scholarly journals Contextual and individual factors associated with dissatisfaction with the Brazilian Unified National Health System, 2011-2012

2016 ◽  
Vol 32 (10) ◽  
Author(s):  
Lúcia Gimenes Passero ◽  
Jessye Melgarejo do Amaral Giordani ◽  
Fernando Neves Hugo ◽  
Vanessa Bielefeldt Leotti Torman ◽  
Suzi Alves Camey ◽  
...  

Abstract: User satisfaction is known to be related to quality of healthcare. The aim of this study was to evaluate the influence of contextual and individual factors associated with user dissatisfaction with the Brazilian Unified National Health System (SUS). This was a cross-sectional multilevel study. Data were collected via telephone by the ombudsman's office of the SUS. Telephone numbers were randomly selected from a telephone company database. Health services, socioeconomic, and individual demographic variables were evaluated, in addition to information on the municipalities. The outcome variable was dissatisfaction with the SUS. Hierarchical multilevel logistic regression was used, and 18,673 individuals were contacted. Prevalence of dissatisfaction was 63.4% (95%CI: 62.7-64.1). Unmet demand (OR = 3.66), waiting time > 4 hours (OR = 2.82), and number of Primary Healthcare Units (OR = 0.89) were associated statistically with dissatisfaction. Characteristics of the health teams' work process showed a strong association with dissatisfaction.

2018 ◽  
Vol 34 (1) ◽  
Author(s):  
Rafaela Soares Rech ◽  
Fernando Neves Hugo ◽  
Jessye Melgarejo do Amaral Giordani ◽  
Lúcia Gimenes Passero ◽  
Juliana Balbinot Hilgert

The Brazilian network of emergency care, in recent years, has shown significant progress. The objective was to evaluate contextual and individual factors associated with the satisfaction with public emergency health services. This was a cross-sectional multilevel study carried out between June 2011 and January 2012. Data were collected via telephone at the ombudsman’s office of the Brazilian Unified National Health System (SUS). Telephone numbers were randomly selected from a telephone company database. Health services, socioeconomic, and individual demographic variables were evaluated, in addition to information about the municipalities. The outcome variable was dissatisfaction with public emergency health services in Brazil. Multilevel logistic regression was performed and 7,027 individuals from 61 municipalities answered the survey. The prevalence of perceived dissatisfaction was 48.1% (95%CI: 46.9-49.3). Variables that remained significantly associated with the outcome are: age up to 20 years, 16 or more years of education, lives in the Central region, non-resolved demands, longer waiting times, and accessing emergency in a primary care service. Prevalence of a perceived dissatisfaction is predominantly associated with care’s waiting time and the length needed to resolve the demand.


2013 ◽  
Vol 16 (3) ◽  
pp. 622-632
Author(s):  
Katia Cristina Bassichetto ◽  
Denise Pimentel Bergamaschi ◽  
Deivis Elton Schlickmann Frainer ◽  
Vania Regina Salles Garcia ◽  
Edina Aparecida Tramarin Trovões

The nutritional status of people living with HIV/AIDS (PLWHA) is related to morbidity and mortality and its monitoring is important in the maintenance of the health status. This is a cross-sectional study carried out in Brazilian National Health System in the Municipality of São Paulo. It describes anthropometrical characteristics: weight and height; indices of weight for height (W/H), height for age (H/A), body mass index for age (BMI/A) and Z score for height and weight. The study includes 772 participants from all ages: children, adolescents, adults and elderly. The graphical analysis shows that in under-5s and in the 5 to 19 years old group, the W/H, the H/A and the BMI/A curves are similar to the reference population with an exception in the H/A for 5 to 19 years old group which is left-shifted (mean Z = -0.66). In the case of adults, graphics for the study population show median weight apparently lower than in the reference population for most age groups in the case of men, and when age is greater in women. The proportion of people over 20 years old with AIDS on anti-retroviral therapy is lower when coinfection is present (p < 0.001). The findings of the study showed that, for children and adolescents with HIV/AIDS, the average weight and height are lower than the values for non infected population. For adults and elderly, the weight average is lower than the reference population with a worsening among coinfected patients. This underscores the need to direct more effort in nutritional actions thus helping enhance the health status of this group.


