RESUMO
BACKGROUND: The magnitude of economic losses attributed to sleep problems and insufficient physical activity (PA) remains unclear. This study aimed to investigate the association between insufficient PA, sleep problems, and direct healthcare costs. OBJECTIVE: To investigate the association between insufficient physical activity (PA), sleep problems, and direct healthcare costs among adults. DESIGN AND SETTING: Adults aged ≥ 50 years attended by the Brazilian National Health Service were tracked from 2010 to 2014. METHODS: Direct healthcare costs were assessed using medical records and expressed in US$. Insufficient PA and sleep problems were assessed through face-to-face interviews. Differences were identified using the analysis of covariance and variance for repeated measures. RESULTS: In total, 454 women and 166 men were enrolled. Sleep problems were reported by 28.9% (95%CI: 25.2% to 32.4%) of the sample, while insufficient PA was reported by 84.8% (95%CI: 82.1% to 87.6%). The combination of sleep problems and insufficient PA explained 2.3% of all healthcare costs spent on these patients from 2010 to 2014, which directly accounts for approximately US$ 4,765.01. CONCLUSION: The combination of sleep problems and insufficient PA plays an important role in increasing direct healthcare costs in adults. Public health stakeholders, policymakers, and health professionals can use these results to reinforce the need for strategies to improve sleep quality and increase PA, especially in nations that finance their National Health Systems.
Assuntos
Exercício Físico , Custos de Cuidados de Saúde , Transtornos do Sono-Vigília , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/economia , Estudos Longitudinais , Brasil , Custos de Cuidados de Saúde/estatística & dados numéricos , Idoso , Fatores SocioeconômicosRESUMO
ABSTRACT BACKGROUND: The magnitude of economic losses attributed to sleep problems and insufficient physical activity (PA) remains unclear. This study aimed to investigate the association between insufficient PA, sleep problems, and direct healthcare costs. OBJECTIVE: To investigate the association between insufficient physical activity (PA), sleep problems, and direct healthcare costs among adults. DESIGN AND SETTING: Adults aged ≥ 50 years attended by the Brazilian National Health Service were tracked from 2010 to 2014. METHODS: Direct healthcare costs were assessed using medical records and expressed in US$. Insufficient PA and sleep problems were assessed through face-to-face interviews. Differences were identified using the analysis of covariance and variance for repeated measures. RESULTS: In total, 454 women and 166 men were enrolled. Sleep problems were reported by 28.9% (95%CI: 25.2% to 32.4%) of the sample, while insufficient PA was reported by 84.8% (95%CI: 82.1% to 87.6%). The combination of sleep problems and insufficient PA explained 2.3% of all healthcare costs spent on these patients from 2010 to 2014, which directly accounts for approximately US$ 4,765.01. CONCLUSION: The combination of sleep problems and insufficient PA plays an important role in increasing direct healthcare costs in adults. Public health stakeholders, policymakers, and health professionals can use these results to reinforce the need for strategies to improve sleep quality and increase PA, especially in nations that finance their National Health Systems.
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BACKGROUND: This study was based on filling a gap in our knowledge regarding the issue of what the protective effect of physical exercise on patients within the Brazilian National Health System could be, in relation to low back pain. OBJECTIVES: To determine the prevalence of chronic low back pain (CLBP) and to analyze the protective effect of physical exercise among patients over 50 years old attended at primary healthcare units (PHUs). DESIGN AND SETTING: Analytical cross-sectional study at Universidade Estadual Paulista (UNESP) that was conducted in two PHUs (Parque Cedral and Vila Real), located in different regions of the city of Presidente Prudente, Brazil. METHODS: In total, 327 patients were interviewed and evaluated at which retrospective characteristics covering the previous 12 months. The Nordic questionnaire was used to classify CLBP, and the Baecke questionnaire for physical activity level. The body mass index (kg/m2) was calculated using body mass and height values, both collected at the time of the interview. RESULTS: High prevalence of low back pain was found; 175 patients (53.5%) reported having had at least one episode of low back pain in the previous year. Of these, 71 (21.7%) answered yes to all four questions on the Nordic questionnaire and were classified as CLBP. Physical exercise remained associated with CLBP, independent of other factors (odds ratio = 0.35; 95% confidence interval = 0.15-0.80). CONCLUSION: High prevalence of low back pain was identified among PHU users. Physical exercise was associated as an independent protective factor against this pathological condition.
