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Vegi ASF, Guedes LFF, Felisbino-Mendes MS, Malta DC, Fernandes EL, Machado IE. Burden of non-communicable diseases attributed to alcohol consumption in 2019 for the Brazilian Unified Health System. Public Health 2024; 233:201-207. [PMID: 38944900 DOI: 10.1016/j.puhe.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/05/2024] [Accepted: 05/08/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE To estimate the health and economic burden of non-communicable diseases (NCDs) attributed to alcohol consumption in 2019 for the Brazilian Unified Health System (SUS) stratified by states. STUDY DESIGN Observational, descriptive, and ecological study. METHODS We used population attributable fractions (PAFs) of NCDs due to alcohol consumption from the Global Burden of Disease study. We applied the PAFs to the costs of hospitalizations and outpatient procedures of medium to high complexity paid by SUS for each outcome, obtained from official databases. We also calculated the disability-adjusted life years (DALYs) and mortality caused by alcohol-related NCDs. We converted the costs into international dollars (Int$) using the purchasing parity power in 2019. RESULTS Alcohol-related NCDs accounted for 8.48% of deaths and 7.0% of DALYs among men, and 1.33% of deaths and 1.6% of DALYs among women. The main diseases were substance use, digestive, and neoplastic diseases. The SUS spent Int$202.0 million on alcohol-related NCDs, mostly on hospitalizations. The highest health burden was observed in the states of the Northeast region, and the highest expenses in the states from the South. The burden and cost values varied by sex, age group, and state. CONCLUSION The study showed that alcohol consumption has a significant impact on Brazilian population morbidity and mortality and SUS expenditures, especially among men. These results can support policies for the prevention and control of alcohol consumption and health promotion at the subnational level, prioritizing strategies that are more appropriate to local realities.
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Affiliation(s)
- A S F Vegi
- Federal University of Ouro Preto, Postgraduate Program in Health and Nutrition, Ouro Preto, Minas Gerais, Brazil
| | - L F F Guedes
- Federal University of Ouro Preto, Postgraduate Program in Health and Nutrition, Ouro Preto, Minas Gerais, Brazil
| | - M S Felisbino-Mendes
- Federal University of Minas Gerais, Postgraduate Program in Nursing, Department of Maternal and Child Nursing and Public Health, Belo Horizonte, Minas Gerais, Brazil
| | - D C Malta
- Federal University of Minas Gerais, Postgraduate Program in Nursing, Department of Maternal and Child Nursing and Public Health, Belo Horizonte, Minas Gerais, Brazil; Federal University of Minas Gerais, Postgraduate Program in Public Health, Belo Horizonte, Minas Gerais, Brazil
| | - E L Fernandes
- School of Medicine, Federal University of Ouro Preto (UFOP) - Ouro Preto, Minas Gerais, Brazil
| | - I E Machado
- Federal University of Ouro Preto, Postgraduate Program in Health and Nutrition, Ouro Preto, Minas Gerais, Brazil; School of Medicine, Federal University of Ouro Preto (UFOP) - Ouro Preto, Minas Gerais, Brazil.
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de Sousa DP, de Assis Oliveira F, Arcanjo DDR, da Fonsêca DV, Duarte ABS, de Oliveira Barbosa C, Ong TP, Brocksom TJ. Essential Oils: Chemistry and Pharmacological Activities-Part II. Biomedicines 2024; 12:1185. [PMID: 38927394 PMCID: PMC11200837 DOI: 10.3390/biomedicines12061185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024] Open
Abstract
The importance of essential oils and their components in the industrial sector is attributed to their chemical characteristics and their application in the development of products in the areas of cosmetology, food, and pharmaceuticals. However, the pharmacological properties of this class of natural products have been extensively investigated and indicate their applicability for obtaining new drugs. Therefore, this review discusses the use of these oils as starting materials to synthesize more complex molecules and products with greater commercial value and clinic potential. Furthermore, the antiulcer, cardiovascular, and antidiabetic mechanisms of action are discussed. The main mechanistic aspects of the chemopreventive properties of oils against cancer are also presented. The data highlight essential oils and their derivatives as a strategic chemical group in the search for effective therapeutic agents against various diseases.
