (Basic Health Unit), increase and subsequent stabilization of medical care provided by the AMA and initial reduction (2005) and subsequent increase (2011) in the number of assistance in PS (emergency room). This was also observed in the STS Freguesia do ?? / Brasil??ndia. Were analyzed 156 medical records, it was notice that 91.7% of patients were treated at the AMA conform the objectives of this device. However, 81.4% of these patients require medical monitoring, and 22% are not accompanied. Considering the ordinance 1101 / MS 2011, 85% of patients had access to more than 2 visits / year in AMA and 71.2% of patients at 1 medical consultation / year at UBS. It was concluded that the AMA increased the supply of consultations in S??o Paulo and favored the patient's access to the health system. However, the poor articulation of health care net associated with lack of knowledge of the patients about the health devices affects the promotion and health monitoring. This study subsidied the analysis of health system in S??o Paulo city before and after Ama inclusion in the Health Care net and encourage new studies to be conducted on this topic.A AMA (Assist??ncia M??dica Ambulatorial) foi a estrat??gia criada pelo munic??pio de S??o Paulo para ampliar o acesso dos pacientes que necessitam de atendimento imediato. Em sua trajet??ria, de 2005 a 2013, a rotina da AMA ?? alvo de discuss??es que deixam sua proposta de trabalho question??vel, o que leva a necessidade de estudo e compreens??o sobre seu impacto na demanda e rede de aten????o. O objetivo principal dessa pesquisa foi o de realizar uma an??lise da distribui????o da demanda dos atendimentos m??dicos realizados na AMA, UBS e PS no munic??pio de S??o Paulo, em especial na Supervis??o T??cnica de Sa??de Freguesia do ?? e Brasil??ndia (STS F??/Bras). Por meio da pesquisa descritiva explorat??ria e utilizando os dados do SIA (Sistema de Informa????o Ambulatorial), fichas de atendimento e, relat??rios de servi??os e frequ??ncia, foi poss??vel analisar o perfil dos pacientes que utilizam a AMA e como estes est??o inseridos em rela????o ao acompanhamento pela rede de assist??ncia. Observou-se que de 2002 a 2013 houve redu????o de 30% dos atendimentos realizados pela UBS (unidade b??sica de sa??de), aumento e posterior estabiliza????o do n??mero de atendimentos m??dicos prestados pela AMA e, redu????o inicial (2005) e posterior aumento (ap??s 2011) no n??mero de atendimentos em PS (pronto-socorro). O mesmo foi observado na STS F??/Bras. Tamb??m foram analisadas 156 fichas de atendimento, onde p??de-se notar que 91,7% dos pacientes que foram atendidos na AMA correspondem aos objetivos deste equipamento. Por??m, 81,4% destes pacientes necessitam de acompanhamento externo, sendo que 22% n??o est??o acompanhados por nenhum estabelecimento de sa??de. Tecendo uma an??lise frente a portaria 1101/MS de 2011, 85% dos pacientes tiveram acesso a mais de 2 consultas/ano na AMA e 71,2% dos pacientes a 1 consulta/ano na UBS, caracterizando maior utiliza????o da AMA em rela????o a UBS. Concluiu-se que a AMA aumentou a oferta de consultas no munic??pio de S??o Paulo e favoreceu o acesso do paciente ao sistema. Por??m, a deficiente articula????o da rede de aten????o, associada a falta de conhecimento da popula????o sobre qual equipamento utilizar, pode comprometer significativamente a promo????o e acompanhamento de sa??de. O estudo subsidiou a an??lise do sistema de sa??de do munic??pio de S??o Paulo, antes e ap??s a inclus??o das AMAs na rede de aten????o e fomenta para que novos estudos sejam realizados sobre o tema.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2015-07-17T14:42:37Z No. of bitstreams: 1 Adriana Vieira da Silva Pissinato.pdf: 1973687 bytes, checksum: 57c3b76578d9382985adcba057732cc9 (MD5)Made available in DSpace on 2015-07-17T14:42:37Z (GMT). No. of bitstreams: 1 Adriana Vieira da Silva Pissinato.pdf: 1973687 bytes, checksum: 57c3b76578d9382985adcba057732cc9 (MD5) Previous issue date: 2014-11-24application/pdfporUniversidade Nove de JulhoPrograma de Mestrado Profissional em Administra????o - Gest??o em Sistemas de Sa??deUNINOVEBrasilAdministra????ogest??o em sa??deadministra????o de servi??os de sa??desa??de p??blicanecessidadesdemandas de servi??os de sa??dehealth managementhealth services administrationpublic healthhealth services needsdemandADMINISTRACAO::ADMINISTRACAO DE SETORES ESPECIFICOSA repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blicaThe impact of the medical ambulatory assistance unit (AMA) in the s??o Paulo city on demand in network attention in public healthinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis-710462410973612412600info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da Uninoveinstname:Universidade Nove de Julho (UNINOVE)instacron:UNINOVEORIGINALAdriana Vieira da Silva Pissinato.pdfAdriana Vieira da Silva Pissinato.pdfapplication/pdf1973687http://localhost:8080/tede/bitstream/tede/1120/2/Adriana+Vieira+da+Silva+Pissinato.pdf57c3b76578d9382985adcba057732cc9MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82089http://localhost:8080/tede/bitstream/tede/1120/1/license.txt7b5ba3d2445355f386edab96125d42b7MD51tede/11202015-07-17 11:42:37.408oai:localhost: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Biblioteca Digital de Teses e Dissertaçõeshttp://bibliotecatede.uninove.br/PRIhttp://bibliotecatede.uninove.br/oai/requestbibliotecatede@uninove.br||bibliotecatede@uninove.bropendoar:2015-07-17T14:42:37Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)false
dc.title.por.fl_str_mv A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica
