scholarly journals Time trends in physical activity of adult users of the Brazilian National Health System: 2010-2014. Longitudinal study

2017 ◽  
Vol 135 (4) ◽  
pp. 369-375 ◽  
Author(s):  
Bruna Camilo Turi ◽  
Jamile Sanches Codogno ◽  
Rômulo Araújo Fernandes ◽  
Kyle Robinson Lynch ◽  
Eduardo Kokubun ◽  
...  
Keyword(s):  
Physical Activity ◽  
Longitudinal Study ◽  
Health System ◽  
National Health ◽  
Time Trends ◽  
Economic Status ◽  
National Health System ◽  
Sports Participation ◽  
Male Sex

ABSTRACT CONTEXT AND OBJECTIVE: In this longitudinal study, we aimed to describe time trends of physical activity (PA) in different domains from 2010 to 2014 among users of the Brazilian National Health System, taking into account the effects of sex, age and economic status (ES). DESIGN AND SETTING: Longitudinal study conducted in five primary care units in Bauru (SP), Brazil. METHODS: The sample was composed of 620 men and women who were interviewed in 2010, 2012 and 2014. The same group of researchers conducted the interviews, using the questionnaire developed by Baecke et al. Scores for occupational, exercise/sport, leisure-time/transportation and overall PA were considered in this longitudinal survey. Time trends of PA over the four years of follow-up were assessed according to sex, age and ES. RESULTS: We found that after four years of follow-up, the reduction in overall PA (-13.6%; 95% confidence interval, CI = -11.9 to -15.3) was statistically significant. Additionally, declines in the occupational domain and exercise/sports participation were affected by age, while the reduction in overall PA was affected by sex, age and ES. CONCLUSIONS: Overall PA decreased significantly from 2010 to 2014 among these outpatients of the Brazilian National Health System, and age and male sex were important determinants of PA in its different domains.

scholarly journals Association between obesity and knee osteoarthritis in users of brazilian unified national health system

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Eduardo Paul Chacur ◽  
Thiago Montes Fidale ◽  
Jean Ezequiel Limongi ◽  
Fernando Leonardo Diniz ◽  
Dalton Muller Pessoa Filho ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Examination ◽  
Health System ◽  
National Health ◽  
Strong Association ◽  
National Health System ◽  
Radiological Examination ◽  
Continuous Variables ◽  
Functional Classification ◽  
Knee Oa

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.

scholarly journals Time trends in leisure time physical activity and physical fitness in elderly people: 20 year follow-up of the Spanish population national health survey (1987-2006)

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Domingo Palacios-Ceña ◽  
Cristina Alonso-Blanco ◽  
Rodrigo Jiménez-Garcia ◽  
Valentin Hernández-Barrera ◽  
Pilar Carrasco-Garrido ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Fitness ◽  
Elderly People ◽  
National Health ◽  
Health Survey ◽  
Time Trends ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
National Health Survey

scholarly journals Determinants of outpatient expenditure within primary care in the Brazilian National Health System

2017 ◽  
Vol 135 (3) ◽  
pp. 205-212 ◽  
Author(s):  
Bruna Camilo Turi ◽  
Jamile Sanches Codogno ◽  
Flávia Mori Sarti ◽  
Nana Kwame Anokye ◽  
Rômulo Araújo Fernandes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health System ◽  
National Health ◽  
Laboratory Tests ◽  
Healthcare Expenditure ◽  
National Health System ◽  
Moderate Physical Activity ◽  
Total Body Mass ◽  
Factors Associated

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.

Time trends in leisure time physical activity and physical fitness in the elderly: Five-year follow-up of the Spanish National Health Survey (2006–2011)

Maturitas ◽  
2015 ◽  
Vol 80 (4) ◽  
pp. 391-398 ◽  
Author(s):  
Carmen Casado-Pérez ◽  
Valentín Hernández-Barrera ◽  
Rodrigo Jiménez-García ◽  
Cesar Fernández-de-las-Peñas ◽  
Pilar Carrasco-Garrido ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Fitness ◽  
National Health ◽  
Health Survey ◽  
Time Trends ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
The Elderly ◽  
National Health Survey

Effectiveness of Direct-acting Antivirals for the Treatment of Chronic Hepatitis C in Rwanda: A Retrospective Study

2020 ◽  
Author(s):  
Sabin Nsanzimana ◽  
Michael J Penkunas ◽  
Carol Y Liu ◽  
Dieudonne Sebuhoro ◽  
Alida Ngwije ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hepatitis C ◽  
Health System ◽  
National Health ◽  
Virological Failure ◽  
National Health System ◽  
Sub Saharan Africa ◽  
Direct Acting Antivirals ◽  
Direct Acting

