Abstract Research and literature on the juvenile criminal justice system in Brazil has focused on the specific legal aspects and rights guarantees of the procedures related to the apprehension of adolescents in flagrante delicto, without highlighting the issues related to the obstacles to the investigation of violence committed at the time of apprehension. As for the criminal justice system, the creation and disputes related to pre-trial hearings have shed light on the first moments immediately after the arrest of adults in flagrante delicto and the importance of structuring a state support network for the collection and recording of any violence committed at the time of arrest. In this article, we seek to understand to what extent the difference between the two procedures creates a dichotomy between mechanisms for determining violence, what are possible reasons for resistance to incorporating pre-trial hearings into the juvenile justice system, and what are the possible ways to deepen the debate on police violence and the presentation to authorities of the justice systems. pretrial pre trial article systems

Resumo As pesquisas e produções bibliográficas sobre o sistema de justiça juvenil criminal no Brasil têm se debruçado aos aspectos jurídicos e garantias de direitos específicos dos procedimentos relacionados à apreensão de adolescentes em flagrante, sem darem destaque às questões ligadas aos entraves para apuração de violências cometidas no momento das apreensões. Já em relação ao sistema de justiça criminal, a criação e as disputas relacionadas às audiências de custódia têm lançado luz aos primeiros momentos imediatamente após a prisão em flagrante de adultos e a importância da estruturação de uma rede de apoio do Estado para a coleta e o registro de eventuais violências cometidas no momento da prisão. Neste artigo, busca-se compreender em que medida a diferença entre os dois procedimentos cria uma dicotomia entre mecanismos de apuração de violências, quais seriam possíveis motivos para a resistência da incorporação das audiências de custódia para o sistema de justiça juvenil, e quais os caminhos possíveis para aprofundar o debate sobre violência policial e a apresentação a autoridades dos sistemas de justiças. apreensões artigo buscase busca justiças

ABSTRACT: Both in International Law and in different domestic legal systems, the territorial rights of indigenous peoples have been interpreted following an “eco-cultural” understanding. This understanding bases the recognition of territorial rights primarily on the need to protect the material and spiritual link of these peoples with their territories. In this article, I will argue that the use of this kind of interpretation carries two risks for the indigenous peoples themselves. On the one hand, it could limit the recognition of rights to only those peoples who maintain a traditional and sustainable occupation and use of their lands and resources. On the other, it could restrict the type of use that indigenous peoples can make of their lands, territories, and resources.

RESUMEN: Tanto en el Derecho Internacional como en diferentes ordenamientos jurídicos domésticos, los derechos territoriales de los pueblos indígenas han sido interpretados siguiendo una comprensión “eco-cultural”. Esta comprensión basa el reconocimiento de derechos principalmente en la necesidad de proteger el vínculo material y espiritual de estos pueblos con sus territorios. En este artículo, sostendré que la utilización de este tipo de interpretación conlleva dos riesgos para estos propios pueblos. Por una parte, puede limitar el reconocimiento de derechos solo a aquellos pueblos que mantengan una posesión tradicional de sus territorios. Por otra, puede restringir el tipo de uso que los pueblos o comunidades indígenas puedan hacer de sus tierras, territorios y recursos.

Abstract The objective of this article is to analyze the transformations in the legal-social discourses around incest, emanating from liberal reformism and the legal transition during the second half of the 19th century, in Michoacán. We start from the fact that the enactment of the Civil Marriage Act (1859) upended the legal systems by reducing the fields in which incest was committed. From that moment on, the lawsuits began to move away from the spiritual terrain, to have only legal repercussions of a criminal nature. Through the methodology of discourse analysis and having as main sources judicial records, legislation and literature of the time, the changes that occurred in the sixties in the justice delivery system, the reduction of incest files and the generation of new discursive nodes are enunciated, all of which outlines modifications in the representations of said crime.

