Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 255
Filter
1.
Rev. chil. endocrinol. diabetes ; 16(3): 53-59, 2023. ilus, tab
Article in Spanish | LILACS | ID: biblio-1451959

ABSTRACT

En abril de 2021 el ministerio de salud de Chile da a conocer un estudio que explicita un importante déficit de médicos con especialidades derivadas de la Medicina Interna. En endocrinólogos de adultos se estima un déficit de 14 profesionales en el sistema público de Salud al año 2024, así como un endocrinólogo infantil y 10 diabetólogos; y una lista de espera estimada en 23.000 consultas de la especialidad para 2020. OBJETIVOS: cuantificar el número de especialistas en endocrinología de adultos, infantil y diabetología de nuestro país, y su distribución en nuestro territorio. MÉTODOS: Se realiza la búsqueda de todos los médicos registrados bajo la especialidad endocrinología y diabetología en la Superintendencia de Salud, su distribución por regiones del país, en relación del número de habitantes regional y nacional. RESULTADOS: Existen 340 especialistas en endocrinología y 188 diabetólogos a nivel nacional; 1.93 y 1.33 por cada 100.000 habitantes, respectivamente. El 75% de ellos se registra en las regiones Metropolitana, Valparaíso y Bio Bío. En 5 regiones del país se registra un profesional para toda la región; en una región no se registran profesionales de endocrinología ni diabetología. CONCLUSIONES: Este trabajo da cuenta de una desigual distribución regional de especialistas en endocrinología y diabetes en Chile. Se deben plantear estrategias de corto y mediano plazo para incentivar a especialistas que migren hacia regiones de alta necesidad.


In April 2021, the Ministry of Health of Chile unveiled a report showing a significant deficit of medical doctors with specialties derived from Internal Medicine. In adult endocrinologists, a deficit of 14 professionals in the public health system is estimated as of 2024, as well as one pediatric endocrinologist and 10 diabetologists; and a waiting list estimated of 23,000 consultations for the specialty by 2020. OBJECTIVES: to quantify the number of specialists in adult and pediatric endocrinology and diabetology, and their geographic distribution. METHODS: A search for all physicians registered under the endocrinology and diabetology specialties was carried out in the Superintendence of Health website; their geographic distribution according to regional and national inhabitants was studied. RESULTS: There are 340 endocrinology and 188 diabetes' specialists at the national level, 1.93 and 1.33 per 100.000 inhabitants, respectively. A 75% of them are registered in the Metropolitan, Valparaíso and Bio Bío areas. In five regions, just one professional is registered; there are no endocrinology or diabetology professionals registered in one region. CONCLUSIONS: our work accounts for an unequal regional distribution of specialists in endocrinology and diabetes in Chile. Short- and medium-term strategies should be proposed to encourage specialists to migrate to regions of high demand.


Subject(s)
Humans , Delivery of Health Care/statistics & numerical data , Endocrinologists/supply & distribution , Chile , Demography
2.
Acta sci., Health sci ; 44: e56262, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1367442

ABSTRACT

The aim of this study is to evaluate the direct diagnostic costs for disease groups and other variables (such as gender, age, seasons) that are related to the direct diagnostic costs based on a 3-year data. The population of the study consisted of 31,401 patients who applied to family medicine outpatient clinic in Turkey between January 1st, 2016 and December 31st, 2018. With this study, we determined in which disease groups of the family medicine outpatient clinic weremost frequently admitted. Then, total and average diagnostic costs for these disease groups were calculated. Three-year data gave us the opportunity to examine the trend in diagnostic costs. Based on this, we demonstratedwhich diseases' total and average diagnostic costs increased or decreased during 3 years. Moreover, we examined how diagnostic costs showed a trend in both Turkish liras and USA dollars' rate for 3 years. Finally, we analysedwhether the diagnostic costs differed according to variables such as age, gender and season. There has been relatively little analysis on the diagnostic costs in the previous literature. Therefore, we expect to contribute to both theoristsand healthcare managers for diagnostic costs with this study.


Subject(s)
Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Costs and Cost Analysis/economics , Costs and Cost Analysis/statistics & numerical data , Family Practice/instrumentation , Family Practice/statistics & numerical data , Ambulatory Care Facilities/supply & distribution , Outpatients/statistics & numerical data , International Classification of Diseases/economics , Disease , Delivery of Health Care/statistics & numerical data , Ambulatory Care/statistics & numerical data
3.
Ciênc. cuid. saúde ; 21: e57088, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1384520

ABSTRACT

RESUMO Objetivo: descrever o perfil dos pacientes com crise hipertensiva atendidos em uma Unidade de Pronto Atendimento. Método: estudo transversal descritivo, realizado por meio da análise de 80 prontuários de pacientes com quadro de crise hipertensiva, atendidos em uma unidade de pronto atendimento, entre o período de março de 2018 a fevereiro de 2019. Os dados foram coletados por meio de roteiro estruturado e receberam tratamento estatístico descritivo. Resultados: Após a análise dos 80 prontuários, constatou-se que a média de idade entre os pacientes atendidos foi de 58,03, sendo a faixa etária adulta a mais prevalente (53,8%). Constatou-se que a média da pressão arterial sistólica foi significativamente maior em homens em relação às mulheres (p=0,013). Quanto à sintomatologia, a cefaleia foi a mais prevalente, com 35,0%. Verificou-se que durante o atendimento da crise hipertensiva, a maioria dos pacientes fez uso de apenas uma droga para redução da PA, sendo o inibidor adrenérgico de ação central o mais citado. Quanto ao desfecho, grande parte dos pacientes recebeu alta (93,8%) logo após o atendimento, porém, 6,3% permaneceram em internamento de curta permanência até a estabilização do quadro. Considerações finais: Este estudo possibilitou a caracterização da população com crise hipertensiva atendida em um pronto atendimento, a qual evidencia uma possível fragilidade existente entre a articulação dos níveis de atenção à saúde.


RESUMEN Objetivo: describir el perfil de los pacientes con crisis hipertensiva atendidos en una Unidad de Pronta Atención. Método: estudio transversal descriptivo, realizado por medio del análisis de 80 registros médicos de pacientes con cuadro de crisis hipertensiva, atendidos en una unidad de pronta atención, entre el período de marzo de 2018 a febrero de 2019. Los datos fueron recogidos por medio de guion estructurado y recibieron tratamiento estadístico descriptivo. Resultados: después del análisis de los 80 registros médicos, se constató que el promedio de edad entre los pacientes atendidos fue de 58,03, siendo la franja etaria adulta la más prevalente (53,8%). Se constató que el promedio de la presión arterial sistólica fue significativamente mayor en hombres que en las mujeres (p=0,013). En cuanto a la sintomatología, la cefalea fue la más prevalente, con 35,0%. Se verificó que, durante la atención de la crisis hipertensiva, la mayoría de los pacientes hizo uso de solo una droga para reducción de la PA, siendo el inhibidor adrenérgico de acción central el más relatado. Respecto al resultado, gran parte de los pacientes recibió el alta (93,8%) inmediatamente después de la atención, sin embargo, el 6,3% permaneció en internamiento de corta estancia hasta la estabilización del cuadro. Consideraciones finales: este estudio posibilitó la caracterización de la población con crisis hipertensiva atendida en una pronta atención, la cual evidencia una posible fragilidad existente entre la articulación de los niveles de atención a la salud.


