Ações federais para apoio e fortalecimento local no combate ao COVID-19: a atenção primária à saúde (APS) no assento do condutor

The Ministry of Health, through the Secretariat of Primary Health Care and in partnership with the Secretariat of Health Surveillance, built and implemented strategies of Primary Health Care (PHC) within the scope of support to local managers and in partnership with the Council National Secretary of State (CONASS) and Municipal Health (CONASEMS) to combat COVID-19. These actions have PHC as the main responsible for several areas and physical, human and financial resources, as well as allowing to boost national progress towards the use of information and communication technologies and new partnerships for conducting research.El Ministerio de Salud, a través de la Secretaría de Atención Primaria de Salud y en asociación con la Secretaría de Vigilancia Sanitaria, elaboró ​​e implementó estrategias de Atención Primaria de Salud (APS) dentro del alcance del apoyo a los gerentes locales y en asociación con la Secretaría Consejo Nacional de Salud Estado (CONASS) y Salud Municipal (CONASEMS) para combatir COVID-19. Estas acciones tienen a PHC como el principal responsable de varias áreas y recursos físicos, humanos y financieros, además de promover el progreso nacional en el uso de tecnologías de información y comunicación y nuevas alianzas para realizar investigaciones.O Ministério da Saúde, por intermédio da Secretaria de Atenção Primária à Saúde e em parceria com a Secretaria de Vigilância em Saúde construiu e implementou estratégias da Atenção Primária à Saúde (APS) no âmbito do apoio aos gestores locais e em articulação com o Conselho Nacional de Secretários Estaduais (CONASS) e Municipais de Saúde (CONASEMS) para o combate ao COVID-19. Essas ações têm a APS como a grande responsável por diversas áreas e recursos físicos, humanos e financeiros, assim como permite impulsionar o avanço nacional para o uso de tecnologias de informação e comunicação e novas parcerias para realização de pesquisas

Lean demand management: application in a national health department

Demand management is essential for any organization and seeks to balance demand and productive capacity with a focus on customer orders. Thus, raising and studying in detail the demands is necessary in order to plan the daily operations, independently of being manufacturing or services, private or public sectors. Lean Thinking is a philosophy that emerged in the manufacturing field to improve production systems performance, simultaneously reducing operational wastes. This article aims to apply Lean principles to demand management in a Brazilian government department responsible for managing strategic health projects. Through interviews with managers 1027 monthly demands were raised in the department, of which 308 are demands requested and executed internally and 719 are transversal between various sectors. In addition, 42–45% of such demands are related to advisory and administrative support, taking the department’s focus on processes that add value, such as Policies and Norms, Regional Monitoring, Qualification and Accreditation, and Projects and Studies. Regarding Lean waste, after the survey of demands, the operations related to the main demands showed waste according to the Ohno classification: 32% were classified as overprocessing, waiting 28%, and overproduction and defects/quality 14% each. This panorama demonstrates the need for better demand management so that the processes focus on delivering value, overcoming the resistance of employees as an obstacle.This work was partially supported by FCT—Fundação para a Ciência e Tecnologia within the R&D Units Project Scope: UIDB/00319/2020

Utilização de serviços de saúde pela população adulta de São Leopoldo, Rio Grande do Sul, Brasil: resultados de um estudo transversal Health services utilization by the adult population in São Leopoldo, Rio Grande do Sul State, Brazil: a cross-sectional study

O objetivo do estudo foi descrever as características da população adulta em São Leopoldo, Rio Grande do Sul, Brasil, quanto ao uso de serviços de saúde. Avaliaram-se como desfecho: não se consultar com médico no último mês, utilizar serviços do SUS e se consultar nos serviços privados. Foi realizado um estudo transversal com indivíduos de ambos os sexos, de 20 a 69 anos. Das 1.098 pessoas respondentes, 623 (56,7%; IC95%: 53,8-59,7) não haviam se consultado com médico no último mês. Dos 487 indivíduos que tinham se consultado, 51,2% utilizaram os serviços do SUS, 26,9% os serviços privados e 22% outros serviços. Consultar estava associado com sexo feminino e idade elevada. A análise evidenciou que os indivíduos nas categorias intermediárias de renda, escolaridade e classe econômica se consultavam menos do que as correspondentes altas e baixas categorias. Os resultados sugerem que a classe intermediária, por não possuir "capacidade de compra" para serviços privados e/ou por não utilizar o sistema público, tenderia a procurar assistência de saúde com menor frequência.<br>The aim was to describe healthcare utilization by adults in a Brazilian city. The outcomes were medical appointments in the previous month and use of public (Unified National Health System - SUS) versus private healthcare services. A population-based cross-sectional study with 1,098 adults aged 20 years or over was carried out. No medical appointment in the previous month was reported by 623 persons (56.7%, 95%CI: 53.8-59.7). Of the 487 individuals who had consulted a physician, 51.2% used the public healthcare system, 26.9% private care, and 22% other services. Consultation was associated with female gender and older age. Individuals in the intermediate categories for income, schooling, and socioeconomic status consulted less than the corresponding high and low categories. The results suggest that the middle class in this city lacks the purchasing power to seek care in the private sector while also using public services less, thus generally seeking healthcare less frequently