Resumen El objetivo del artículo es analizar las transformaciones en los discursos jurídico-sociales en torno al incesto, emanados del reformismo liberal y la transición jurídica durante la segunda mitad del siglo XIX, en Michoacán. Partimos del hecho de que la promulgación de la Ley de Matrimonio Civil (1859) trastocó los ordenamientos legales al reducir los campos en que se cometía incesto. A partir de ese momento, las demandas judiciales comenzaron a alejarse del terreno espiritual, para tener únicamente repercusiones legales de orden penal. Mediante la metodología del análisis del discurso y teniendo como fuentes principales expedientes judiciales, legislación y literatura de la época, se enuncian los cambios ocurridos en los años sesenta en el sistema de impartición de justicia, la reducción de expedientes de incesto y la generación de nuevos nodos discursivos, lo cual bosqueja modificaciones en las representaciones de dicho delito.

Abstract: The article explores the growing integration of AI in the military sphere. It highlights its potential to improve efficiency and accuracy in field operations, predictive analytics, and logistics due to its ability to process large volumes and learn autonomously. The study also emphasizes the role of AI in analyzing data from various sources such as satellite images, intelligence information and social media, which helps in target identification and operation of autonomous vehicles. It also addresses important ethical and legal challenges, including transparency in decision-making and liability for errors or collateral damage. It raises concerns about the vulnerability of military systems to attack, their tampering and the potential for accidental damage. The research employs a qualitative review of existing literature on types of AI and applications in the military context, focusing on benefits and risks. The study aims to synthesize key issues related to military AI capabilities, oversight, and governance, providing directions and precautions for responsible development of AI in defense.

Abstract The aging of the world population intensifies discussions about the inadequacy of cities to meet the needs of older people. Free public transport is not enough to provide greater inclusion for this age group. This article aims to present reflections on the effectiveness of free public transport for the inclusion of older people in the city of São Paulo. Qualitative, exploratory research and a documentary survey were carried out. As a result, complementary items are suggested for the implementation of free public transport for older people, relating to public policies, infrastructure, transport systems, education, and incorporation of technologies. It is concluded that these suggestions contribute to the proposition of aspects to be addressed in future studies and the new Legal Framework for Collective Public Transport, aiming at more inclusive cities. group Paulo Qualitative out result policies infrastructure systems education technologies Transport

Resumo O envelhecimento da população mundial acirra as discussões sobre a inadequação das cidades às suas necessidades. A gratuidade no transporte público não basta para proporcionar maior inclusão da pessoa idosa. Este artigo visa apresentar reflexões acerca da efetividade do transporte público gratuito para a inclusão de pessoas idosas na cidade de São Paulo. Realizaram-se uma pesquisa qualitativa, exploratória, e um levantamento documental. Como resultado, sugerem-se itens complementares à implementação da gratuidade no transporte público para pessoas idosas, relativos a políticas públicas, infraestrutura, sistemas de transporte, educação e incorporação de tecnologias. Conclui-se que essas sugestões contribuem para a proposição de aspectos a serem endereçados em estudos futuros e no novo Marco Legal do Transporte Público Coletivo, visando a cidades mais inclusivas. necessidades idosa Paulo Realizaramse Realizaram se qualitativa exploratória documental resultado sugeremse sugerem públicas infraestrutura tecnologias Concluise Conclui Coletivo inclusivas

ABSTRACT Death processes have been progressively transferred to hospital spaces due to biomedicalization and the use of technologies, generating important challenges for healthcare systems. The COVID-19 pandemic exposed the lack of unified criteria and principles for a dignified death in the hospital. This study corresponds to a narrative review using Higgins & Green's methodological framework as a reference. A systematized search was carried out with the question: What are the elements considered in the decision-making of hospital teams regarding access and use of life support technology and dying processes in adult critically ill patients? The searches conducted during October 2022 in MEDLINE/PubMed, Scopus, Science Direct, CINAHL, Biblioteca Virtual en Salud (BVS), Cochrane Library, and Scielo identified 1499 records for screening, and 148 were retrieved for full-text review. Eighty-four articles were included in the review, identifying seven categories. The evidence shows variability in decision-making associated with the clinical status of the patient, the criteria of the medical professional, added to structural elements of the health system and political-legal aspects. The literature recommends reflexive, dynamic, flexible, and individualized decision-making processes that consider the patient's preferences, clinical judgment, prognosis, and available resources. Communication, advance care planning, interdisciplinary discussions, external consultations, and the involvement of ethical committees are crucial throughout the process.

