Analysis of financial resources for public health in Brazilian capitals: a time trend ecological study

This study aimed to analyze part of the financial resources used to fund public health actions in the 26-Brazilian capitals, from 2008 to 2018. This is a time-trend ecological study involving revenue and expenditure indicators provided by the Information System on Public Budget for Health (SIOPS). The values were deflated based on the Extended National Consumer Price Index of 2018 in Brazil to allow the comparison over the years. The mean annual variation of health investments, in Brazilian Reais (BRL) was assessed using linear regressions. Pearson’s correlation coefficients were estimated between federal revenues and expenditures with the capitals’ resources. All capitals presented statistically significant positive correlations for the origin of the budget resource invested in health. The lowest coefficient was found in the capital city of Macapá (Amapá State) (r = 0.860) and the highest, in Fortaleza (Ceará State) (r = 0.997). Belo Horizonte (Minas Gerais State) was the capital with the highest annual increase in federal transfers (about BRL 67.91 per year) and Teresina (Piauí State) presented the highest annual increase in health expenditures among the capitals (about BRL 55.42 per year). We found a increase in the transfers of the Brazilian Unified National Health System (SUS) and municipal resources in almost all capitals, but there are still inequalities in the distribution of financial resources among Brazilian capitals from different regions. Health funding is affected by the municipalization of SUS and it is not the single factor affecting the access and quality of health services.

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Trends in Stroke-Related Mortality in the ABC Region, São Paulo, Brazil: An Ecological Study Between 1997 and 2012

The Open Cardiovascular Medicine Journal ◽

10.2174/1874192401711010111 ◽

2017 ◽

Vol 11 (1) ◽

pp. 111-119 ◽

Cited By ~ 7

Author(s):

Luiz Vinicius de Alcantara Sousa ◽

Laércio da Silva Paiva ◽

Francisco Winter dos Santos Figueiredo ◽

Tabata Cristina do Carmo Almeida ◽

Fernando Rocha Oliveira ◽

...

Keyword(s):

Ecological Study ◽

Temporal Trend ◽

Linear Regression Analysis ◽

Age Groups ◽

National Health System ◽

Sao Paulo ◽

Capital City ◽

São Paulo ◽

Using Data ◽

Related Mortality

Background: Stroke is the second leading cause of death and the third leading cause of physical disability in the world, with a high burden of morbidity and mortality, but it has been shown a reduction in mortality worldwide over the past two decades, especially in regions with higher income. Objective: The study analyzed the temporal trend and the factors associated with stroke-related mortality in the cities that make up the ABC region of São Paulo (Santo André, São Bernardo do Campo, São Caetano do Sul, Diadema, Mauá, Ribeirão Pires, and Rio Grande da Serra), in comparison to data from the capital city of São Paulo, in the state of São Paulo, Brazil. Method: This was an ecological study conducted in 2017 using data from 1997 to 2012. Data were collected in 2017 from the Department of Informatics of the Brazilian Unified National Health System (DATASUS), where the Mortality Information System (SIM/SUS) was accessed. Linear regression analysis was used to estimate the temporal trend of stroke-related mortality according to sex, stroke subtypes, and regions. The confidence level adopted was 95%. Results: There was a reduction in the mortality rates stratified according to sex, age groups above 15 years, and subtypes of stroke. Mortality from hemorrhagic and non-specified stroke decreased in all regions. However, a significant reduction in ischemic stroke-related mortality was observed only in the ABC region and in Brazil. Conclusion: The ABC region showed greater mortality due to stroke in males, the age group above 49 years, and non-specified stroke between 1997 and 2012.

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PP58 The Alliance Between Health Technology Assessment And Public Health In National Screening Policies

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462319002113 ◽

2019 ◽

Vol 35 (S1) ◽

pp. 48-48

Author(s):

Leonor Varela-Lema ◽

Janet Puñal-Riobóo ◽

Paula Cantero-Muñoz ◽

Maria José Faraldo-Vallés

Keyword(s):

