University of Alabama at Birmingham (UAB) Executive Doctor of Science Degree in Administration-Health Services program spent four days in April 2013, studying the Brazilian health care system. This was the program’s first trip to a South American country and it included intensive lectures, discussions and tours.Students in the
The host institution was Pontifícia Universidade Católica do Paraná (PUCPR). The university is located in Curitiba, the capital and largest city in the Brazilian state of Paraná. PUCPR has a long-standing relationship with UAB that includes collaboration for several years on tobacco cessation research.
“The smoking cessation program was the most rewarding thing I saw. They had teamwork, compassion and excitement for what they do every day,” said Polly Davenport, Class 3, CEO of Ochsner Medical Center-North Shore. “It is a very good place to go get care and they understand they are not going to impact outcomes unless they get a handle on these primary care issues.”
PUCPR Professor Marcia Cubas set the stage for the visit on day one with an overview of Brazil’s Unified Health System (SUS). Jadwiga “Yogi” Wartak, Class 44, who participated as part of the alumni travel experience, says she learned a great deal during the visit.
"In Brazil, they are in the beginning stages of quantifying what effect the government actions are having on overall healthcare improvement, such as health promotions and national policies,” said Wartak, pictured in front of Iguazu Falls. “Analyzing various quality measures is new. These beginning stages, however, are already showing a strong focus on population management, with coordination of care between primary care units and community outreach.”
The group met with administrators and clinicians from several hospitals in Brazil including Hospital de Clínicas da Universidade Federal do Paraná, a large public hospital, and Hospital Santa Casa, a not-for-profit hospital.
The students also spent time at Hospital do Trabalhador where they posed for a group picture. This is a teaching hospital that specializes in trauma; occupational health; and maternal and child health. The hospital also houses a thirty-bed “pediatric sector” and Center for Integral Assistance of Cleft Lip and Palate.
The group was welcomed at Unidade de Saúde – Alvorada by an energetic and compassionate staff. Unidade de Saúde – Alvorada is a primary care facility with an advanced patient-centered medical home type of model. In their model, primary medical care, behavioral health treatment, a pharmacy, and a dental clinic are all under the same roof; and each patient is cared for by an interdisciplinary team of health professionals.
The Unidade de Saúde – Alvorada team was proud to showcase their facility but even more proud to highlight the personal connections they have with each of their patients. They have a geographic map that is covered with colored push pins. The system literally pinpoints their patients on the map by location and condition.
“The system with the pins was rudimentary but it works very well and it is humanizing because you know each dot represents an actual patient,” said Steve Cullen, Class 3, chief strategy officer at Integrated Medical Systems International. “I would also stress that most of the facilities we visited focused on the human aspect. They may not have the technology or the flash but they knew their patients and they knew what was going on. It was impressive.”
Shortly thereafter they visited Hospital Marcelino Champagnat (HMC) which is considered Curitiba’s gold standard hospital. HMC is the only private hospital in a system that owns four other large public hospitals. While HMC was built to cater exclusively to private patients, the UAB group was fascinated to learn that the facility’s profits are used to subsidize the four other not-for-profit hospitals in the system.
“Curitiba is a forerunner in restructuring primary healthcare in Brazil and serves as a reference to the rest of the country for Public Health," said Wartak.
Other highlights of the visit also included meeting with officials at the state and city health departments; a local primary care facility; and Unimed, a private health insurance company and the world’s largest healthcare co-op.
To see more pictures from this trip to South America visit the SHP Flickr "sets" page.