Estresse ocupacional e satisfação dos usuários com os cuidados de saúde primários em Portugal

The Portuguese primary healthcare sector has suffered changes due to a reform on the lines of the conceptual framework referred to by some authors as "New Public Management." These changes may be generating higher levels of occupational stress with a negative impact at individual and organizational levels. This study examines the experience of stress in 305 health professionals (physicians, nurses and clinical secretaries) and satisfaction with the services provided by them from 392 users. The population under scrutiny is taken from 10 type A and 10 type B Family Health Units (FHU). The results show that 84.2% of professionals report moderate to high levels of occupational stress with the nurses being those with higher levels. Users reported good levels of satisfaction, especially with the nursing services. There were no differences in stress level between type A and type B FHU, though there were at the level of user satisfaction of type B FHU users who show higher levels of satisfaction. It was seen that dimensions of user satisfaction were affected by stress related to excess work.info:eu-repo/semantics/publishedVersio

Controle público e eqüidade no acesso a hospitais sob gestão pública não estatal Public control and equity of access to hospitals under non-State public administration

OBJETIVO: Analisar as organizações sociais de saúde à luz do controle público e da garantia da eqüidade no acesso aos serviços de saúde. MÉTODOS: Utilizou-se a técnica de estudo de caso e foram selecionadas duas organizações sociais de saúde na região metropolitana de São Paulo. As categorias analíticas foram eqüidade no acesso e controle público, baseando-se em entrevistas com informantes-chave e relatórios técnico-administrativos. RESULTADOS: Observou-se que financiamento global e o controle administrativo das organizações sociais de saúde são atribuições do gestor estadual. A presença do gestor local é importante para a garantia da eqüidade no acesso, sendo que o controle público se expressa por ações fiscalizadoras mediante procedimentos contábil-financeiros. CONCLUSÕES: A eqüidade no acesso e o controle público não são contemplados na gestão dessas organizações. A questão central encontra-se na capacidade do poder público se fazer presente na implementação dessa modalidade no âmbito local, garantido a eqüidade no acesso e contemplando o controle público.<br>OBJECTIVE: To analyze social health organizations in the light of public control and the guarantee of equity of access to health services. METHODS: Utilizing the case study technique, two social health organizations in the metropolitan region of São Paulo were selected. The analytical categories were equity of access and public control, and these were based on interviews with key informants and technical-administrative reports. RESULTS: It was observed that the overall funding and administrative control of the social health organizations are functions of the state administrator. The presence of a local administrator is important for ensuring equity of access. Public control is expressed through supervisory actions, by means of accounting and financial procedures. CONCLUSIONS: Equity of access and public control are not taken into consideration in the administration of these organizations. The central question lies in the capacity of the public authorities to have a presence in implementing this model at the local level, thereby ensuring equity of access and taking public control into consideration