scholarly journals Characteristics of primary care and rates of pediatric hospitalizations in Brazil

2020 ◽  
Vol 54 ◽  
pp. 32
Author(s):  
Lívia Anniele Sousa Lisboa ◽  
Rejane Christine de Sousa Queiroz ◽  
Erika Bárbara Abreu Fonseca Thomaz ◽  
Núbia Cristina da Silva ◽  
Thiago Augusto Hernandes Rocha ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Center ◽  
Medical Professional ◽  
Pediatric Care ◽  
Population Census ◽  
Cross Sectional ◽  
Health Care Center ◽  
The North ◽  
Unified Health System ◽  
Annual Population

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.

scholarly journals Analysis of Social Determinants and the Utilization of Tele-Urgent Pediatrics Care During a Pandemic (Preprint)

2020 ◽  
Author(s):  
Saif Khairat ◽  
Phillip McDaniel ◽  
Matthew Jensen ◽  
Tia Francis ◽  
Barbara Edson ◽  
...  
Keyword(s):  
Vulnerable Populations ◽  
Care Center ◽  
Urgent Care ◽  
Pediatric Care ◽  
High Concentration ◽  
Cross Sectional ◽  
Low Concentration ◽  
Health Care Center ◽  
Geographical Regions ◽  
Before And After

BACKGROUND Telehealth is increasingly used to provide specialty consultations to infants and children receiving care. However, there is uncertainty if the Covid-19 pandemic has influenced the use of telehealth among vulnerable populations. OBJECTIVE The objective of this research was to compare the overall use of tele-urgent care visits for pediatric before and after the pandemic especially among vulnerable populations. METHODS We conducted a cross-sectional analysis of Pediatric tele-urgent care visits at a Virtual Care Center at a Southeastern Health Care Center. The main outcome of this study was the utilization of Pediatrics tele-urgent visits across geographical regions with different levels of social disparities and between 2019 and 2020. RESULTS Of 584 tele-urgent care visits, 388 (66.4%) visits occurred in 2020 during the pandemic compared to 196 (33.6%) visits in 2019. Among 808 NC zip codes, 181 (22%) consisted of a high concentration of vulnerable populations, where 17.7% of the tele-urgent care visits originated from. The majority (67.8%) of tele-urgent care visits originated from zip codes with a low concentration of vulnerable populations. There was a significant association between the rate of Covid19 cases and the concentration level of social factors in a given ZCTA area. CONCLUSIONS The use of tele-urgent visits for pediatric care doubled during the Covid19 pandemic. The majority of the tele-urgent care visits after Covid19 originated from regions where there is a low presence of vulnerable populations. In addition, our geospatial analysis found that geographic regions with a high concentration of vulnerable populations had a significantly higher rate of Covid19 confirmed cases and deaths compared to regions with a low concentration of vulnerable populations.

scholarly journals Retrospective study of the distribution of doctors in municipalities of extreme poverty in Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B L O Luizeti ◽  
E M M Massuda ◽  
L F G Garcia
Keyword(s):  
Public Health ◽  
Health System ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Extreme Poverty ◽  
The Public ◽  
The North ◽  
Unified Health System ◽  
Shortage Of Doctors ◽  
Demographic Distribution

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.

scholarly journals 463 - Evaluating the Implementation of a Memory Clinic using the RE-AIM model. The experience of the “Memory and Neuropsychiatry Clinic” in Hospital del Salvador, Chile

2020 ◽  
Vol 32 (S1) ◽  
pp. 184-185
Author(s):  
T. Leon ◽  
L. Castro ◽  
F. Mascayano ◽  
BA. Lawlor ◽  
A. Slachevsky
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Latin American ◽  
Care Service ◽  
Care Center ◽  
Health Care Service ◽  
Multidisciplinary Teams ◽  
Outpatient Services ◽  
Health Care Center ◽  
Dementia Patients

