RESUMEN
BACKGROUND: The early identification of the Breathing Symptoms within the scope of Primary Health Care is recommended, and is also one of the strategies of national sanitary authorities for reaching the elimination of tuberculosis. The purpose of this study is to consider which attributes and which territories have shown the most significant progress in Primary Health Care, in terms of coordination of Health Care Networks, and also check if those areas of Primary Health Care that are most critical regarding coordination, there were more or less cases of avoidable hospitalizations for tuberculosis. METHODS: This is an ecological study that uses primary and secondary data. For analysis, coropletic maps were developed through the ArcGIS software, version 10.2. There was also the calculation of gross annual and Bayesian rates for hospitalizations for tuberculosis, for each Primary Health Care territory. RESULTS: There were satisfactory results for attributes such as Population (n = 37; 80.4 %), Primary Health Care (n = 43; 93.5 %), Support System (n = 45; 97.8 %); the exceptions were Logistics System (n = 32; 76.0 %) and Governance System, with fewer units in good condition (n = 31; 67.3 %). There is no evidence of any connection between networks' coordination by Primary Health Care and tuberculosis avoidable admissions. CONCLUSION: The results show that progress has been made regarding the coordination of the Health Care Networks, and a positive trend has been shown, even though the levels are not excellent. It was found no relationship between the critical areas of Primary Health Care and tuberculosis avoidable hospitalizations, possibly because other variables necessary to comprehend the phenomena.
Asunto(s)
Prestación Integrada de Atención de Salud , Atención Primaria de Salud/organización & administración , Calidad de la Atención de Salud/organización & administración , Tuberculosis/diagnóstico , Teorema de Bayes , Brasil/epidemiología , Prestación Integrada de Atención de Salud/organización & administración , Femenino , Encuestas Epidemiológicas , Hospitalización , Humanos , Masculino , Guías de Práctica Clínica como Asunto , Tuberculosis/epidemiología , Tuberculosis/prevención & controlRESUMEN
O estudo teve como objetivo analisar a concordância de diagnósticos clínicos e atestados de óbitos comparados aos relatórios finais de autópsia. A pesquisa foi elaborada utilizando-se casos autopsiados maiores de 1 ano, apresentando diagnóstico da causa básica de morte, ocorridos em hospital universitário entre 1993 e 1995. Na análise de concordância foram aplicados os métodos estatísticos de qui-quadrado (c2), regressão logística multivariada e coeficiente kappa. A percentagem de autópsias em óbitos foi de 5,6. O principal motivo de solicitação para autópsias foi confirmação diagnóstica. A concordância dos diagnósticos clínicos e relatórios finais foi igual a 0,537 (IC 95 0,451 a 0,622), tendo sido influenciado pela alta concordância entre autópsias solicitadas para pesquisa. Entre atestados do óbito e relatórios finais obteve-se concordância igual a 0,651 (IC 95 0,510 a 0,792). Constatou-se baixa percentagem de autópsias no período de estudo para um hospital-escola. Os níveis de concordância entre diagnósticos obtidos mostram que a autópsia continua sendo importante para o diagnóstico correto da causa de óbito.