RESUMO
As solicitações de cobertura para home care estão entre as mais complexas discussões hoje existentes no universo jurídico dos planos de saúde. A partir de um estudo normativo-jurisprudencial, o presente artigo tem como objetivo examinar os serviços de saúde domiciliares à luz das coberturas dos contratos de planos de saúde. Com esta meta, passa por diversos tópicos inerentes a este assunto, incluindo determinados fenômenos jurídicos e sociais que ajudam a entendê-lo, assim como o regime jurídico que regula a matéria. Na sequência, o artigo foca os serviços domiciliares, com ênfase naqueles que, à luz das normas aplicáveis, são considerados como de cobertura obrigatória. Após, comenta também a complexidade terminológica que envolve o tema. Ao final, passa ao exame da jurisprudência existente sobre planos de saúde e cobertura para serviços domiciliares, com destaque para os recentes precedentes que, na opinião dos autores, adotam uma posição mais aceitável e razoável, capaz de representar um verdadeiro ponto de equilíbrio a esta temática tão controvertida.
Demands for home care coverage are stirring the most complex discussions currently existing in the legal universe of health insurance contracts. Based on a normative-jurisprudential study, this essay's scope examines home health care services in light of the coverage of health insurance contracts. With this goal, several topics on the subject are dealt with, including certain juridical and social phenomena that facilitate its understanding, as well as the legal regime that regulates this matter. It follows focusing on home health care services, with emphasis on those that, in light of the applicable regulatory standards, are considered to be of compulsory coverage. Next, the terminological complexity that involves this subject is also commented. At the end, the existing jurisprudence regarding health care insurances and the coverage for home health care services is examined, highlighting recent precedents that, in the authors' opinion, adopt an acceptable and reasonable position, capable of representing a true balance point for this controversial matter.
RESUMO
The purposes of this study were to examine the relationships among knowledge of and confidence in health care services (HHCS), acculturation, characteristics of family caregivers of Mexican descent, and differences by caregivers' relationship (spouse or adult child). A sample of Mexican-descent older adults and their caregivers was recruited (n = 74 dyads) in Arizona. Each participant completed questionnaires on knowledge, confidence, and acculturation. There were moderate but significant associations among higher Anglo Orientation with Knowledge and with Confidence. Fear of HHCS was positively associated with higher Anglo Orientation and English Language Preference; and negatively associated with Mexican Orientation and Spanish Language Preference. For Spouse caregivers, Fear of HHCS was positively correlated with higher Anglo Orientation and English Language Preference; for Offspring caregivers, Fear of HHCS was negatively correlated with Mexican Orientation and Spanish Language Preference. Results support assessing caregiver cohort and socio-cultural context to decrease HHCS use disparities by Mexican-descent caregiving families.
Assuntos
Aculturação , Cuidadores/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Disparidades em Assistência à Saúde/etnologia , Serviços de Assistência Domiciliar/estatística & dados numéricos , Americanos Mexicanos , Adulto , Arizona , Cuidadores/psicologia , Estudos de Coortes , Relações Familiares , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
La atención médica domiciliaria es una estrategia que permite evitar infecciones asociadas al cuidado de la salud en individuos con deficiencias inmunológicas como los adultos mayores. Se realizó una investigación de tipo descriptivo-longitudinal, en la que se tuvieron en cuenta condiciones relacionadas con el dispositivo de micronebulización como: el tiempo de uso, el lavado del dispositivo y su almacenamiento. Con respecto al terapeuta se tuvo en cuenta: lavado de manos y aplicación del protocolo de limpieza y desinfección. Se realizaron dos tomas de muestra a diecisiete dispositivos de micronebulización individual de adultos mayores pertenecientes al programa de hospitalización domiciliaria de Forja Empresas Ltda, a los quince y treinta días de uso después de la entrega del dispositivo en dos momentos: antes y después del procedimiento de la terapia respiratoria. Se identificaron ocho microorganismos en la primera toma de muestra que se clasificaron como flora transitoria y diecinueve microorganismos en la segunda, en la que se encontró flora residente, transitoria y potencialmente patógena. En relación al protocolo de limpieza y desinfección, realizado por los terapeutas, se observó modificaciones al protocolo establecido por Forja Empresas Ltda, sin embargo dicho protocolo no incluye el lavado de manos, punto indispensable para la atención del paciente. Se hace necesario brindarles información oportuna a los pacientes, familiares y/o cuidadores sobre el almacenamiento adecuado del dispositivo con el fin de evitar presencia de microorganismos que pueden afectar la salud de los adultos mayores.
Home health care is a strategy that allows avoiding infections associated with health care of individuals with immune deficiencies such as older adults. A descriptive-longitudinal investigation was conducted, which took into account conditions related to the micro-nebulization equipment device such as: its time of use, cleansing, and storage. With respect to the therapist, it was taken into account: hand washing and implementation of the protocol of cleaning and disinfection. Two different samples were taken to seventeen individual micro-nebulization equipment devices of older adults belonging to the program of home hospitalization of Forging Companies Ltd., after fifteen and thirty days of use after the delivery of the device in two times: before and after the respiratory procedure. Eight microorganisms were identified in the first portion of the sample that were classified as transitory flora and nineteen microorganisms in the second one, where resident, transient, and potentially pathogenic flora was found. In relation to the protocol of cleaning and disinfection carried out by the therapists. Changes to the protocol established by Forging Companies Ltd. were observed; however, this protocol does not include the washing of hands, which is a vital point for patient care. It is necessary to provide patients, family members and/or caregivers with timely information about the proper storage of the device in order to avoid the presence of microorganisms that can affect the health of older adults.