ENARE key terms

Brazil's publicly funded health system, founded on the constitutional right to health and organized around universality, integrality, and social participation. It delivers primary, secondary, and tertiary care through public and contracted private providers under unified management.

The founding values of Brazil's health system: universality (access for everyone), integrality (care across promotion, prevention, and treatment), and equity (differential support according to need). They guide how services are planned, funded, and delivered.

The first-contact, community-based level of care, usually delivered by family health teams. It coordinates continuity of care, handles most common conditions, and organizes referral to specialized services through a defined territory and enrolled population.

Brazil's model for organizing primary care around multidisciplinary teams assigned to a defined geographic area and population. Teams include physicians, nurses, nursing assistants, and community health agents, emphasizing longitudinal care and health promotion.

A lay health worker who lives in the served community and links households to the primary care team. They register families, conduct home visits, promote health education, and help monitor priority groups such as pregnant women and chronic patients.

The bidirectional flow of patients and information between levels of care. Referral sends a patient from primary care to a specialist or hospital; counter-referral returns the patient with findings and a care plan back to the originating team.

Participation of citizens in setting policy and overseeing health services, mainly through health councils and health conferences at municipal, state, and national levels. It is a constitutional directive of the Brazilian health system.

The principle of allocating resources and care according to need so that avoidable differences in health status between groups are reduced. It treats unequal needs unequally rather than giving identical services to everyone.

The social, economic, environmental, and cultural conditions in which people live and work that shape health outcomes. They include income, education, housing, sanitation, employment, and access to services, and explain much of the inequality in disease burden.

A management process that authorizes and allocates hospital admissions and procedures within the public system, matching clinical need and urgency to available capacity. It aims to ensure equitable access and efficient use of beds.

The systematic collection, analysis, and use of health-related data to detect problems and guide action. It spans epidemiological, sanitary, environmental, and worker health surveillance, including outbreak detection and response.

The legal obligation of health professionals and institutions to report specified diseases, injuries, and events to health authorities. It enables surveillance, outbreak investigation, and timely public health response, and applies even to suspected cases.

An approach to care that values communication, dignity, autonomy, and the subjective experience of patients and workers. It includes welcoming reception, respect for rights, and shared decision-making within health services.

The practice of receiving users at a health service with attentive listening and responsible assessment of their needs, including risk classification. It ensures that no one is turned away without a plan, regardless of the reason for seeking care.

A clinical approach that expands the focus beyond disease to include the person's life context, social network, and suffering. It encourages shared responsibility among team members and the construction of individualized therapeutic projects.

An individualized care plan built collaboratively by the team and the user for complex cases. It defines goals, responsibilities, and actions over time and is reviewed as the situation changes.

A structured triage process that sorts patients by urgency using clinical protocols, so that the most severe cases are treated first regardless of arrival order. It is used in emergency departments and in primary care reception.

Organized arrangements of health services across levels of care linked by referral flows, protocols, and shared information. They aim to provide continuous, coordinated care for a defined population rather than fragmented episodes.

A pathway describing the recommended actions and services for a specific health condition across all levels of care. It standardizes flows and responsibilities from prevention through rehabilitation.

Workplace-based learning that uses real problems from daily practice to transform both professional competence and the organization of services. It differs from one-off training by being continuous, team-oriented, and linked to local needs.

The field that studies health and disease in populations and organizes collective responses to them. It combines epidemiology, health planning, social sciences, and policy to address determinants and service delivery.

The study of the distribution and determinants of health-related states in populations and the application of this knowledge to control health problems. It relies on measures of frequency, association, and impact.

The number of new cases of a condition arising in a population during a specified period, divided by the population at risk. It measures the rate at which new disease occurs and is used to study causation and acute events.

The proportion of a population that has a condition at a given point or period, counting both new and existing cases. It reflects burden and is influenced by incidence and by duration of disease.

The ratio of the incidence of an outcome in the exposed group to that in the unexposed group. A value above one indicates higher risk among the exposed; it is the main measure of association in cohort studies.

The ratio of the odds of exposure among cases to the odds of exposure among controls. It approximates relative risk when the outcome is rare and is the standard measure in case-control studies.

Two properties of a diagnostic test: sensitivity is the proportion of truly diseased people correctly identified as positive; specificity is the proportion of truly healthy people correctly identified as negative. They are intrinsic to the test and threshold chosen.

The probability that a person actually has (positive predictive value) or does not have (negative predictive value) a condition given a test result. Unlike sensitivity and specificity, it depends on the prevalence of the condition in the tested population.

A plot of sensitivity against one minus specificity across all possible test thresholds. The area under the curve summarizes overall discriminatory ability, with values near 0.5 indicating no better than chance.

An observational design that follows groups defined by exposure status over time and compares outcome incidence. It can establish temporal order and estimate relative risk, but is susceptible to loss to follow-up and confounding.

An observational design that selects people with an outcome (cases) and without it (controls) and looks back at prior exposures. It is efficient for rare diseases but vulnerable to recall and selection bias.