ABSTRACT Objective: to describe the profile of patients with hypertensive crisis treated at an Emergency Care Unit. Method: descriptive cross-sectional study carried out through the analysis of 80 medical records of patients with hypertensive crisis, treated at an emergency care unit, between March 2018 and February 2019. Data were collected using a structured script and were subjected to descriptive statistical treatment. Results: after analyzing the 80 medical records, it was found that the mean age of the treated patients was 58.03, with the adult age group being the most prevalent (53.8%). It was found that the mean systolic blood pressure was significantly higher in men than in women (p=0.013). As for symptoms, headache was the most prevalent, with 35.0%. It was found that during the treatment of the hypertensive crisis, most patients used only one drug to reduce BP, with centrally acting antiadrenergic drugs being the most cited. Regarding the outcome, most of the patients were discharged (93.8%) soon after treatment; however, 6.3% remained in short-term hospitalization until their condition stabilized. Final considerations: this study made it possible to characterize the population with hypertensive crisis treated in an emergency room, showing a possible fragility in the articulation between health care levell


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Patients/psychology , Health Profile , Emergency Medical Services/statistics & numerical data , Emergency Service, Hospital/statistics & numerical data , Hypertension/diagnosis , Hypertension/drug therapy , Medical Records/statistics & numerical data , Cross-Sectional Studies/methods , Nursing/statistics & numerical data , Delivery of Health Care/statistics & numerical data , Emergency Service, Hospital/standards , Arterial Pressure , Arterial Pressure/drug effects , Clinical Study , Hospitals, Packaged/statistics & numerical data , Hypertension/nursing , Hypertension/epidemiology
4.
Braz. J. Pharm. Sci. (Online) ; 58: e20301, 2022. graf
Article in English | LILACS | ID: biblio-1420476

ABSTRACT

Abstract In Brazil, medicine dispensing is a pharmacy service provided within the national health system that allows the pharmacist to interact directly with the patient in order to prevent, detect and solve problems related to pharmacotherapy and health needs. However, it is known that most dispensing services provided in the country are still limited to supplying medications and, at their finest, offering advice on medication utilization. Attempts to change this scenario present new challenges the area of pharmacy, which involve the need for a patient-centered pharmaceutical service model. This paper describes the patient-centered pharmaceutical service of high-cost medicine dispensing performed at a pharmacy linked to the Brazilian Unified Health System. In the model described here, the medicine-dispensing activity is the pharmacist's main field of practice, which consists of identifying patient needs related to health care itself and medication utilization. It also aims to introduce the instrument developed (a Pharmaceutical Care Protocol) that contributed to implementing this clinical service provided by the pharmacist. The protocols guide and qualify the service by providing information that helps in evaluating the effectiveness and safety of treatments and in the preparation of the care plan and can be used as a basis for other services that intend to adopt clinical pharmacy practices.


Subject(s)
Pharmacists/ethics , Pharmacy/classification , Brazil/ethnology , Patients/classification , Costs and Cost Analysis/statistics & numerical data , Delivery of Health Care/statistics & numerical data
5.
Rev. méd. Maule ; 36(2): 24-33, dic. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1377956

ABSTRACT

In the Family Medicine Unit (UMF) of the UC Health Network there is a program of multiple interventions based on a Chronic Control Model (CCM), led by a nurse who coordinates the activities and ensures compliance, aspiring to a change in its model of care and self-sustainability. It has been running for several years and its implementation and results have not been evaluated. Objective: This study aims to describe the situation of the Program, at its different levels: structure, processes and results. Material and method: Observational, descriptive longitudinal study of patients seen between July 2010 and June 2012, based on: methodology proposed by A. Donabedian; E. Wagner recommendations for the MTC; Monthly Statistical Registers and recommendations of the GES DM2 and HTA (MINSAL) Guides. Results: Hypertensive patients present a reduction of 11.2 mmHg in SBP and 7.8 mmHg in DBP (p 0.04). Diabetics present a reduction in HbA1c by 1.5 percentage points (p 0.04), and mixed patients present a SBP / DBP reduction of 10.3 and 6.8 mmHg respectively and an HbA1c reduction of 1.1 percentage points (p 0.092). Conclusions: After an average of 15 months, hypertensive patients significantly improve their mean SBP, DBP and compensation percentages; diabetics significantly improve their mean HbA1c and compensation percentages; mixed patients manage to improve their blood pressure and HbA1c levels, but this is not statistically significant.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Chronic Disease/therapy , Diabetes Mellitus, Type 2/pathology , Hypertension/pathology , Private Health Care Coverage , Cardiovascular Diseases/complications , Epidemiology, Descriptive , Delivery of Health Care/statistics & numerical data , Family Practice/statistics & numerical data
6.
2021; Secretaria de Estado da Saúde; 20210000. 81 p. ilus.
Monography in Portuguese | LILACS, CONASS, ColecionaSUS, SES-TO | ID: biblio-1369818

ABSTRACT

Este Caderno de Textos foi elaborado com o propósito de subsidiar o itinerário e gestão na Formação de Apoiadores Institucionais para o Acolhimento em Redes de Atenção à Saúde (ApI-ARAS), no que tange ao Planejamento, Monitoramento e Avaliação, a partir dos pressupostos da Política Nacional de Humanização (PNH) e Política Nacional de Educação Permanente em Saúde (PNEPS). O ApI-ARAS é uma proposta integrada de qualificação das frentes de Apoio Institucional no âmbito do SUS no Tocantins, com o objetivo de fortalecer o Acolhimento em Redes de Atenção à Saúde. Acreditamos que o encontro destes atores no processo formativo tem potencial para o fortalecimento da atuação dos apoiadores institucionais. Este Caderno integra conteúdos referentes ao Planejamento, Monitoramento e Avaliação, articulando com outros Cadernos, especialmente construídos para subsidiar o processo formativo ApI-ARAS, dialogando com os temas previstos na Matriz Curricular do Curso: Apoio como potência e intervenção na realidade; Saúde do(a) trabalhador(a) do SUS; Acolhimento em Redes de Atenção à Saúde; e Eixos avaliativos e indicadores. Neste volume foram contemplados aspectos referentes ao desenho do processo formativo, bases pedagógicas, metodológicas e de intervenção, além do delineamento do monitoramento e avaliação, norteadores para o processo de ensino-aprendizagem e gestão. Esperamos que este material contribua para reflexões acerca das questões que permeiam o universo do trabalho e para a (re)organização do processo de trabalho em saúde, promovendo a autonomia dos sujeitos envolvidos na produção de saúde.


This Textbook was prepared with the purpose of subsidizing the itinerary and management in the Training of Institutional Supporters for Reception in Health Care Networks (ApI-ARAS), with regard to Planning, Monitoring and Evaluation, based on the assumptions of the National Humanization Policy (PNH) and National Policy on Permanent Education in Health (PNEPS). ApI-ARAS is an integrated proposal for the qualification of Institutional Support fronts within the scope of the SUS in Tocantins, with the objective of strengthening the Reception in Health Care Networks. We believe that the meeting of these actors in the training process has the potential to strengthen the performance of institutional supporters. This Notebook integrates contents related to Planning, Monitoring and Evaluation, articulating with other Notebooks, specially built to subsidize the ApI-ARAS training process, dialoguing with the themes foreseen in the Curriculum Matrix of the Course: Support as power and intervention in reality; Health of SUS workers; Reception in Health Care Networks; and Evaluation axes and indicators. In this volume, aspects related to the design of the training process, pedagogical, methodological and intervention bases, in addition to the design of monitoring and evaluation, guiding the teaching-learning and management process were considered. We hope that this material will contribute to reflections on the issues that permeate the universe of work and for the (re)organization of the health work process, promoting the autonomy of the subjects involved in the production of health.


