This study aimed to evaluate the oral switch (OS) stewardship intervention in the intensive care unit (ICU). This was a retrospective study with a convenience sample in two Brazilian ICUs from different hospitals in patients with sepsis receiving antibiotic therapy. The stewardship intervention included OS in patients diagnosed with sepsis when clinical stability was achieved. The primary outcome was overall mortality. Other variables evaluated were as follows: cost of antimicrobial treatment, daily costs of intensive care, acute kidney injury, and length of stay. There was no difference in mortality between the OS and non-OS groups (p = 0.06). Length of stay in the ICU (p = 0.029) was shorter and acute kidney injury incidence (p = 0.032) and costs of antimicrobial therapy (p < 0.001) were lower in the OS group. OS stewardship programs in the ICU may be considered a safe strategy. Switch therapy reduced the cost and shortened the length of stay in ICUs.

Purpose: Innovation has been widely studied in business and economics, but different innovation and innovativeness measures have been used by scholars. Within this context, this research aims to identify the main innovation and innovativeness measures used by high-impact or recent papers within the past 10 years. Design/methodology/approach: Regarding methodology, the bibliometric process Proknow-C was used, selecting 26 papers from a sample exceeding 2,000 articles in the Web of Science database. Findings: Based on the literature review, these articles’ innovativeness measures were classified in terms of inputs, capabilities and outputs. In summary, the articles of the bibliometric portfolio used diverse innovativeness measures comprising inputs (R&D investments, R&D staff qualification, patents, etc.), capabilities and processes (culture, leadership, knowledge, strategy, etc). and outputs (number of innovations, percentage of revenues of innovative products, etc.). Furthermore, a new innovativeness classification was proposed with eight types of organizations considering the presence of inputs, capabilities and outputs. Research limitations/implications: Although Proknow-C is an established bibliometric process, it naturally has some limitations to select a bibliometric portfolio of approximately 20 articles from a sample exceeding 2,000 articles. The major limitations involve the filters used, such as aligned titles, number of citations in Google Scholar, Pareto principle, aligned abstracts and full text availability. Originality/value: This research contributes to theory, as it covers high-impact and recent papers concerning innovativeness, specifically by analysing the main measures used and by gathering recommended future research directions, beyond proposing an innovativeness classification. It also contributes to practice, as it gathers diverse innovation measures, which could be used by managers in their organizations.

Background: Health care is a complex economic and social system, which combines market elements and public and social interest. This combination in Brazil, like systems in China and United States of America, is operationalized through the public and private system. The sector represents approximately 9% of the country’s GDP, of which 56% is privately sourced and 44% is of public origin. In the private sector includes a structure with 711 private health institutions, 47 million beneficiaries and revenues of US$30 billion a year. Methods: Therefore, this research describes and analyzes the complementarity of Private Health before the Brazilian Unified Health System, highlighting its main characteristics, scenarios, and trends in the face of the health system and the Brazilian market. This descriptive and exploratory research uses secondary data from various sources, submitted to quantitative data analysis methods. The object of the research is the history of private health in Brazil and its main actors. Results: The data are organized into three groups, each with its approach of collection and analysis. Thus, it is perceived as the notorious growth of large operators, to the detriment of operators with a lower concentration of beneficiaries; the increasing concentration of the market through mergers and acquisitions promoted by large publicly traded corporations, especially in regions with a lower rate of private health coverage; and the growth of the sector through business plans, whose central characteristic is the dependence on the country’s employability rate. Conclusions: It is possible to perceive an intense trend of concentration of Brazilian private health in large institutions that have capitalized and have a great appetite for growth through mergers and acquisitions, whether from smaller operators or health institutions that integrate their health networks, following complementary health models already consolidated in countries such as China, and the United States of America, among others. This concentration projects a market with fewer options and competitiveness, reduction in transaction costs and increase the operational effectiveness of health care.

The need to develop alternatives to improve health assistance access and qualification was emergent and urgent even before the advent of Covid-19. Such demand is necessary in regard to both public and private systems. In this context, the theme of cost and effectiveness is technically adequate and viable to analyze these alternatives. Analyzing the history of research development on the topic and identifying its gaps is thus an essential step in facing this challenge. Therefore, the objective of this study was to modestly contribute to a bibliometric examination of scientific production based on the theme of cost-effectiveness to guide future research, despite the maturity of the theme, and as well as its future challenges. As a result, several essential aspects of the theoretical approach to the theme were observed, such as its conceptualization, purpose, and objective within public and private institutions, identifying its main authors, universities, reference countries, and funding institutions, authors’ relationship networks, and related themes. One of the most important factors identified is the absence of the theme applied to contemporary topics in health, such as telemedicine, telehealth, robotics, artificial intelligence, new drugs and medicines, and new healthcare protocols.

OBJECTIVES: To correlate the incidence of leptospirosis with sociodemographic data in the Brazilian Unified Health System from 2011 to 2022.METHODS: This ecological study used national health and economic secondary data sources. Secondary analyses summarized the scenario of disease-related hospitalizations among federative units. In total, two analyses were conducted: variable description for relationship analysis and a secondary analysis with population health and sanitation indicators and economic indicators from the Instituto Brasileiro de Geografia e Estatística (IBGE - Brazilian Institute of Geography and Statistics). The statistical analysis following this framework summarized raw data by year-monthfederative unit. A time series regression was conducted, comparing the time variable with other national-level variables. Then, several simple linear regressions were performed.RESULTS: Linear regressions show the relationship between the reduction in cases and improved access to treated water and sewage collection, whereas an increase in per capita income seems to be inversely related to leptospirosis incidence. Geospatial distribution shows higher incidence in the Brazilian South and Southeast. Disease lethality varied over time but without significant change during the period. The average treatment cost remained constant over the years, despite its complexity. CONCLUSION: Leptospirosis incidence in Brazil from 2011 to 2021 decreased and wasassociated with improvements in socioeconomic conditions despite no changes in lethality.