Autor: lariisasd

Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities.

Abstract: Starting in the late 1980s, many Latin American countries began social sector reforms to alleviate poverty, reduce socioeconomic inequalities, improve health outcomes, and provide financial risk protection. In particular, starting in the 1990s, reforms aimed at strengthening health systems to reduce inequalities in health access and outcomes focused on expansion of universal health coverage, especially for poor citizens. In Latin America, health-system reforms have produced a distinct approach to universal health coverage, underpinned by the principles of equity, solidarity, and collective action to overcome social inequalities. In most of the countries studied, government financing enabled the introduction of supply-side interventions to expand insurance coverage for uninsured citizens—with defined and enlarged benefits packages—and to scale up delivery of health services. Countries such as Brazil and Cuba introduced tax-financed universal health systems. These changes were combined with demand-side interventions aimed at alleviating poverty (targeting many social determinants of health) and improving access of the most disadvantaged populations. Hence, the distinguishing features of health-system strengthening for universal health coverage and lessons from the Latin American experience are relevant for countries advancing universal health coverage.

Abstract: This paper presents improvements of LARIISA, a framework that makes use of context-aware information to support decision-making and governance in the public health area. More specifically, two relevant e-health applications are presented to illustrate the LARIISA system. The first one uses Bayesian networks in dengue scenarios. The second application uses ontology to manage home care scenarios. In both cases, the contributions related to the LARIISA framework include patient health diagnosis provided remotely, support for decision-making health systems, and context information for context-aware health systems.

Abstract: LARIISA is a framework that makes use of context-aware to support decision-making and governancein the public health area. This paper presents the CLARIISA, an evolution of LARIISA towards an intelligent classifier model for enhancing the decision making process. Two applications are shown to illustratethe upgrade on the LARIISA system. The first one uses the Bayesian networks on a dengue case. The second uses ontology to manage home care scenarios. In both cases, the contributions related to our framework include patient health diagnosis provided remotely, support for decision making health systems, and context information for context-aware health systems.

Abstract: Introduction:
The Brazilian National Health System May Reduce Inequalities In Access To Health Services Through Strategies That Can Reach Those Most In Need With no Access To Care Services.

Objective:
To Identify Factors Associated With The Use Of Health Service By Children Aged 5 To 9 Years In The City Of Sobral, Ceará, Northeastern Brazil.

Results:
Only 558 (17.0%) Children Used Health Care Services In The 30 Days Preceding This Survey. Children With Any Health Condition (or = 3.90) Who Were Frequent Attenders Of Primary Care Strategy Of Organization (the Family Health Strategy, Fhs) (or = 1.81) And Living In The City’s Urban Area (or = 1.51) Were More Likely To Use Health Services. Almost 80% Of Children Used Fhs as Their Referral Care Service. Children From Poorer Families And With Easier Access To Services Were More Likely To Be Fhs Users.

Conclusion:
The Study Showed That Access To Health Services Has Been Relatively Equitable Through The Fhs, a Point Of Entry To The Local Health System.

Social Determinants Of Health; Health Service/utilization; Health Services Accessibility; Equity; Family Health; Child Health Services

Agradeço a oportunidade de participar dessa discussão que envolve tema tão relevante para o SUS. Oswaldo Tanaka nos brinda com um texto instigante e oportuno, face aos desafios apresentados para o estabelecimento de sistemas universais de saúde, principalmente no que diz respeito aos três domínios analisados: gestão, avaliação e tomada de decisão.