MARIA INES BAPTISTELLA NEMES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Profile of the cohort of people being treated for HIV infection in the SUS, Brazil, 2015-2018(2023) SATO, Ana Paula Sayuri; NEMES, Maria Ines Battistella; ALVES, Ana Maroso; SOUZA, Evelyn Lima de; SANTOS, Barbara dos Reis; NUNES, Luceime Olivia; SANTOS, Angelica Carreira dos; KUMOW, Aline; NASCIMENTO, Felipe Parra doOBJECTIVE: To build an integrated database of individual and service data from the cohort of people who started antiretroviral therapy (ART), from 2015 to 2018, in Brazil. METHODS: Open cohort study that includes people aged 15 years or older who started ART from 2015 to 2018, with follow-up in services of the Brazilian Unified Health System (SUS), and who responded to the 2016/2017 Qualiaids national survey. The source of individual data was the related HIV database, derived from the probabilistic linkage between data from the SUS systems of diagnostic information, medication, tests, and deaths. The data source for the services was the services' response database to the Qualiaids survey. After analysis of consistency and exclusions, the database of individuals was deterministically related to the database of services. RESULTS: The cohort comprised 132,540 people monitored in 941 SUS services. Of these services, 59% are located in the Southeast region and 49% followed 51 to 500 cohort participants. The average performance of organization and management of patient care ranged from 29% to 75%. Most of the cohort participants are male, black and mixed, aged between 20 and 39 years old, and have between 4 and 11 years of schooling. Median baseline T-CD4 was 419 cells/mm3, 6% had an episode of tuberculosis, and 2% died of HIV disease. CONCLUSION: For the first time in Brazil, this cohort provides the opportunity for a joint analysis of individual factors and services in the production of positive and negative clinical outcomes of HIV treatment.
- Performance assessment of primary health care facilities in Brazil: Concordance between web-based questionnaire and in-person interviews with health personnel(2023) NUNES, Luceime Olivia; CASTANHEIRA, Elen Rose Lodeiro; SANINE, Patricia Rodrigues; AKERMAN, Marco; NEMES, Maria Ines BaptistellaThis study is a concordance analysis comparing answers to two external assessment tools for Primary Health Care (PHC) facilities that use two different data collection methodologies: (a) external assessment through structured interviews and direct observation of facilities conducted by the National Program for Improvement of Access and Quality of Primary Care (AE-PMAQ-AB), and (b) a computerized web-based self-administered questionnaire for Assessment of the Quality of Primary Health Care Services (QualiAB). The two surveys were answered by 1,898 facilities located in 437 municipalities in the state of Sao Paulo, Brazil, between 2017 and 2018. Both surveys aimed to assess the management and organization of PHC facilities. A total of 158 equivalent questions were identified. The answers were grouped by thematic similarity into nine domains: Territory characteristics; Local management and external support; Structure; Health promotion, disease prevention, and therapeutic procedures; Attention to unscheduled patients; Women's health; Children's health; Attention to chronic conditions; and Oral health. The results show a high level of concordance between the answers, with 81% of the 158 compared questions showing concordance higher than 0.700. We showed that the information obtained by the web-based survey QualiAB was comparable to that of the structured interview-based AE-PMAQ-AB, which is considered the gold standard. This is important because web-based surveys are more practical and convenient, and do not require trained interviewers. Online assessment surveys can allow immediate access to answers, reports and guidelines for each evaluated facility, as provided by the QualiAB system. In this way, the answers to this type of survey can be directly employed by users, allowing the assessment to fulfill all phases of an assessment process.