Author(s):  
Mariana Guelli ◽  
Tulio Loyola Correa

Background and Aims Stroke is one of the leading causes of death and disability in adults, accounting for a high number of hospitalizations worldwide.This study aims to evaluate the epidemiology of hospitalizations for stroke in Brazil during 2019 and 2020. Methods Cross-sectional, descriptive and retrospective study, which evaluated the epidemiology of hospital admissions for stroke in the Brazilian National Health System in the years 2019 and 2020.Hospital admissions were evaluated by sex, race and age group using the national database (DATASUS – Department of Informatics of the Unified Health System). The official classification of race/skin color in Brazil is composed of five categories: White, Brown [Pardo], Black,Yellow and Indigenous. Results During this time period, there was a total of 316,859 hospitalizations for stroke in the Brazilian National Health System, with 163,120 (51.5%) hospital admissions in 2019 and 153,739 (48.5%) in 2020. Also, 166,178 (52.4%) patients were male and 150,681 (47.6%) were female. Regarding race (n=250,446); 106,998 (42.7%) patients considered themselves white, 116,601 (46.6%) brown, 17,085 (6.8%) black and 9,762 (3.9%) others. Regarding age groups; 64,939 (20.5%) were >80 years old, 163,114 (51.5%) were 60-79, 74,605 (23.5%) were 40-59 and 14,201 (4.5%) were <40. Conclusions The majority of patients hospitalized for stroke were 60-79 years old and white or brown. The similar number of hospital admissions in 2019 and 2020 may suggest that hospitalizations for stroke were not significantly impacted by hospital’s oversaturation by the COVID-19 pandemic.


2018 ◽  
Vol 26 (100) ◽  
pp. 986-1003
Author(s):  
Maria da Graça Munareto Rodrigues ◽  
Maria de Lourdes Drachler ◽  
Jussara Munareto ◽  
José Carlos de Carvalho Leite

Abstract A cross-sectional study investigated the effectiveness of an education at work in health program in a Brazilian federal university, by sending an electronic questionnaire to 553 active and former participants (80.5% participation). Means of approximately 3.00 (scale from zero to 4.00) for program’s clarity of purpose, suitability of process, and impact, indicated that the program was largely effective. Clarity of purpose was greater among preceptors and mentors when compared to students. The program’s impact was perceived as greater by the students when compared to the lifelong learning of preceptors and mentors, and by females. Building the capacity of preceptors and mentors for education at work in the Brazil’s national health system could advance the effectiveness of the program.


2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Eduardo Paul Chacur ◽  
Thiago Montes Fidale ◽  
Jean Ezequiel Limongi ◽  
Fernando Leonardo Diniz ◽  
Dalton Muller Pessoa Filho ◽  
...  

Verify possible associations between obesity and knee OA in users of Brazilian Unified National Health System (Sistema Único de Saúde - SUS) of primary care network in Catalão-GO, Brazil. This is an observational study conducted in 2014 and 2015. A total of 81 volunteers from the Basic Attention Network in the city of Catalão, with body mass index (BMI) over 30 kg/m2 in both sexes, age between 40 and 60 years, and OA on radiological examination of the knee. Obesity was classified according to BMI. The diagnosis of osteoarthritis (OA) was made clinically and by radiography according to Kellgren radiological classification. The level of physical activity was assessed using the Baecke questionnaire and the Gordon Functional Classification. The volunteers underwent an anthropometric evaluation and physical examination with inspection and palpation of the joint and subsequent radiological examination of the knee. The volunteers answered a questionnaire on the level of physical activity and functional classification. Data analysis was performed using Fisher’s exact test or chi-square test was used for comparisons of two proportions. In comparisons of continuous variables, Student’s t-test or the nonparametric Wilcoxon-Mann-Whitney test was used. The level of significance was set to 5%. Practice of regular physical exercise decreases functional impairment in obese individuals with knee OA. The weight variable demonstrated a strong association with the severity of OA and degree of functionality of patients. Obesity and OA durations and lack of patient guidance are variables that may contribute to the progression of knee OA. Although the incidence among men is lower, they are more severely affected and anthropometric evaluation and physical examination are an efficacy implementations for Brazilian users of SUS.