Este Libro de Texto fue elaborado con el propósito de subsidiar el itinerario y la gestión en la Formación de Apoyos Institucionales para la Acogida en Redes de Atención a la Salud (API-ARAS), en lo que se refiere a Planificación, Seguimiento y Evaluación, con base en los presupuestos de la Política Nacional de Humanización ( PNH) y Política Nacional de Educación Permanente en Salud (PNEPS). ApI-ARAS es una propuesta integrada para la calificación de frentes de Apoyo Institucional en el ámbito del SUS en Tocantins, con el objetivo de fortalecer la Acogida en las Redes de Atención a la Salud. Creemos que el encuentro de estos actores en el proceso de formación tiene el potencial de fortalecer la actuación de los promotores institucionales. Este Cuaderno integra contenidos relacionados con la Planificación, Seguimiento y Evaluación, articulándose con otros Cuadernos, especialmente construidos para subsidiar el proceso de formación ApI-ARAS, dialogando con los temas previstos en la Matriz Curricular del Curso: Apoyo como poder e intervención en la realidad; Salud de los trabajadores del SUS; Acogida en Redes de Atención a la Salud; y Ejes e indicadores de evaluación. En este volumen se consideraron aspectos relacionados con el diseño del proceso de formación, bases pedagógicas, metodológicas y de intervención, además del diseño de seguimiento y evaluación, orientando el proceso de enseñanza-aprendizaje y de gestión. Esperamos que este material contribuya a la reflexión sobre las cuestiones que permean el universo del trabajo y para la (re)organización del proceso de trabajo en salud, promoviendo la autonomía de los sujetos involucrados en la producción de salud.


Subject(s)
Humans , Education, Continuing/methods , Delivery of Health Care/statistics & numerical data , Education/methods
7.
Rev. chil. salud pública ; 25(2): 248-254, 2021.
Article in Spanish | LILACS | ID: biblio-1370774

ABSTRACT

INTRODUCCIÓN. El sistema de salud chileno se basa en el modelo de atención primaria. En este contexto, la demanda generada por la atención de usuarios policonsultantes constituye una problemática universal. Surge entonces la necesidad de identificar a esta población para implementar medidas. El objetivo de este estudio es caracterizar el perfil de usuarios policonsultantes en el servicio de urgencia del Hospital San Camilo, pertenecientes al CESFAM San Felipe El Real, entre junio 2018-mayo 2019. MATERIALES Y MÉTODOS. Estudio observacional, retrospectivo y descriptivo. Los datos fueron obtenidos desde base de datos anonimizada de usuarios atendidos en el servicio de salud; se seleccionaron pacientes pertenecientes al Centro con 7 o más consultas anuales en urgencia del Hospital San Camilo y se analizaron variables como sexo, edad, previsión y patologías consultadas. RESULTADOS. De 128 pacientes pertenecientes al CESFAM catalogados como policonsultantes, dos tercios del total son del sexo femenino, con un claro predominio de los primeros dos tramos de FONASA. En ambos sexos la población es mayormente pediátrica y le sigue a esto la población femenina de edad media. DISCUSIÓN. Con estos resultados se caracteriza a los usuarios policonsultantes del centro estudiado, lo que permite focalizar planes para estas personas implementando mejoras en resolutividad.


INTRODUCTION. The Chilean health system is based on the primary care model. In this context, the demand generated by the attention of polyconsultant users constitutes a universal problem. Is necessary to identify this population to implement measures. The objective of this study is to characterize the profile of polyconsultant users in the emergency department of San Camilo Hospital, belonging to the CESFAM San Felipe El Real, between June 2018-May 2019. MATERIALS AND METHODS. Observational, retrospective and descriptive study. From an anonymized database that collects information from users treated in the health service, patients belonging to the Center were selected if they had 7 or more annual consultations in the emergency care of the San Camilo Hospital. Variables such as sex, age, prevention and pathologies were analyzed. RESULTS. Of 128 patients belonging to CESFAM cataloged as polyconsultant, two thirds of the total are female, with a clear predominance of the first two sections of FONASA. In both sexes the population is mostly pediatric, and this is followed by the middle-aged female population. DISCUSSION. With these results, the polyconsultant users of the center studied are characterized, which allows to focus plans on these people and improve the resolution in these areas.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Primary Health Care/statistics & numerical data , Emergency Service, Hospital/statistics & numerical data , Chile , Retrospective Studies , Delivery of Health Care/statistics & numerical data
9.
Rev. Col. Bras. Cir ; 48: e20202644, 2021. graf
Article in English | LILACS | ID: biblio-1155365

ABSTRACT

ABSTRACT Objective: to establish the epidemiological profile of ostomized patients treated at the Health Care Service for Ostomy Patients in Juiz de Fora and region (SASPO/JF) and to quantify the pathologies that led to the stoma as well as the ostomy-related complications. Method: a retrospective study was carried out with the analysis of 496 medical records of patients registered at HCSOP/JF over 30 years and who remained in at the service in June 2018. The following variables were considered: age, sex, pathology that led to the stoma, type, time, location and complications of stomas. Results: 53.43% were male patients and 46.57% female. The average age was 56.24 years among men and 58.40 years among women. Eight patients had two types of ostomies simultaneously and a total of 504 ostomies were as follows: 340 colostomies (67.46%), 117 ileostomies (23.21%) and 47 urostomies (9.33%). Additionally, 47.65% of the colostomies and 76.92% of the ileostomies were temporary, while all urostomies were permanent. In 70.24% of cases, the reason for making the stoma was malignancy. There were 277 stomas with one or more complications (54.96%). Conclusions: most of the ostomized patients were over 50 years old and the main diagnosis that led to the stoma was malignancy. Ileostomies had a higher percentage of complications than colostomies and urostomies and, for all types of stomas, the most frequent complication was dermatitis.


RESUMO Objetivo: elaborar o perfil epidemiológico dos pacientes estomizados atendidos no Serviço de Atenção à Saúde da Pessoa Ostomizada de Juiz de Fora e região (SASPO/JF) e quantificar tanto as patologias que levaram à confecção, quanto as complicações presentes nas estomias. Método: realizado estudo retrospectivo com análise de 496 prontuários de pacientes cadastrados no SASPO/JF ao longo de 30 anos e que permaneciam em atendimento no serviço em junho de 2018. Foram consideradas as seguintes variáveis: idade, sexo, patologia que levou à confecção do estoma, tipo, caráter temporal, localização e complicações das estomias. Resultados: 53,43% dos pacientes eram do sexo masculino e 46,57% do sexo feminino. A média de idade entre os homens foi de 56,24 anos e entre as mulheres foi de 58,40 anos. Oito pacientes apresentaram dois tipos de estomias simultaneamente e o total de 504 estomias foi distribuído da seguinte forma: 340 colostomias (67,46%), 117 ileostomias (23,21%) e 47 urostomias (9,33%). Além disso, 47,65% das colostomias e 76,92% das ileostomias foram temporárias, enquanto todas as urostomias foram permanentes. Em 70,24% dos casos, o motivo para confecção do estoma foi a neoplasia maligna. Foram encontrados 277 estomas com uma ou mais complicações (54,96%). Conclusão: as estomias predominaram em pacientes com mais de 50 anos e o principal diagnóstico que levou à confecção dos estomas foi a neoplasia maligna. As ileostomias apresentaram maior percentual de complicações do que as colostomias e urostomias e, para todos os tipos de estomas, a complicação mais frequente foi a dermatite.