RESUMEN Los procesos de muerte han sido transferidos progresivamente a los espacios hospitalarios producto de la biomedicalización y el uso de tecnologías, generando importantes desafíos para los sistemas sanitarios. La pandemia por COVID-19 dejo al descubierto la falta de criterios unificados, y de principios para una muerte digna en el hospital. Este estudio corresponde a una revisión narrativa que utiliza como referencia el marco metodológico de Higgins & Green. Se realizó una búsqueda sistematizada con la pregunta: ¿Cuáles son los elementos considerados en la toma de decisiones de equipos hospitalarios respecto al acceso y uso de la tecnología de soporte vital y procesos de muerte en pacientes críticos adultos? Las búsquedas realizadas durante octubre de 2022 en MEDLINE/PubMed, Scopus, Science direct, CINAHL, Biblioteca Virtual en Salud (BVS), Cochrane Library y Scielo, identicaron1.499 registros para screening, 148 fueron recuperados para revisión en texto completo. 84 artículos fueron incluidos en la revisión, identificando siete categorías. La evidencia muestra variabilidad en la toma de decisiones asociada al estado clínico del paciente, al criterio del profesional médico, sumado a elementos estructurales del sistema sanitario y los aspectos político-legales. La literatura recomienda procesos de toma de decisiones reflexivos, dinámicos, flexibles e individualizados que consideren las preferencias del paciente, el juicio clínico, el pronóstico y los recursos disponibles. La comunicación, la planificación anticipada de los cuidados, los debates interdisciplinarios, las consultas externas y la participación de comités éticos son cruciales durante todo el proceso.

Resumen El objetivo general del artículo fue analizar sistemáticamente mediante la revisión de literatura el impacto de la vulneración del derecho a contradicción en el proceso de colaboración eficaz que recurre al empleo de la prueba pericial. La metodología utilizada fue cualitativa, de tipo básico y con diseño de revisión sistemática, por ello contó con una muestra de 6 artículos relacionados con la temática del estudio. Respecto a los resultados, se determinó que la prueba pericial aporta cogniciones de otras materias cuya relación con el Derecho acrecienta la posibilidad de comprender la situación y resolver un juicio de la manera más integral posible, para lo cual también debe cerciorarse el principio de contradicción. Por otra parte, la indagación se limitó al no realizar comparaciones constitucionales con otros sistemas legales para concebir las diferencias constantes que implican concepciones a tener en consideración; sin embargo, el valor del estudio recayó en el reconocimiento del impacto que la vulneración del derecho mencionado implica para las sociedades y los individuos según su responsabilidad y las imputaciones por las cuales deben responder. Finalmente, se concluyó que el principio de contradicción es crucial para un juicio íntegro y debe reforzarse cuando se reciba evidencia desde otras ramas del conocimiento.

Abstract The general objective of the article was to systematically analyze through literature review the impact of the violation of the right to contradiction in the process of effective collaboration that resorts to the use of expert evidence. The methodology used was qualitative, basic and with a systematic review design, so it had a sample of 6 articles related to the subject of the study. Regarding the results, it was determined that the expert evidence provides cognitions of other matters whose relationship with the Law increases the possibility of understanding the situation and resolving a trial in the most comprehensive way possible, for which the principle of contradiction must also be ascertained. On the other side, the inquiry was limited by not making constitutional comparisons with other legal systems to conceive the constant differences that imply conceptions to be taken into consideration; however, the value of the study lay in the recognition of the impact that the violation of the aforementioned right implies for companies and individuals according to their responsibility and the imputations for which they must respond. Finally, it was concluded that the adversarial principle is crucial for an integral judgment and should be reinforced when evidence is received from other branches of knowledge.