Public Health ◽

Decision Making ◽

Newborn Screening ◽

Health Technology Assessment ◽

Technology Assessment ◽

National Health System ◽

Health Technology ◽

Screening Tests ◽

Special Focus ◽

Screening Programs

IntroductionDecision making regarding national population-based prenatal and newborn screening policies is recognized to be highly challenging. This paper aims to describe the formalized collaboration that has been established between the Spanish National Public Health Screening Advisory Committee (PHSAC) and the Spanish Network of Health Technology Assessment (HTA) agencies to support the development of evidence- and consensus-based recommendations to support this process.MethodsIn-depth description and analysis of the strategic and methodological processes that have been implemented within the Spanish National Health System prenatal and newborn screening frameworks, with special emphasis on the role, actions, and responsibilities of HTA agencies.ResultsThe role of HTA agencies is threefold: (i) support the PHSAC by providing evidence on safety, effectiveness and cost/effectiveness of the screening tests/strategies, as well as contextualized information regarding costs, organizational, social, legal and ethical issues; (ii) collaborate with the PHSAC in the development of formal evidence- and consensus-based recommendations for defining population screening programs, when required; (iii) analyze real-world data that is generated by piloted programs. This paper will provide real-life examples of how these processes were implemented in practice, with a special focus on the development of the non-invasive prenatal testing (NIPT) policy. Recommendations for NIPT were developed by a multidisciplinary group based on the European network for Health Technology Assessment (EUnetHTA) rapid assessment report and the predictive models that were built using national statistics and other contextualized data.ConclusionsThe current work represents an innovative approach for prenatal and newborn screening policymaking, which are commonly difficult to evaluate due to the low quality of evidence and the confounding public health issues. The paper raises awareness regarding the importance of joint collaborations in areas where evidence is commonly insufficient for decision making.

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Relationship (or its lack) between population and a water and sanitation service: a study of users' perception in Vitória (ES) Brazil

Journal of Water and Health ◽

10.2166/wh.2010.067 ◽

2010 ◽

Vol 8 (4) ◽

pp. 764-778 ◽

Cited By ~ 6

Author(s):

Sara Ramos da Silva ◽

Léo Heller ◽

Jorge de Campos Valadares ◽

Sandy Cairncross

Keyword(s):

Public Health ◽

Health Risk ◽

Water Supply ◽

Health Authority ◽

Capital City ◽

Public Health Authority ◽

Water And Sanitation ◽

Local Public Health ◽

Water Handling ◽

Inadequate Knowledge

The objective of this paper is to identify and analyse the perception of groups of dwellers of Vitória, Espírito Santo, Brazil, regarding their relationship with the water and sanitation service and aspects of water handling. Participants living in four distinct urban districts of the capital city were interviewed in their own houses and the Discourse of the Collective Subject approach was employed to order the data so obtained. The testimonies revealed the health risk to which individuals were exposed by virtue of: (i) inadequate knowledge concerning the water supply offered, (ii) lack of stimulus to exert their citizens' rights and obligations in relation to the water provided for their consumption and (iii) poor channels of communication between the community, the water and sanitation service and the local public health authority. The study concluded that there is a need to rethink the forms of information provided to the population that are presently adopted by these institutions.

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Shining a Light also Casts a Shadow: Neuroimaging Incidental Findings in Neuromarketing Research

Neuroethics ◽

10.1007/s12152-021-09463-x ◽

2021 ◽

Author(s):

Owen M. Bradfield

Keyword(s):

Public Health ◽

Rapid Growth ◽

Incidental Findings ◽

Brain Research ◽

Social Value ◽

Financial Resources ◽

Potential Health ◽

Functional Brain ◽

Public Health Systems ◽

The Social

AbstractRapid growth in structural and functional brain research has led to increasing ethical discussion of what to do about incidental findings within the brains of healthy neuroimaging research participants that have potential health importance, but which are beyond the original aims of the study. This dilemma has been widely debated with respect to general neuroimaging research but has attracted little attention in the context of neuromarketing studies. In this paper, I argue that neuromarketing researchers owe participants the same ethical obligations as other neuroimaging researchers. The financial resources available to neuromarketing firms and the social value of neuromarketing studies should command greater attention to the elucidation and management of incidental findings. However, this needs to be balanced against finite resources available within most public health systems.

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Impact of social service and public health spending on teenage birth rates across the USA: an ecological study

BMJ Open ◽

10.1136/bmjopen-2016-013601 ◽

2017 ◽

Vol 7 (5) ◽

pp. e013601 ◽

Cited By ~ 2

Author(s):

Heather L Sipsma ◽

Maureen Canavan ◽

Melissa Gilliam ◽

Elizabeth Bradley

Keyword(s):

Public Health ◽

Social Service ◽

Ecological Study ◽

Health Spending ◽

Birth Rates ◽

Teenage Birth ◽

Public Health Spending ◽

The Usa

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Project BHTRM: new strategy of monitoring and acting in spinal cord injuries in the city of Belo Horizonte

Coluna/Columna ◽

10.1590/s1808-18512014130400387 ◽

2014 ◽

Vol 13 (4) ◽

pp. 322-324

Author(s):

Diogo Guilherme de Vasconcelos Gonçalves ◽

Guilherme Zanini Rocha ◽

José Augusto Malheiros ◽

Paula Martins ◽

Aluízio Augusto Arantes Junior ◽

...