Subject(s)
Humans , Male , Female , Adult , Aged , Ostomy/methods , Ostomy/statistics & numerical data , Colorectal Neoplasms/surgery , Colonic Neoplasms/surgery , Delivery of Health Care/statistics & numerical data , Colostomy/methods , Colostomy/statistics & numerical data , Ileostomy/methods , Ileostomy/statistics & numerical data , Retrospective Studies , Colorectal Surgery , Middle Aged
10.
Salud pública Méx ; 62(5): 540-549, sep.-oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1390317

ABSTRACT

Abstract Objective: To analyze acute myocardial infarction (AMI) admissions and in-hospital mortality rates and evaluate the competence of the Ministry of Health (MOH) hospitals to provide AMI treatment. Materials and methods: We used a mixed-methods approach: 1) Joinpoint analysis of hospitalizations and in-hospital mortality trends between 2005 and 2017; 2) a nation-wide cross-sectional MOH hospital survey. Results: AMI hospitalizations are increasing among men and patients aged >60 years; women have higher mortality rates. The survey included 527 hospitals (2nd level =471; 3rd level =56). We identified insufficient competence to diagnose AMI (2nd level 37%, 3rd level 51%), perform pharmacological perfusion (2nd level 8.7%, 3rd level 26.8%), and mechanical reperfusion (2nd level 2.8%, 3rd level 17.9%). Conclusions: There are wide disparities in demand, supply, and health outcomes of AMI in Mexico. It is advisable to build up the competence with gender and age perspectives in order to diagnose and manage AMI and reduce AMI mortality effectively.


Resumen Objetivo: Analizar las tendencias de admisiones y mortalidad hospitalaria por infarto agudo al miocardio (IAM) y evaluar la competencia hospitalaria de la Secretaría de Salud (SS) para tratarlo. Material y métodos. Enfoque de métodos mixtos: Jointpoint análisis de tendencias de hospitalizaciones y mortalidad hospitalaria entre 2005 y 2017, y encuesta en hospitales de la SS. Resultados: Las hospitalizaciones por IAM están aumentando entre hombres y pacientes >60 años. Las mujeres tienen mayor mortalidad. La encuesta incluyó 527 hospitales (2º nivel =471, 3er nivel =56). Los hospitales tienen competencias insuficientes para diagnosticar IAM (2º nivel 37%, 3er nivel 51%), realizar perfusión farmacológica (2º nivel 8.7%, 3er nivel 26.8%) y reperfusión mecánica (2º nivel 2.8%, 3er nivel 17.9%). Conclusiones: Existen disparidades en demanda, oferta y resultados en salud del IAM. Es aconsejable fortalecer las competencias, con perspectivas de género y edad, para diagnosticar y tratar IAM, y reducir su mortalidad efectivamente.


Subject(s)
Female , Humans , Male , Delivery of Health Care/statistics & numerical data , Myocardial Infarction , Cross-Sectional Studies , Hospital Mortality , Clinical Competence , Hospitalization , Mexico/epidemiology , Myocardial Infarction/therapy , Myocardial Infarction/epidemiology
11.
Colomb. med ; 51(3): e204534, July-Sept. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142822

ABSTRACT

Abstract Background: Valle del Cauca is the region with the fourth-highest number of COVID-19 cases in Colombia (>50,000 on September 7, 2020). Due to the lack of anti-COVID-19 therapies, decision-makers require timely and accurate data to estimate the incidence of disease and the availability of hospital resources to contain the pandemic. Methods: We adapted an existing model to the local context to forecast COVID-19 incidence and hospital resource use assuming different scenarios: (1) the implementation of quarantine from September 1st to October 15th (average daily growth rate of 2%); (2-3) partial restrictions (at 4% and 8% growth rates); and (4) no restrictions, assuming a 10% growth rate. Previous scenarios with predictions from June to August were also presented. We estimated the number of new cases, diagnostic tests required, and the number of available hospital and intensive care unit (ICU) beds (with and without ventilators) for each scenario. Results: We estimated 67,700 cases by October 15th when assuming the implementation of a quarantine, 80,400 and 101,500 cases when assuming partial restrictions at 4% and 8% infection rates, respectively, and 208,500 with no restrictions. According to different scenarios, the estimated demand for reverse transcription-polymerase chain reaction tests ranged from 202,000 to 1,610,600 between September 1st and October 15th. The model predicted depletion of hospital and ICU beds by September 20th if all restrictions were to be lifted and the infection growth rate increased to 10%. Conclusion: Slowly lifting social distancing restrictions and reopening the economy is not expected to result in full resource depletion by October if the daily growth rate is maintained below 8%. Increasing the number of available beds provides a safeguard against slightly higher infection rates. Predictive models can be iteratively used to obtain nuanced predictions to aid decision-making


Resumen Introducción: Valle del Cauca es el departamento con el cuarto mayor número de casos de COVID-19 en Colombia (>50,000 en septiembre 7, 2020). Debido a la ausencia de tratamientos efectivos para COVID-19, los tomadores de decisiones requieren de acceso a información actualizada para estimar la incidencia de la enfermedad, y la disponibilidad de recursos hospitalarios para contener la pandemia. Métodos: Adaptamos un modelo existente al contexto local para estimar la incidencia de COVID-19, y la demanda de recursos hospitalarios en los próximos meses. Para ello, modelamos cuatro escenarios hipotéticos: (1) el gobierno local implementa una cuarentena desde el primero de septiembre hasta el 15 de octubre (asumiendo una tasa promedio de infecciones diarias del 2%); (2-3) se implementan restricciones parciales (tasas de infección del 4% y 8%); (4) se levantan todas las restricciones (tasa del 10%). Los mismos escenarios fueron previamente evaluados entre julio y agosto, y los resultados fueron resumidos. Estimamos el número de casos nuevos, el número de pruebas diagnósticas requeridas, y el numero de camas de hospital y de unidad de cuidados intensivos (con y sin ventilación) disponibles, para cada escenario. Resultados: El modelo estimó 67,700 casos a octubre 15 al asumir la implementación de una nueva cuarentena, 80,400 y 101,500 al asumir restricciones parciales al 4 y 8% de infecciones diarias, respectivamente, y 208,500 al asumir ninguna restricción. La demanda por pruebas diagnósticas (de reacción en cadena de la polimerasa) fue estimada entre 202,000 y 1,610,600 entre septiembre 1 y octubre 15, a través de los diferentes escenarios evaluados. El modelo estimó un agotamiento de camas de cuidados intensivos para septiembre 20 al asumir una tasa de infecciones del 10%. Conclusión: Se estima que el levantamiento paulatino de las restricciones de distanciamiento social y la reapertura de la economía no debería causar el agotamiento de recursos hospitalarios si la tasa de infección diaria se mantiene por debajo del 8%. Sin embargo, incrementar la disponibilidad de camas permitiría al sistema de salud ajustarse rápidamente a potenciales picos inesperados de infecciones nuevas. Los modelos de predicción deben ser utilizados de manera iterativa para depurar las predicciones epidemiológicas y para proveer a los tomadores de decisiones con información actualizada.