RESUMEN El artículo tiene como objetivo analizar los problemas actuales del uso de mecanismos filosóficos y legales para garantizar la calidad de la educación superior en las universidades de humanidades. Los autores utilizan una metodología integral, análisis teórico, examen de documentos, análisis comparativo, pensamiento sistémico y análisis de componentes estructurados. Describen la aplicación de mecanismos filosóficos y legales que garantizan la calidad de la educación superior en Kirguistán y Uzbekistán. Se destacan tanto las características generales como específicas de este proceso. Se establece que la base filosófica común para asegurar la calidad en ambos casos es el concepto de desarrollo sostenible, cuya implementación está asegurada por un conjunto de mecanismos legales, organizativos y económicos. Se concluye que la implementación de estos mecanismos para asegurar la calidad de la educación superior se da de manera autónoma. Los documentos no presentan suficientemente el método del programa-objetivo y la planificación indicativa. Al evaluar la eficacia de la gestión de la calidad de la educación en las universidades de humanidades de Kirguistán y Uzbekistán, los autores concluyen que la educación de humanidades no puede considerarse un recurso para el desarrollo sostenible, ya que existen opiniones opuestas de políticos y filósofos académicos en publicaciones científicas y documentos gubernamentales.

ABSTRACT The article aims to analyze the current issues of using philosophical and legal mechanisms to ensure the quality of higher education in humanities universities. The authors use comprehensive methodology, theoretical analysis, document examination, comparative analysis, systems thinking, and structured component analysis. They describe the application of philosophical and legal mechanisms ensuring the quality of higher education in Kyrgyzstan and Uzbekistan. Both general and specific features of this process are highlighted. It is established that the common philosophical basis for ensuring quality in both cases is the concept of sustainable development, whose implementation is ensured by a set of legal, organizational, and economic mechanisms. It is concluded that the implementation of these mechanisms to ensure the quality of higher education occurs autonomously. The documents do not sufficiently present the program-target method and indicative planning. While assessing the effectiveness of education quality management in humanities universities in Kyrgyzstan and Uzbekistan, the authors conclude that humanities education cannot be regarded as a resource for sustainable development since there are opposite opinions of politicians and academic philosophers in scientific publications and government documents.

Resumo O presente artigo é resultado de uma análise comparada entre as diversas espécies de sistemas eleitorais, com o fim de estabelecer as bases para uma justiça eleitoral. São estudadas as principais características de sistemas eleitorais, no que diz respeito às suas funções normativas, executivas e jurisdicionais, bem como a independência e autonomia entre elas; à sua alocação em uma das três esferas de poder estatal; ao recrutamento, à carreira e às prerrogativas dos membros que a integram; e aos princípios fundamentais e diretrizes que orientam suas decisões. O objeto da pesquisa contempla direitos nacionais representativos de sistemas jurídicos de influência do common law e do civil law e, com lastro em normas internacionais, a justiça eleitoral é situada como uma instituição indispensável para a salvaguarda de direitos fundamentais, sob a ótica dos direitos humanos. De modo qualitativo, com suporte legislativo e doutrinário, enseja-se uma exposição e a reflexão sobre as conformações da justiça eleitoral, seus estândares mínimos e o papel que ela desempenha na manutenção de uma democracia. eleitorais normativas jurisdicionais elas estatal recrutamento integram decisões internacionais humanos qualitativo doutrinário ensejase enseja se democracia

Abstract This article is the result of a comparative analysis of the various types of electoral systems, with the aim of establishing the foundations of electoral justice. The main characteristics of electoral systems are studied in terms of their normative, executive and adjudicative functions, as well the independence and autonomy among them; the allocation of such functions to one of the three spheres of state power; the recruitment, career and prerogatives of their members; and the main principles and guidelines orienting their decisions. The research is focused on national rights representative of legal systems influenced by common law and civil law. Based on international norms, electoral justice is contextualized as an indispensable mechanism of safeguarding fundamental rights from a human rights perspective. With a qualitative approach, supported by legislation and legal doctrine, the paper presents and reflects on the forms of electoral justice, its minimum standards, and the role played by such justice in the maintenance of a democracy. The research is focused on the subject of national rights representative of legal systems influenced by common law and civil law; with support from international norms, electoral justice is contextualized as an indispensable institution to safeguard fundamental rights from the perspective of human rights. In a qualitative approach, with support from legislative and doctrinal texts, the article provides an exposition and reflection on the forms of electoral justice, the minimum standards and the role played by such justice in maintaining a democracy. normative them power recruitment members decisions norms approach doctrine democracy texts

