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Abstract Peri-implant diseases, including peri-implant mucositis (PIM) and peri-implantitis, are a chronic inflammatory disorder triggered by bacterial biofilm in susceptible hosts. Potential risk factors for peri-implant diseases include smoking, dental plaque accumulation, poor oral hygiene, genetics, and absence of peri-implant keratinized mucosa. This cohort study aimed to evaluate the influence of patient-, implant-, and prosthetic-related factors on PIM and peri-implant bone loss (PBL) around dental implants after 1 year of loading. A total of 54 subjects (22 males and 32 females) were included in the study. Peri-implant clinical parameters were assessed and standardized periapical radiographs of each dental implant were obtained 15 days after the definitive prosthesis installation (baseline) and at 3, 6, and 12 months of follow-up. A total of 173 implants were evaluated. PIM affected 44.8% of the implants and no significant association was found between the investigated parameters and PIM incidence, except for type of implant connection. A significantly higher incidence of PIM (80.0%) was observed for implants with internal hexagon connection type after 1 year of follow-up (p = 0.015). Moreover, a mean PBL of 0.35 ± 1.89 mm was observed and no dental implant was affected by peri-implantitis after 1 year of function. No specific influence of patient, implant, or prosthetic factors on PBL was observed. No association was found between the occurrence of PIM/PBL and the patient-, implant-, and prosthetic-related factors investigated in this cohort study, except for the type of dental-implant connection. Periimplant Peri periimplant peri (PIM periimplantitis, periimplantitis implantitis, implantitis hosts smoking accumulation hygiene genetics mucosa patient , patient- implant- prostheticrelated related (PBL loading 5 22 (2 3 females baseline (baseline 6 followup. followup follow up. up 17 evaluated 448 44 8 44.8 80.0% 800 80 0 (80.0% p 0.015. 0015 0.015 . 015 0.015) Moreover 035 35 0.3 189 89 1.8 function PIMPBL dentalimplant 2 ( 4 44. 80.0 (80.0 001 0.01 01 03 0. 18 1. 80. (80. 00 0.0 (80 (8

https://doi.org/10.1590/1807-3107bor-2024.vol38.0040

The relationship between project management and digital transformation: Systematic literature review transformation
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Gonçalves, Marcelo Luiz A

; Penha, Renato

; Silva, Luciano F

; Martens, Cristina D. P

; Silva, Vlamir F

RAM. Revista de Administração Mackenzie

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2023, Volume 24 N. 4 elocation eRAMR230075

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Purpose: This article aims to investigate the relationship between project management (PM) and digital transformation (DT) in organizations. Originality/value: This article contributes to expanding the knowledge of the relationship between PM and DT, indicating that PM and its different approaches are used strategically to enable DT implementation in organizations. In addition, it is evidenced that DT demands individuals with technical and behavioral competencies to work in innovative and rapid organizational, cultural, and technological contexts arising from adopting new digital technologies. Design/methodology/approach: The research is characterized as exploratory with a qualitative approach. The methodology adopted was the systematic literature review and sought to understand the relationship and convergence between PM and DT. The research was carried out broadly, and the articles were selected on the Web of Science, Scopus, and Google Scholar bases, forming the analysis corpus with 104 articles published from 2015 to 2020. Findings: The results converged in the composition of four factors: competencies; strategy; digital technologies; and portfolio, programs, and projects, demonstrating the evolutionary and adaptive capacity of PM to support major changes such as DT. Purpose (PM (DT organizations Originality/value Originalityvalue Originality value addition organizational cultural technologies Design/methodology/approach Designmethodologyapproach Design approach broadly Science Scopus bases 10 201 2020 Findings factors strategy portfolio programs projects 1 20 202 2