Abstract Background Direct-acting antivirals (DAAs) are becoming accessible in sub-Saharan Africa. This study examined the effectiveness of DAAs in patients treated through the Rwandan national health system and identified factors associated with treatment outcomes. Methods This retrospective study used data from the national hepatitis C virus (HCV) program for patients who initiated DAAs between November 2015 and March 2017. Sustained virological response at 12 weeks after treatment (SVR12) was the primary outcome. Logistic regression models were fit to estimate the relationship between patients’ clinical and demographic characteristics and treatment outcome. Results 894 patients started treatment during the study period; 590 completed treatment and had SVR12 results. Among the 304 patients without SVR12 results, 48 were lost to follow-up and 256 had no SVR12 results but clinical data indicated they likely completed treatment; these patients were classified as nonvirological failure because viral clearance could not be determined. In a per-protocol analysis of 590 patients with SVR12 results, SVR12 was achieved in 540 (92%), and virological failure occurred in 50 (8%). Pretreatment HCV RNA above the median split was associated with virological failure. Intention-to-treat analyses including all patients showed that SVR12 was achieved in 540 (60%), with nonvirological failure in 304 (34%) and virological failure in 50 (6%). Patients in Western Province were more likely to experience nonvirological failure than patients in Kigali, likely owing to the 5–7-hour travel required to access testing and treatment. Conclusions DAAs were effective when implemented through the Rwandan national health system. Decentralization and enhanced financing are underway in Rwanda, which could improve access to treatment and follow-up as the country prepares for HCV elimination.

scholarly journals Effectiveness of Maintenance Immunosuppression Therapies in a Matched-Pair Analysis Cohort of 16 Years of Renal Transplant in the Brazilian National Health System

2020 ◽  
Vol 17 (6) ◽  
pp. 1974 ◽  
Author(s):  
Rosângela Maria Gomes ◽  
Wallace Breno Barbosa ◽  
Brian Godman ◽  
Juliana de Oliveira Costa ◽  
Nélio Gomes Ribeiro Junior ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Transplant ◽  
Health System ◽  
National Health ◽  
Real World ◽  
Graft Loss ◽  
National Health System ◽  
Treatment Regimens

The maintenance of patients with renal transplant typically involves two or more drugs to prevent rejection and prolong graft survival. The calcineurin inhibitors (CNI) are the most commonly recommended medicines in combinations with others. While immunosuppressive treatment regimens are well established, there is insufficient long-term effectiveness data to help guide future management decisions. The study analyzes the effectiveness of treatment regimens containing CNI after renal transplantation during 16 years of follow-up with real-world data from the Brazilian National Health System (SUS). This was a retrospective study of 2318 SUS patients after renal transplantion. Patients were propensity score-matched (1:1) by sex, age, type and year of transplantation. Kaplan–Meier analysis was used to estimate the cumulative probabilities of survival. A Cox proportional hazard model was used to evaluate factors associated with progression to graft loss. Multivariable analysis, adjusted for diabetes mellitus and race/color, showed a greater risk of graft loss for patients using tacrolimus plus mycophenolate compared to patients treated with cyclosporine plus azathioprine. In conclusion, this Brazilian real-world study, with a long follow-up period using matched analysis for relevant clinical features and the representativeness of the sample, demonstrated improved long-term effectiveness for therapeutic regimens containing cyclosporine plus azathioprine. Consequently, we recommend that protocols and clinical guidelines for renal transplantation should consider the cyclosporine plus azathioprine regimen as a potential first line option, along with others.

scholarly journals Self-rated health and hospital services use in the Spanish National Health System: a longitudinal study

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Nayara Tamayo-Fonseca ◽  
Andreu Nolasco ◽  
Jose A. Quesada ◽  
Pamela Pereyra-Zamora ◽  
Inmaculada Melchor ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Health System ◽  
National Health ◽  
National Health System ◽  
Hospital Services ◽  
Self Rated Health ◽  
System A ◽  
Spanish National Health System ◽  
Services Use

scholarly journals Pharmacoeconomic analysis of long term use of darbepoetin-α in treating chronic nephropathy-induced anemia in dialysed patients

2007 ◽  
Vol 8 (2) ◽  
pp. 61-69
Author(s):  
Nicola Giotta ◽  
Ercole Biamino ◽  
Mario Eandi
Keyword(s):  
Health System ◽  
National Health ◽  
Average Cost ◽  
Conversion Factor ◽  
Pharmacoeconomic Analysis ◽  
National Health System ◽  
Chronic Nephropathy ◽  
Italian National Health