- Delphi Technique in the validation process of the national application of the Questionnaire for Primary Care Assessment (QualiAB)(2021) ZARILI, Thais Fernanda Tortorelli; CASTANHEIRA, Elen Rose Lodeiro; NUNES, Luceime Olivia; SANINE, Patricia Rodrigues; CARRAPATO, Josiane Fernandes Lozigia; MACHADO, Dinair Ferreira; RAMOS, Nadia Placideli; MENDONCA, Carolina Siqueira; NASSER, Mariana Arantes; ANDRADE, Marta Campagnoni; NEMES, Maria Ines BattistellaThis article aims to describe the use of the Delphi Technique in a process of updating and validating the content of the Primary Care Services Quality Assessment Questionnaire (QualiAB) for national application. In this study, 19 experts with experience in research in health evaluation, care and management in primary Health Care (PHC) agreed to participate. A revised version of the QualiAB instrument with 105 indicators was submitted for evaluation as to its relevance, national applicability and acceptability. The modified Delphi Technique was performed in two rounds. The response rate of experts in the first round was 73.6%, 40 indicators were accepted and 65 did not reach consensus. of which 54 obtained suggestions to change the question and/or indicator. In the second, the response rate was 92.8%, and 65 indicators were resent with incorporation of changes, of which six were accepted Of the remaining 59, 51 obtained suggestions for change The modified Delphi technique contributed to the Improvement of the QualiAB instrument as an intermediate step in an iterative validation process. However, the performance in two rounds proved to be insufficient to validate the organizational quality indicators in view of the scope and diversity of the actions performed by the PHC services.
- Evaluation of comprehensive care for older adults in primary care services(2020) PLACIDELI, Nadia; CASTANHEIRA, Elen Rose Lodeiro; DIAS, Adriano; SILVA, Pedro Alcantara da; CARRAPATO, Josiane Lozigia Fernandes; SANINE, Patricia Rodrigues; MACHADO, Dinair Ferreira; MENDONCA, Carolina Siqueira; ZARIL, Thais Fernanda Tortorelli; NUNES, Luceime Olivia; MONTI, Jose Fernando Casquel; HARTZ, Zulmira Maria de Araujo; NEMES, Maria Ines BattistellaOBJECTIVE: To evaluate the performance of comprehensive care for older adults in primary care services in the Brazilian Unified Health System in the state of Sao Paulo, Brazil. METHODS: A total of 157 primary care services from five health regions in midwestern Sao Paulo responded, from October to December 2014, the pre-validated 2014 questionnaire for primary care services assessment and monitoring. We selected 155 questions, based on national policies and guidelines on this theme. The responses indicate the service performance in older adults' care, clustered into three areas of analysis: health care for active and healthy aging (45 indicators, d1), chronic noncommunicable diseases care (89 indicators, d2), and support network in aging care (21 indicators, d3). Performance was measured by the sum of positive (value 1) or negative (value 0) responses for each indicator. Services were clustered according to k-means of the performance scores of each domain. After weighting the domains (Z tests), we estimated the associations between the scores of each domain and independent management variables (typology, planning and evaluation of services), with simple and multiple linear regression. RESULTS: Chronic noncommunicable diseases care (d2) showed, for all clusters, better average performance (55.7) than domains dl (35.4) and d3 (39.2). Service performance in the general area of planning and evaluation associates with the performance of older adults' care. CONCLUSIONS: The evaluated services had incipient implementation of comprehensive care for older adults. The evaluation framework can contribute to processes to improve the quality of primary health care.
- Importance of local management for delivery of primary health care according to Alma-Ata principles(2018) NUNES, Luceime Olivia; CASTANHEIRA, Elen Rose Lodeiro; DIAS, Adriano; ZARILI, Thais Fernanda Tortorelli; SANINE, Patricia Rodrigues; MENDONCA, Carolina Siqueira; MONTI, Jose Fernando Casquel; CARRAPATO, Josiane Fernandes Lozigia; PLACIDELI, Nadia; NEMES, Maria Ines BattistellaObjective. To describe the characteristics of the management process in primary health care units as well as the profile of managers, and to discuss the implications of these elements for the attainment of Unified Health System principles in Brazil in accordance with the propositions of the Alma-Ata Declaration. Method. This descriptive, cross-sectional study used data collected with the Primary Care Service Quality Assessment tool (QualiAB), a self-administered, web-based instrument. QualiAB was voluntarily answered by 157 unit managers from 41 municipalities in the state of Sao Paulo from October to December 2014. Results. Of 157 units, 67 (42.7%) were family health care units and 58 (36.9%) were ""traditional"" units; 95 (60.5%) were located in urban peripheries. At the time of the study, eight (5.0%) units did not have a manager and eight (5.0%) were managed by the city health secretary. Almost 80% of the managers were nurses and performed multiple tasks in addition to management. Multidisciplinary support (technical supervision as a means of continuing education) was available in 75 (47.7%) units; 60 (38.2%) units did not have any kind of multidisciplinary support. Participation in evaluative processes was mentioned in 130 (82.8%) units. The main results of evaluations were planning and reprogramming of activities with the engagement of the multiprofessional team in 40 units (25.5%) and definition of an annual activity plan in 38 (24.2%). Twenty-nine units (17.8%) did not have access to the results of evaluations. Conclusion. The study supports the importance of work process management and the need to (re)invest in training and recognition of local management as a strategy to produce primary health care that is capable of promoting health as a right and a condition of citizenship.