2020 ◽  
Vol 28 (4) ◽  
pp. 737-750
Author(s):  
Yarima Pupo Ochoa

This article discusses a set of issues relevant to the current state of the health care system of the Republic of Cuba. The purpose of the study is to give an idea of the dynamics of national health development and compare the results achieved in this sector from 2010 to 2018. The consideration of these problems begins with a description of the demographic context that reflects the general health status of the population. The basic structure of the health system, beneficiaries and benefits in the field of health, sources of financing and expenditures on health, available resources and user satisfaction with the services received were also taken into account. The paper also provides an assessment of the main problems that the Ministry of Health will have to solve in the short and medium term, which will entail the need to develop and implement new management strategies for health institutions. The study was based on a theory of analysis of the health sector adapted to the specifics of Cuban public health, providing guidance to the work of the Ministry of Health and health managers in order to achieve a higher level of satisfaction and quality.


2017 ◽  
Vol 135 (3) ◽  
pp. 205-212 ◽  
Author(s):  
Bruna Camilo Turi ◽  
Jamile Sanches Codogno ◽  
Flávia Mori Sarti ◽  
Nana Kwame Anokye ◽  
Rômulo Araújo Fernandes ◽  
...  

ABSTRACT CONTEXT AND OBJECTIVE: One of the big challenges facing governments worldwide is the financing of healthcare systems. Thus, it is necessary to understand the factors and key components associated with healthcare expenditure. The aim here was to identify demographic, socioeconomic, lifestyle and clinical factors associated with direct healthcare expenditure within primary care, among adults attended through the Brazilian National Health System in the city of Bauru. DESIGN AND SETTING: Cross-sectional study conducted in five primary care units in Bauru (SP), Brazil. METHODS: Healthcare expenditure over the last 12 months was assessed through medical records of adults aged 50 years or more. Annual healthcare expenditure was assessed in terms of medication, laboratory tests, medical consultations and the total. Body mass index, waist circumference, hypertension, age, sex, physical activity and smoking were assessed through face-to-face interviews. RESULTS: The total healthcare expenditure for 963 participants of this survey was US$ 112,849.74 (46.9% consultations, 35.2% medication and 17.9% laboratory tests). Expenditure on medication was associated with overweight (odds ratio, OR = 1.80; 95% confidence interval, CI: 1.07-3.01), hypertension (OR = 3.04; 95% CI: 1.91-4.82) and moderate physical activity (OR = 0.56; 95% CI: 0.38-0.81). Expenditure on consultations was associated with hypertension (OR = 1.67; 95% CI: 1.12-2.47) and female sex (OR = 1.70; 95% CI: 1.14-2.55). CONCLUSIONS: Our results showed that overweight, lower levels of physical activity and hypertension were independent risk factors associated with higher healthcare expenditure within primary care.


2021 ◽  
Vol 10 (15) ◽  
pp. e455101522971
Author(s):  
Guilherme Vaz de Melo Trindade ◽  
Diego Alexandre Gomes Sousa ◽  
Ana Elisa Santos Duarte ◽  
Jássia Lopes Freitas da Silveira ◽  
Roberto Lazzarini de Oliveira ◽  
...  

This cross-sectional study collected data from the Brazilian National Health System (NHS) patients’ that filled their psychotropic prescriptions in NHS owned pharmacies. The study aimed to identify oversights in psychotropic prescriptions leading to insecure therapeutic. Patients in use of at least one psychotropic drug in 12 months were identified by a retrospective data search and considered for the study. After examining 15,001 patients in use of psychotropic medicines, 7,440 met the inclusion criterion. The majority of patients were women (67.1%), 54.2% of prescriptions analysed over the studied period presented multiple medicines including one psychotropic, and 54.7% cursing with psychotropic monotherapy. In 92.7% of cases, only one medicine was dispensed and prescriptions from psychiatrists represented only 17.6% of cases. In terms of safety, 9.5% of patients had at least one potential drug interaction of clinical significance, and 71.5% of elder patients had at least one drug that was potentially inappropriate for their age group use. These findings suggest urgency in integrating patients’ medical records information to pharmacotherapy history at the pharmacy computer technology applied for dispensing, reducing harm to patients in the use of psychotropic drugs.


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