RESUMO Objetivo: Este artigo tem como objetivo investigar a relação entre o gerenciamento de projetos (GP) e a transformação digital (TD) nas organizações. Originalidade/valor: Este trabalho contribui para ampliar o conhecimento da relação existente entre o GP e a TD, indicando que o GP e suas diferentes abordagens são utilizados de forma estratégica para viabilizar a execução da TD nas organizações. Além disso, é evidenciado que a TD demanda indivíduos com competências técnicas e comportamentais para trabalharem em contextos inovadores e de rápidas mudanças organizacionais, culturais e tecnológicas, advindas com a adoção de novas tecnologias digitais. Design/metodologia/abordagem: A pesquisa é caracterizada como exploratória com abordagem qualitativa. A metodologia adotada foi a revisão sistemática da literatura, e busca compreender a relação e a convergência entre o GP e a TD. A pesquisa foi realizada de forma ampla e os artigos foram selecionados nas bases Web of Science, Scopus e Google Scholar, formando o corpus de análise com 104 artigos publicados no período de 2015 a 2020. Resultados: Os resultados convergiram para a formação de quatro fatores: competências; estratégia; tecnologias digitais; e portfólio, programas e projetos, demonstrando a capacidade evolutiva e adaptativa do GP para suportar grandes mudanças, como a TD. Objetivo (GP (TD organizações Originalidade/valor Originalidadevalor Originalidade valor disso organizacionais tecnológicas digitais Design/metodologia/abordagem Designmetodologiaabordagem Design qualitativa literatura Science Scholar 10 201 2020 Resultados fatores estratégia portfólio 1 20 202 2

https://doi.org/10.1590/1678-6971/eramr230075.en

Distance learning course improves primary care dentists’ diagnosis and self-efficacy in the management of oral lesions
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CARDOSO, Fernanda Brochier

; WAGNER, Vivian Petersen

; CORRÊA, Ana Paula Borngräber

; MARTINS, Marco Antônio Trevizani

; MARTINS, Manoela Domingues

; D’ÁVILA, Otávio Pereira

; GONÇALVES, Marcelo Rodrigues

; HARZHEIM, Erno

; UMPIERRE, Roberto Nunes

; CARRARD, Vinicius Coelho

Brazilian Oral Research

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2022, Volume 36 elocation e101

Abstract: En | Text: En | PDF: En

Abstract Oral cancer represents a public health issue because of its high mortality rate, resulting mainly from diagnostic delays. Insufficient training in oral diagnosis is usually perceived by dentists. Distance learning could be used as an auxiliary tool to bridge that gap. This study evaluated the impact of a distance learning course on oral mucosal lesion diagnosis offered to public healthcare dentists. Participants of an online course answered a pretest/posttest comprising clinical images of 30 clinical cases. Participants were questioned about the diagnosis and informed their decision on the cases (referring the cases to a specialist or managing them themselves), as a parameter of perceived self-efficacy. A total of 442 dentists enrolled in the course. Their pass rate was 97%. Classification of the nature of the lesions, diagnostic hypotheses, sensitivity, and specificity improved by 13.4%, 10.0%, 13.4%, and 6.6%, respectively (p<0.01, Wilcoxon test). Regarding management, there was a 16.6% reduction in the intention to refer cases, while confidence in the diagnosis of benign lesions increased by 40%. A distance learning course may be useful in continuing education actions for primary care dentists, improving their diagnostic abilities and encouraging them in the management of oral lesions. Moreover, this strategy could contribute to disseminating knowledge to remote regions, particularly among primary health care professionals.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0101

[SciELO Preprints] - Eighteen years in two days: the next steps for remote consultation in Brazil
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Aita Schmitz, Carlos André Rodrigues Gonçalves, Marcelo Nunes Umpierre, Roberto Martins Costa, Manuela Harzheim, Erno Souza da Silva, Rodolfo Goulart Molina-Bastos, Cynthia Ambrosini Mendonça, Marcos Vinícius Katz, Natan

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Publication date: 2021-11-05

Abstract: En Es Pt

This is an opinion article that aims to support the Disease caused by the New Coronavirus of 2019 (COVID-19) post-pandemic regarding the regulation of care through digital resources. Through a literature review, an attempt was made to conceptualize remote consultation and to survey both the historical evolution of technological appropriation by health and the regulation on the subject. Texts covering the pre-pandemic and pandemic periods in Brazil, the United States, the European Union and Australia were evaluated. We tried to highlight the main fallacies, sophisms and dissensions that orbit the theme, as well as the real points where there is a need for greater commitment for decision makers: data security and privacy, reimbursement parity and interstate licensing. It is concluded that the technological appropriation by health has divided the world into at least three segments: those that maintained the autonomy of professionals and patients; those who retarded technological advancement through bureaucracy; and those who forbade advances. The pandemic has generated positive reallocations among these groups and there is a need to refine progress and avoid setbacks.