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Affiliation(s)
| | | | - Daniel Dias Rufino Arcanjo
- LAFMOL—Laboratory of Functional and Molecular Studies in Physiopharmacology, Department of Biophysics and Physiology, Federal University of Piaui, Teresina 64049-550, Brazil; (D.D.R.A.); (C.d.O.B.)
| | - Diogo Vilar da Fonsêca
- Collegiate of Medicine, Federal University of São Francisco Valley, Bahia 48607-190, Brazil;
| | - Allana Brunna S. Duarte
- Laboratory of Pharmaceutical Chemistry, Federal University of Paraíba, João Pessoa 58051-900, Brazil;
| | - Celma de Oliveira Barbosa
- LAFMOL—Laboratory of Functional and Molecular Studies in Physiopharmacology, Department of Biophysics and Physiology, Federal University of Piaui, Teresina 64049-550, Brazil; (D.D.R.A.); (C.d.O.B.)
| | - Thomas Prates Ong
- Department of Food Science and Nutrition, School of Pharmaceutical Sciences, University of São Paulo (USP), São Paulo 05508-000, Brazil;
- Food Research Center (FoRC), University of São Paulo, São Paulo 05508-000, Brazil
| | - Timothy John Brocksom
- Department of Chemistry, Federal University of São Carlos, São Carlos 13565-905, Brazil;
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Moreira PVL, de Arruda Neta ADCP, Ferreira FELL, de Araújo JM, Rodrigues REDA, de Lima RLFC, Vianna RPDT, da Silva Neto JM, O’Flaherty M. Predicting the prevalence of type 2 diabetes in Brazil: a modeling study. Front Public Health 2024; 12:1275167. [PMID: 38756893 PMCID: PMC11096587 DOI: 10.3389/fpubh.2024.1275167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 04/08/2024] [Indexed: 05/18/2024] Open
Abstract
Aims We adopted a modeling approach to predict the likely future prevalence of type 2 diabetes, taking into account demographic changes and trends in obesity and smoking in Brazil. We then used the model to estimate the likely future impact of different policy scenarios, such as policies to reduce obesity. Methods The IMPACT TYPE 2 DIABETES model uses a Markov approach to integrate population, obesity, and smoking trends to estimate future type 2 diabetes prevalence. We developed a model for the Brazilian population from 2006 to 2036. Data on the Brazilian population in relation to sex and age were collected from the Brazilian Institute of Geography and Statistics, and data on the prevalence of type 2 diabetes, obesity, and smoking were collected from the Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey (VIGITEL). Results The observed prevalence of type 2 diabetes among Brazilians aged over 25 years was 10.8% (5.2-14.3%) in 2006, increasing to 13.7% (6.9-18.4%) in 2020. Between 2006 and 2020, the observed prevalence in men increased from 11.0 to 19.1% and women from 10.6 to 21.3%. The model forecasts a dramatic rise in prevalence by 2036 (27.0% overall, 17.1% in men and 35.9% in women). However, if obesity prevalence declines by 1% per year from 2020 to 2036 (Scenario 1), the prevalence of diabetes decreases from 26.3 to 23.7, which represents approximately a 10.0% drop in 16 years. If obesity declined by 5% per year in 16 years as an optimistic target (Scenario 2), the prevalence of diabetes decreased from 26.3 to 21.2, representing a 19.4% drop in diabetes prevalence. Conclusion The model predicts an increase in the prevalence of type 2 diabetes in Brazil. Even with ambitious targets to reduce obesity prevalence, type 2 diabetes in Brazil will continue to have a large impact on Brazilian public health.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Martin O’Flaherty
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
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Neves RG, Tomasi E, Duro SMS, Saes-Silva E, Saes MDO. [Complications due to diabetes mellitus in Brazil: 2019 nationwide study]. CIENCIA & SAUDE COLETIVA 2023; 28:3183-3190. [PMID: 37971002 DOI: 10.1590/1413-812320232811.11882022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 04/17/2023] [Indexed: 11/19/2023] Open
Abstract
Inadequate management of diabetes mellitus (DM) can lead to complications that affect quality of life. The prevalence of DM and its complications is increasing, presenting an uneven distribution in the population. The objective was to estimate the prevalence of complications due to DM and to assess inequalities in the Brazilian population. It involved a cross-sectional study, with data from the 2019 National Health Survey (NHS). The complications evaluated were: diabetic coma, heart attack/cerebrovascular accident/stroke; kidney problem; vision problem and foot ulcer or amputation. The related factors were schooling and income. The prevalence of complications was calculated separately, combination in pairs, presence of any complications and number of complications. Inequality was estimated through adjusted analysis and the slope index (SII) and concentration index (CIX) indices. The sample consisted of 6,317 people with DM. More than a third (37.8%) reported having some complication. Vision problems (30.6%) and kidney problems (9.7%) were the most prevalent. The prevalence of having "one" and "two or more" complications were 25.4% and 12.4%, respectively. Inequalities were found with a higher prevalence of complications among the least educated and the poorest.
