[ad_1]
The new Minister of Health, Luiz Henrique Mandetta, said in his inaugural speech that he intended to create a third shift – in the evening – to visit health posts from the country. The doctor and former federal deputy did not give details on the program, but two very different initiatives, already implemented in the country, can give an idea of the functioning of projects of this type.
Among the few information available to date, the Mandetta plan focuses on basic care – the first level of care, which also includes prevention.
It is first and foremost a system similar to that of long-term care provided in the municipal health units of Porto Alegre. In São Paulo, the "Health Owl" also offered a night service, but with a different proposal: during the first quarter of 2017, the then mayor's director, João Doria, created a group of work responsible for scheduling the image examinations carried out between 20:00 and 12:00. night in philanthropic hospitals.
Spending, Transportation and Security
Judging by the experience of São Paulo, the challenges are great. Maurício Faria, advisor to the Court of Auditors of the Municipality of São Paulo and rapporteur of an audit performed in the owl, pointed out the demands of UOL : costs necessary for the operation of a third position (doctors, nurses, reception staff, cleaning, maintenance), lack of public transport during this period to allow patients to arrive on the scene and lack of security, which can be a major problem at night.
According to the São Paulo City Hall, the program provided for an investment of 17 million Australian dollars as part of a program of joint efforts of 90 days duration .
The MTC audit revealed that there was no reduction in waiting time: the queue had been reduced, but it had increased further in the month following the closure of the program .
45 thousand consultations in Porto Alegre
In the capital of the state of Rio Grande do Sul, the presence until 22 hours – usually the closing of health offices at 17 hours – was part election promises by Mayor Nelson Marchezan (PSDB). The project was implemented in March 2017 and is now available in three units – until the end of the term in 2018, the goal is to add eight.
About 45,000 patients had nocturnal appointments. In addition to doctors and nurses, there are also dentists.
The number is high, higher than expected. Our capacity is 100% occupied in this period. We identified a large number of people who had never been consulted during the day because of working hours and who are now using the service
Thiago Frank, coordinator of primary health care at the Department of Health of Canada. Porto Alegre
] For Frank, the main challenge is precisely to meet the demand: in some cases, without gravity, the patient can not be followed that night.
"This pushes us to open the other five units as quickly as possible, for we thought it would be difficult to attract professionals to work at night, but the forecast has not yet been confirmed: many are already working during the day and are interested in the extended position. "
On average, says the coordinator, the monthly expenses of each unit badiduous at night reach R $ 100,000 – an amount considered proportional overtime hours of operation.
With regard to transport and security, he indicates that the stations of Porto Alegre were selected according to their ease of access: one of them is located at Inside a bus terminal. "These high traffic areas are already creating an increased security environment, and we have not had a worse situation in this respect," said the coordinator.
Source link