Keyword(s):

Public Health ◽

Spinal Cord Injuries ◽

Health Management ◽

Active Monitoring ◽

Rehabilitation Care ◽

New Strategy ◽

Group 2 ◽

Belo Horizonte ◽

The City ◽

Group 1

Objective: The BHTRM Project aims at studying the epidemiology of TRM in the city of Belo Horizonte and providing the means to monitor these patients. Method: To assess the efficacy and solvability of the project, two groups of patients treated at the João XXIII Hospital were compared in two distinct periods. Group 1 - from May 1, 2011 to July 31, 2011, months of project initiation and Group 2 - from December 1, 2012 to February 28, 2013. Results: Despite the 34% increase in the number of assisted patients, there is a 30% drop in the average number of days of hospitalization, as well as a decrease in the average days waiting for surgery of patients requiring surgical treatment, from 10.9 to 4.84, a drop of 56%. Conclusion: BHTRM Project is a useful tool in public health management. It optimizes the treatment of patients with spinal trauma by decreasing the time between admission and surgery. Also provides active monitoring of patient care and ensures better integration of rehabilitation care.

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Bypassing the Technocratic State in South Korea

Asian Medicine ◽

10.1163/15734218-12341483 ◽

2021 ◽

Vol 16 (1) ◽

pp. 36-57

Author(s):

James Flowers

Keyword(s):

Public Health ◽

South Korea ◽

Traditional Medicine ◽

Herbal Medicines ◽

The State ◽

Financial Resources ◽

Cultural Resources ◽

Korean Medicine ◽

Treatment Plans ◽

Rapid Transmission

Abstract This article reveals an important, yet hidden, Korean response to the COVID-19 pandemic in 2020 that goes beyond the actions of the state. It focuses on the Korean medicine doctors who were excluded from any government-led public health or treatment plans for COVID-19. Bypassing the state, they used telehealth to provide herbal medicines to 20 percent of COVID-19 patients in South Korea. Traditional medicine doctors volunteered their services and financial resources to fill a gap in COVID-19 care. Most observers attribute Korean success in controlling COVID-19 to the leadership of the technocratic state with buy-in from the population. However, the case of Korea offers an example of bottom-up healthcare in a community where people chose their own native cultural resources and helps to explain how doctors were able to take the initiative to autonomously work with people in the community to help to stop the otherwise rapid transmission of the virus.

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Confronting the Moscow Healthcare System with the Shocks of COVID-19

City Healthcare ◽

10.47619/2713-2617.zm.2021.v2i1;41-46 ◽

2021 ◽

Vol 2 (1) ◽

pp. 41-46

Author(s):

Aleksandr N. Tsibin ◽

Munira F. Latypova ◽

Olga I. Ivanushkina

Keyword(s):

Public Health ◽

Large Scale ◽

Virus Disease ◽

Laboratory Diagnosis ◽

Capital City ◽

Laboratory Diagnostics ◽

Successful Implementation ◽

Laboratory Service ◽

The Government ◽

Challenging Situation

Introduction. Transmissible coronavirus SARS-CoV-2I is the seventh known coronavirus that causes an acute infectious disease predominantly affecting the lungs (Corona Virus Disease 2019, COVID-19). The COVID-19 pandemic exposed serious gaps in health systems preparedness. The epidemic urgently required priority organizational measures to contain and reduce the spread of COVID-19. Public health authorities had to make decisions in a challenging situation where there was a lack of knowledge, experience, and great confidence, and the number of infected was steadily increasing. Purpose. The purpose of this article is to present the unique experience of Moscow in organizing a large-scale laboratory examination of the population of a metropolis with about 12.6 million inhabitants to meet the needs of the capital in testing for SARS-CoV-2 virus and combating its circulation in conditions of the COVID-19 pandemic. Materials and Methods. The decisions made and the measures taken by the Government of Moscow, the Moscow Operational Staff, the DZM and the DZM Laboratory Service to slow the growth of the COVID-19 epidemic among the population of the capital are listed step-by-step. Results. In the course of organizational activities, sufficient capacity to maintain the public health infrastructure in terms of laboratory diagnosis of the new coronavirus infection was ensured by the joint efforts. Safe laboratory diagnostics for detecting, treating, and isolating COVID-19 cases and contacts have been established in the capital city. Thanks to the successful implementation of timely decisions, the spread of infection in the city of Moscow has been slowed. The Moscow government has reported a steady decline in cases of the new coronavirus disease and most hospitals have switched to a safe treatment regimen for patients requiring hospitalization. Centralized laboratories with readiness to perform screening and referral studies for COVID-19 outbreaks have been established within the structure of the DZM.