Subject(s)
Humans , Models, Statistical , Delivery of Health Care/statistics & numerical data , COVID-19/therapy , Health Resources/statistics & numerical data , Colombia , COVID-19/epidemiology , Health Resources/supply & distribution , Hospital Bed Capacity/statistics & numerical data , Intensive Care Units/statistics & numerical data
12.
Medicina (B.Aires) ; 80(3): 203-210, jun. 2020. graf, tab
Article in English | LILACS | ID: biblio-1125071

ABSTRACT

Social vulnerability has proved to be an independent risk factor for hypoglycemia in patients with diabetes. In some countries, patients who are in a vulnerable situation are assisted in the public health system which provides free medical care. This study compares the prevalence of hypoglycemia among patients with type 2 diabetes (T2D), in public versus private sector and its relationship with social vulnerability. This multicentric descriptive study included 600 patients with T2D from public and private care institutions of Argentina. Socioeconomic level (SEL) was evaluated through the Marketing Argentinean Association survey. Number of severe, documented symptomatic and asymptomatic hypoglycemias were registered. Among the patients included, 66% were assisted in the public sector. The 41% of patients (n = 246) registered at least 1 episode of any hypoglycemia event being more prevalent in the public sector compared to the private sector (50% vs. 22%). In the adjusted analysis it was observed a greater risk of hypoglycemia in public sector (OR 4, 95% CI 2.65-6.04) and in patients that did not have diabetological education (OR 2.28 95% CI 1.35-3.84). Similarly, unemployment (OR 5.04 95% CI 2.69-9.46), and marginal SEL (OR 60.79 95% CI 14.89-248.13) increased the risk of hypoglycemia. Several factors related to social vulnerability as unemployment, marginal SEL and poor sanitary education showed a significant increase in the hypoglycemia risk. Professionals working with people with diabetes must take into account these factors for a safe treatment of the disease.


La vulnerabilidad social ha demostrado ser un factor de riesgo independiente de hipoglucemia en pacientes con diabetes. Los pacientes que se encuentran en situación de vulnerabilidad social reciben asistencia en el sistema de salud pública que brinda atención médica gratuita. Este estudio compara la prevalencia de hipoglucemia en pacientes con diabetes tipo 2 en el sector público frente al privado y su relación con la vulnerabilidad social. Se realizó un estudio multicéntrico descriptivo que incluyó 600 pacientes con diabetes tipo 2 de instituciones de atención pública y privada de Córdoba. El nivel socioeconómico se evaluó a través de la encuesta de la Asociación Argentina de Marketing que evalúa la dimensión social, educativa y económica para estratificar el nivel socioeconómico. Se registró el número de hipoglucemias graves, documentadas sintomáticas y asintomáticas. El 66% de los pacientes pertenecían al sector público. El 41% de los pacientes (n = 246) registró al menos 1 episodio de cualquier evento de hipoglucemia. En el análisis ajustado, se observó un mayor riesgo de hipoglucemia en el sector público (OR 4, 95% CI 2.65-6.04), en pacientes que no tenían educación diabetológica previa (OR 2.28, 95% CI 1.35-3.84), en desempleados (OR 5.04, 95% CI 2.69-9.46) y en aquellos con nivel socioeconómico marginal (OR 60.79 95% CI 14.89-248.13). Factores relacionados con la vulnerabilidad social como el desempleo, el nivel socioeconómico marginal y educación sanitaria deficiente mostraron un aumento en el riesgo de hipoglucemia. Los profesionales que trabajan con personas con diabetes deben tener en cuenta estos factores para un tratamiento seguro de la enfermedad.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Hospitals, Private/statistics & numerical data , Delivery of Health Care/statistics & numerical data , Diabetes Mellitus, Type 2/epidemiology , Hospitals, Public/statistics & numerical data , Hypoglycemia/epidemiology , Argentina/epidemiology , Socioeconomic Factors , Logistic Models , Prevalence , Cross-Sectional Studies , Risk Factors , Public Sector , Private Sector , Vulnerable Populations/statistics & numerical data , Diabetes Complications/epidemiology , Diabetes Mellitus, Type 2/physiopathology , Social Determinants of Health , Hypoglycemia/physiopathology
13.
Rev. saúde pública (Online) ; 54: 32, 2020. tab, graf
Article in English | LILACS | ID: biblio-1094411

ABSTRACT

ABSTRACT OBJECTIVE To evaluate the association among characteristics of primary health care center (PHCC) with hospitalizations for primary care sensitive conditions (PCSC) in Brazil. METHOD In this study, a cross-sectional ecological study was performed. This study analyzed the 27 capitals of Brazil's federative units. Data were aggregated from the following open access databases: National Program for Access and Quality Improvement in Primary Care, the Hospital Information System of Brazilian Unified Health System and Annual Population Census conducted by the Brazilian Institute of Geography and Statistics. Associations were estimated among characteristics of primary care with the number of three PCSC as the leading causes of hospitalization in children under-5 population in Brazil: asthma, diarrhea, and pneumonia. RESULTS In general, PHCC showed limited structural adequacy (37.3%) for pediatric care in Brazil. The capitals in South and Southeast regions had the best structure whereas the North and Northeast had the worst. Fewer PCSC hospitalizations were significantly associated with PHCC which presented appropriate equipment (RR: 0.98; 95%CI: 0.97-0.99), structural conditions (RR: 0.98; 95%CI: 0.97-0.99), and signage/identification of professionals and facilities (RR: 0.98; 95%CI: 0.97-0.99). Higher PCSC hospitalizations were significantly associated with PHCC with more physicians (RR: 1.23, 95%CI: 1.02-1.48), it forms (RR: 1.01, 95%CI: 1.01-1.02), and more medications (RR: 1.02, 95%CI: 1.01-1.03) CONCLUSION Infrastructural adequacy of PHCC was associated with less PCSC hospitalizations, while availability medical professional and medications were associated with higher PCSC hospitalizations.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Primary Health Care/statistics & numerical data , Hospitalization/statistics & numerical data , Pneumonia/therapy , Pneumonia/epidemiology , Asthma/therapy , Asthma/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Cross-Sectional Studies , Delivery of Health Care/statistics & numerical data , Diarrhea/therapy , Diarrhea/epidemiology
14.
Article in English | LILACS | ID: biblio-1094410

ABSTRACT

ABSTRACT OBJECTIVE To evaluate if factors related to the mother's previous guidance on her children's dental health and the school attendance of children influence the regular dental care of preschoolers living in the rural area of a municipality in Southern Brazil. METHODS A population-based study was conducted with 264 children under five years of age and their mothers. Socioeconomic and behavioral data were collected using a questionnaire, and the children were subjected to dental health tests. The outcome was the regular use of dental services. The main exposure variables were children's care in daycare centers or schools and maternal guidance on the child's dental health. Poisson regression analysis with robust variance adjustment was used to estimate prevalence ratios, considering a 95% confidence interval. RESULTS The prevalence of regular use was 11.4% (95%CI 7.5-15.2). In the adjusted analysis, the regular use of services was associated with the child attending day care center/school (PR = 2.44; 95%CI 1.38-4.34), and the mother received dental health guidance (PR = 4.13; 95%CI 1.77-9.61), even with control for socioeconomic, maternal and child variables. CONCLUSION When mothers receive previous information on child dental health care and children attend schools or daycare centers, the likelihood of regular dental appointments in preschoolers living in rural locations increases.


