ANA LUIZA D AVILA VIANA
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
13 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 13
- Regionalização e acesso à saúde nos estados brasileiros: condicionantes históricos e político-institucionais(2012) LIMA, Luciana Dias de; VIANA, Ana Luiza d'Avila; MACHADO, Cristiani Vieira; ALBUQUERQUE, Mariana Vercesi de; OLIVEIRA, Roberta Gondim de; IOZZI, Fabiola Lana; SCATENA, Joao Henrique Gurtler; MELLO, Guilherme Arantes; PEREIRA, Adelyne Maria Mendes; COELHO, Ana Paula SantanaThis article examines the healthcare regionalization process in the Brazilian states in the period from 2007 to 2010, seeking to identify the conditions that favor or impede this process. Referential analysis of public policies and especially of historical institutionalism was used. Three dimensions sum up the conditioning factors of regionalization: context (historical-structural, political-institutional and conjunctural), directionality (ideology, object, actors, strategies and instruments) and regionalization features (institutionality and governance). The empirical research relied mainly on the analysis of official documents and interviews with key actors in 24 states. Distinct patterns of influence in the states were observed, with regionalization being marked by important gains in institutionality and governance in the period. Nevertheless, inherent difficulties of the contexts prejudice greater advances. There is a pressing need to broaden the territorial focus in government planning and to integrate sectorial policies for medium and long-term regional development in order to empower regionalization and to overcome obstacles to the access to healthcare services 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.
- Atenção primária à saúde e coordenação do cuidado nas regiões de saúde: perspectiva de gestores e usuários(2017) BOUSQUAT, Aylene; GIOVANELLA, Ligia; CAMPOS, Estela Márcia Saraiva; ALMEIDA, Patty Fidelis de; MARTINS, Cleide Lavieri; MOTA, Paulo Henrique dos Santos; MENDONÇA, Maria Helena Magalhães de; MEDINA, Maria Guadalupe; VIANA, Ana Luiza d’Ávila; FAUSTO, Márcia Cristina Rodrigues; PAULA, Daniel Baffini deAbstract This paper aims to analyze the healthcare coordination by Primary Health Care (PHC), with the backdrop of building a Health Care Network (RAS) in a region in the state of São Paulo, Brazil. We conducted a case study with qualitative and quantitative approaches, proceeding to the triangulation of data between the perception of managers and experience of users. We drew analysis realms and variables from the three pillars of healthcare coordination – informational, clinical and administrative/organizational. Stroke was the tracer event chosen and therapeutic itineraries were conducted with users and questionnaires applied to the managers. The central feature of the construction of the Health Care Network in the studied area is the prominence of a philanthropic organization. The results suggest fragility of PHC in healthcare coordination in all analyzed realms. Furthermore, we identified a public-private mix, in addition to services contracted from the Unified Health System (SUS), with out-of-pocket payments for specialist consultation, tests and rehabilitation. Much in the same way that there is no RAS without a robust PHC capable of coordinating care, PHC is unable to play its role without a solid regional arrangement and a virtuous articulation between the three federative levels.
- O Pacto pela Saúde e o processo de regionalização no estado de Mato Grosso(2015) MARTINELLI, Nereide Lúcia; VIANA, Ana Luiza d'Ávila; SCATENA, João Henrique GurtlerThe regionalization of health in the state of Mato Grosso started in the 1990s. In this work, it was analyzed the performance of the State Secretary of Health, in the period 2006-2011, by the dimensions: institutional, governance and impacts of regionalization, in order to identify whether the bases established in the presence of the Pact facilitated it or hindered it. Secondary data were used, documents and also interviews with state, region and municipal managers. The rules instituted facilitated, but the regionalized structures had their functions modified; the regionalization process was partially implemented and poses challenges to federal entities to advance in its consolidation.
- Descentralização e regionalização: dinâmica e condicionantes da implantação do Pacto pela Saúde no Brasil(2012) LIMA, Luciana Dias de; QUEIROZ, Lucia F. N. de; MACHADO, Cristiani Vieira; VIANA, Ana Luiza d'AvilaDecentralization and regionalization represent constitutional guidelines for the organization of the Unified Health System, which in the last 20 years has required the adoption of mechanisms to coordinate and accommodate federative tensions in Brazil's healthcare sector. This paper analyzes the national implementation of the Health Pact between 2006 and 2010 involving a strategy that reconfigures intergovernmental relations in the sector. The study involved the analysis of documents, official data and interviews with federal, state and municipal managers in the Brazilian states. The content of the national proposal is initially discussed, including its implications for health policy. The different rhythms and degrees of implementation of the Health Pact are then reviewed, with respect to adherence by states and municipalities and the formation of Regional Management Boards. Lastly, the conditioning factors for the multiplicity of experiences observed in the country are identified and the challenges facing progress toward a decentralized and regionalized health system in Brazil are discussed.
- SUS management in interstate health regions: assessment of the government´s capacity(2022) ALELUIA, Italo Ricardo Santos; MEDINA, Maria Guadalupe; VILASBOAS, Ana Luiza Queiroz; VIANA, Ana Luiza DAvilaThis study displays an assessment of SUS management in a Brazilian interstate health region. An evaluative study was conducted with levels of regional analysis and data production, combining interviews with key informants and documentary analysis. Sources and data were compared and linked to analytical categories of the Government Triangle, showing a cutout of the outcomes and the government???s capacity as-sessment. There is a low capacity for government in interstate health regions when managers and co-management spaces are unable to influence regional political decisions, limiting themselves to normative and ratifying government strategies. Disparities in the management capacity among the border states prevent the sustainability of co-ordinating state decision-making goals, exposing that management strategies are not enough to in-stitutionalize interstate regionalization. There is a predominance of low SUS governance capacity in interstate health regions, and its political pat-tern becomes an unclear project restricted to the ideological level. The broad documentary appre-ciation with the use of powerful theoretical ref-erential are methodological contributions of this research for the political analysis of SUS manage-ment in spaces that were the least examined, such as interstate borders.
- 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.