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Affiliation(s)
- Rosália Garcia Neves
- Secretaria Estadual de Saúde do Rio Grande do Sul, 3ª Coordenadoria Regional de Saúde. R. Marechal Floriano 204, Centro. 96015-440 Pelotas RS Brasil.
| | - Elaine Tomasi
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas (UFPel). Pelotas RS Brasil
| | | | - Elizabet Saes-Silva
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande. Rio Grande RS Brasil
| | - Mirelle de Oliveira Saes
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande. Rio Grande RS Brasil
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dos Santos VP, Cerutti CI, Alencar MJC, Queiroz AB, Ferreira LDM, Fidelis C, de Araújo JS, Alves CAS. Influence of atherosclerosis risk factors on the anatomical distribution of peripheral arterial disease in patients with chronic limb-threatening ischemia: a cross-sectional study. J Vasc Bras 2023; 22:e20230014. [PMID: 37576729 PMCID: PMC10421571 DOI: 10.1590/1677-5449.202300141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/18/2023] [Indexed: 08/15/2023] Open
Abstract
Background Atherosclerosis risk factors can have different impacts on cardiovascular diseases and on the anatomical distribution of Peripheral Arterial Disease (PAD). Objectives To study the influence of atherosclerosis risk factors on the anatomical distribution of PAD in patients with chronic limb-threatening ischemia (CLTI). Methods We performed an observational, cross-sectional, and analytical study that included 476 hospitalized patients with CLTI due to PAD. We compared the presence of atherosclerosis risk factors (age, gender, diabetes mellitus, smoking, and hypertension) in patients with PAD involving three different anatomic areas (aortoiliac, femoropopliteal, and infrapopliteal). Multivariate analysis was performed to identify associations between atherosclerosis risk factors and PAD distribution. Results The mean age of the 476 patients was 69 years, 249 (52%) were men, and 273 (57%) had diabetes. Seventy-four percent (353) had minor tissue loss. Multivariate analysis identified three risk factors associated with PAD anatomical distribution (gender, smoking, and DM). Women had a 2.7 (CI: 1.75-4.26) times greater chance of having femoropopliteal disease. Smokers had a 3.6-fold (CI: 1.54-8.30) greater risk of aortoiliac disease. Diabetic patients were 1.8 (CI: 1.04-3.19) times more likely to have isolated infrapopliteal occlusive disease. Conclusions The study showed that gender, DM, and smoking impact on the anatomical distribution of PAD in patients with CLTI. Diabetic patients were more likely to have only infrapopliteal disease, women had a greater risk of femoropopliteal PAD, and smokers had a greater risk of aortoiliac occlusive disease.
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Affiliation(s)
- Vanessa Prado dos Santos
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - Camila Izabel Cerutti
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - Marcelo José Carlos Alencar
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - André Brito Queiroz
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - Lucas de Mello Ferreira
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - Cícero Fidelis
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
| | - José Siqueira de Araújo
- Universidade Federal da Bahia - UFBA, Hospital Universitário Professor Edgard Santos - HUPES, Salvador, BA, Brasil.