Este es un artículo de opinión que tiene como objetivo apoyar la discusión pospandémica de la Enfermedad causada por el Nuevo Coronavirus de 2019 (COVID-19) en cuanto a la regulación de la atención a través de recursos digitales. A través de una revisión de la literatura, se intentó conceptualizar la consulta remota y relevar tanto la evolución histórica de la apropiación tecnológica por parte de la salud como la regulación sobre el tema. Se evaluaron los textos que cubren los períodos prepandémico y pandémico en Brasil, Estados Unidos, la Unión Europea y Australia. Intentamos resaltar las principales falacias, sofismas y disensiones que orbitan el tema, así como los puntos reales donde existe la necesidad de un mayor compromiso de los tomadores de decisiones: seguridad y privacidad de los datos, paridad de reembolso y licencias interestatales. Se concluye que la apropiación tecnológica por parte de la salud ha dividido al mundo en al menos tres segmentos: los que mantenían la autonomía de profesionales y pacientes; los que retrasaron el avance tecnológico a través de la burocracia; y los que prohibieron los avances. La pandemia ha generado reasignaciones positivas entre estos grupos y es necesario perfeccionar el progreso y evitar retrocesos.

Este é um artigo de opinião que objetiva subsidiar a discussão pós-pandemia da Doença causada pelo Novo Coronavírus de 2019 (COVID-19) a respeito da regulamentação do atendimento por meio de recursos digitais. Buscou-se, por meio de revisão de literatura, conceituar a consulta remota e fazer um levantamento tanto da evolução histórica da apropriação tecnológica pela saúde como da regulamentação sobre o tema. Foram avaliados textos cobrindo os períodos pré-pandêmico e pandêmico no Brasil, Estados Unidos, União Europeia e Austrália. Procurou-se evidenciar as principais falácias, sofismas e dissensos que orbitam o tema, bem como os reais pontos onde há necessidade de maior empenho para os tomadores de decisão: segurança de dados e privacidade, paridade de reembolso e licenciamento interestadual. Conclui-se que a apropriação tecnológica pela saúde dividiu o mundo em pelo menos três segmentos: os que mantiveram a autonomia de profissionais e pacientes; os que retardaram o avanço tecnológico por meio de burocracia; e os que proibiram os avanços. A pandemia gerou realocações positivas entre esses grupos e existe a necessidade de refinar avanços e evitar retrocessos.

https://doi.org/10.1590/SciELOPreprints.3126

Primary Care Asssement Tool: diferenças regionais a partir da Pesquisa Nacional de Saúde do Instituto Brasileiro de Geografia e Estatística
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Pinto, Luiz Felipe

; Quesada, Leonardo Arêas

; D’Avila, Otavio Pereira

; Hauser, Lisiane

; Gonçalves, Marcelo Rodrigues

; Harzheim, Erno

Ciência & Saúde Coletiva

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sep 2021, Volume 26 N. 9 Pages 3965 - 3979

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Em 2019, o Instituto Brasileiro de Geografia e Estatística (IBGE) de forma inédita entre os institutos oficiais de estatística em todo o mundo, incluiu um módulo especial sobre avaliação da atenção primária à saúde em seu principal inquérito populacional de base domiciliar, a Pesquisa Nacional de Saúde (PNS). O inquérito considerou a versão reduzida do instrumento Primary Care Assessment Tool (PCAT), desenvolvida e disseminada por Starfield e Shi para avaliar a existência e extensão das características de estrutura e processos dos serviços de atenção primária em saúde. Trata-se da maior amostra probabilística com o uso desse instrumento já realizada em um único país do mundo que entrevistou usuários com 18 anos ou mais (n = 9.677). Os resultados dos escores gerais do PCAT do Brasil (5,9 [5,8; 5,9]) apontam grandes contrastes regionais e intraregionais, com a região Sul do país destacando-se com as melhores avaliações dos serviços de atenção primária (escore geral = 6,3 [6,2; 6,5]) e a região norte, por outro lado, com as menores (escore geral = 5,5 [5,3; 5,7]). Foram também observadas diferenças estatisticamente significantes e mais favoráveis entre os moradores de domicílios cadastrados pelas equipes de saúde da família, entre os mais idosos e entre que mais utilizam os serviços de saúde (adultos com morbidades referidas).