The main aim of this retrospective study was to perform a pharmacoeconomic analysis of long term use of darbepoetin-α (DARB) after switch from erythropoietin-ß (EPO-ß) in treating chronic nephropathy-induced anemia in dialysed patients. Secondary objective was the assessment of the actual EPO-ß-to-DARB dose conversion factor. We extracted data of 78 patients who have been treated with EPO-ß for at least 6 months and then switched to DARB from the database of the dialysis center of the Asti (Piedmont, Italy) hospital. From these, we selected 47 patients (23 males and 24 females) who completed a 120-weeks follow-up treatment with DARB.
All patients were treated with a dose adjustment schedule to keep haemoglobin levels in the range 11-12g/dl. Pre-switch EPO-ß administration was thrice a week, while DARB was administered once a week, both via intravenous. Initial DARB dose has been calculated on the basis of the theoretical 200:1 conversion factor. Actual cumulative EPO and DARB consumption was recorded for all patients. Drug costs were valued according to purchasing prices for the Italian National Health System (October 2006).
In the 24 pre-switch weeks the average cost (±SD) per patient for EPO-ß was € 2,309.86 (±1,434.78). In the 120 weeks of follow-up the average cost (±SD) per patient for DARB/24 weeks ranged from a minimum of € 1,487.09 (±1,125.51) to a maximum of € 2,125.73 (±1,546.85). 
The switch of 47 patients to DARB produced an overall net saving for the dialysis centre estimated in 119,540.72 Euro/120 weeks, under the hypothesis that EPO-ß semester costs remain constant: the conversion from EPO-ß to DARB has the potential to maintain long term good haemoglobin control and induces significant savings for the National Health System.
However the dosage should be adjusted on an individual basis in order to avoid excessive fluctuation of Hb concentrations. The actual conversion factor resulted on average higher than theoretical factor settling to 240-280:1.


scholarly journals Physical activity during the early years of life and osteoporosis in adulthood: study among users of the Brazilian National Health System

2016 ◽  
Vol 22 (4) ◽  
pp. 353-358
Author(s):  
Bruna Camilo Turi ◽  
Jamile Sanches Codogno ◽  
Kyle Robinson Lynch ◽  
Lia Grego Muniz de Araújo ◽  
Bruna Locci ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health System ◽  
National Health ◽  
National Health System ◽  
Early Years

scholarly journals Anemia, sarcopenia, physical activity, and the risk of tuberculosis in the older population: a nationwide cohort study

2021 ◽  
Vol 12 ◽  
pp. 204062232110159
Author(s):  
Jung Eun Yoo ◽  
Dahye Kim ◽  
Hayoung Choi ◽  
Young Ae Kang ◽  
Kyungdo Han ◽  
...  
Keyword(s):  
Physical Activity ◽  
Screening Program ◽  
Chronic Obstructive ◽  
Older Population ◽  
Timed Up And Go ◽  
Obstructive Pulmonary Disease ◽  
Mild Anemia ◽  
Increased Risk ◽  
Male Sex

Background: The aim of this study was to investigate whether physical activity, sarcopenia, and anemia are associated an with increased risk of tuberculosis (TB) among the older population. Methods: We included 1,245,640 66-year-old subjects who participated in the National Screening Program for Transitional Ages for Koreans from 2009 to 2014. At baseline, we assessed common health problems in the older population, including anemia and sarcopenia. The subjects’ performance in the timed up-and-go (TUG) test was used to predict sarcopenia. The incidence of TB was determined using claims data from the National Health Insurance Service database. Results: The median follow-up duration was 6.4 years. There was a significant association between the severity of anemia and TB incidence, with an adjusted hazard ratio (aHR) of 1.28 [95% confidence interval (CI), 1.20–1.36] for mild anemia and 1.69 (95% CI, 1.51–1.88) for moderate to severe anemia. Compared with those who had normal TUG times, participants with slow TUG times (⩾15 s) had a significantly increased risk of TB (aHR 1.19, 95% CI, 1.07–1.33). On the other hand, both irregular (aHR 0.88, 95% CI 0.83–0.93) and regular (aHR 0.84, 95% CI, 0.78–0.92) physical activity reduced the risk of TB. Male sex, lower income, alcohol consumption, smoking, diabetes, and asthma/chronic obstructive pulmonary disease increased the risk of TB. Conclusion: The risk of TB among older adults increased with worsening anemia, sarcopenia, and physical inactivity. Physicians should be aware of those modifiable predictors for TB among the older population.

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