RESUMO OBJETIVO Avaliar se fatores relacionados à orientação prévia da mãe sobre saúde bucal dos seus filhos e a frequência escolar das crianças influenciam o atendimento odontológico regular de pré-escolares moradores da área rural de um município do Sul do Brasil. MÉTODOS Um estudo de base populacional foi conduzido com 264 crianças menores de cinco anos e suas mães. Dados socioeconômicos e comportamentais foram coletados por meio de questionário e as crianças foram submetidas a exames de saúde bucal. O desfecho foi o uso regular de serviços odontológicos. As variáveis de exposição principais foram o atendimento infantil em creches ou escolas e orientação materna sobre a saúde bucal da criança. A análise de regressão de Poisson com ajuste robusto de variância foi utilizada para estimar as razões de prevalência e intervalos de confiança de 95%. RESULTADOS A prevalência de uso regular foi 11,4% (IC95% 7,5-15,2). Na análise ajustada o uso regular de serviços foi associado à criança frequentar creche/escola (RP = 2,44; IC95% 1,38-4,34) e a mãe ter recebido orientação de saúde bucal (RP = 4,13; IC95% 1,77-9,61), mesmo com controle para variáveis socioeconômicas, maternas e da criança. CONCLUSÃO Quando as mães recebem informações prévias sobre os cuidados com a saúde bucal infantil e as crianças frequentam escolas ou creches, aumenta a probabilidade de consultas odontológicas regulares em pré-escolares residentes em localidades rurais.


Subject(s)
Humans , Child, Preschool , Adolescent , Adult , Young Adult , Schools/statistics & numerical data , Oral Health/education , Health Education, Dental , Dental Care/methods , Delivery of Health Care/statistics & numerical data , Rural Population , Socioeconomic Factors , Brazil , Health Knowledge, Attitudes, Practice , Oral Health/statistics & numerical data , Rural Health , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Dental Care/statistics & numerical data , Middle Aged , Mother-Child Relations
15.
Rev. bras. enferm ; 73(3): e20180400, 2020. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1101514

ABSTRACT

ABSTRACT Objective: To analyze publications regarding judicial demands related to the violation of the rights of the client who uses private health insurance in Brazil. Method: Integrative review, from September to October 2017, of national character, with complete texts online, in Portuguese and English, published between 2012 and 2017 in the Virtual Health Library portal, excluding studies that were duplicated or with indiscriminate methodology. Results: The judicial demands were for: medication (32%); ward hospitalization (11%); surgical procedures (9%); orthosis, prothesis and special materials (9%); others (9%); and diagnostic procedures, outpatient service, hospitalization in Intensive Care Units, food formulas and disposable diapers (30%). Conclusion: The prevalence of legal disputes arising from the failure in providing health service by private health insurances was observed, which makes it easier for the administrators to identify the sought health products and services in order to reorganize the administrative sphere and provide quality care.


RESUMEN Objetivo: Analizar las publicaciones acerca de las demandas judiciales relacionadas con la infracción a los derechos del usuario que utiliza un plan privado de salud en Brasil. Método: Revisión integrativa realizada entre septiembre y octubre de 2017, en ámbito nacional en los idiomas portugués e inglés, con textos completos y publicados en línea de 2012 a 2017 en el Portal de la Biblioteca Virtual en Salud, con la exclusión de los duplicados y de metodología indiscriminada. Resultados: Las demandas judiciales fueron: un 32% por medicamentos; un 11% por internación en enfermería; un 9% por procedimientos quirúrgicos; un 9% por ortesis, prótesis y materiales especiales; un 9% por otros; y un 30% por procedimientos diagnósticos, de atención ambulatoria, de internación en un Centro de Terapia Intensiva, de fórmulas alimentarias y pañales desechables. Conclusión: Se demostró una prevalencia de los litigios judiciales resultantes de una falla en la prestación del servicio de salud por los planes privados, lo que les facilita a los gestores identificar los productos y servicios de salud necesarios para reorganizar la esfera administrativa y la prestación de una asistencia con calidad.


RESUMO Objetivo: Analisar as publicações a respeito de demandas judiciais relacionadas à infração aos direitos do usuário que utiliza plano privado de saúde no Brasil. Método: Revisão integrativa de setembro a outubro de 2017, com caráter nacional em português e inglês, textos online completos e publicados entre 2012 e 2017 no Portal da Biblioteca Virtual em Saúde, excluindo os duplicados e com metodologia indiscriminada. Resultados: As demandas judiciais foram: 32% medicamentos; 11% internação em enfermaria; 9% procedimentos cirúrgicos; 9% órtese, prótese e materiais especiais; 9% outros; e 30% de procedimentos diagnósticos, atendimento ambulatorial, internação em Centro de Terapia Intensiva, fórmulas alimentares e fraldas descartáveis. Conclusão: Demonstra-se a prevalência dos litígios judiciais decorrentes da falha na prestação do serviço de saúde pelos planos privados, o que facilita aos gestores identificar produtos e serviços de saúde pleiteados para reorganização da esfera administrativa e prestação de assistência com qualidade.


Subject(s)
History, 21st Century , Humans , Prepaid Health Plans/legislation & jurisprudence , Delivery of Health Care/economics , Judicial Role/history , Brazil , Prepaid Health Plans/standards , Prepaid Health Plans/statistics & numerical data , Delivery of Health Care/standards , Delivery of Health Care/statistics & numerical data , Health Services Accessibility
16.
Ciênc. Saúde Colet. (Impr.) ; 24(12): 4555-4568, dez. 2019. tab
Article in Portuguese | LILACS | ID: biblio-1055749

ABSTRACT

Resumo Este estudo explorou os efeitos da crise financeira nas receitas e despesas, na produção de serviços e indicadores de saúde e de desempenho no município do Rio de Janeiro no período de 2013 a 2018. Analisou-se receitas, despesas, parâmetros de provisão de serviços e indicadores de desempenho e de saúde, a partir de dados de acesso livre e restrito. Utilizou-se a análise institucional de Giddens. As receitas e despesas sofreram redução, sendo maiores nos investimentos e receitas não vinculadas. A provisão de serviços encolheu, com queda da cobertura na Atenção Primária, produção ambulatorial, internações totais, número de leitos, médicos e agentes comunitários de saúde, cirurgias realizadas e taxa de ocupação de hospitais. Os tempos de espera para ambulâncias, exames e consultas ambulatoriais, bem como o número de solicitações pendentes na regulação aumentaram. Indicadores de saúde e desempenho persistiram, em sua maioria, dentro dos parâmetros anteriores, corroborando a potência assistencial da Atenção Primária, apesar do impacto financeiro e estrutural da austeridade. A conjuntura atual ameaça o direito à saúde e as respostas governamentais, como a desvinculação de receitas, sinalizam uma ampliação desse risco.