Abstract This thesis analyzes the antiterrorism and counterterrorism systems of Argentina, Brazil, and Mexico in response to global Islamic terrorism, particularly following the September 11, 2001 attacks. Although these countries have centered their efforts on immediate threats, such as organized crime, they are not fully prepared to face Islamic terrorism. Antiterrorism laws in these countries need improvements to effectively address this global threat. Public policies on intelligence, cybersecurity, and control of weapons of mass destruction are crucial, but require greater coordination and effectiveness. Counterterrorism forces have significant capabilities but face challenges in terms of training and resources. Globalization has facilitated the expansion of terrorist networks, increasing the risk of attacks in Latin America, which must strengthen its security measures and international cooperation. The growth of the Muslim population and the arrival of Syrian refugees present both opportunities and challenges, underscoring the need for integration policies and prevention of radicalization. The fight against terrorism requires a multidimensional approach, integrating legal, operational, preventive, and international cooperation measures. Argentina, Brazil, and Mexico must adapt and strengthen their security systems to effectively confront global Islamic terrorism.

Resumen Esta tesis analiza los sistemas antiterroristas y contraterroristas de Argentina, Brasil y México frente al terrorismo islámico global, especialmente tras los atentados del 11 de septiembre de 2001. Aunque estos países han centrado sus esfuerzos en amenazas inmediatas como el crimen organizado, no están completamente preparados para enfrentar el terrorismo islámico. Las leyes antiterroristas en estos países necesitan mejoras para abordar eficazmente esta amenaza global. Las políticas públicas en inteligencia, ciberseguridad y control de armas de destrucción masiva son cruciales, pero requieren mayor coordinación y efectividad. Las fuerzas contraterroristas tienen capacidades importantes, pero enfrentan desafíos en términos de entrenamiento y recursos. La globalización ha facilitado la expansión de redes terroristas, aumentando el riesgo de ataques en América Latina, que debe reforzar sus medidas de seguridad y cooperación internacional. El crecimiento de la población musulmana y la llegada de refugiados sirios presentan tanto oportunidades como desafíos, subrayando la necesidad de políticas de integración y prevención de la radicalización. La lucha contra el terrorismo requiere un enfoque multidimensional, integrando medidas legales, operativas, preventivas y de cooperación internacional. Argentina, Brasil y México deben adaptarse y fortalecer sus sistemas de seguridad para enfrentar eficazmente el terrorismo islámico global.

RESUMEN Organizaciones internacionales especializadas debaten permanente sobre la museología. Estas instituciones suelen elaborar recomendaciones que, a pesar de no ser vinculantes, se con sideran normas de soft law, ya que influyen en el derecho interno de los países. No obstante, la influencia del soft law dependerá de cuán permeables sean los sistemas jurídico-administrativos. Por ello, en el presente trabajo se propone analizar la permeabilidad de los países de Latinoamérica y el Caribe a las tendencias globales en torno a los museos a partir de la evaluación de cuatro variables que reconstruyen el grado de implementación de las recomendaciones emanadas de organismos internacionales especializados. Se adopta una metodología de semaforización con una escala de valoración de tres niveles que describe el estado de situación de cada país. Los resultados muestran que los países de la región presentan situaciones muy dispares respecto a la situación de sus museos en el sistema nacional.

ABSTRACT Specialized international organizations discuss museology on an ongoing basis. These institutions usually develop various recommendations that, despite not binding, are considered soft law norms since they influence the generation or modification of the internal law of the countries. However, the influence of these soft law norms will depend on howpermeable the legal- administrative systems are. For this reason, this paper proposes to analyze the permeability of the countries of Latin America and The Caribean to global trends regarding museums based on the evaluation offour variables that reconstruct the degree of implementation of the recommendations issued by specialized international organizations. A traffic light methodology is adopted with a three-level assessment scale that describes the status of each country. The results show that the region’s countries present very different situations regarding the situation of their museums in the national system.