- The QualiRede intervention: improving the performance of care continuum in HIV, congenital syphilis, and hepatitis C in health regions(2019) NEMES, Maria Ines Battistella; CASTANHEIRA, Elen Rose Lodeiro; ALVES, Ana Maroso; ADANIA, Carolina Simone Souza; LOCH, Ana Paula; MONROE, Aline Aparecida; SOUZA, Rosa Alencar; GIANNA, Maria Clara; CAMINADA, Sirlene; FARIAS, Norma Suely de Oliveira; SOUSA, Paula de Oliveira e; DOMINGUES, Carmen Silva Bruniera; SILVA, Mariliza Henrique da; CERVANTES, Vilma; YAMASHIRO, Juliana; CARACIOLO, Joselita Maria de Magalhães; SILVA, Fabiano Lima da; NEMES FILHO, Alexandre; JESUS, Gabriel Lima de; HELENA, Ernani Tiaraju de Santa; ALBIERO, José Francisco Gontan; LIMA, Marcela Soares Silveira; BELLENZANI, Renata; KEHRIG, Ruth Terezinha; VALE, Felipe Campos do; NUNES, Luceime Olivia; MENDONÇA, Carolina Siqueira; ZARILI, Thais Fernanda Tortorelli; VILELA, Mara Cristina; DANTAS, Jean Carlos de Oliveira; PAULA, Ivone de; TAYRA, Ângela; COELHO, Débora Moraes; SANTOS, Glauber Palha dos; QUEVEDO, Dulce Castro; SILVA, Marcia Aparecida da; SILVA, Iraci Batista da; NASSER, Mariana Arantes; ANDRADE, Marta Campagnoni; SANTOS, Maria Altenfelder; MERCURI, Juliana; TRINDADE, Katia Valeska; NEVES, Maria Aparecida Teixeira das; TOLEDO, Renata Villanueva Alves de; ALMEIDA, Maria Cecília Rossi de; LIMA, Iraty NunesABSTRACT Introduction: Care continuum models have supported recent strategies against sexually transmitted diseases, such as HIV and Hepatitis C (HCV). Methods: HIV, HCV, and congenital syphilis care continuum models were developed, including all stages of care, from promotion/prevention to clinical control/cure. The models supported the intervention QualiRede, developed by a University-Brazilian National Health System (SUS) partnership focused on managers and other professionals from six priority health regions in São Paulo and Santa Catarina. Indicators were selected for each stage of the care continuum from the SUS information systems and from the Qualiaids and QualiAB facility’s process evaluation questionnaires. The indicators acted as the technical basis of two workshops with professionals and managers in each region: the first one to identify problems and to create a Regional Technical Group; and the second one to design action plans for improving regional performance. Results: The indicators are available at www.qualirede.org. The workshops took place in the regions of Alto Tietê, Baixada Santista, Grande ABC, and Registro (São Paulo) and of Foz do Rio Itajaí (Santa Catarina), which resulted in regional action plans in São Paulo, but not in Santa Catarina. A lack of awareness was observed regarding the new HIV and HCV protocols, as well as an incipient use of indicators in routine practices. Conclusion: Improving the performance of the care continuum requires appropriation of performance indicators and coordination of care flows at local, regional, and state levels of management.