dc.title.alternative.eng.fl_str_mv The impact of the medical ambulatory assistance unit (AMA) in the s??o Paulo city on demand in network attention in public health
title A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica
spellingShingle A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica
Pissinato, Adriana Vieira da Silva
gest??o em sa??de
administra????o de servi??os de sa??de
sa??de p??blica
necessidades
demandas de servi??os de sa??de
health management
health services administration
public health
health services needs
demand
ADMINISTRACAO::ADMINISTRACAO DE SETORES ESPECIFICOS
title_short A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica
title_full A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica
title_fullStr A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica
title_full_unstemmed A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica
title_sort A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica
author Pissinato, Adriana Vieira da Silva
author_facet Pissinato, Adriana Vieira da Silva
author_role author
dc.contributor.advisor1.fl_str_mv Motta, Lara Jansiski
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/6750462252900819
dc.contributor.referee1.fl_str_mv Assis, S??nia Francisca Monken de
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/4648925294194872
dc.contributor.referee2.fl_str_mv Akerman, Marco
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/9206528078547920
dc.contributor.referee3.fl_str_mv Novaretti, M??rcia Cristina Zago
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/7914282268625215
dc.contributor.referee4.fl_str_mv Seoane, Antonio Ferreira
dc.contributor.referee4Lattes.fl_str_mv http://lattes.cnpq.br/2825390537787327
dc.contributor.authorID.fl_str_mv 28176140899
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/3165532765828447
dc.contributor.author.fl_str_mv Pissinato, Adriana Vieira da Silva
contributor_str_mv Motta, Lara Jansiski
Assis, S??nia Francisca Monken de
Akerman, Marco
Novaretti, M??rcia Cristina Zago
Seoane, Antonio Ferreira
dc.subject.por.fl_str_mv gest??o em sa??de
administra????o de servi??os de sa??de
sa??de p??blica
necessidades
demandas de servi??os de sa??de
topic gest??o em sa??de
administra????o de servi??os de sa??de
sa??de p??blica
necessidades
demandas de servi??os de sa??de
health management
health services administration
public health
health services needs
demand
ADMINISTRACAO::ADMINISTRACAO DE SETORES ESPECIFICOS
dc.subject.eng.fl_str_mv health management
health services administration
public health
health services needs
demand
dc.subject.cnpq.fl_str_mv ADMINISTRACAO::ADMINISTRACAO DE SETORES ESPECIFICOS
description Medical Assistance Ambulatory (AMA) was the strategy created by the city of S??o Paulo to fix the problem from the spontaneous demand coming from basic health units (UBS) and emergency rooms (PS). AMA routine from 2005 to 2013 has been the target of discussions that leave its work proposal questionable, which leads to the need of study and understanding of its impact on demand and Health Care net. The aim of this research was to conduct an analysis of the distribution of demand for medical care provided in the AMA, UBS and PS in S??o Paulo; especially in Freguesia do ?? and Brasil??ndia Regional Administration of Health. This exploratory and descriptive study using the data from SIA ??? Datasus, medical records and medical reports about the distribution of demand through the number of medical consultations of AMA Services to analyze the profile of patients using the AMA and how they are inserted in the Health Care net. It was observed that from 2002 to 2013 there was a reduction of 30% of visits made by UBS (Basic Health Unit), increase and subsequent stabilization of medical care provided by the AMA and initial reduction (2005) and subsequent increase (2011) in the number of assistance in PS (emergency room). This was also observed in the STS Freguesia do ?? / Brasil??ndia. Were analyzed 156 medical records, it was notice that 91.7% of patients were treated at the AMA conform the objectives of this device. However, 81.4% of these patients require medical monitoring, and 22% are not accompanied. Considering the ordinance 1101 / MS 2011, 85% of patients had access to more than 2 visits / year in AMA and 71.2% of patients at 1 medical consultation / year at UBS. It was concluded that the AMA increased the supply of consultations in S??o Paulo and favored the patient's access to the health system. However, the poor articulation of health care net associated with lack of knowledge of the patients about the health devices affects the promotion and health monitoring. This study subsidied the analysis of health system in S??o Paulo city before and after Ama inclusion in the Health Care net and encourage new studies to be conducted on this topic.
publishDate 2014
dc.date.issued.fl_str_mv 2014-11-24
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dc.identifier.citation.fl_str_mv Pissinato, Adriana Vieira da Silva. A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica. 2014. 107 f. Disserta????o( Programa de Mestrado Profissional em Administra????o - Gest??o em Sistemas de Sa??de) - Universidade Nove de Julho, S??o Paulo .
dc.identifier.uri.fl_str_mv http://bibliotecatede.uninove.br/handle/tede/1120
identifier_str_mv Pissinato, Adriana Vieira da Silva. A repercuss??o das unidades de assist??ncia m??dica ambulatorial (AMA) no munic??pio de S??o Paulo sobre a demanda na rede de aten????o em sa??de p??blica. 2014. 107 f. Disserta????o( Programa de Mestrado Profissional em Administra????o - Gest??o em Sistemas de Sa??de) - Universidade Nove de Julho, S??o Paulo .
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