The sanctity of the doctor-patient relationship is deeply embedded in tradition - the Hippocratic oath, medical ethics, professional codes of conduct, and legislation - all of which are being disrupted by big data and 'artificial' intelligence (AI). The transition from paper-based records to electronic health records, wearables, mobile health applications and mobile phone data has created new opportunities to scale up data collection. Databases of unimaginable magnitude can be harnessed to develop algorithms for AI and to refine machine learning. Complex neural networks now lie at the core of ubiquitous AI systems in healthcare. A transformed healthcare environment enhanced by innovation, robotics, digital technology, and improved diagnostics and therapeutics is plagued by ethical, legal and social challenges. Global guidelines are emerging to ensure governance in AI, but many low- and middle-income countries have yet to develop context-specific frameworks. Legislation must be developed to frame liability and account for negligence due to robotics in the same way human healthcare providers are held accountable. The digital divide between high- and low-income settings is significant and has the potential to exacerbate health inequities globally.

Resumen Este artículo es la conferencia presentada en el XI CONGRESO REDOEDA en Curitiba Brasil en 2023. Donde se expone y se reflexionan sobre los resultados de dos proyectos de implementación de sistemas de IA que fueron instalados en la Corte Constitucional y el Consejo de Estado de Colombia; por parte de un equipo mixto de juristas de la Universidad del Rosario y el laboratorio IALAB de la Universidad de Buenos Aires. Acá se reflexiona de como la IA no solo modifica, haciendo más eficiente, el proceso de producir decisiones judiciales, sino igualmente como su implementación, desarrollo y puesta en práctica impacta en la cultura jurídica de las altas cortes, y sus procesos organizacionales. Teniendo un impacto directo en el principio de eficiencia judicial para desarrollar la tutela judicial efectiva, el acceso a la justicia, y la protección en derechos fundamentales.

Abstract This article is the conference presented at the XI REDOEDA CONGRESS in Curitiba Brazil in 2022. Where the results of two projects for the implementation of AI systems that were installed in the Constitutional Court and the Council of State of Colombia are presented and reflected on; by a mixed team of jurists from the Universidad del Rosario and the IALAB laboratory of the University of Buenos Aires. Here we reflect on how AI not only modifies, making more efficient, the process of producing judicial decisions, but also how its implementation, development and putting into practice impacts the legal culture of the high courts, and their organizational processes. Having a direct impact on the principle of judicial efficiency to develop effective judicial protection, access to justice, and protection of fundamental rights.

Resumen: Este artículo tiene como objetivo analizar el desempeño de la red hospitalaria del Sistema Único de Salud brasileño (SUS, por sus siglas en portugués) a partir de las bases de datos nacionales del Sistema de Información Hospitalaria (SIH, por sus siglas en portugués) y del Registro Nacional de Establecimientos de Salud (CNES, por sus siglas en portugués). Para ello, se utilizó un conjunto de indicadores que cubren la producción de hospitalizaciones, el perfil de la atención, la calidad y el desempeño asociados con la capacidad de los hospitales y la naturaleza legal. El análisis de varianza con prueba de Tukey-Kramer se utilizó en el análisis de datos para identificar las diferencias entre los hospitales públicos y privados; el análisis de moderación para verificar el efecto de la capacidad del hospital; y el modelo Pabon Lasso para integrar los resultados. Los resultados mostraron que un aumento en la cantidad de camas influye en el desempeño de los indicadores de manera distinta tanto en los hospitales públicos como en los privados. Los hospitales públicos tuvieron mayor ganancia de eficiencia de escala con el aumento de camas, mientras que los hospitales privados sin fines de lucro mostraron un mejor desempeño en el conjunto de indicadores y más equilibrado en las diferentes capacidades. La aplicación del modelo Pabon Lasso demostró que los pequeños hospitales, tanto públicos como privados, tuvieron un bajo desempeño. También mostró que los hospitales públicos o privados de mediano tamaño tuvieron un buen desempeño. Sin embargo, cada categoría guarda particularidades en su perfil de desempeño, reflejando una diversidad de prácticas y resultados operativos. Por lo tanto, los resultados de este estudio confirman los hallazgos previos de que el desempeño hospitalario tiende a mejorar con el aumento del número de camas, pero también revela que hay una variación significativa dependiendo de la naturaleza legal de estas instituciones. Resumen SUS, SUS (SUS portugués SIH, SIH (SIH CNES, CNES (CNES portugués. . ello hospitalizaciones atención TukeyKramer Tukey Kramer hospital capacidades embargo operativos instituciones