Assuntos
Dor Crônica , Dor Lombar , Brasil , Estudos Transversais , Exercício Físico , Humanos , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
BACKGROUND: This study was based on filling a gap in our knowledge regarding the issue of what the protective effect of physical exercise on patients within the Brazilian National Health System could be, in relation to low back pain. OBJECTIVES: To determine the prevalence of chronic low back pain (CLBP) and to analyze the protective effect of physical exercise among patients over 50 years old attended at primary healthcare units (PHUs). DESIGN AND SETTING: Analytical cross-sectional study at Universidade Estadual Paulista (UNESP) that was conducted in two PHUs (Parque Cedral and Vila Real), located in different regions of the city of Presidente Prudente, Brazil. METHODS: In total, 327 patients were interviewed and evaluated at which retrospective characteristics covering the previous 12 months. The Nordic questionnaire was used to classify CLBP, and the Baecke questionnaire for physical activity level. The body mass index (kg/m2) was calculated using body mass and height values, both collected at the time of the interview. RESULTS: High prevalence of low back pain was found; 175 patients (53.5%) reported having had at least one episode of low back pain in the previous year. Of these, 71 (21.7%) answered yes to all four questions on the Nordic questionnaire and were classified as CLBP. Physical exercise remained associated with CLBP, independent of other factors (odds ratio = 0.35; 95% confidence interval = 0.15-0.80). CONCLUSION: High prevalence of low back pain was identified among PHU users. Physical exercise was associated as an independent protective factor against this pathological condition.
Assuntos
Humanos , Pessoa de Meia-Idade , Dor Lombar , Dor Crônica , Brasil , Exercício Físico , Estudos Transversais , Estudos RetrospectivosRESUMO
OBJECTIVE: Investigate whether obesity is responsible for costs due to productivity loss (PL) in adults, during 30 months of follow-up. METHODS: Absenteeism and disability retirement were considered as PL. For classification of obesity, body mass index (BMI) and waist circumference (WC) values were considered. The statistical software BioEstat (release 5.0) was used and the significance level was set at P valueâ<â0.05. RESULTS: For the men, BMI and WC accounted for â¼60% and â¼30% of retirement due to disability (Pâ=â0.001). For the women, this percentage represented â¼19% for BMI and â¼8% for WC, both Pâ<â0.05. Physical activity was not a significant confounder in any of the analyses (Pâ>â0.05). CONCLUSION: Total and abdominal obesity were responsible for increased costs from PL due to early retirement among adults aged 50 years or older.
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Pessoas com Deficiência , Eficiência , Obesidade/economia , Aposentadoria/economia , Absenteísmo , Idoso , Índice de Massa Corporal , Brasil/epidemiologia , Estudos de Coortes , Efeitos Psicossociais da Doença , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade Abdominal/economia , Obesidade Abdominal/epidemiologia , Aposentadoria/estatística & dados numéricos , Fatores de Risco , Circunferência da CinturaRESUMO
Abstract Given the importance of physical activity for health promotion and for the prevention of chronic non-communicable diseases, the Unified Health System (SUS) has changed its strategy of action in the last decades, trying to adopt preventive activities, seeking better quality of life of the Brazilian population and reduce costs with treatment of diseases. The aim of this study was to investigate changes in physical activity and sedentary behavior patterns in users of the Brazilian National Unified Health System during 18 months and the impact of sex and time on such variables. One hundred and ninety-eight participants (58 men and 140 women) were evaluated. Physical activity level was assessed using the Baecke questionnaire. Men had higher scores in all physical activity variables compared to women: walking (p-value= 0.013), cycling (p-value= 0.001) and commuting (p-value= 0.007), but not for TV watching (p-value= 0.362). After 18 months, in the overall sample, walking score increased 25.9% (95%CI= 10.6 to 41.1), but not cycling (1.5% [95%CI= -2.7 to 5.7]), commuting (14.4% [95%CI= -0.4 to 29.3]) and TV watching (1.6% [95%CI= -5.7 to 9.1]). Men were usually more active than women in active behaviors, but not in TV watching. However, differences over time were similar between sexes.
