Avaliação de programas de promoção da saúde à pessoa idosa: uma análise da qualidade de serviços na saúde suplementar
Population aging is a challenging phenomenon widely discussed around the world. In Brazil, the healthcare system needs to implement new ways to minimize the effects of this question and, in this context, health promotion emerges as a strategy to face the impacts of this demographic transition, wh...
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| Format: | doctoralThesis |
| Language: | pt_BR |
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Universidade Federal do Rio Grande do Norte
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| Online Access: | https://repositorio.ufrn.br/handle/123456789/47238 |
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| Summary: | Population aging is a challenging phenomenon widely discussed around the world. In Brazil,
the healthcare system needs to implement new ways to minimize the effects of this question
and, in this context, health promotion emerges as a strategy to face the impacts of this
demographic transition, which makes it possible to mitigate risks, fragility and vulnerability,
common to the aging process. This research aims to analyze the quality of health promotion
services for the elderly, through the evaluation of a health promotion program for the elderly
in supplementary health. An integrative literature review was realized about evaluation of
health promotion programs for the elderly, it was developed between January and June 2020;
a documentary research (developed through the study of secondary data requested from the
National Supplementary Health Agency) was submitted to descriptive statistical analysis and
Descending Hierarchical Analysis on IRaMuTeQ®; a consensus of experts, who used the
Delphi technique in three rounds: a) questionnaire of open questions was treated through
Content Analysis, b) questionnaire of closed questions, using the Likert scale and the use of
coefficient of variation, and c) the treatment of the results and questionnaire of open questions
for final consensus. Finally, a study of case was carried out in a health promotion about risks
and diseases prevention program aimed to the elderly and offered by a private health operator.
For this, semi-structured interviews were used, treated by means of Content Analysis and
institutional documents, and submitted to Document Analysis. The results were crossed with
the dimensions of quality of health promotion services for the elderly and guidelines from the
National Supplementary Healthcare Agency. Most part of the researches about this subject
discuss the evaluation of the impacts of health promotion actions to the participating public, a
few of them gives emphasis on the evaluation of services, structure and work processes; there
was a gradual commitment by the regulatory agency to establish guidelines, financial
incentives, and qualification of programs for health operators, and this resulted in an increase
in the number of new programs. However, despites all efforts, the number of programs
focusing on the elderly is still small, given the growing demand in the national territory.
Seventeen dimensions of quality of health promotion services for the elderly were found and
resulted in guiding principles in the theoretical and practical fields, serving as a framework for
the planning, execution and evaluation of health promotion practices for the elderly; those
same dimensions, when applied to a health promotion program for the elderly, it enables the
verification of an adequate structure for provision of services, where processes were based on
care strategies and presented satisfactory empirical results, but not measured with evidence and the absence of health service quality management routines that include monitoring and
performance evaluations stands out. In conclusion, the knowledge generated by this study
regards to find the gaps in the literature, limitations of the regulator, and scarcity of specific
assessment instruments, followed by the elaboration and application of the proposed
dimensions, to be able to support decisions making and conceive means for the reach of
efficiency, efficacy and effectiveness in health promotion aimed at the elderly and care
management for this public, as a way to contribute to the professional field and academic literature. |
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