LIZA YURIE TERUYA UCHIMURA
Projetos de Pesquisa
Unidades Organizacionais
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Regionalization of health surveillance: a performance evaluation proposal in a health region in Brazil(2017) ALBUQUERQUE, Ana Coelho de; CESSE, Eduarda Ângela Pessoa; FELISBERTO, Eronildo; SAMICO, Isabella; UCHIMURA, Liza Yurie Teruya; ESTIMA, NathalieAbstract Objectives: To evaluate the performance of the regionalization of the Vigilância em Saúde (VS) (Health Surveillance) in a region in Sao Paulo State. Methods: a quantitative cross-sectional study was carried out at the V Diretoria Regional de Saúde da Secretaria de Saúde do Estado de São Paulo (V Board of the Regional Health Secretary of São Paulo State Health Department). A structured questionnaire was developed from the three dimensions of the research (Policy, Structure and Organization). The escore médio (EM) (average score) was used as the central tendency and for each dimension and attributes, the synthetic indices were constructed. Three cutoff points for assessing the performance were assigned: values equal to or below 4.99 were considered unsatisfactory; between 5.00 and 6.99, intermediaries; and equal to or above 7.00, satisfactory. Results: The performance of the regionalization of the VS was considered satisfactory, with emphasis on the 'Policy' (EM 8.51) and 'Organization' (EM 8.18) dimensions. The ‘Structure’ obtained intermediate performance (EM 6.78). The proposed methodology demonstrated to be appropriate to evaluate the performance of the regionalization of VS, because its strengths and weaknesses were allowed to be identified. Conclusions: despite of the regionalization is an ongoing process, it is necessary for the establishment of a political project that will take up effectively as a strategy for the reorganization of the healthcare in Brazil.
- Contributions on the regionalization process in two regions in the Southeast of Brazil(2017) UCHIMURA, Liza Yurie Teruya; FERREIRA, Maria Paula; SOUZA, Miriam Regina; VIANA, Ana Luiza d’ÁvilaAbstract Objectives: to analyze the contributions of regionalization in North-Barretos and South-Barretos regions, focusing on political, structural and organizational changes. Methods: mixed sequential explanatory methods using records analysis from the Comissão Intergestores Regional (CIR) (Regional Inter-managers Commission (CIR), interviews with questionnaire and guides along with 42 key agents (managers and providers of services) conducted in August 2015. The descriptive statistical results were presented with mean scores for each of the question in the questionnaire. The analysis of the thematic content was performed by using the Atlas-ti software and categories of the mixed themes were generated representing the following dimensions: policy, structure and organization. Results: the study identified that the Estrutura Regional da Secretaria Estadual de Saúde (Regional Structure of the State Health Department) is the most important institution in health policy decisions. Several contributions can be identified in the process of regionalization, mainly in the organizational aspect of the health system. The records demonstrated the frequent presence of themes related to networks, regulation and financing and the definition of flow of patients. Conclusions: regionalization in the North-Barretos and South-Barretos regions have contributed for a better organization in health actions and services. The intergovernmental forums do not work with coordination and they are not a collaborative place to negotiate health issues in these regions in São Paulo State
- Physicians’ circularity in health regions in Brazil(2017) SEIXAS, Paulo Henrique; UCHIMURA, Liza Yurie Teruya; VIANA, Ana Luiza d’Ávila; SILVA, Rodrigo Calado daAbstract Objectives: to characterize the medical circularity in Brazil and to discuss the case in the North and South Barretos regions, São Paulo. Methods: a cross-sectional study using secondary data from the national registrations and a case study of physician’s sample in the North-Barretos and South-Barretos regions. Results: in the health regions in Brazil, on an average, 45% of the physicians in activities circulate in more than one region. The Capitals of the States have more stable physicians while more than 50% of the medical workforce work in other regions. The professionals with the greatest tendency to move from one work place to another are those who work in surgical specialties in services to uphold the diagnostic and therapy. Conclusions: there is a high circulation of physicians among the regions, with distinct characteristics between geographical and health regions. In case of Barretos area, the professionals move from one workplace to another according to their professional association and specialized practice.
