First year of COVID-19 in Brazil: Factors associated with the spread of COVID-19 in small and large cities.

AIM: To test the association between sociodemographic and social characteristics with COVID-19 cases and deaths in small and large Brazilian cities. METHODS: This ecological study included COVID-19 data available in State Health Secretaries (managed by brasil.io API) and three national databases (IBGE, DATASUS and Embrapa). Temporal spread of COVID-19 in Brazil during the first year considered as outcome: a) days until 1st case in each city since 1st in the country; b) days until 1,000 cases/100,000 inhabitants since 1st case in each city; c) days until 1st death until 50 deaths/100,000 inhabitants. Covariates included geographic region, city social and environmental characteristics, housing conditions, job characteristics, socioeconomic and inequalities characteristics, and health services and coverage. The analysis were stratified by city size into small (<100,000 inhabitants) and large cities (≥100,00 inhabitants). Multiple linear regressions were performed to test associations of all covariates to adjust to potential confounders. RESULTS: In small cities, the first cases were reported after 82.2 days and 1,000 cases/100,000 were reported after 117.8 days, whereas in large cities these milestones were reported after 32.1 and 127.7 days, respectively. For first death, small and large cities took 121.6 and 36.0 days, respectively. However, small cities were associated with more vulnerability factors to first case arrival in 1,000 cases/100,000 inhabitants, first death and 50 deaths/100,000 inhabitants. North and Northeast regions positively associated with faster COVID-19 incidence, whereas South and Southeast were least. CONCLUSION: Social and built environment characteristics and inequalities were associated with COVID-19 cases spread and mortality incidence in Brazilian cities.

Is it possible to automate the discovery of process maps for the time-driven activity-based costing method? A systematic review.

OBJECTIVES: The main objective of this manuscript was to identify the methods used to create process maps for care pathways that utilized the time-driven activity-based costing method. METHODS: This is a systematic mapping review. Searches were performed in the Embase, PubMed, CINAHL, Scopus, and Web of Science electronic literature databases from 2004 to September 25, 2022. The included studies reported practical cases from healthcare institutions in all medical fields as long as the time-driven activity-based costing method was employed. We used the time-driven activity-based costing method and analyzed the created process maps and a qualitative approach to identify the main fields. RESULTS: A total of 412 studies were retrieved, and 70 articles were included. Most of the articles are related to the fields of orthopedics and childbirth-related to hospital surgical procedures. We also identified various studies in the field of oncology and telemedicine services. The main methods for creating the process maps were direct observational practices, complemented by the involvement of multidisciplinary teams through surveys and interviews. Only 33% of the studies used hospital documents or healthcare data records to integrate with the process maps, and in 67% of the studies, the created maps were not validated by specialists. CONCLUSIONS: The application of process mining techniques effectively automates models generated through clinical pathways. They are applied to the time-driven activity-based costing method, making the process more agile and contributing to the visualization of high degrees of variations encountered in processes, thereby making it possible to enhance and achieve continual improvements in processes.

Applying process mining in health technology assessment.

Objective: Propose a process mining-based method for Health Technology Assessment. Methods: Articles dealing with prior studies in Health Technology Assessment using Process Mining were identified. Five research questions were defined to investigate these studies and present important points and desirable characteristics to be addressed in a proposal. The was defined method with five steps and was submitted to a case study for evaluation. Results: The Literature search identified six main characteristics. As a result, the five-step method proposed was applied in the radical prostatectomy surgical procedure between the robot assisted technique and laparoscopy. Conclusion: It was demonstrated in this article the creation of the proposal of an efficient method with its replication for other health technologies, coupled with the good interpretation of the specialists in terms of comprehensibility of the discovered patterns and their correlation with clinical protocols and guidelines.

Design of a geospatial model applied to Health management.

OBJECTIVE: To identify geographically the beneficiaries categorized as prone to Type 2 Diabetes Mellitus, using the recognition of patterns in a database of a health plan operator, through data mining. METHOD: The following steps were developed: the initial step, the information survey. Development, construction of the process of extraction, transformation, and loading of the database. Deployment, presentation of the geographical information through a georeferencing tool. RESULTS: As a result, the mapping of Paraná according to its health care network and the concentration of Type 2 Diabetes Mellitus is presented, enabling the identification of cause-and-effect relationships. CONCLUSION: It is concluded that the analysis of georeferenced information, linked to health information obtained through the data mining technique, can be an excellent tool for the health management of a health plan operator, contributing to the decision-making process in Health.