Resumo: O artigo tem como objetivo analisar o desempenho da rede hospitalar do Sistema Único de Saúde (SUS) com base nos bancos de dados nacionais do Sistema de Informações Hospitalares (SIH) e do Cadastro Nacional de Estabelecimentos de Saúde (CNES). A pesquisa utilizou um conjunto de indicadores abrangendo a produção de internações, o perfil de atendimentos, a qualidade e o desempenho, associados ao porte dos hospitais e à natureza jurídica. Para análise de dados, empregou-se: a análise da variância com teste de Tukey-Kramer para evidenciar as diferenças entre hospitais públicos e privados; a análise de moderação para verificar o efeito do porte hospitalar; e o modelo Pabon Lasso para integrar os resultados. Estes demonstram que o aumento no número de leitos influencia o desempenho dos indicadores de maneira distinta para hospitais públicos e privados. Hospitais públicos apresentaram ganhos de eficiência de escala superiores com o aumento de leitos e os privados sem fins lucrativos, um desempenho superior no conjunto de indicadores e mais equilibrado nos diferentes portes. A aplicação do modelo Pabon Lasso demonstrou que hospitais pequenos, tanto públicos quanto privados, apresentam baixo desempenho, e evidenciou também que, a partir do médio porte, os hospitais públicos e privados apresentam um bom desempenho. No entanto, cada categoria exibe particularidades em seu perfil de performance, refletindo uma diversidade de práticas e resultados operacionais. Desse modo, o estudo confirma achados anteriores de que o desempenho hospitalar tende a melhorar com o aumento do número de leitos, mas revela também que ele varia significativamente em função da natureza jurídica dessas instituições. Resumo SUS (SUS SIH (SIH CNES. CNES . (CNES) internações atendimentos empregouse empregou se empregou-se TukeyKramer Tukey Kramer lucrativos portes pequenos entanto performance operacionais modo instituições (CNES

Abstract: This article aims to analyze the performance of the Brazilian Unified National Health System (SUS, acronym in Portuguese) hospital network based on the national databases of the Brazilian Hospital Information System (SIH, acronym in Portuguese) and the Brazilian National Registry of Health Establishments (CNES, acronym in Portuguese). The research used a set of indicators covering the production of admissions, the profile, quality and performance of care, associated with hospital size and legal nature. For data analysis, the Analysis of Variance with Tukey-Kramer test was used to highlight the differences between public and private hospitals, the moderation analysis to verify the effect of hospital size and the Pabon Lasso model to integrate the results. The results show that the increase in the number of beds influences the performance of the indicators differently for public and private hospitals. Public hospitals showed higher gains in scale efficiency with the increase in beds, whereas private non-profit hospitals showed a higher performance in the set of indicators and a more balanced performance in the different sizes. The application of the Pabon Lasso model showed that small hospitals, both public and private, perform poorly. It also showed that from medium-sized onwards, public and private hospitals perform well. However, each category displays particularities in its performance profile, reflecting a diversity of practices and operational results. This study thus confirms previous findings that hospital performance tends to improve as the number of beds increases, but also reveals that it varies significantly depending on the legal nature of these institutions. Abstract SUS, SUS (SUS Portuguese SIH, SIH (SIH CNES, CNES (CNES Portuguese. . admissions profile care TukeyKramer Tukey Kramer nonprofit non profit sizes poorly mediumsized medium sized onwards well However increases institutions