- Evaluation performance in health regions in Brazil(2017) UCHIMURA, Liza Yurie Teruya; FELISBERTO, Eronildo; FUSARO, Edgar Rodrigues; FERREIRA, Maria Paula; VIANA, Ana Luiza d' ÁvilaAbstract Objectives: To propose a regional synthetic indicator (ISR) to evaluate the health system performance in Brazilian regions based on a national database source available free of charge in a global network of computers. Methods: a cross-sectional study using secondary data, considered seven variables of five dimensions in the health system (population's health conditions, health system coverage, financing, human resources and SUS production) analyzed from a survey of 438 Brazilian regions and adopted factor analysis and cluster models, conditioned by variables, such as: socioeconomic development, offering and service complexity and which resulted in a grouping of five strata. Results: mapping and scheduling based on ISR in health regions in Brazil and a detailed analysis of different indicators that compose them. The regions that showed better perfor-mance are in the Southeast, South and Midwest. Conclusions: This article sums efforts of other authors to extend the evaluation studies in health systems in a regional level. In addition, it is expected that the researches broaden their scope and implement the discussions about the process of regionalization in order to provide health policies, a universalized access and care comprehensiveness.
- The Regionalization Process in Brazil: influence on Policy, Structure and Organization dimensions(2017) VIANA, Ana Luiza d'Ávila; FERREIRA, Maria Paula; CUTRIM, Maria Alice; FUSARO, Edgar Rodrigues; SOUZA, Miriam Regina de; MOURÃO, Laís; PEREIRA, Ana Paula Chancharulo de Moraes; MOTA, Paulo Henrique dos Santos; IOZZI, Fabíola Lana; UCHIMURA, Liza Yurie TeruyaAbstract Objectives: to analyze the influence and performance on Policy, Structure and Organization dimensions in the regionalization process in five health regions in Brazil. Methods: a quantitative, cross-sectional study using primary data from 217 fulfilled interviews with managers, service providers and representatives of society in five health regions in Brazil. Calculation on the Influence Index that measures the contribution level of three dimensions in regionalization. Results: after analyzing the three dimensions that influence the regionalization process separately, it is necessary to point out that there is a better performance on the Policy dimension in front of all the others; on the other hand, Structure dimension shows itself to be feeble, configuring a real obstacle to progress the regionalization process; Organization occupies an intermediate place in all the regions of the study. The insufficient availability of physical, human and financial resources impedes to advance the regionalization and the achievement of its major objectives, which are the integration of services and coordination care. Conclusions: regionalization follows an uncertain path and without clear direction of its objectives, goals and deployed instruments. The Regional planning, in the case of health, is still a theoretical exercise.
- O processo de regionalização do SUS: revisão sistemática(2017) MELLO, Guilherme Arantes; PEREIRA, Ana Paula Chancharulo de Morais; UCHIMURA, Liza Yurie Teruya; IOZZI, Fabíola Lana; DEMARZO, Marcelo Marcos Piva; VIANA, Ana Luiza d’ÁvilaAbstract This review focuses only on specific studies into the SUS regionalization process, which were based on empirical results and published since 2006, when the SUS was already under the aegis of the Pact for Health framework. It was found that the regionalization process is now underway in all spheres of government, subject to a set of challenges common to the different realities of the country. These include, primarily, that committee-structured entities are valued as spaces for innovation, yet also strive to overcome the bureaucratic and clientelist political culture. Regional governance is further hampered by the fragmentation of the system and, in particular, by the historical deficiency in planning, from the local level to the strategic policies for technology incorporation. The analyses enabled the identification of a culture of broad privilege for political negotiation, to the detriment of planning, as one of the main factors responsible for a vicious circle that sustains technical deficiency in management.
