scholarly journals COVID-19 pandemic impact on dentists in Latin America’s epicenter: São-Paulo, Brazil

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256092
Author(s):  
Tatiane Fernandes Novaes ◽  
Maisa Camillo Jordão ◽  
Carlos Felipe Bonacina ◽  
André Oswaldo Veronezi ◽  
Carlos Ariel Rodrigues de Araujo ◽  
...  
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Professionals ◽  
Negative Impact ◽  
Sao Paulo ◽  
The State ◽  
Financial Impact ◽  
São Paulo ◽  
Ordinal Logistic Regression Analysis ◽  
The Impact

The state of São Paulo, Brazil, where more than 94.000 dentists are currently registered, has become the epicenter of COVID-19 in Latin America. The aim of this cross-sectional study was to evaluate the impact of COVID-19 pandemic on dentists in this state. A semi-structured questionnaire was sent via e-mail to 93.280 dentists with active registration in the Dental Council of São Paulo (CROSP). The impact of COVID-19 pandemic was assessed through questions related to demographic, socioeconomic, dental practice characteristics and personal protective equipment (PPE) use. Ordinal logistic regression analysis was performed to investigate the association between all the variables (p<0.05). Over 8 days, 2113 responses were received. Only 26.52% of the sample reported a low-income reduction (from 0–10%), while the majority of dentists reported a more negative financial impact, 35.6% with a reduction of more than 50% of their monthly income. Dentists who worked in the private sector and at the capital had a greater financial impact when compared to those of the public sector and countryside of the state (p<0.05). Furthermore, about 83% reported not having received any specific training to control the transmission of coronavirus in the health area. This study provides evidence of the negative impact of the COVID-19 pandemic on the routine of dentists in the state of São Paulo, Brazil. Hopefully, this study will help dental and other health care professionals to better understand the consequences of disease in dental settings and strengthen preparedness throughout the dental health care system.

scholarly journals Modelling the impact of delaying vaccination against SARS-CoV-2 assuming unlimited vaccine supply

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Marcos Amaku ◽  
Dimas Tadeu Covas ◽  
Francisco Antonio Bezerra Coutinho ◽  
Raymundo Soares Azevedo ◽  
Eduardo Massad
Keyword(s):  
Mathematical Model ◽  
Vaccination Campaign ◽  
Vaccination Rate ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
Health Authorities ◽  
The World ◽  
The Moment ◽  
The Impact

Abstract Background At the moment we have more than 177 million cases and 3.8 million deaths (as of June 2021) around the world and vaccination represents the only hope to control the pandemic. Imperfections in planning vaccine acquisition and difficulties in implementing distribution among the population, however, have hampered the control of the virus so far. Methods We propose a new mathematical model to estimate the impact of vaccination delay against the 2019 coronavirus disease (COVID-19) on the number of cases and deaths due to the disease in Brazil. We apply the model to Brazil as a whole and to the State of Sao Paulo, the most affected by COVID-19 in Brazil. We simulated the model for the populations of the State of Sao Paulo and Brazil as a whole, varying the scenarios related to vaccine efficacy and compliance from the populations. Results The model projects that, in the absence of vaccination, almost 170 thousand deaths and more than 350 thousand deaths will occur by the end of 2021 for Sao Paulo and Brazil, respectively. If in contrast, Sao Paulo and Brazil had enough vaccine supply and so started a vaccination campaign in January with the maximum vaccination rate, compliance and efficacy, they could have averted more than 112 thousand deaths and 127 thousand deaths, respectively. In addition, for each month of delay the number of deaths increases monotonically in a logarithmic fashion, for both the State of Sao Paulo and Brazil as a whole. Conclusions Our model shows that the current delay in the vaccination schedules that is observed in many countries has serious consequences in terms of mortality by the disease and should serve as an alert to health authorities to speed the process up such that the highest number of people to be immunized is reached in the shortest period of time.

scholarly journals Determinants of neonatal, postneonatal and maternal mortality on models of primary health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A B Guerra ◽  
L M Guerra ◽  
L F Probst ◽  
B V Castro Gondinho ◽  
G M Bovi Ambrosano ◽  
...  
Keyword(s):  
Health Care ◽  
Infant Mortality ◽  
Maternal Mortality ◽  
Public Policies ◽  
Family Health ◽  
Mortality Rates ◽  
Sao Paulo ◽  
The State ◽  
Care Organization ◽  
São Paulo