Abstract In 2019, unprecedentedly among the official statistical institutes worldwide, the IBGE included a particular module on evaluating primary health care in its central population-based population survey, the National Health Survey (PNS-2019). The survey considered the reduced version of the Primary Care Assessment Tool (PCAT), developed and disseminated by Starfield and Shi, to assess the existence and extent of the structure and process characteristics of PHC services. It is the most significant probabilistic sample using this instrument ever conducted in a single country in the world that interviewed users aged 18 or over (n=9,677). The results of the Brazilian overall PCAT scores (5.9 [5.8; 5.9]) point to significant regional and intraregional contrasts, with the South of the country standing out with the best evaluations of primary care services (overall score = 6.3 [6.2; 6.5]) and the North with the worse (overall score = 5,5 [5,3; 5,7]). There were also statistically significant and more favorable differences between residents of households registered by family health teams, among older adults, and those using health services the most (adults with reported morbidities).

https://doi.org/10.1590/1413-81232021269.10112021

Primary Care Asssement Tool: diferenças regionais a partir da Pesquisa Nacional de Saúde do Instituto Brasileiro de Geografia e Estatística
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Pinto, Luiz Felipe

; Quesada, Leonardo Arêas

; D’Avila, Otavio Pereira

; Hauser, Lisiane

; Gonçalves, Marcelo Rodrigues

; Harzheim, Erno

Ciência & Saúde Coletiva

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sep 2021, Volume 26 N. 9 Pages 3965 - 3979

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232021269.10112021 127 downloads

O Papel da Telessaúde na Pandemia Covid-19: Uma Experiência Brasileira
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Silva, Rodolfo Souza da

; Schmtiz, Carlos André Aita

; Harzheim, Erno

; Molina-Bastos, Cynthia Goulart

; Oliveira, Elise Botteselle de

; Roman, Rudi

; Umpierre, Roberto Nunes

; Gonçalves, Marcelo Rodrigues

Ciência & Saúde Coletiva

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jun 2021, Volume 26 N. 6 Pages 2149 - 2157

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O SARS-CoV-2, vírus causador da Covid-19, é o terceiro coronavírus a causar doença grave em humanos e que apresentou disseminação global nas duas últimas décadas. Nesse contexto, diversos departamentos nacionais de saúde pública, entre eles o Ministério da Saúde do Brasil, trouxeram destaque àquilo que era, até então, considerado um serviço de apoio ao sistema de saúde: a telessaúde e a telemedicina. Pretendemos apresentar as ações realizadas por um serviço nacional de telessaúde no Brasil, tanto no suporte aos profissionais de saúde da Atenção Primária à Saúde quanto a pacientes, além de discutir o potencial de reorganizar um sistema de saúde. Estudo de prevalência que sumariza as ações de telemedicina adotadas pelo TelessaúdeRS-UFRGS no período da 9ª à 27ª semana epidemiológica de 2020 para apoio aos serviços de saúde do Sistema Único de Saúde (SUS). Houve aumento de 76,8% da demanda de teleconsultorias telefônicas no período avaliado em comparação com o mesmo período em 2019, sendo 28,8% dessa demanda total decorrente de dúvidas relacionada à Covid-19. A pandemia por Covid-19 demandou rápida resposta com a organização de materiais sobre a doença, uma nova equipe para execução das atividades de telemonitoramento e teleconsultas, além da elaboração de um manual para teleconsultas na Atenção Primária à Saúde.

Abstract SARS-CoV-2, the virus that causes Covid-19, is the third coronavirus to cause severe disease in humans and to spread globally in the past two decades. In this context, several national public health departments, including the Brazilian Ministry of Health, highlighted what was, until then, considered a support service to the health system: telehealth and telemedicine. We intend to present the actions carried out by a national telehealth service in Brazil, both as a Primary Health Care (PHC) support service to professionals and to patients, as well as discussing the potential to reorganize a health system. This is a prevalence study that summarizes the measures adopted by Brazilian Telehealth Center from the 9th to the 27th epidemiological weeks of 2020 to support the health services of the Brazilian Unified Health System (SUS). There was an increase of 76.8% in the demand for telephone teleconsultations during the evaluated period compared to the same period in 2019, with 28.8% of the entire demand arising from doubts related to Covid-19. The Covid-19 pandemic demanded a quick response, with the organization of materials about the disease, a new team to carry out telemonitoring and teleconsultation activities, in addition to the creation of a manual for teleconsultations in Primary Health Care.