- Region and Networks: multidimensional and multilevel approaches to analyze the health regionalization process in Brazil(2017) VIANA, Ana Luiza d'Ávila; BOUSQUAT, Aylene; FERREIRA, Maria Paula; CUTRIM, Maria Alice Bezerra; UCHIMURA, Liza Yurie Teruya; FUSARO, Edgar Rodrigues; SOUZA, Miriam Regina de; MOTA, Paulo Henrique dos Santos; PEREIRA, Ana Paula Chancharulo de Morais; IOZZI, Fabíola Lana; ALBUQUERQUE, Mariana Vercesi deAbstract Objectives: to present a methodology used by the Policy, Planning and Region Management research and the Health Care Networks in Brazil - the Regions and Networks research. Methods: description of the analytical scheme in the process of choosing health regions and criteria to select cities and health units, instruments for collecting primary and secondary data and the indicators database, besides the regional typology elaborated for data analysis. Results: the analytical scheme is based on the health policy analysis; policy, structure and organization were defined as the macro dimensions. For each one of these, sub-dimensions were defined. The questionnaire was elaborated by variables that were possible to analyze the regionalization process determinants. Five health regions were selected from the previously defined criteria. Conclusions: the method allowed to establish attributes in the regionalization, constructed by specific components - integration, coordination and regulation. The multilevel approach was important because it portrayed different perceptions from the stakeholder managers and providers according to their bonds in the city, regional and state scenarios.
- Tipologia das regiões de saúde: condicionantes estruturais para a regionalização no Brasil(2015) VIANA, Ana Luiza D´Ávila; BOUSQUAT, Aylene; PEREIRA, Ana Paula Chancharulo de M.; UCHIMURA, Liza Yurie Teruya; ALBUQUERQUE, Mariana Vercesi de; MOTA, Paulo Henrique dos Santos; DEMARZO, Marcelo Marcos Piva; FERREIRA, Maria PaulaThe socioeconomic development, supply and complexity of health actions and services in a regional context may be considered structural constraints to the success of the current process of health care regionalization in Brazil. The main objective of this study is to identify the structural determinants of the regionalization process by building a typology of health regions in Brazil. A typology of Brazilian health regions was developed from available secondary data sources. The dimensions and groups that form the typology were identified through factor analysis and cluster analysis. The type of service provider both for out and inpatients was also identified. Results: the regions were classified into five independent groups according to their socioeconomic profile and characteristics of the health service supply. The characterization of Brazilian health regions through the typology demonstrates high levels of heterogeneity throughout Brazil, and the complex organization of the regional health systems. The proposed typology could contribute to future research and better understanding of this complex and contradictory scenario, supporting the urgently required development of integrated regional public policies that simultaneously involve economic and social development and the strengthening of regional spaces of governance in order to promote the organization of regional health systems grounded on the principles of the SUS (Brazilian National Health System), under a shared, joint management with the objective of ensuring the universal right to health.
- Unidades de Pronto Atendimento (UPAs): características da gestão às redes de atenção no Paraná(2015) UCHIMURA, Liza Yurie Teruya; VIANA, Ana Luiza d'Ávila; SILVA, Hudson Pacífico da; IBAñEZ, NelsonThe Emergency Care Units (UPAs) are classified from the National Policy of Emergency Care, according to the installed physical capacity, the number of beds available, people management, and the ability to perform daily medical consultations. This study aimed to identify the structural characteristics and of service planning of the UPAs of the Paraná care networks. It is a case study with semi-structured interviews carried out with UPAs coordinators, in 2012. The data were stored and analyzed in absolute and relative frequencies. The UPAs need to be integrated into a health care network policy to expand its resoluteness.
- Managers and clinicians: Perceptions of the impact of regionalization in two regions in Canada(2019) UCHIMURA, L.Y.T.; VIANA, A.L.D.; MARCHILDON, G.P.The aim of this paper is to examine the approach taken to regionalization in Ontario, Canada, and its impact on health system performance as perceived by managers and clinicians. This is a qualitative study, with thematic analysis, based on interviews with 23 managers and clinicians working in primary healthcare and emergency care in two regions of Ontario. Our findings demonstrate that both sets of actors see regional structures as contributing significantly to improving their respective health system although they also identify areas that require improvement. Managers and clinicians agreed on propositions to focus on health determinants, major considerations specific to the local context (population, geography) and support for a three-level system with well-defined functions. However, they also expressed differing propositions about the political power of hospitals. © 2019 The Canadian College of Health Leaders.