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Gomes OV, Guimarães MP, Nicacio JM, Morena L, Silva AMLD, Morais Junior JCD, Souza CDFD, Barral Netto M, Lima JAC, Armstrong ADC. Urbanization and kidney dysfunction in Brazilian indigenous people: a burden for the youth. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:240-245. [PMID: 36888763 PMCID: PMC9983479 DOI: 10.1590/1806-9282.20220934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/14/2022] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The aim of this study was to investigate whether the degree of urbanization influences the prevalence of chronic kidney disease in Brazilian indigenous people. METHODS This is a cross-sectional study conducted between 2016 and 2017 in northeastern Brazil and includes individuals aged between 30 and 70 years from two specific indigenous groups who volunteered to participate in the study: the Fulni-ô people (lowest degree of urbanization) and the Truká group (greater degree of urbanization). Cultural and geographical parameters were used to characterize and measure the magnitude of urbanization. We excluded individuals with known cardiovascular disease or renal failure who required hemodialysis. Chronic kidney disease was defined as a single measurement of an estimated glomerular filtration rate <60 mL/min/1.73 m2 using the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. RESULTS A total of 184 indigenous people from the Fulni-ô group and 96 from the Truká group with a median age of 46 years (interquartile range: 15.2) were included. We found a chronic kidney disease rate of 4.3% in the total indigenous population, generally affecting an older population: 41.7% over 60 years old (p<0.001). The Truká people had a chronic kidney disease prevalence of 6.2%, with no differences in kidney dysfunction across age groups. The Fulni-ô participants had a chronic kidney disease prevalence of 3.3%, with a higher proportion of kidney dysfunction in older participants (of the six Fulni-ô indigenous people with chronic kidney disease, five were older). CONCLUSION Our results suggest that a higher degree of urbanization seems to negatively influence the prevalence of chronic kidney disease in Brazilian indigenous people.
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Affiliation(s)
- Orlando Vieira Gomes
- Universidade do Estado da Bahia, Postgraduation Program in Human Ecology and Socio-Environmental Management - Juazeiro (BA), Brazil.,Universidade Federal do Vale do São Francisco, School of Medicine - Petrolina (PE), Brazil
| | | | - Jandir Mendonça Nicacio
- Universidade do Estado da Bahia, Postgraduation Program in Human Ecology and Socio-Environmental Management - Juazeiro (BA), Brazil.,Universidade Federal do Vale do São Francisco, School of Medicine - Petrolina (PE), Brazil
| | - Leela Morena
- Universidade Federal do Vale do São Francisco, School of Medicine - Petrolina (PE), Brazil
| | | | | | | | | | | | - Anderson da Costa Armstrong
- Universidade do Estado da Bahia, Postgraduation Program in Human Ecology and Socio-Environmental Management - Juazeiro (BA), Brazil.,Universidade Federal do Vale do São Francisco, School of Medicine - Petrolina (PE), Brazil
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Nucci LB, Rinaldi AEM, Ramos AF, Itria A, Enes CC. Impact of a reduction in sugar-sweetened beverage consumption on the burden of type 2 diabetes in Brazil: A modeling study. Diabetes Res Clin Pract 2022; 192:110087. [PMID: 36130646 DOI: 10.1016/j.diabres.2022.110087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/04/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022]
Abstract
AIM To model the impact of a 20 % tax on sugar-sweetened beverages (SSBs) on the disease burden of T2DM among Brazilian adults. METHODS This is an ex-ante risk comparative study. The model applied a 20 % tax on SSB and projected the incidence, prevalence, and mortality of T2DM over a 20-year period (2019 to 2039). Using recent national data on consumption, previously published cross- and own-price elasticities of SSBs and diabetes relative risk we estimated changes on T2DM burden. RESULTS With a 20 % tax on SSBs, after 10 years, we estimated a reduction of 37,303 new cases of T2DM for men and 56,757 for women; 184,129 prevalent cases for men and 219,236 for women; and 5,386 and 6,075 deaths for men and women, respectively. After 20 years, 8.6 % and 12.4 % new cases of T2DM will have been prevented, 4.0 % and 5.5 % prevalent cases, and 13.7 % and 12.7 % deaths among men and women, respectively. CONCLUSIONS SSB taxes have the potential to reduce the burden of and deaths attributable to T2DM. Our results show that a fiscal policy may significantly impact strategic plans to tackle noncommunicable diseases.