https://doi.org/10.1590/1413-81232021266.39662020

O Papel da Telessaúde na Pandemia Covid-19: Uma Experiência Brasileira
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Silva, Rodolfo Souza da

; Schmtiz, Carlos André Aita

; Harzheim, Erno

; Molina-Bastos, Cynthia Goulart

; Oliveira, Elise Botteselle de

; Roman, Rudi

; Umpierre, Roberto Nunes

; Gonçalves, Marcelo Rodrigues

Ciência & Saúde Coletiva

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jun 2021, Volume 26 N. 6 Pages 2149 - 2157

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232021266.39662020 1244 downloads

Impact of soft tissue graft on the preservation of compromised sockets
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Segnini, Bruno

; Borges-Filho, Fausto F. F.

; G.Nicoli, Lélis

; Gonçalves, Marcelo

; Marcantonio, Cláudio

; Oliveira, Guilherme J.P.L.

; Marcantonio, Elcio Jr.

Acta Odontológica Latinoamericana

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jun 2021, Volume 34 N. 2 Pages 119 - 126

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO

ABSTRACT The aim of this pilot study was to evaluate the impact of the association of free gingival graft (FGG) or collagen-matrix xenograft (CMX) to deproteinized bovine bone graft (DBBG) on the preservation of post-extraction sockets with facial-wall defects. Sixteen patients who presented a maxillary tooth with a facial bone defect and indication of extraction were selected. After the surgical procedure, all the post-extraction sockets were filled with DBBG and covered with a collagen membrane. The cervical part of the socket was then sealed with either FGG or CMX. Clinical and tomographic analyses were performed at baseline and 4 months after the grafting procedure. The FGG sockets showed higher values for the width of the bone ridge than the CMX sockets at 4 months. There was no difference regarding biopsy composition. In conclusion, regardless of the type of soft tissue graft used, socket preservation with DBBG at sites presenting facial bone defects enabled implant placement without further guided bone regeneration, whether the sockets were sealed with FGG or CMX.

197 downloads

10.

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020–2021
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Albuquerque, José Olimpio Moura de

; Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Pino, Francisco Alberto

; Sato, Ana Paula Sayuri

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Silva, Solange Maria Saboia e

; Caldeira, Luiz Artur Vieira

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Silva, Fabiana Érica Vilanova da

; Glasser, Paula Regina

; Burihan, Patrícia Carla Piragibe Ramos

; Cavazzana, Cinthya Luzia

; Mello, Debora Silva de

; Pellini, Alessandra Cristina Guedes

; Nishio, Fernando Yoshiki

; Kian, Fernanda Miyashiro

; Braga, Elza de Santana

; Bertelli, Nilza Maria Piassi

; Fracini, Wagner

; Gonçalves, Marcelo Dell Áquila

; Zular, Paulete Secco

; Piva, Regiane de Santana

; Masi, Eduardo

Revista de Saúde Pública

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2021, Volume 55 elocation 62

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9–11.8%) to 25.0% (95%CI: 21.7–28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection.

https://doi.org/10.11606/s1518-8787.2021055003970

11.

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020–2021
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Albuquerque, José Olimpio Moura de

; Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Pino, Francisco Alberto

; Sato, Ana Paula Sayuri

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Silva, Solange Maria Saboia e

; Caldeira, Luiz Artur Vieira

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Silva, Fabiana Érica Vilanova da

; Glasser, Paula Regina

; Burihan, Patrícia Carla Piragibe Ramos

; Cavazzana, Cinthya Luzia

; Mello, Debora Silva de

; Pellini, Alessandra Cristina Guedes

; Nishio, Fernando Yoshiki

; Kian, Fernanda Miyashiro

; Braga, Elza de Santana

; Bertelli, Nilza Maria Piassi

; Fracini, Wagner

; Gonçalves, Marcelo Dell Áquila

; Zular, Paulete Secco

; Piva, Regiane de Santana

; Masi, Eduardo

Revista de Saúde Pública

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2021, Volume 55 elocation 62

Abstract: En | Text: En | PDF: En

https://doi.org/10.11606/s1518-8787.2021055003970 43 downloads

12.