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Quantifying the relationship between lockdowns, mobility, and effective reproduction number (Rt) during the COVID-19 pandemic in the Greater Toronto Area

BMC Public Health ◽

10.1186/s12889-021-11684-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Christopher Dainton ◽

Alexander Hay

Keyword(s):

Public Health ◽

Secular Trend ◽

Reproduction Number ◽

Time Lag ◽

Correlation Coefficients ◽

Greater Toronto Area ◽

Global Mobility ◽

The Relationship ◽

Second Wave ◽

Over Time

Abstract Background The effectiveness of lockdowns in mitigating the spread of COVID-19 has been the subject of intense debate. Data on the relationship between public health restrictions, mobility, and pandemic growth has so far been conflicting. Objective We assessed the relationship between public health restriction tiers, mobility, and COVID-19 spread in five contiguous public health units (PHUs) in the Greater Toronto Area (GTA) in Ontario, Canada. Methods Weekly effective reproduction number (Rt) was calculated based on daily cases in each of the five GTA public health units between March 1, 2020, and March 19, 2021. A global mobility index (GMI) for each PHU was calculated using Google Mobility data. Segmented regressions were used to assess changes in the behaviour of Rt over time. We calculated Pearson correlation coefficients between GMI and Rt for each PHU and mobility regression coefficients for each mobility variable, accounting for time lag of 0, 7, and 14 days. Results In all PHUs except Toronto, the most rapid decline in Rt occurred in the first 2 weeks of the first province-wide lockdown, and this was followed by a slight trend to increased Rt as restrictions decreased. This trend reversed in all PHUs between September 6th and October 10th after which Rt decreased slightly over time without respect to public health restriction tier. GMI began to increase in the first wave even before restrictions were decreased. This secular trend to increased mobility continued into the summer, driven by increased mobility to recreational spaces. The decline in GMI as restrictions were reintroduced coincides with decreasing mobility to parks after September. During the first wave, the correlation coefficients between global mobility and Rt were significant (p < 0.01) in all PHUs 14 days after lockdown, indicating moderate to high correlation between decreased mobility and decreased viral reproduction rates, and reflecting that the incubation period brings in a time-lag effect of human mobility on Rt. In the second wave, this relationship was attenuated, and was only significant in Toronto and Durham at 14 days after lockdown. Conclusions The association between mobility and COVID-19 spread was stronger in the first wave than the second wave. Public health restriction tiers did not alter the existing secular trend toward decreasing Rt over time.

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The Evolution of Measles in Romania Between 2016 and 2018. A comprehesive overview

Revista de Chimie ◽

10.37358/rc.19.10.7619 ◽

2019 ◽

Vol 70 (10) ◽

pp. 3665-3670

Author(s):

Simona Nicoleta Musat ◽

Maria Roxana Nemes ◽

Cosmin Alec Moldovan ◽

Tudor Harsovescu ◽

Ioan Sorin Tudorache ◽

...

Keyword(s):

Public Health ◽

Health System ◽

Health Management ◽

National Health System ◽

Public Health Issue ◽

Complication Rates ◽

Vaccination Rates ◽

Grand Total ◽

System Data ◽

Health System Data

Measles is an ever-growing threat, a major public health issue, being responsible for a large number of deaths, especially in children. This paper aims to study all cases of measles in Romanian hospitals, cases reported by National School of Public Health, Management and Professional Development, Bucharest on a two year period of time; the study focuses on frequency and pattern territorial distribution of cases, temporal evolution, complication rates and the social pressure the such an infectious disease is putting onto the national health system. Data gathered shows a total number of 2,985 for 2016, 10,181 for 2017 and 8,364 for the entire 2018, with a grand total of 21,530 patients analyzed by our study. The analysis clearly shows, on one hand, a descending rate in vaccination coverage, compared with the national assigned target and, on the other hand, a continuous drop in vaccination rates with the first dose of Measles-mumps-rubella vaccine (MMR), both being in equal manner dangerous situations for the entire health system in Romania.

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