Abstract This study aimed to portray the effects of the Brazilian financial crisis, and especially in Rio de Janeiro in the 2013-18 period. We analyzed revenues, expenditure, service provision, and health performance indicators from free access and restricted data. We adopted the Giddens' Structuration Theory. Revenues and expenditures shrunk, and this reduction was higher for investments and unlinked revenues. The provision of services declined, resulting in decreased primary care coverage, outpatient production, total hospital admissions, number of beds, doctors, community health workers, surgeries performed, and hospital occupancy rate. An increase was observed in waiting times for ambulances, exams and outpatient visits, as well as the number of pending requests in regulation. Health and performance indicators remained mostly unchanged, within previous parameters, corroborating the care capacity of PHC, despite financial and structural contingencies imposed by austerity. The current situation threatens the right to health, and governmental response, such as unlinking revenues, point to an increased risk of this occurrence.


Subject(s)
Humans , Primary Health Care/economics , Health Expenditures , Delivery of Health Care/economics , Economic Recession , Income , Primary Health Care/statistics & numerical data , Surgical Procedures, Operative/statistics & numerical data , Time Factors , Bed Occupancy/statistics & numerical data , Brazil , Health Care Rationing , Cities , Delivery of Health Care/statistics & numerical data , Ambulatory Care/economics , Hospitalization/statistics & numerical data
17.
Rev. bras. enferm ; 72(5): 1235-1242, Sep.-Oct. 2019. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1042151

ABSTRACT

ABSTRACT Aim: To develop a clinical risk stratification score for people living with AIDS and to analyze its association with clinical and sociodemographic aspects. Method: Cross-sectional study involving 150 adults with AIDS, in outpatient follow-up. A structured instrument was applied and, sequentially, inferential statistical techniques on the developed score. Results: 45.3% of the participants were classified as in high clinical risk. TL-CD4+ <500cel/mm3 count, detectable viral load, presence of opportunistic diseases, chronic diseases and clinical manifestations were associated with high clinical risk. There was a significant difference in the mean risk between the categories of variables employment status (p = 0.003) and economic class (p = 0.035). There was a higher risk for brown people (OR = 5.55), unemployed status (OR = 16,51) and belonging to classes C (OR = 20.07) and D (OR = 53,32), and a lower risk for individuals with higher schooling (OR = 0.02). Conclusion: The proposed score quantifies clinical situations and points out sociodemographic aspects that predispose to instability and aggravation of AIDS, supporting the qualification of care.


RESUMEN Objetivo: Elaborar una puntuación para estratificación de riesgo clínico de personas viviendo con sida y analizar su asociación con aspectos clínicos y sociodemográficos. Método: Estudio transversal que involucra a 150 adultos con sida, en seguimiento de ambulatorio. Se aplicó instrumento estructurado y, secuencialmente, técnicas estadísticas que interfieren en la puntuación elaborada. Resultados: El 45,3% de los participantes fueron clasificados en el riesgo clínico alto. La cuenta de LT−CD4+<500cel/mm3, la carga viral detectable, la presencia de enfermedades oportunistas, las enfermedades crónicas y manifestaciones clínicas se asociaron al riesgo clínico elevado. Se verificó una diferencia significativa en el riesgo medio entre las categorías de variables de empleo (p=0,003) y la clase económica (p=0,035). Se constató un mayor riesgo para las personas pardas (OR=5,55), alejadas del empleo (OR=16,51) y pertenecientes a las clases C (OR=20,07) y D (OR=53,32), y menor riesgo entre los individuos con mayor escolaridad (OR=0,02). Conclusión: La puntuación propuesta cuantifica situaciones clínicas y apunta aspectos sociodemográficos que predisponen a la inestabilidad y agudización del sida, subsidiando la calificación del cuidado.


RESUMO Objetivo: Elaborar um escore para estratificação de risco clínico de pessoas vivendo co.m Aids e analisar sua associação com aspectos clínicos e sociodemográficos. Método: Estudo transversal envolvendo 150 adultos com aids, em acompanhamento ambulatorial. Aplicou-se instrumento estruturado e, sequencialmente, técnicas estatísticas inferenciais sobre o escore elaborado. Resultados: 45,3% dos participantes foram classificados no risco clínico alto. A contagem de LT-CD4+<500cel/mm3, carga viral detectável, presença de doenças oportunistas, doenças crônicas e manifestações clínicas associaram-se ao risco clínico elevado. Verificou-se diferença significativa no risco médio entre as categorias das variáveis situação empregatícia (p = 0,003) e classe econômica (p = 0,035). Constatou-se maior risco para pessoas pardas (OR = 5,55), afastadas do emprego (OR = 16,51) e pertencentes às classes C (OR = 20,07) e D (OR = 53,32), e menor risco entre os indivíduos com maior escolaridade (OR = 0,02). Conclusão: O escore proposto quantifica situações clínicas e aponta aspectos sociodemográficos que predispõem a instabilidade e agudização da aids, subsidiando a qualificação do cuidado.


Subject(s)
Humans , Male , Female , Adult , Aged , Risk , Acquired Immunodeficiency Syndrome/classification , Delivery of Health Care/methods , Cross-Sectional Studies , Acquired Immunodeficiency Syndrome/blood , CD4 Lymphocyte Count/methods , Delivery of Health Care/standards , Delivery of Health Care/statistics & numerical data , Middle Aged
18.
Rev. bras. enferm ; 72(5): 1304-1310, Sep.-Oct. 2019. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1042135

ABSTRACT

ABSTRACT Objective: To identify tuberculosis-related health care and surveillance actions in Prison Health Units. Method: Cross-sectional study, of quantitative, exploratory and descriptive character. We visited 13 Teams of Prison Health, and nurses and technicians were interviewed regarding epidemiological surveillance instruments, physical structure and materials. Results: Search for respiratory symptoms in admission was reported by 6 (46.2%) of the teams, and the smear microscopy was the most requested test. The Logbook of Respiratory Symptoms and the Logbook for Monitoring Tuberculosis Cases were used in 7 (53.8%) institutions. Two of them (15.4%) had a location for sputum collection and 1 (7.7%) had a radiographer. The Directly Observed Therapy was reported in 7 (53.8%) units. Conclusion: Health care actions related to the search for respiratory symptoms and Directly Observed Therapy should be expanded, as well as surveillance actions and recording in official documents of the National Tuberculosis Control Program.


RESUMEN Objetivo: Identificar acciones asistenciales y de control de la tuberculosis en Unidades de Salud en Prisiones. Método: Estudio transversal, de tipo cuantitativo, exploratorio y descriptivo. Se visitaron a 13 equipos de Salud en Prisiones, de los cuales participaron enfermeros y técnicos de enfermería de una entrevista sobre los instrumentos de control epidemiológico, la estructura física local y los materiales. Resultados: La búsqueda de sintomáticos respiratorios durante la admisión fue relatada por 6 (un 46,2%) equipos, siendo la baciloscopía el examen más solicitado. El Libro de Registro de Sintomáticos Respiratorios y el Libro de Registro de Seguimiento de los casos de Tuberculosis son utilizados en 7 (un 53,8%) instituciones. Dos (un 15,4%) de ellas contaban con un local para recolección de esputo y 1 (un 7,7%) tiene radiógrafo. El Tratamiento Directamente Observado se mencionó en 7 (un 53,8%) unidades. Conclusión: Las acciones asistenciales relacionadas con la búsqueda de sintomáticos respiratorios y el Tratamiento Directamente Observado deberían ser ampliadas, así como las acciones de control y registro en los documentos oficiales del Programa Nacional de Control de la Tuberculosis.