Synchronous teleconsultation in the management of temporomandibular disorder
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Stüermer, Vanessa Müller

; Roxo-Gonçalves, Michelle

; Carrard, Vinicius Coelho

; Gonçalves, Marcelo Rodrigues

; Goulart, Bárbara Niegia Garcia de

Revista CEFAC

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2021, Volume 23 N. 4 elocation e5321

Abstract: En | Text: En | PDF: En

ABSTRACT Purpose: to analyze synchronous teleconsultation as a support tool in the management of temporomandibular disorders in primary health care and to identify which factors have an impact on decisions about teleconsultation. Methods: retrospective study perfomed in TelessaúdeRS, between May 2018 to May 2020. This study used primary data from synchronous teleconsultation, requested by primary health care professionals and carried out by multiprofessional teleconsultants. The data collected were the information reported by the requester, the teleconsultant's suggestions and if there was referral of the patient for specialized care after teleconsultation. The statistical association was investigated between patient characteristics and decision of teleconsultation; and teleconsultation conduct suggestions and decision of teleconsultation, using Fisher's exact test and modeling was performed using binary logistic regression considering 5% of significance (p≤0.05). Results: during the period, 56 teleconsultations had a temporomandibular diagnostic hypothesis, these 79.2% patients were female and the average age was 43.7 years. In 59.1% of teleconsultations, primary care management was suggested, with 72.4% of patients being managed. An association was found between the decision of teleconsultation and referral to specialized care (p <000.1). The trauma report (p = 0.004) was associated with a greater chance of being referred for special care and suggestions for pharmacological (p <0.001) and non-pharmacological (p = 0.007) treatments were introduced among the teleconsultation managed in primary care. Conclusion: teleconsultation helped to manage the majority of temporomandibular disorder, streamlining care and having the potential to avoid unnecessary referrals to special care.

https://doi.org/10.1590/1982-0216/20212345321

13.

Avaliação Econômica de um Serviço de Telemedicina para ampliação da Atenção Primária à Saúde no Rio Grande do Sul: o microcusteio do Projeto TeleOftalmo
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Zanotto, Bruna Stella

; Etges, Ana Paula Beck da Silva

; Siqueira, Ana Célia

; Silva, Rodolfo Souza da

; Bastos, Cynthia

; Araujo, Aline Lutz de

; Moreira, Taís de Campos

; Matturro, Lucas

; Polanczyk, Carisi Anne

; Gonçalves, Marcelo

Ciência & Saúde Coletiva

Journal Metrics
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apr 2020, Volume 25 N. 4 Pages 1349 - 1360

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Este estudo avaliou o custo de um serviço público de telediagnóstico em oftalmologia. O método de custeio baseado em atividades e tempo (TDABC) foi adotado para examinar os componentes de custos relacionados à teleoftalmologia. Com este método, também foi possível estabelecer o custo unitário padrão que o telediagnóstico deveria ter, dada a capacidade instalada e utilização de profissionais. Dados de um ano de telediagnósticos foram considerados, e avaliou-se a mudança do custo por telediagnóstico ao longo do período de adaptação da tecnologia no sistema. O custo padrão calculado por diagnóstico oftalmológico a distância foi de R$ 119, considerando a emissão de 1.080 laudos de telediagnóstico oftalmológico por mês. Foi identificado um desequilíbrio entre as atividades que sugere a capacidade do método TDABC orientar ações de gestão e melhoria na alocação dos recursos. Ao longo de um ano, o custo unitário real passou de R$ 783 para R$ 283, ainda havendo espaço para se aproximar do custo padrão estimado. Avaliações econômicas parciais possuem importante aporte para subsidiar a incorporação de novas tecnologias. O TDABC merece destaque nesse sentido, pois permite obter informações mais precisas sobre custo da tecnologia, melhorando a capacidade de dimensionamento e gerenciamento da organização de saúde.