Abstract Background The state of São Paulo recorded a significant reduction in infant mortality, but the desired reduction in maternal mortality was not achieved. Knowledge of the factors with impact on these indicators would be of help in formulating public policies. The aims of this study were to evaluate the relations between socioeconomic and demographic factors, health care model and both infant mortality and maternal mortality in the state of São Paulo, Brazil. Methods In this ecological study, data from national official open sources were used. Analyzed were 645 municipalities in the state of São Paulo, Brazil. For each municipality, the infant mortality and maternal mortality rates were calculated for every 1000 live births, 2013. The association between these rates, socioeconomic variables, demographic models and the primary care organization model in the municipality were verified. We used the zero-inflated negative binomial model. Gross analysis was performed and then multiple regression models were estimated. For associations, we adopted “p” at 5%. Results The increase in the HDI of the city and proportion of Family Health Care Strategy implemented were significantly associated with the reduction in both infant mortality (neonatal + post-neonatal) and maternal mortality rates. In turn, the increase in birth and caesarean delivery rates were associated with the increase in infant and maternal mortality rates. Conclusions It was concluded that the Family Health Care Strategy model that contributed to the reduction in infant (neonatal + post-neonatal) and maternal mortality rates, and so did actors such as HDI and cesarean section. Thus, public health managers should prefer this model. Key messages Implementation of public policies with specific focus on attenuating these factors and making it possible to optimize resources, and not interrupting the FHS. Knowledge of the factors with impact on these indicators would be of help in formulating public policies.

scholarly journals Building a "Smiling Brazil"? Implementation of the Brazilian National Oral Health Policy in a health region in the State of São Paulo

2015 ◽  
Vol 31 (1) ◽  
pp. 82-96 ◽  
Author(s):  
Aline Guerra Aquilante ◽  
Geovani Gurgel Aciole
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Oral Health ◽  
Health Care Professionals ◽  
Health Department ◽  
Work Conditions ◽  
Oral Health Care ◽  
Sao Paulo ◽  
São Paulo ◽  
Oral Health Policy

This paper is a case study on the implementation of the Brazilian National Oral Health Policy (PNSB), known as "Smiling Brazil", in the cities of the Regional Health Department of Araraquara (DRS III) in São Paulo State. A structured questionnaire was given to the municipal oral health coordinators, an interview with oral health care professionals and managers was conducted, and the official data provided by the Brazilian Ministry of Health were coded to assess the policy's scope: (i) expansion and qualification of actions; (ii) work conditions; (iii) care; (iv) access; and (v) planning and management. The quantitative and qualitative analyses were linked by methods triangulation. In terms of PNSB implementation, the majority of the cities (52.6%) were classified as "good", with 42.1% classified as "bad". Approximately 10 years after launching the PNSB, despite strides in oral health care and access to different levels of care, the cities still experience difficulties in implementing the policy's principles.

scholarly journals How the ‘plates’ of a health system can shift, change and adjust during economic recessions. A qualitative interview study of public and private health providers in Brazil’s São Paulo and Maranhão states

2020 ◽  
Author(s):  
Giuliano Russo ◽  
Maria Luiza Levi Paim ◽  
Maria Teresa Seabra Soares de Britto e Alves ◽  
Bruno Luciano Carneiro Alves de Oliveira ◽  
Ruth Helena de Souza Britto Ferreira de Carvalho ◽  
...  
Keyword(s):  
Health System ◽  
Access To Care ◽  
Health Systems ◽  
Low Income ◽  
Sao Paulo ◽  
São Paulo ◽  
Public And Private ◽  
Qualitative Interview Study ◽  
Economic Recessions ◽  
The Impact

Background. Economic recessions carry an impact on population health and access to care; less is known on how health systems adapt to the conditions brought by a downturn. This particularly matters now that the COVID-19 epidemic is putting health systems under stress. Brazil is one of the world’s most affected countries, and its health system was already living the aftermath of the 2015 recession. Methods. Between 2018 and 2019 we conducted 46 semi-structured interviews with health practitioners, managers and policy-makers to explore the impact of the 2015 recession on public and private providers in prosperous (São Paulo) and impoverished (Maranhão) states in Brazil. Thematic analysis was employed to identify drivers and consequences of system adaptation and coping strategies. Nvivo software was used to aid data collection and analysis. We followed the Standards for Reporting Qualitative Research to provide an account of the findings.Results. We found the concept of ‘health sector crisis’ to be politically charged among healthcare providers in São Paulo and Maranhão. Contrary to expectations, the public sector was reported to have found ways to compensate for diminishing federal funding, having outsourced services and adopted flexible – if insecure – working arrangements. Following a drop in employment and health plans, private health insurance companies streamlined their offer, at times at the expenses of coverage. Low-cost walk-in clinics were hit hard by the recession, but also credited for having moved to cater for higher-income customers in Maranhão.Conclusions. The ‘plates’ of a health system may shift and adjust in unexpected ways in response to recessions, and some of these changes might outlast the crisis. As low-income countries enter post-COVID recessions, it will be important to monitor the adjustments taking place in health systems, to ensure that past gains in access to care and job security are not eroded.