RESUMO Objetivo: Identificar ações assistenciais e de vigilância relacionadas à tuberculose em Unidades de Saúde Prisional. Método: Estudo transversal, de caráter quantitativo, exploratório e descritivo. Foram visitadas 13 Equipes de Saúde Prisional e entrevistados enfermeiros e técnicos de enfermagem com relação à instrumentos de vigilância epidemiológica, estrutura física e materiais. Resultados: A busca de sintomáticos respiratórios na admissão foi relatada por 6(46,2%) equipes, sendo a baciloscopia o exame mais solicitado. O Livro de Registro de Sintomáticos Respiratórios e o Livro de Registro de Acompanhamento dos Caso de Tuberculose eram utilizados em 7(53,8%) instituições. Duas (15,4%) apresentavam local para coleta de escarro e 1(7,7%) possuía radiógrafo. O Tratamento Diretamente Observado foi referido em 7(53,8%) unidades. Conclusão: As ações assistenciais relacionadas à busca de sintomáticos respiratório e Tratamento Diretamente Observado deveriam ser ampliadas, bem como as ações de vigilância e registro nos documentos oficiais do Programa Nacional de Controle da Tuberculose.


Subject(s)
Humans , Male , Adult , Prisons/standards , Prisoners/statistics & numerical data , Tuberculosis/therapy , Prisons/organization & administration , Prisons/statistics & numerical data , Tuberculosis/epidemiology , Population Surveillance/methods , Prevalence , Cross-Sectional Studies , Directly Observed Therapy , Delivery of Health Care/standards , Delivery of Health Care/statistics & numerical data
19.
Rev. bras. ciênc. vet ; 26(3): 75-81, jul./set. 2019. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1390842

ABSTRACT

O transtorno de acumulação de animais, é uma psicopatologia caracterizada pela aquisição de muitos animais mantidos em espaços inadequados, onde os cuidados básicos de saúde, alimentação e bem-estar são negligenciados. O objetivo deste estudo foi caracterizar o perfil de acumuladores de animais no município de Guarulhos e elaborar um instrumento de coleta de dados para ser utilizado em vistoria técnica nestes casos. Foi realizado um levantamento e análise descritiva dos arquivos de casos de acumuladores de animais atendidos pelo serviço municipal. Dentre os 26 casos recebidos no período de 2012-2017, 12 (46,16%) eram referentes a casos de acumulação de animais. Estas ocorrências foram encaminhadas ao serviço de saúde como denúncias. Os dados obtidos, por meio das análises dos prontuários, foram refinados e, posteriormente, transcritos em planilhas considerando as variáveis de interesse, assim, facilitando o processo de interpretação. Para caracterizar o perfil dos casos de acumuladores, os dados adquiridos foram analisados por meio de cálculos de médias e frequências relativas. O perfil de acumuladores se caracterizou por mulheres, solteiras, idosas, desempregadas ou aposentadas, que residem sozinha em casa própria, portadoras de comorbidades ou fatores psicológicos associados, acumulando cães e gatos, especificamente, cães em sua maioria. O instrumento de vistoria em atenção a indivíduos em situação de acúmulo de animais proposto apresenta caracterização do indivíduo, ambiente, condições gerais dos animais e, ainda, indicadores de comprometimento de bem-estar animal ou maus-tratos.


Animal hoarding disorder is a psychopathy characterized by the acquisition of many animals that are kept in improper locations, in which the basic health care, feeding and well-being are neglected. The objective of this study was to characterize the profile of animal hoarders in the city of Guarulhos and to elaborate an instrument of data collection to be used in technical survey in cases of animal hoarding. Amongst the 26 cases analyzed, 12 (46,16%) were related to animal hoarding. These cases were sent to the health care service as denounces. Data obtained through analysis of medical records were refined and later transcribed into spreadsheets considering the variables of interest, thus facilitating the interpretation process. To characterize the profile of the hoarding cases, data were analyzed by means of calculations of means and relative frequencies. Hoarders profile is characterized as female, single, elderly, unemployed or retired, living alone at her own house, with associated comorbidities or psychological disorders, hoarding dogs and cats, specifically dogs in most cases. The proposed instrument presents characterization of the individual, environment, general conditions of the animals and also indicators of impairment of animal welfare or animal abuse.


Subject(s)
Humans , Animals , Psychopathology , Animal Welfare , Cats , Delivery of Health Care/statistics & numerical data , Dogs , Hoarding Disorder/diagnosis , Animals, Domestic/abnormalities
20.
Ciênc. Saúde Colet. (Impr.) ; 24(7): 2745-2760, jul. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1011857

ABSTRACT

Resumo Este artigo busca discutir a evolução das desigualdades em saúde e no acesso aos serviços de saúde nas grandes regiões a partir de inquéritos domiciliares realizados de 1998 a 2013. As desigualdades sociais foram analisadas pelas razões de extremos de anos de escolaridade, considerando duas faixas etárias (18 a 59 anos e 60 anos ou mais). Nas condições de saúde, observa-se, nos dois grupos etários, uma pior avaliação do estado de saúde e um aumento da prevalência de diabetes e hipertensão, o que pode estar relacionado à expansão da atenção básica. Quanto à realização de consultas médicas no último ano, encontra-se, no geral, maior acesso, com manutenção de pequenas desigualdades. A maior utilização de consulta odontológica entre os de menor escolaridade provoca uma redução nas desigualdades, que ainda são significativas. As internações hospitalares, ao longo da série, são maiores entre os menos escolarizados, e há uma redução nas taxas nos dois grupos etários, em quase todas as regiões. Percebe-se um aumento na realização de mamografia por mulheres menos escolarizadas, com diminuição da desigualdade. Os resultados corroboram a necessidade da continuidade dos inquéritos domiciliares para o monitoramento das desigualdades regionais e sociais no acesso ao sistema de saúde.


Abstract This article discusses trends in health inequalities and access to health services across the regions of Brazil using data from household surveys conducted between 1998 and 2013. Social inequality was measured based on the ratio between the extremes of years of schooling considering two age groups (18 to 59 years and 60 years and over). The findings show a decline in health status and increase in prevalence of diabetes and hypertension in both age groups, which may be related to the expansion of primary healthcare. The findings regarding the percentage of people who had had a medical appointment in the last 12 months show that low levels of inequalities persist despite a general improvement in access. Despite an increase in the percentage of people with up to 3 years of schooling who had had a dental appointment in the last year, significant inequalities persist. The percentage of people who reported being admitted to hospital in the last 12 months was greater among people with up to 3 years of schooling throughout the study period. The hospitalization rate decreased in both age groups across almost all regions. The proportion of women aged between 50 and 69 years with up to 3 years of schooling who had had a mammogram increased, leading to a decrease in inequality. The findings show the need to ensure the continuity of household surveys to monitor inequalities in access to health care services by region and social group.


Subject(s)
Humans , Female , Adolescent , Adult , Aged , Young Adult , Health Status , Health Status Disparities , Health Services Accessibility , Primary Health Care/organization & administration , Social Class , Brazil , Mammography/statistics & numerical data , Surveys and Questionnaires , Age Factors , Delivery of Health Care/statistics & numerical data , Educational Status , Healthcare Disparities/statistics & numerical data , Hospitalization/statistics & numerical data , Middle Aged
SELECTION OF CITATIONS
SEARCH DETAIL