Resumo Dada a importância da atividade física para promoção da saúde, assim como para a prevenção de doenças crônicas não transmissíveis, o Sistema Único de Saúde (SUS) mudou a estratégia de atuação nas últimas décadas, procurando adotar atividades preventivas, buscando melhorar a qualidade de vida da população brasileira e diminuir gastos com tratamento de doenças. Objetivou-se investigar as mudanças na prática de atividade física e tempo de televisão em usuários do SUS durante um período de 18 meses e o impacto do sexo e tempo nessas variáveis. Foram avaliados 198 participantes (58 homens e 140 mulheres). Nível de atividade física foi mensurado através do questionário de Baecke. Homens apresentaram maiores escores em todas as variáveis de atividade física: caminhada (p-valor 0,013), ciclismo (p-valor 0,001) e locomoção (p-valor 0,007) do que mulheres, mas não para assistir televisão (p-valor= 0,362). Após 18 meses, em toda a amostra, o escore de caminhada aumentou 25,9% (IC95%= 10,6 - 41,1), mas não ciclismo (1,5% [95%CI= -2,7 - 5,7]), locomoção (14,4% [95%CI= -0,4 - 29,3]) e televisão (1,6% [95%CI= -5,7 - 9,1]). Entre usuários do SUS, homens foram usualmente mais ativos que mulheres em comportamentos ativos, mas não ao assistir televisão. Porém, diferenças ao longo do tempo foram similares entre os sexos.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Sistema Único de Saúde , Exercício Físico , Atividades de Lazer , Estilo de VidaRESUMO
Aims: To analyze factors associated with osteoporosis among outpatients of the Brazilian National Health System and to identify their association with hospital and labor economic outcomes. Methods: Cross-sectional study carried out in the city of Presidente Prudente / SP. The sample consisted of 542 adults of both sexes and aged ≥ 50 years old. The occurrence of osteoporosis, health-related productivity loss, use of hospital services and level of physical activity were assessed using questionnaires. Statistical analysis was composed of chi-square test, binary logistic regression and Mann-Whitney test. The significance level adopted was p-value <0.05. Results: The prevalence of osteoporosis was 14.4% (95% CI: 11.4% - 17.3%) and it was associated with female sex (p = 0.001), lower economic status (p-value = 0.036) and obesity (p-value = 0.003). Participants with osteoporosis showed a higher incidence of surgery in the last 12 months (OR = 2.13 [1.04 to 4.35]), productivity loss (OR = 1.91 [1.13 to 3.42]) and disability retirement (OR = 2.03 [1.20 to 3.43]). Over the past 12 months, the sum of direct and indirect economic loss was R$ 1,382,630.00. Conclusion: The female sex, lower economic status and obesity were associated with a higher occurrence of osteoporosis, and consequent higher use of hospital services and significant economic losses.(AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Osteoporose/complicações , Sistema Único de Saúde , Serviços Técnicos Hospitalares , Saúde Ocupacional , Custos de Cuidados de Saúde , EficiênciaRESUMO
ABSTRACT Postural instability, a fundamental signal/symptom of Parkinson's disease (PD), is characterized by the association between postural alignment, joint range of motion, and muscular rigidity. The aim of the present study was to analyze the relationship between performance in the functional reach test (FRT) and associated factors such as joint range of motion and PD clinical features. Twenty-five people with PD in stages 1 and 1.5 of the Hoehn & Yahr scale participated in the study. The analyzed dependent variables were: FRT performance and scores in the items of clinical evaluation of the Unified Parkinson's Disease Rating Scale: pull-test, motor rigidity, and motor condition were used. The average distance in the FRT was 25.3 cm and the mean anterior-posterior displacement of the center of pressure was 2.69 cm. The ankle range of motion was associated with FRT performance, while postural stability was associated with the anterior-posterior displacement of the center of pressure during the FRT. We conclude that FRT performance in people with PD is determined by the individual level of balance and by the ankle joint amplitude and muscular rigidity and functional alterations due to aging are responsible for FRT performance.
