Cost-minimization analysis of teledermatology versus conventional care in the Brazilian National Health System.

Aims: Cost-minimization analysis (CMA) comparing the teledermatology service of the State of Santa Catarina, Brazil with the provision of conventional care, from the societal perspective. Patients & methods: All costs related to direct patient care were considered in calculation of outpatient costs. The evaluation was performed using the parameters avoided referrals and profile of hospitalizations. The economic analysis was developed through a decision tree. Results: Totally, 40% of 79,411 tests performed could be managed in primary care, avoiding commuting and expanding the patients' access. The CMA showed the teledermatology service had a cost per patient of US$196.04, and the conventional care of US$245.66. Conclusion: In this scenario, teledermatology proved to be a cost-saving alternative to conventional care, reducing commuting costs.

Lay abstract Diagnosis and treatment of skin diseases through teledermatology avoid patient referrals, improves accessibility to specialized care, as well as the skin care provided by physicians. This study compared the costs of the teledermatology service of the State of Santa Catarina, Brazil with the costs of the provision of conventional care, to check which of them was more efficient. All costs related to direct patient care were considered in the calculation of costs. Totally, 40% of 79,411 dermatological tests performed could be locally managed in primary care, avoiding commuting, and expanding the patients' access to care. The teledermatology service had a cost per patient of US$196.04, compared with the cost of conventional care of US$245.66. In this evaluation, teledermatology proved to be cheaper than conventional care, reducing commuting costs.

Injury deaths in the metropolitan region of Florianópolis, Southern Brazil, 1996-2002.

The objective was to analyse injury mortality in the metropolitan region of Florianópolis, Brazil, from 1996 to 2002. The study design was an ecological model. The mortality distribution was calculated along with the mortality rate due to injury in general and also by specific causes for each year during the study period and for the region's most populous towns. Injury mortality rates decreased in the period, but the homicide mortality increased by 103% when comparing the years 1996 and 2002. Most of the victims were children, young people and old people. This study confirmed a greater vulnerability among young people and the elderly, predominantly in the male population. The significant increase in the mortality rate due to homicides in this region was particularly noticeable and followed the same trend as has been observed in other regions of the country.

Padronização e confiabilidade das medidas antropométricas para pesquisa populacional / Standardization and reliability of anthropometric measurements for population surveys

O objetivo do presente estudo foi padronizar e determinar a confiabilidade das medidas realizadas por cinco antropometristas de una pesquisa populacional, A padronização, com conteùdos teóricos e práticos relativos à técnica de mensuração antropométrica, foi realizada em setembro de 2006 e março de 2007, quando foram aferidos o erro técnico de mediço (ETM) intra - avaliador e interavaliador, respectivamente. Para determinar o ETM intra - avaliador, 107 escolares foram avaliados em dois dias distintos. Para aferição do ETM inter - avaliadores, 22 escolares foram avaliados um de cada vez, durante o mesmo período, pelos cinco avaliadores e por um avaliador padrão. De forma general, o resultado de ETM absoluto intra - avaliador para as dobras cutâneas foi menor que 1 mm. Para as circunferências quase todos tiveram valores menores que 1 cm. A análise do ETM relativo intra - avaliador indica que, para as dobras cutâneas subescapular, suprailíaca e panturrilha medial a maioria dos valores esteve acima dos valores limites para antropometristas iniciantes. Quase todos os valores de R intra - avaliadores foram maiores que 0,95 para as dibras cutâneas e maiores que 0,99 para as circunferências. Observa - se que os resultados de ETM absoluto e de R do estudo interavaliador foram similares aos do estudo intra - avaliador. Em relação ao ETM relativo interavaliador verificou - se uma melhora dos antropometristas, devido a maior ocorrência de valores dentro dos limites aceitáveis. Este estudo mostrou que após a realização de duas aferições do ETM, os antropometristas melhoraram seu desempenho e pode - se considerar que o processo de treinamento e de padronização de medidas antropométricas foi bem sucedido.