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Affiliation(s)
- Luciana Bertoldi Nucci
- Pontifical Catholic University of Campinas (PUC-Campinas), Center for Life Sciences, Postgraduate Program in Health Sciences, Campinas, SP, Brazil
| | - Ana Elisa M Rinaldi
- Federal University of Uberlândia (UFU), School of Medicine, Postgraduate Program in Health Sciences, Uberlândia, MG, Brazil
| | - Amanda Ferreira Ramos
- Federal University of Uberlândia (UFU), School of Medicine, Nutrition Course, Uberlândia, MG, Brazil
| | - Alexander Itria
- Federal University of Sao Carlos (UFSCar), Management and Technology Sciences Center, Postgraduate Program in Economy, Sorocaba, SP, Brazil
| | - Carla Cristina Enes
- Pontifical Catholic University of Campinas (PUC-Campinas), Center for Life Sciences, Postgraduate Program in Health Sciences, Campinas, SP, Brazil.
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Muzy J, Campos M, Emmerick I, Avelar FGD. Characterization of primary health care for patients with diabetes based on the PMAQ-AB. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022279.17542021en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract This article aims to present a proposal for making the instruments used in the three cycles of the PMAQ-AB compatible and to analyze the information on access, coverage, structure, organization and provision of services in PHC related to care for DM in Brazil, according to regions, from the perspective of family health professionals and users. We performed an analysis of the degree of compatibility of the PMAQ-AB questions (2012, 2014 and 2017). To analyze the temporal evolution of the components, we performed a proportion difference test. We calculated the percentage difference between the perspective of professionals and users, per year analyzed, for Brazil. In general, there was an improvement in the quality of care and examinations, except for the diabetic foot. Worse results were found for the North region in relation to the other regions. Despite the structural improvement and the quality of care reported by professionals, there are significant gaps in the quality of care for patients with DM in the SUS. In the scenario of scarce investment added to the growing prevalence of DM, obstacles become progressively more challenging. Therefore, monitoring and evaluating the quality of services provided are essential tasks of the Brazilian Health System.
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Muzy J, Campos M, Emmerick I, Avelar FGD. Characterization of primary health care for patients with diabetes based on the PMAQ-AB. CIENCIA & SAUDE COLETIVA 2022; 27:3583-3602. [PMID: 36000646 DOI: 10.1590/1413-81232022279.17542021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 05/11/2022] [Indexed: 11/22/2022] Open
Abstract
This article aims to present a proposal for making the instruments used in the three cycles of the PMAQ-AB compatible and to analyze the information on access, coverage, structure, organization and provision of services in PHC related to care for DM in Brazil, according to regions, from the perspective of family health professionals and users. We performed an analysis of the degree of compatibility of the PMAQ-AB questions (2012, 2014 and 2017). To analyze the temporal evolution of the components, we performed a proportion difference test. We calculated the percentage difference between the perspective of professionals and users, per year analyzed, for Brazil. In general, there was an improvement in the quality of care and examinations, except for the diabetic foot. Worse results were found for the North region in relation to the other regions. Despite the structural improvement and the quality of care reported by professionals, there are significant gaps in the quality of care for patients with DM in the SUS. In the scenario of scarce investment added to the growing prevalence of DM, obstacles become progressively more challenging. Therefore, monitoring and evaluating the quality of services provided are essential tasks of the Brazilian Health System.
