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Santos KMRD, Oliveira LPBAD, Fernandes FCGDM, Santos EGDO, Barbosa IR. Hospitalizations due to primary care sensitive conditions in a population of older adults in the state of Rio Grande do Norte from 2008 to 2016. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2019. [DOI: 10.1590/1981-22562019022.180204] [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 Objective : To identify hospitalizations to primary care sensitive conditions among older adults in the state of Rio Grande do Norte, Brazil. Method : An ecological study using information from the Hospitalization Information System of the Unified Health System was carried out. Mortality rate, permanence and costs resulting from hospitalization in the period from 2008 to 2016 were analyzed according to residence, age and sex. Results : The greatest proportions of hospitalizations were due to bacterial pneumonias and gastroenteritis. Illnesses that could be prevented by immunization had the longest average stay (on average 17 days); the highest admission rates were among men and for the over 80 age group, both in the period 2008-2010. In the period 2014-2016, hospitalizations for primary care sensitive conditions (or HPCSC) corresponded to 30.90% of all hospitalizations and 16.36% of the hospitalization expenses of the state. The average cost per HPCSC was R$970.54 during the same three-year period. Conclusion : In Rio Grande do Norte, hospitalizations due to primary care sensitive conditions among older adults is decreasing, although it is still an important cause of hospitalization and public health spending.
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Araujo MEA, Silva MT, Galvao TF, Pereira MG. Prevalence of health services usage and associated factors in the Amazon region of Brazil: a population-based cross-sectional study. BMJ Open 2017; 7:e017966. [PMID: 29151052 PMCID: PMC5701988 DOI: 10.1136/bmjopen-2017-017966] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To estimate the prevalence of healthcare use and associated factors in the Manaus metropolitan region and to describe the reasons for lack of access. DESIGN Cross-sectional population-based study. SETTING A survey conducted between May and August of 2015 in eight cities from Manaus metropolitan region, Amazonas, Brazil. PARTICIPANTS 4001 adults ≥18 years of age. PRIMARY OUTCOMES MEASURES Physician visits, dentist visits and hospitalisations in the last 12 months were the primary outcomes. Associated factors were investigated through the calculation of prevalence ratio (PR) obtained by hierarchical Poisson regression modelling. RESULTS 4001 adults were included in the study, 53% of whom were women. The self-reported prevalence of medical visits was 77% (95% CI 75% to 77%); dentist visits, 36% (95% CI 34% to 37%) and hospital admission, 7% (95% CI 6% to 7%). Physician visits were higher in women PR=1.18 (95% CI 1.14 to 1.23), the elderly PR=1.18 (95% CI 1.10 to 1.26) and people with health insurance PR=1.14 (95% CI 1.10 to 1.19). Dentist visits declined with older age PR=0.38 (95% CI 0.30 to 0.49), lower education level PR=0.62 (95% CI 0.51 to 0.74) and lower economic class PR=0.65 (95% CI 0.57 to 0.75). Hospitalisations were found to be twice as frequent for women than for men and three times as frequent among those who reported very poor health status. Among the individuals who did not receive medical attention in the previous 2 weeks, 58% reported lack of facilities or appointment unavailable and 14% reported lack of doctors. CONCLUSION While more than half visited the doctor in the last year, a lower proportion of people with socioeconomic inequities visited the dentist. Organisational and service policies are needed to increase equity in health services in the region.
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Affiliation(s)
- Maria Elizete A Araujo
- Post-Graduate Program Health Sciences, University of Brasilia, Brasilia, Federal District, Brazil
- Getulio Vargas University Hospital, Federal University of Amazonas, Manaus, Amazonas, Brazil
| | - Marcus T Silva
- Faculty of Medicine, Federal University of Amazonas, Manaus, Amazonas, Brazil
- Post-Graduate Program of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Sao Paulo, Brazil
| | - Tais F Galvao
- Faculty of Pharmaceutical Sciences, State University of Campinas, Campinas, Sao Paulo, Brazil
| | - Mauricio G Pereira
- Faculty of Medicine, University of Brasilia, Brasilia, Federal District, Brazil
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de Moraes SA, Lopes DA, de Freitas ICM. Sex-specific differences in prevalence and in the factors associated to the search for health services in a population based epidemiological study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2015; 17:323-40. [PMID: 24918407 DOI: 10.1590/1809-4503201400020004eng] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 09/13/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To identify the access to health care services and associated factors in adults living in the city of Ribeirão Preto, São Paulo, Brazil, in 2007. METHODS A cross-sectional population-based epidemiological study with a sample developed in three stages. The variability introduced in the third sampling fraction was corrected by the attribution of weights, resulting in a sample of 2,471 participants. The outcome prevalence was estimated according to socio-demographic, behavioral and health-related variables. In order to identify associated factors, the regression of Poisson was used, obtaining crude and adjusted prevalence ratios. All estimates were calculated taking into account the effect of the sampling design. RESULTS The outcome prevalence increased according to the age, being higher in female individuals. A different set of variables remained in the final models, considering each gender separately. Among men, the monthly income > R$ 1,400.00; scores > 823.6 to the Economic Indicator of Ribeirão Preto (IERP) and daily average of sitting down time (154.4 - 240 min/day) constituted themselves into protective factors, whereas the increase of age and scholarship, hospitalization, diabetes and hypertension constituted risk factors for the use of the services. Among women, health self-reported as regular, hospitalization, diabetes and hypertension characterized factors positively associated to the outcome at matter. CONCLUSIONS The results indicate the need for planning actions aimed at capturing male individuals, as well as the revaluation of detection and control of diabetes and hypertension programs, aimed at the primary prevention of terminal cardiovascular events.