AbstractThe prevalence of dementia in Chile is 1.06 %, meaning that over 200,000 people are affected. In 2017, the Ministry of Health launched the National Plan of Dementia, which proposed establishing a range of health-care services from primary care to Memory Units (MU).MUs have emerged as a new health care service composed of multidisciplinary teams with the goal of improving diagnosis and management of dementia patients.The creation and implementation of a MU should take into consideration the organization of a particular healthcare system. In this context, the evaluation of a Chilean MU might provide information for the standardization and replication of such a health service on a regional basis.The objective of this paper was to evaluate the implementation processes of a MU using the RE-AIM model, a multi-component model aimed to assist the evaluation of the implementation of ongoing programs.Regarding “R” (Reach): from March 2018 up to June 2019, a total of 510 patients were referred and assessed at the Hospital del Salvador. Most patients came from primary care (51.9 %) and from outpatient services at the Hospital (39.2 %), particularly from the Neurology (63.3%) and Psychiatry (16.0 %) departments. We estimated that the MU assessed 5.39% of dementia patients living in the area of referral.In relationship with “E” (Effectiveness): of patients evaluated by the MU, 60 (11%) were discharged. Of these, 41 (66%) were referred to primary health care, 9 (17%) to other outpatient services, 6 (10%) to a specialized mental health care center, and 4 (7%) to a daycare center.Due to the short lifespan of our MU, no other RE-AIM dimensions could be evaluated yet.This was the first evaluation of the implementation of a MU in Chile as part of the Chilean Dementia Plan. It showed that it is possible to implement a MU in a Latin American country and improve access to dementia diagnosis, management, and treatment. Ongoing challenges include continuing to collect clinical data, creating research projects as part of the MU, and developing a MU protocol that can be adopted elsewhere in Chile and other Latin American countries.

scholarly journals Timing and reasons for antenatal care booking among women in a tertiary health care center in Southern Nigeria

2017 ◽  
Vol 6 (9) ◽  
pp. 3731 ◽  
Author(s):  
Ntiense Macaulay Utuk ◽  
Anyiekere Ekanem ◽  
Aniekan Monday Abasiattai
Keyword(s):  
Antenatal Care ◽  
Care Center ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Safe Motherhood ◽  
Cross Sectional ◽  
Post Secondary ◽  
Health Care Center ◽  
Southern Nigeria ◽  
The Mean

Background: Antenatal care is one of the four pillars of safe motherhood and its benefits in preventing adverse feto-maternal outcome is proven. Commencement of antenatal care early has been shown to be key for this benefit to be fully realized. The aim of this study was to determine the antenatal booking pattern of pregnant women and its determinants in our environment.Methods: A cross sectional study of women attending the booking clinic in the University of Uyo Teaching Hospital, Akwa Ibom State, Southern Nigeria over a three-month period.Results: The mean age of the respondents was 28.5 years. The mean gestational age at booking was 18.3 weeks. The majority of the patients were married (94.1%). 68.1% had a post-secondary education. 33.5% of patients were nultiparous, while 3.5% were grand multiparous. The majority of patients (72.4%) booked late for antenatal care. Age group, marital status, mode of delivery was not significantly associated with timing of booking. High levels of patient’s education, high levels of husband’s education as well as grand multiparity were significantly associated with late booking (P<0.05). Majority (65.4%) of patients claimed that it was safe to book at any time during pregnancy.Conclusions: The majority of women booked late for antenatal care. In our study, we have found that general and health education, subsidisation of cost for antenatal care and introduction of focused antenatal care will help to reverse this trend.

scholarly journals Interprofessional collaboration among care professionals in obstetrical care: are perceptions aligned?

2017 ◽  
Vol 27 (4) ◽  
pp. 279-286 ◽  
Author(s):  
Anita Romijn ◽  
Pim W Teunissen ◽  
Martine C de Bruijne ◽  
Cordula Wagner ◽  
Christianne J M de Groot
Keyword(s):  
Primary Care ◽  
The Netherlands ◽  
Interprofessional Collaboration ◽  
Cross Sectional Study ◽  
Measurement Scale ◽  
Cross Sectional ◽  
Communication Accommodation ◽  
Obstetrical Care ◽  
The North ◽  
Ensure Patient Safety