An experimental study in which participants are randomly assigned to interventions and followed prospectively. Randomization balances known and unknown confounders, making it the strongest design for causal inference when well conducted.

A systematic error arising when the groups compared differ in ways related to both exposure and outcome because of how participants were chosen or retained. It cannot be corrected by increasing sample size.

A variable associated with both the exposure and the outcome that is not on the causal pathway, distorting the observed association. It can be addressed by randomization, restriction, matching, or statistical adjustment.

The practice of integrating the best available research evidence with clinical expertise and patient values and preferences. It involves formulating answerable questions, appraising studies, and applying findings to individual decisions.

A structured synthesis that uses explicit, reproducible methods to identify, appraise, and combine studies on a focused question. When statistically pooled, it becomes a meta-analysis and provides the highest level of evidence for many questions.

The set of practices and systems aimed at preventing avoidable harm during health care, including medication errors, falls, infections, and communication failures. It emphasizes reporting, learning, and system redesign rather than individual blame.

An unintended injury or harm to a patient caused by health care management rather than by the underlying disease. It may be preventable or not and is a focus of incident reporting and quality improvement.

The single most effective measure to prevent transmission of health-care-associated infections. It follows defined moments and techniques, using alcohol-based preparations or soap and water depending on the situation.

An infection acquired by a patient during care in a health service that was not present or incubating at admission. It includes device-associated infections and surgical site infections and is a major target of prevention programs.

The conjunto de normas e medidas destinadas a proteger trabalhadores, pacientes e o ambiente de riscos biológicos, químicos e físicos nos serviços de saúde. Inclui uso de equipamentos de proteção individual, descarte adequado de resíduos e precauções padrão.

Um conjunto de medidas aplicadas a todos os pacientes, independentemente do diagnóstico, para reduzir o risco de transmissão de agentes infecciosos. Inclui higiene das mãos, uso de luvas, avental, máscara e óculos conforme o risco de exposição a sangue e fluidos corporais.

Grupo de profissionais de diferentes formações que atua de modo articulado no cuidado ao usuário. Compartilha avaliações, decisões e responsabilidades, superando a fragmentação entre especialidades.

Articulação entre diferentes áreas do conhecimento que vai além da justaposição de saberes. Pressupõe troca, negociação de perspectivas e construção conjunta de intervenções sobre um problema comum.

Movimento que substituiu o modelo asilar por cuidado em liberdade, com serviços comunitários e atenção psicossocial. Tem como princípios a desinstitucionalização, a reabilitação psicossocial e a garantia de direitos das pessoas com transtornos mentais.

Serviço comunitário de saúde mental que oferece atendimento diário a pessoas com sofrimento psíquico grave e persistente. Funciona com equipe multiprofissional e articula ações com a atenção primária, a rede de urgência e a assistência social.

Conjunto articulado de serviços e dispositivos de saúde mental em diferentes níveis de complexidade, incluindo atenção básica, CAPS, ambulatórios e leitos hospitalares. Organiza o fluxo e a continuidade do cuidado em saúde mental no território.

Conjunto de atividades relacionadas ao medicamento, desde a seleção e programação até a dispensação e o acompanhamento do uso. Integra a atenção à saúde e visa ao uso racional, seguro e acessível de medicamentos.

Prescrição e consumo de medicamentos adequados às necessidades clínicas, em doses e por período apropriados, com menor custo para o paciente e a sociedade. Requer avaliação individual, informação adequada e adesão ao tratamento.

Prática centrada no paciente que aplica conhecimentos farmacológicos para otimizar o uso de medicamentos. Envolve conciliação medicamentosa, identificação de problemas relacionados a fármacos e acompanhamento da efetividade e segurança do tratamento.

Garantia de acesso regular e permanente a alimentos de qualidade e em quantidade suficiente, sem comprometer outras necessidades essenciais. Abrange desde a produção e o abastecimento até o consumo e a utilização biológica dos alimentos.

Área que atua sobre as atividades cotidianas das pessoas para promover autonomia, participação e saúde. Utiliza recursos e adaptações para superar barreiras funcionais, sensoriais, cognitivas ou sociais em contextos de vida reais.

Processo destinado a desenvolver, recuperar ou manter capacidades funcionais e a participação social de pessoas com deficiência ou após agravos. Envolve ações multiprofissionais e adaptações do ambiente e do cotidiano.

Prática pedagógica que busca ampliar a autonomia das pessoas e comunidades no cuidado da própria saúde. Não se limita à transmissão de informações, envolvendo diálogo, escuta e construção compartilhada de saberes.

Atuação profissional que analisa e intervém sobre as expressões da questão social que afetam o processo saúde-doença. Contribui para o acesso a direitos, benefícios e recursos, e para a articulação intersetorial do cuidado.

Registro digital das informações clínicas e administrativas de um usuário ao longo do tempo. Permite continuidade do cuidado, comunicação entre equipes e apoio à decisão, exigindo garantia de sigilo e integridade dos dados.