Design of a geospatial model applied to Health management / La producción de un modelo geoespacial aplicado a la gestión de la salud / Concepção de um modelo geoespacial aplicado na gestão à saúde

ABSTRACT Objective: To identify geographically the beneficiaries categorized as prone to Type 2 Diabetes Mellitus, using the recognition of patterns in a database of a health plan operator, through data mining. Method: The following steps were developed: the initial step, the information survey. Development, construction of the process of extraction, transformation, and loading of the database. Deployment, presentation of the geographical information through a georeferencing tool. Results: As a result, the mapping of Paraná according to its health care network and the concentration of Type 2 Diabetes Mellitus is presented, enabling the identification of cause-and-effect relationships. Conclusion: It is concluded that the analysis of georeferenced information, linked to health information obtained through the data mining technique, can be an excellent tool for the health management of a health plan operator, contributing to the decision-making process in Health.

RESUMEN Objetivo: Identificar geográficamente a los beneficiarios categorizados como propensos a la enfermedad Diabetes mellitus tipo 2, utilizándose el reconocimiento de patrones en una base de datos de cierta compañía de seguro médico por medio de la minería de datos. Método: Se desarrollaron las siguientes etapas: fase inicial, levantamiento de información. Desarrollo, construcción del proceso de extracción, transformación y carga en la base de datos. Implantación, presentación de la información geográfica mediante la herramienta de georreferenciación. Resultados: Se presenta el mapeo de Paraná (Brasil) con relación a su red asistencial y la concentración de Diabetes mellitus tipo 2, proporcionando la identificación de las relaciones de causa-efecto. Conclusión: Se concluyó que el análisis de las informaciones georreferenciadas, vinculadas a las informaciones de salud obtenidas por la técnica de minería de datos, puede ser una excelente herramienta en la gestión de salud de cierta compañía de seguro médico, lo que contribuye al apoyo a la toma de decisiones en salud.

RESUMO Objetivo: Identificar geograficamente os beneficiários categorizados como propensos à doença Diabetes Mellitus Tipo 2, utilizando o reconhecimento de padrões em uma base de dados de uma operadora de plano de saúde, por meio da mineração de dados. Método: Desenvolveram-se as seguintes etapas: fase inicial, levantamento de informações. Desenvolvimento, construção do processo de extração, transformação e carga do banco de dados. Implantação, apresentação das informações geográficas por meio da ferramenta de georreferenciamento. Resultados: Como resultados, apresenta-se o mapeamento do Paraná em relação a sua rede assistencial e a concentração de Diabetes Mellitus Tipo 2, oportunizando a identificação de relações de causa-efeito. Conclusão: Conclui-se que a análise de informações georreferenciadas, vinculadas às informações de saúde obtidas por meio da técnica de mineração de dados, pode ser um excelente instrumento para a gestão da saúde de uma operadora de plano de saúde, contribuindo para o apoio à tomada de decisões em saúde.

Comparação entre a intervenção cirúrgica convencional e a intervenção endovascular dos aneurismas intracranianos realizados no Sistema Único de Saúde / Comparing intracranial aneurysm conventional surgical technique with endovascular technique carried out in the Public Health System

Os aneurismas intracranianos acometem cerca de 6% da população. O tratamento é realizado por meio de duas técnicas, a endovascular (embolização) e a convencional (microcirurgia). Este estudo teve como objetivo evidenciar a gestão comparativa de duas técnicas cirúrgicas no Paraná, no período de 2008 a 2016. Trata-se de uma pesquisa descritiva, documental, com abordagem quantitativa e análise simples dos dados secundários do DATASUS. No Paraná, a técnica endovascular é realizada em 84% dos pacientes diagnosticados com aneurisma intracraniano e representa 91% do custo total. O custo médio do paciente submetido à técnica endovascular é 93% maior quando comparado à microcirurgia. A média de permanência é 66,9% menor nos pacientes embolizados e a taxa de mortalidade diminui em 64,5% na técnica endovascular. Apesar do custo, a técnica endovascular reduz em mais da metade a média de permanência e taxa de mortalidade, constatando sua elevada segurança (AU).

The intracranial aneurisms occur in about 6% of world population. There are two possible techniques to treat intracranial aneurysms: the endovascular (embolization) and the conventional (microsurgery) surgery. The present study aims at comparing the aforementioned surgical techniques in the State of Paraná, Brazil, between 2008 and 2016. Our research is descriptive, documental, with a quantitative approach and simple analysis of the DATASUS secondary data. In Paraná, the endovascular technique is carried out in 84% of patients that are diagnosed as having intracranial aneurysm, and accounts for a total cost of 91%. The average cost of a patient undergoing endovascular technique is 93% higher if compared to the microsurgery technique. Results show that when using the endovascular technique the embolized patient hospital stay was 66,9% lower, and mortality rate decrease was 64,5%. Despite its cost, the endovascular treatment reduces hospital stay and mortality rate by over half due to its high safety (AU)