BackgroundIn an obstetrical team, obstetricians, midwives and nurses work together in a dynamic and complex care setting. Different professional cultures can be a barrier for effective interprofessional collaboration. Although the different professional cultures in obstetrical care are well known, little is understood about discrepancies in mutual perceptions of collaboration. Similar perceptions of collaboration are important to ensure patient safety. We aimed to understand how different care professionals in an obstetrical team assess interprofessional collaboration in order to gain insight into the extent to which their perceptions are aligned.MethodsThis cross-sectional study was performed in the north-western region of the Netherlands. Care professionals from five hospitals and surrounding primary-care midwifery practices were surveyed. The respondents consisted of four groups of care professionals: obstetricians (n=74), hospital-based midwives known as clinical midwives (n=42), nurses (n=154) and primary-care midwives (n=109). The overall response rate was 80.8%. We used the Interprofessional Collaboration Measurement Scale (IPCMS) to assess perceived interprofessional collaboration. The IPCMS distinguishes three subscales: communication, accommodation and isolation. Data were analysed using non-parametrical tests.ResultsOverall, ratings of interprofessional collaboration were good. Obstetricians rated their collaboration with clinical midwives, nurses and primary-care midwives more positively than these three groups rated the collaboration with obstetricians. Discrepancies in mutual perceptions were most apparent in the isolation subscale, which is about sharing opinions, discussing new practices and respecting each other.ConclusionWe found relevant discrepancies in mutual perceptions of collaboration in obstetrical care in the Netherlands. Obstetrical care is currently being reorganised to enable more integrated care, which will have consequences for interprofessional collaboration. The findings of this study indicate opportunities for improvement especially in terms of perceived isolation.

scholarly journals Municipal Management, Infrastructure And Perception Of Users: A Description Of National Program For Improving Access And Quality Of Primary Care In The Brazilian Semiarid

10.3823/2515 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Marília Gomes De Sousa Bezerra ◽  
Roseanne De Sousa Nobre ◽  
Artemizia Francisca De Sousa ◽  
Maísa De Lima Claro
Keyword(s):  
Primary Care ◽  
Cross Sectional ◽  
Unified Health System ◽  
Quality Of Primary Care ◽  
Brazilian Semiarid ◽  
Municipal Management ◽  
Access And Quality ◽  
Objective Description

Introduction: The Ministry of Health with the aim of improving the service provided by the Unified Health System has been creating work tools to identify which points need to receive more attention to be optimized. Objective: Description of the role of municipal management, infrastructure assessment and perception of users of primary care. Method: Cross-sectional and descriptive study, conducted with Basic Units of Piauí municipality in 2015. The data were represented by tables. Results: 90% of the units reported receiving support for the planning and organization of the work process. Only 14, 81% of the units have equipment and supplies for proper operation. Users recommend the service in 92,62% of the cases. Conclusion: despite the precarious structure of the basic units of the county, the population still recognizes them as the best care.

scholarly journals Hypertension and Micro-Vascular Complications Among Type 2 Dm Adult Patients in Mukalla, Yemen

2020 ◽  
Vol 3 (5) ◽  
pp. 01-04
Author(s):  
Abdullah Ghouth
Keyword(s):  
Care Center ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Health Care Center ◽  
Age Related ◽  
Significant Difference ◽  
High Prevalence

The Background and Purpose: to assess the prevalence of hypertension and micro-vascular complications among type 2 diabetic patients registered in primary health care center in Mukalla city at eastern Yemen. Methods: A Cross-sectional study was conducted in a randomly selected eligible patients from the diabetic registry of the AL Noor Charity Center (ACC), Mukalla city in Yemen. Results: Prevalence of hypertension in the T2DM patients were 46.7% (56/120). Retinopathy is the most micro-vascular complications among the adults having T2DM (73/120, 60.8%) while nephropathy is the least prevalence (13/120, 10.8%), prevalence of neuropathy was 49.2% (59/120). a high prevalence of retinopathy in males (66%) than females (55.7%) and a high prevalence of neuropathy in male adults (52.2%) than females (46%).No statistical significant difference were exit related to gender for any studied complications. Similar findings were observed regarding age related variations. Conclusion: A high prevalence of hypertension, retinopathy and neuropathy were reported among T2DM patients in Mukalla. Adopting effective and safe treatment strategies are highly recommended to prevent premature death and complications due to DM.

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