Impact of COVID-19 pandemic in hospitalizations due to brain tumors from the epicenter of Latin America.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18785-e18785
Author(s):  
Isabella Batista Martins Portugal ◽  
Luis Eduardo Werneck De Carvalho ◽  
Jean Henri Schoueri ◽  
Leandro Fórnias Machado Rezende ◽  
Fernando Luiz Affonso Fonseca ◽  
...  
Keyword(s):  
Health Care ◽  
Latin America ◽  
Health System ◽  
Sao Paulo ◽  
Cns Tumors ◽  
São Paulo ◽  
Outbreak Period ◽  
Starting Point ◽  
The Impact ◽  
The City

e18785 Background: The novel coronavirus disease 2019 (COVID-19) pandemic has disrupted health care systems worldwide. In Brazil, the disease had its first case in the city of São Paulo, thus being the starting point and epicenter of this disease in Latin America. Neurological features are currently well recognized in COVID-19 indicating the neurotropic nature of the virus and include anosmia, myalgia, myositis, encephalitis, meningitis, cerebrovascular disease, Guillain–Barré syndrome, and post-infectious myelitis. CNS tumors though relatively rare (> 2% of all cancers) are a relevant source of cancer-related morbi-mortality worldwide. Although studies have reported higher COVID-19 severity in cancer patients, the consequences of the pandemic on health care for CNS tumors remain inconclusive and will probably be felt for decades. This study aimed to determine the impact of pandemic on the hospital admissions (HA) due to CNS tumors in the city of São Paulo, Brazil. Methods: This is a cross-sectional study of the HAs due to CNS tumors in the city of São Paulo comparing the outbreak period (January-June 2020) and a pre-pandemic corresponding period of the years 2017-2019. Data were obtained from the Brazilian Unified Health System - Hospital Information System database according to the chapter II of the International Classification of Diseases - 10th revision (ICD-10). Linear regression was used to analyze the relationship between the incidence of HAs and time (months). Results: A significant reduction in HAs due to CNS tumors was observed during the outbreak period (January-June 2020). Benign neoplasm of brain and other parts of CNS (-2, CI -2 to -1) and malignant neoplasm of brain (-5, CI -7 to -3) showed to be remarkably affected (see table). To our knowledge, this is the first scientific report of significant reduction of HAs due to CNS tumors during COVID-19 era. Conclusions: Our findings seem to be associated to delayed oncological diagnose and care to CNS tumor patients during the lockdown and health system collapse. A rebound help-seeking effect as well as more severe complications may present in the post‐pandemic. Further studies are needed to evaluate the impact of the ongoing pandemic in CNS neoplasms in order to strategically corroborate public health actions for short- and long-term implications of COVID-19 pandemic. [Table: see text]

scholarly journals Health system financing paradigm in the state of São Paulo

2019 ◽  
Vol 53 ◽  
pp. 39
Author(s):  
Adilson Soares
Keyword(s):  
Public Health ◽  
Health Care ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
High Complexity ◽  
Primary Health ◽  
Capita Spending ◽  
Per Capita ◽  
The City

OBJECTIVE: To analyze the allocation of financial resources in the Brazilian Unified Health System (SUS) in the state of São Paulo by level of care, health region, source of funds and level of government. METHODS: This is an exploratory study based on 2014 data extracted from the Public Health Budget Database, presented in absolute terms, relative terms and per capita. RESULTS: In 2014, R$52.1 bi were spent on public health, 58.0% having corresponded to the expenditures of the municipalities and 42.0% to those of the state government. Regional per capita spending varied from R$561.75 to R$824.85. As for the per capita spending on primary health care, which represented 37.5% of the municipalities’ total expenditure, the lowest value was found in the city of São Paulo and the highest, in Araçatuba. Campinas had the highest per capita expenditure on medium and high complexity care, while Presidente Prudente had the lowest. The highest regional percentage of the current net revenue spent on health was verified in Registro, and the lowest, in the city of São Paulo. CONCLUSIONS: The paradigm of the health sector’s financing in São Paulo revealed that the expenditure on primary health care, level elected by health policy as strategic because it depends on coordination and integral health care in the attention networks, was not considered a priority in relation to the expenditure with the medium and high complexity, exposing the iniquities in the state’s regions.

scholarly journals The Impact of Antipsychotic Polytherapy Costs in the Public Health Care in Sao Paulo, Brazil

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0124791 ◽  
Author(s):  
Denise Razzouk ◽  
Monica Kayo ◽  
Aglaé Sousa ◽  
Guilherme Gregorio ◽  
Hugo Cogo-Moreira ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Sao Paulo ◽  
Public Health Care ◽  
São Paulo ◽  
The Public ◽  
The Impact

Conclusion

2018 ◽  
pp. 298-302
Author(s):  
Francisco Vidal Luna ◽  
Herbert S. Klein
Keyword(s):  
20Th Century ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
Leadership Position ◽  
Role Of The State ◽  
The Impact

This chapter examines the basic themes discussed in the book and the major conclusions reached which explain the rise of São Paulo to its important leadership position. We stress the importance of coffee, the role of the state in promoting the economy, the impact of immigration and the infrastructure established which enabled the state to become the leading economy in the second half of the 20th century

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