RESUMO A instabilidade postural, um sinal/sintoma cardinal da doença de Parkinson (DP), é caracterizada pela associação entre alinhamento postural, amplitude de movimento e rigidez muscular. O objetivo foi analisar a relação entre o desempenho no teste de alcance funcional (TAF) e fatores relacionados a amplitude de movimento e aspectos clínicos da doença. Participaram 25 pessoas com DP nos estágios 1,0 e 1,5 da Hoehn e Yahr. As variáveis dependentes analisadas foram: desempenho no TAF e as pontuações nos itens da avaliação clínica da UnifiedParkinson'sDisease Rating Scale: teste de retropulsão, rigidez muscular e condição motora. A distância média no TAF foi de 25,3 cm e o deslocamento anteroposterior médio do centro de pressão foi de 2,69 cm. A amplitude de movimento articular do tornozelo está associada ao desempenho no TAF, enquanto a estabilidade postural está associada ao deslocamento anteroposterior do centro de pressão durante o TAF. Conclui-se que o desempenho no TAF em pessoas com DP é determinado pelo nível individual de equilíbrio e pela amplitude articular do tornozelo e a rigidez muscular e alterações funcionais do envelhecimento são responsáveis pelo desempenho no TAF.
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Humanos , Recém-Nascido , Lactente , Recém-Nascido , Gravidez , Criança , Adolescente , Cognição , Destreza MotoraRESUMO
ABSTRACT Many factors are associated with sleep disorders, causing an increase in health spending. The objective of this study was to analyze the association of sleep disorders and non-communicablechronic diseases in patients over 50 years of age, attended by Basic Health Care Units of Presidente Prudente. In total, 363 patients participated. The history of diseases was self-reported through the use of a questionnaire, the level of physical activity was evaluated by the Baecke questionnaire, and sleep quality was assessed using the Mini-Sleep Questionnaire. Anthropometric and body composition data were collected using a stadiometer and scale; patients in the highest (75th) percentile were considered obese. Statistical analysis was performed using the Student t test, chi-square test, and binary logistic regression. The results showed that sleep disorders are associated with osteoporosis, arthritis/osteoarthritis, low back pain, depression, and obesity. Additionally, obesity and physical inactivity influence the occurrence of non-communicable chronic diseases.
RESUMO Inúmeros fatores estão associados aos distúrbios do sono ocasionando o aumento nos gastos com saúde. O objetivo do trabalho foi analisar a associação dos distúrbios do sono e doenças crônicas não transmissíveis em pacientes com idade superior a 50 anos atendidos por Unidades Básicas de Saúde de Presidente Prudente. Participaram 363 pacientes. O histórico de doenças foi auto relatada a partir da aplicação de questionário, o nível de atividade física foi verificado através do questionário de Baecke, e a qualidade do sono foi avaliada utilizando o Mini-Sleep questionnaire. Dados antropométricos e de composição corporal foram coletados utilizando estadiômetro e balança, foram considerados obesos os pacientes dentro do percentil 75. A análise estatística foi composta pelos testes t de Student, qui-quadrado, e regressão logística binária. Os resultados mostraram que o distúrbio do sono está associado as doenças osteoporose, artrite/artrose, dor lombar, depressão e obesidade. Adicionalmente obesidade e inatividade física influenciam na ocorrência de doenças crônicas não transmissíveis.