Abstract This study evaluated the cost of public telediagnostic service in ophthalmology. The time-driven activity-based costing method (TDABC) was adopted to examine the cost components related to teleophthalmology. This method allowed us to establish the standard unit cost of telediagnosis, given the installed capacity and utilization of professionals. We considered data from one year of telediagnoses and evaluated the cost per telediagnosis change throughout technology adaptation in the system. The standard cost calculated by distance ophthalmic diagnosis was approximately R$ 119, considering the issuance of 1,080 monthly ophthalmic telediagnostic reports. We identified an imbalance between activities, which suggests the TDABC method’s ability to guide management actions and improve resource allocation. The actual unit cost fell from R$ 783 to R$ 283 over one year – with room to approach the estimated standard cost. Partial economic evaluations contribute significantly to support the incorporation of new technologies. The TDABC method deserves prominence, as it enables us to retrieve more accurate information on the cost of technology, improving the scalability and management capacity of the healthcare system.

https://doi.org/10.1590/1413-81232020254.28992019

14.

Acesso e regulação ao cuidado especializado no Rio Grande do Sul: a estratégia RegulaSUS do TelessaúdeRS-UFRGS
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Katz, Natan

; Roman, Rudi

; Rados, Dimitris Varvaki

; Oliveira, Elise Botteselle de

; Schmitz, Carlos André Aita

; Gonçalves, Marcelo Rodrigues

; Mengue, Sotero Serrate

; Umpierre, Roberto Nunes

Ciência & Saúde Coletiva

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apr 2020, Volume 25 N. 4 Pages 1389 - 1400

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Na Atenção Primária à Saúde (APS) acesso e integralidade são fortemente influenciados pela coordenação do cuidado, que por sua vez recebe impacto positivo da articulação de ações de telessaúde para a telerregulação da assistência. Criamos uma metodologia de telerregulação (Projeto RegulaSUS) baseada em protocolos específicos firmemente alicerçados em evidências. A partir de dados do sistema de regulação e do TelessaúdeRS exploramos os efeitos do RegulaSUS na APS e no acesso ao cuidado especializado. A metodologia foi capaz de criar protocolos abrangentes, com expressiva redução média da fila de consultas especializadas de 30% em 360 dias. Reduziu o tempo de espera na marcação de consultas em especialidades clínicas (mediana de 66 dias), mas não em cirúrgicas. Tempos de espera nos casos mantidos em fila variaram de forma inversa, aumentado em especialidades clínicas e diminuindo em cirúrgicas. O uso de teleconsultorias espontâneas aumentou com a exposição dos profissionais ao RegulaSUS. A intervenção tem potencial na integração de sistemas de saúde, principalmente em países de baixa e média renda, e faz com que a telessaúde atue como metasserviço, construindo redes eficientes, qualificadas e equânimes.

Abstract In Primary Health Care (PHC), access, and integrality are strongly influenced by the coordination of care, which in turn receives a positive impact from the articulation of telehealth actions for teleregulation of care. We created a teleregulation method (RegulaSUS Project) based on specific protocols firmly grounded in scientific evidence. From data of the regulatory system and TelessaúdeRS, we explored the effects of RegulaSUS on PHC and access to specialized care. This method set comprehensive protocols, with a significant mean reduction of 30% in the specialized visits queue over 360 days. It reduced waiting time for medical clinical visits (median of 66 days) but not for surgical appointments. Waiting times for queued cases varied inversely, increasing for clinical and declining for surgical specialties. The use of teleconsultations unrelated to regulation increased with the exposure of professionals to RegulaSUS. The intervention evidence potentiality in the integration of health systems, mainly among low- and middle-income countries, and makes telehealth act as a meta-service, building efficient, qualified, and equitable networks.

https://doi.org/10.1590/1413-81232020254.28942019

15.

Avaliação Econômica de um Serviço de Telemedicina para ampliação da Atenção Primária à Saúde no Rio Grande do Sul: o microcusteio do Projeto TeleOftalmo
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Zanotto, Bruna Stella

; Etges, Ana Paula Beck da Silva

; Siqueira, Ana Célia

; Silva, Rodolfo Souza da

; Bastos, Cynthia

; Araujo, Aline Lutz de

; Moreira, Taís de Campos

; Matturro, Lucas

; Polanczyk, Carisi Anne

; Gonçalves, Marcelo

Ciência & Saúde Coletiva

Journal Metrics
- Sobre o periódico
- SciELO Analytics

apr 2020, Volume 25 N. 4 Pages 1349 - 1360

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232020254.28992019 2663 downloads

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