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Affiliation(s)
- Suzana Alves de Moraes
- Department of Maternal-Child Nursing and Public Health, School of Nursing of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Daniele Almeida Lopes
- School of Nursing of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Isabel Cristina Martins de Freitas
- Department of Maternal-Child Nursing and Public Health, School of Nursing of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Castro SS, Carandina L, Barros MBDA, Goldbaum M, Cesar CLG. Associação entre deficiências físicas e hospitalizações na população da cidade de São Paulo, Brasil. CAD SAUDE PUBLICA 2013. [DOI: 10.1590/s0102-311x2013000500016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo foi verificar a associação entre presença de deficiências físicas e hospitalizações na cidade de São Paulo, Brasil. Foi realizado inquérito de saúde na cidade de São Paulo em 2008. Utilizou-se processo de amostragem probabilística, estratificada (sexo/idade) e por conglomerados em dois estágios (setores censitários e domicílios). Os dados foram coletados por entrevistas por meio de um questionário estruturado, com 21 blocos, com a maioria das questões fechadas. A análise inferencial foi realizada com o uso de razões de prevalência (RP) bruta e ajustada e intervalo de 95% de confiança (IC95%) pelo método de regressão de Poisson. O módulo survey do programa Stata 9.2 foi usado para as análises, com significância de 5%. Foram entrevistadas 2.690 pessoas, com idade média de 38,75 anos (IC95%: 37,54-39,96). A hospitalização foi associada à deficiência (auditiva, RP = 1,59; física, RP = 3,77; múltipla, RP = 3,26). As pessoas com deficiência (auditiva, física - paralisia/amputação e múltipla) relataram internações com mais frequência que aquelas sem deficiência.
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Affiliation(s)
| | - Luana Carandina
- Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil
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Bandeira FM, Faria FPD, Araujo EBD. Quality assessment of inhospital patients unable to speak who use alternative and extended communication. EINSTEIN-SAO PAULO 2011; 9:477-82. [DOI: 10.1590/s1679-45082011ao2083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 10/25/2011] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To implement the use of alternative communication boards in patients hospitalized and unable to communicate by speech. Methods: A descriptive study with a sample of 30 patients hospitalized and unable to communicate by speech. Boards were made with Boardmaker® Software that consists of a graphical database containing Pictorial Communication Symbols. To assess the quality of life of these patients, the Portuguese SF-36, a translated version of the Medical Outcomes Study, was applied before and after the study. Results: We found that all domains of the SF-36 showed changes after the application of communication boards. We observed that the minimum score was assigned to the mental health domain, whereas the most affected and with greatest involvement and least compromise was the overall health status. Conclusion: The quality of life assessment of patients showed improvement with the use of communication boards, demonstrating the importance and necessity of communication between the patient and staff and the patient and family members.
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Costa JSDD, Reis MC, Silveira Filho CV, Linhares RDS, Piccinini F, Fantinel E. Prevalência de internação hospitalar e fatores associados em Pelotas, RS. Rev Saude Publica 2010; 44:923-33. [DOI: 10.1590/s0034-89102010005000026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Accepted: 04/06/2010] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Estimar a prevalência de hospitalizações e identificar características associadas à internação hospitalar. MÉTODOS: Estudo transversal de base populacional realizado com indivíduos de ambos os sexos, de 20 a 69 anos, residentes na zona urbana de Pelotas, RS, entre 1999 e 2000. Foi utilizado questionário padronizado e pré-codificado. Foi realizada análise estratificada entre os sexos e controle de fatores de confusão por meio de Regressão de Poisson. Foram incluídas na análise variáveis socioeconômicas, demográficas, hábitos de vida, morbidades e consulta com médico no último ano. RESULTADOS: Dos 1.916 indivíduos, 146 (7,6%, IC95%:6,4;8,8) haviam sido hospitalizados no último ano desde a entrevista. Entre os homens, as características que se mostraram associadas a internação foram: idade de 50 anos ou mais, entre cinco e sete anos de escolaridade, ex-fumantes, distúrbios psiquiátricos menores e consulta com médico no último ano. Entre as mulheres com idade entre 60 e 69 anos, entre cinco e sete anos de escolaridade e consulta médica no período de um ano antes da entrevista, ocorreram maiores prevalências de hospitalização. As mulheres que consumiam menos de 30 g/dia de álcool mostraram menor freqüência de hospitalização. A prevalência de internação por causas sensíveis à atenção primária foi de 13,0% (IC 95%: 7,6;18,5). CONCLUSÕES: Homens e mulheres apresentaram prevalências semelhantes de internação hospitalar. Foi encontrada associação entre escolaridade e internação, mas não entre renda e internação.