Resumo: O artigo tem como objetivo analisar o desempenho da rede hospitalar do Sistema Único de Saúde (SUS) com base nos bancos de dados nacionais do Sistema de Informações Hospitalares (SIH) e do Cadastro Nacional de Estabelecimentos de Saúde (CNES). A pesquisa utilizou um conjunto de indicadores abrangendo a produção de internações, o perfil de atendimentos, a qualidade e o desempenho, associados ao porte dos hospitais e à natureza jurídica. Para análise de dados, empregou-se: a análise da variância com teste de Tukey-Kramer para evidenciar as diferenças entre hospitais públicos e privados; a análise de moderação para verificar o efeito do porte hospitalar; e o modelo Pabon Lasso para integrar os resultados. Estes demonstram que o aumento no número de leitos influencia o desempenho dos indicadores de maneira distinta para hospitais públicos e privados. Hospitais públicos apresentaram ganhos de eficiência de escala superiores com o aumento de leitos e os privados sem fins lucrativos, um desempenho superior no conjunto de indicadores e mais equilibrado nos diferentes portes. A aplicação do modelo Pabon Lasso demonstrou que hospitais pequenos, tanto públicos quanto privados, apresentam baixo desempenho, e evidenciou também que, a partir do médio porte, os hospitais públicos e privados apresentam um bom desempenho. No entanto, cada categoria exibe particularidades em seu perfil de performance, refletindo uma diversidade de práticas e resultados operacionais. Desse modo, o estudo confirma achados anteriores de que o desempenho hospitalar tende a melhorar com o aumento do número de leitos, mas revela também que ele varia significativamente em função da natureza jurídica dessas instituições.

Resumen: Este artículo tiene como objetivo analizar el desempeño de la red hospitalaria del Sistema Único de Salud brasileño (SUS, por sus siglas en portugués) a partir de las bases de datos nacionales del Sistema de Información Hospitalaria (SIH, por sus siglas en portugués) y del Registro Nacional de Establecimientos de Salud (CNES, por sus siglas en portugués). Para ello, se utilizó un conjunto de indicadores que cubren la producción de hospitalizaciones, el perfil de la atención, la calidad y el desempeño asociados con la capacidad de los hospitales y la naturaleza legal. El análisis de varianza con prueba de Tukey-Kramer se utilizó en el análisis de datos para identificar las diferencias entre los hospitales públicos y privados; el análisis de moderación para verificar el efecto de la capacidad del hospital; y el modelo Pabon Lasso para integrar los resultados. Los resultados mostraron que un aumento en la cantidad de camas influye en el desempeño de los indicadores de manera distinta tanto en los hospitales públicos como en los privados. Los hospitales públicos tuvieron mayor ganancia de eficiencia de escala con el aumento de camas, mientras que los hospitales privados sin fines de lucro mostraron un mejor desempeño en el conjunto de indicadores y más equilibrado en las diferentes capacidades. La aplicación del modelo Pabon Lasso demostró que los pequeños hospitales, tanto públicos como privados, tuvieron un bajo desempeño. También mostró que los hospitales públicos o privados de mediano tamaño tuvieron un buen desempeño. Sin embargo, cada categoría guarda particularidades en su perfil de desempeño, reflejando una diversidad de prácticas y resultados operativos. Por lo tanto, los resultados de este estudio confirman los hallazgos previos de que el desempeño hospitalario tiende a mejorar con el aumento del número de camas, pero también revela que hay una variación significativa dependiendo de la naturaleza legal de estas instituciones.

Abstract: This article aims to analyze the performance of the Brazilian Unified National Health System (SUS, acronym in Portuguese) hospital network based on the national databases of the Brazilian Hospital Information System (SIH, acronym in Portuguese) and the Brazilian National Registry of Health Establishments (CNES, acronym in Portuguese). The research used a set of indicators covering the production of admissions, the profile, quality and performance of care, associated with hospital size and legal nature. For data analysis, the Analysis of Variance with Tukey-Kramer test was used to highlight the differences between public and private hospitals, the moderation analysis to verify the effect of hospital size and the Pabon Lasso model to integrate the results. The results show that the increase in the number of beds influences the performance of the indicators differently for public and private hospitals. Public hospitals showed higher gains in scale efficiency with the increase in beds, whereas private non-profit hospitals showed a higher performance in the set of indicators and a more balanced performance in the different sizes. The application of the Pabon Lasso model showed that small hospitals, both public and private, perform poorly. It also showed that from medium-sized onwards, public and private hospitals perform well. However, each category displays particularities in its performance profile, reflecting a diversity of practices and operational results. This study thus confirms previous findings that hospital performance tends to improve as the number of beds increases, but also reveals that it varies significantly depending on the legal nature of these institutions.