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Affiliation(s)
- Jéssica Muzy
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
| | - Mônica Campos
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
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Lopes CGDS, Rocha TAH, Thomaz ÉBAF, Tonello AS, Rocha NCDS, Duarte KMM, Queiroz RCDS. Desigualdades macrorregionais na atenção primária ao Diabetes Mellitus: comparação dos três ciclos do PMAQ-AB. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-1104202213309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O objetivo do estudo foi identificar desigualdades macrorregionais relacionadas à estrutura e ao processo de trabalho para o atendimento do Diabetes Mellitus (DM) na Atenção Primária à Saúde (APS) ao longo dos três ciclos do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) no Brasil. Trata-se de um estudo ecológico, longitudinal, de abrangência nacional, com dados secundários dos três ciclos do PMAQ-AB. Os dados foram comparados entre as macrorregiões brasileiras utilizando o teste t com a correção de Bonferroni. As regiões Norte e Nordeste apresentaram os menores percentuais de adequação nos itens de estrutura: dependências da unidade (<74%), acessibilidade ao cadeirante (<63%), horário especial de funcionamento (<16%), equipe ampliada (<12%) e insumos (<89%) em todos os ciclos do PMAQ-AB, quando comparadas às demais regiões. Já os itens relacionados ao processo de trabalho apresentaram pouca variação entre as regiões, e os que apresentaram percentuais médios ≤ 75% de adequação foram: agenda especializada (41%, 33%, 41%), apoio matricial (58%, 72%, 70%), oferta e resolubilidade de ações (62%, 64%, 75%) e educação permanente (35%, 42%, 58%). Ainda existe a necessidade de investimentos na estrutura e em melhorias no processo de trabalho das equipes, principalmente nas macrorregiões Norte e Nordeste.
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Muzy J, Campos MR, Emmerick I, Sabino R. Supply and demand of procedures related to diabetes mellitus and its complications in Brazil. CIENCIA & SAUDE COLETIVA 2022; 27:1653-1667. [PMID: 35475843 DOI: 10.1590/1413-81232022274.05612021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/02/2021] [Indexed: 11/21/2022] Open
Abstract
This article aims to present a methodology for monitoring the procedures recommended in the care protocol for diabetic patients, based on the indicator of the ratio between supply and demand for exams, according to Brazil, macro-regions, federative units (FUs), and municipalities. The prevalence of diabetes mellitus (DM) and its complications were estimated using a multinomial model. The offer of DM procedures was obtained from the Ambulatory Information System (SIA/SUS) and the demand from the number of tests defined in the protocol as necessary per year, according to disease risk categories. Based on this, the supply-demand ratio indicator was created. The innovation here consists of analyzing the demand for diabetic care according to established parameters and the supply of health services together. The connection between the recommended treatment protocol and the existence of the service offered concerning the demand for care based on the prevalence of the disease provides a key monitoring tool. And, when analyzed together with the indicator of the ratio between supply and demand for procedures, these measures become a proxy for the quality of prevention and care for patients with the disease.
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Affiliation(s)
- Jéssica Muzy
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480 Manguinhos, 21041-210. Rio de Janeiro RJ Brasil.
| | - Monica Rodrigues Campos
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480 Manguinhos, 21041-210. Rio de Janeiro RJ Brasil.
| | - Isabel Emmerick
- University of Massachusetts Medical School. Massachusetts USA
| | - Raulino Sabino
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480 Manguinhos, 21041-210. Rio de Janeiro RJ Brasil.
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Lopes CGDS, Rocha TAH, Thomaz ÉBAF, Tonello AS, Rocha NCDS, Duarte KMM, Queiroz RCDS. Diabetes Mellitus macro-regional inequalities in PHC: comparing the three PMAQ-AB cycles. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-1104202213309i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT This study aimed to identify macro-regional structure and work process inequalities for Diabetes Mellitus (DM) treatment in Primary Health Care (PHC) throughout the three cycles of the National Program for Access and Quality Improvement of Primary Care (PMAQ-AB) in Brazil. This ecological, longitudinal, nationwide study employed secondary data from the three PMAQ-AB cycles. The data were compared between the Brazilian macro-regions using the t-test with Bonferroni correction. The North and Northeast had the lowest percentages of adequacy in the structure items: unit premises (<74%), wheelchair user accessibility (<63%), special opening hours (<16%), expanded teams (<12%), and supplies (<89%) in all PMAQ-AB cycles when compared to other regions. The items related to the work process barely varied between regions, and those with mean adequacy percentages ≤ 75% were specialized agenda (41%, 33%, 41%), matrix support (58%, 72%, 70 %), offer and resolution of actions (62%, 64%, 75%) and continuing education (35%, 42%, 58%). Investments are still required in the structure and improvement in the teams’ work process, especially in the North and Northeast macro-regions.
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