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Duca GFD, Nader GA, Santos IS, Hallal PC. Hospitalização e fatores associados entre residentes de instituições de longa permanência para idosos. CAD SAUDE PUBLICA 2010; 26:1403-10. [DOI: 10.1590/s0102-311x2010000700019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 06/10/2010] [Indexed: 11/21/2022] Open
Abstract
O estudo avaliou a prevalência de internação hospitalar no período de um ano e os fatores associados com base em um censo entre residentes de instituições de longa permanência para idosos em Pelotas, Rio Grande do Sul, Brasil. A internação hospitalar foi avaliada com a pergunta: "Desde <mês> do ano passado, o(a) Sr.(a) baixou em algum hospital?". Dos 521 indivíduos elegíveis, coletou-se informação de 466 (89,4%). A prevalência de hospitalização no último ano foi de 23,9% (IC95%: 19,9-27,8) e associou-se com: incapacidade para atividades básicas vida diária, ocorrência de queda no último ano e o fato de ser ex-fumante. Indivíduos solteiros e separados tiveram proteção para internação hospitalar. Houve também associação inversa do desfecho com autopercepção de saúde. A alta prevalência de internação hospitalar encontrada em indivíduos residentes em instituições de longa permanência para idosos é um importante indicador para o planejamento dos serviços de saúde, de forma a bem atender as demandas de uma população em transição demográfica e epidemiológica.
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Chaves LDP, Anselmi ML, Santos CBD. Produção física e financeira dos procedimentos cirúrgicos em hospitais sob gestão minicipal em Ribeirão Preto-SP. TEXTO & CONTEXTO ENFERMAGEM 2009. [DOI: 10.1590/s0104-07072009000300015] [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
Estudo exploratório com objetivo descrever a produção física e financeira dos procedimentos cirúrgicos, nas internações hospitalares remuneradas pela Secretaria Municipal de Saúde de Ribeirão Preto, segundo prestador, período 1996-2003. A coleta de dados utilizou a pesquisa documental em banco de dados oficiais da Secretaria Municipal de Saúde sobre internações em cinco hospitais conveniados ao Sistema Único de Saúde. No período houve incremento de 73,1% na produção física e de 121,6% nos recursos financeiros, concentrados nas subespecialidades de ortopedia/traumatologia, gastroenterologia e cirurgias do sistema cardiovascular/linfático. Constatamos a especialização de hospitais em algumas subespecialidades cirúrgicas. A variação na produção evidencia que subespecialidades de maior incorporação tecnológica e melhor remuneração apresentam incremento. O estudo não apresenta estimativas para os anos subseqüentes, o comportamento das diferentes subespecialidades ou diferentes prestadores hospitalares do município, entretanto incremento na produção física e financeira dos procedimentos cirúrgicos, no município estudado, justifica uma análise crítica do gestor do sistema.
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Palazzo LDS, Kelling A, Béria JU, Figueiredo ACL, Gigante LP, Raymann B, Bassani DG. [Physical violence and associated factors: a population-based study in Southern Brazil]. Rev Saude Publica 2009; 42:622-9. [PMID: 18709239 DOI: 10.1590/s0034-89102008000400007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2007] [Accepted: 03/18/2008] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of physical violence and its association with sociodemographic aspects, stressful life events, and the use of health services due to emotional problems. METHODS A cross-sectional population-based study was conducted with a sample of 1,954 14-year-old or older inhabitants of the city of Canoas (Southern Brazil). They were selected by means of conglomerate sampling according to a pre-established system. Data were obtained in visits to households by means of a confidential semi-structured questionnaire. A bivariate analysis was carried out through multinomial logistic regression, and the multivariate analysis by polytomous logistic regression, categorizing the outcome by age group. RESULTS The findings show a prevalence of 9.7% (CI 95%: 8.37;11.03) and association with: women 20 years old and older (OR=2.74; CI 95%: 1.52;4.94); higher schooling rate (p<0.03); higher experience of stressful life events at 20 years of age or more (OR=6.61; CI 95%: 2.71;16.1); and doctors' appointments due to emotional problems as of 10 years of age (p>0.001). CONCLUSIONS The prevalence of physical violence in the population was significant, resulting in important emotional consequences and impact on health services, requiring capacity building of the professionals in the field.
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