scholarly journals Perception of HIV among pregnant women in the public health system in two municipalities of the state of São Paulo

2015 ◽  
Vol 14 (4) ◽  
pp. 282-286
Author(s):  
Cléa Adas Saliba Garbin ◽  
Karina Tonini dos Santos Pacheco ◽  
Thaís Fonseca Santiago ◽  
Simone Miyada ◽  
Artênio José Ísper Garbin ◽  
...  
2022 ◽  
Vol 38 (1) ◽  
Author(s):  
Lewis Fletcher Buss ◽  
Lise Cury ◽  
Caroline Madalena Ribeiro ◽  
Gulnar Azevedo e Silva ◽  
José Eluf Neto

Cervical cancer screening is a multistage process, therefore access to both the primary test and subsequent diagnostic procedures is essential. Considering women undergoing screening on the public health system in the State of São Paulo, Brazil, we aimed to estimate the proportion of women accessing colposcopy within six months of an abnormal smear result. We retrieved records from two administrative databases, the Information System on Uterine Cervical Cancer (SISCOLO) that contains smear results and the Outpatient Information System of the Brazilian Unified National Health System (SIA/SUS) that records colposcopies. A reference cohort consisted of women, aged 25 years or older, with an abnormal smear result between May 1, 2014, and June 30, 2014. We excluded prevalent cases. We linked the reference cohort and records in the SIA/SUS extending to December 31, 2014. After excluding prevalent cases, 1,761 women with abnormal cytology results were left. A total of 700 (39.8%) women were linked to a colposcopy record within the follow-up period; this dropped to 671 (38.1%) women when follow-up was censored at six months. We could notice a slightly higher attendance in women living in the metropolitan region of São Paulo compared with residents of the rest of the state. We found no association between colposcopy attendance and age or cytology class. These results emphasize that access to colposcopy in the public health system in São Paulo is limited. This compromises the quality of screening, and the issue needs to be prioritized in service planning.


2001 ◽  
Vol 59 (3A) ◽  
pp. 504-511 ◽  
Author(s):  
Marcelo E. Bigal ◽  
Janaína O.M. Bigal ◽  
Carlos A. Bordini ◽  
José G. Speciali

Despite the high prevalence, impact and economic importance of headaches, studies on this subject are rare in Brazil. The aim of the present study was to estimate the prevalence of headaches in the public health system of a town in the interior of the State of São Paulo, as well as to estimate the costs resulting from its management. Data refer to the year of 1998 and were obtained according to the following steps: 1) territorial and demographic characterization of the municipality; 2) characterization of the financial indices and social well-being; 3) budget characteristics of the municipality; 4) evaluation of the structuring of the medical service; 5) determination of the prevalence of headaches at different patient care levels; and 6) calculation of the costs of headaches. Headaches represented 7.9% of all visits at basic health units, 9.7% in the emergency room and 1.1% of hospital admissions. The total costs were R$ 85,131.31 (US$ 70,942.76) corresponding to R$ 7.59 (US$ 6,32) per inhabitant/year. The present study shows the need for epidemiological and economic impact studies, which would provide the basis for the rational use of health funds.


2016 ◽  
Vol 19 (1) ◽  
pp. 26-37 ◽  
Author(s):  
Camila Nascimento Monteiro ◽  
Reinaldo José Gianini ◽  
Marilisa Berti de Azevedo Barros ◽  
Chester Luiz Galvão Cesar ◽  
Moisés Goldbaum

ABSTRACT: Introduction: Since 2003, the access to medication has been increasing in Brazil and particularly in São Paulo. The present study aimed to analyze the access to medication obtained in the public sector and the socioeconomic differences in this access in 2003 and 2008. Also, we explored the difference in access to medication from 2003 to 2008. Method: Data were obtained from two cross-sectional population-based household surveys from São Paulo, Brazil (ISA-Capital 2003 and ISA-Capital 2008). Concentration curve and concentration index were calculated to analyze the associations between socioeconomic factors and access to medication in the public sector. Additionally, the differences between 2003 and 2008 regarding socioeconomic characteristics and access to medication were studied. Results: Access to medication was 89.55% in 2003 and 92.99% in 2008, and the proportion of access to medication did not change in the period. Access in the public sector increased from 26.40% in 2003 to 48.55% in 2008 and there was a decrease in the concentration index between 2003 and 2008 in access to medication in the public sector. Conclusions: The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.


Author(s):  
Juliano J. Cerci ◽  
Evelinda Trindade ◽  
Rodrigo Julio Cerci ◽  
Daniel Preto ◽  
Pedro A. Lemos ◽  
...  

Clinics ◽  
2021 ◽  
Vol 76 ◽  
Author(s):  
Maria Fernanda Cassino Portugal ◽  
Marcelo Passos Teivelis ◽  
Marcelo Fiorelli Alexandrino da Silva ◽  
Nickolas Stabellini ◽  
Alexandre Fioranelli ◽  
...  

2019 ◽  
Vol 19 (77) ◽  
Author(s):  
Luiza Fior Pelegrini ◽  
Beatriz Helena Tess ◽  
Olímpio J N V Bittar ◽  
Denis Pajecki

O artigo investigou as formas de acesso a nove serviços de cirurgia bariátrica que operaram, em 2013, 50 ou mais pacientes pelo Sistema Único de Saúde no Estado de São Paulo. Para isso, utilizou-se metodologia qualitativa com base em informações coletadas por entrevistas presenciais com os responsáveis pelos serviços. Cinco centros estavam no interior do Estado, cinco eram de natureza privada sem fins lucrativos e sete eram hospitais de ensino. As análises apontaram duas categorias conforme a integração com a rede de saúde: pouco ou fortemente integrado; e quatro categorias segundo o tipo de acesso: porta aberta, triagem própria, órgão de regulação ou Unidade Básica de Saúde. Dos quatro serviços pouco integrados à rede de saúde, três eram do tipo porta aberta e um realizava triagem própria; dos cinco centros fortemente integrados à rede de saúde, quatro receberam os pacientes encaminhados por instâncias de regulação e um por Unidade Básica de Saúde. As conclusões indicam que há grande heterogeneidade nas características organizacionais e nas formas de acesso aos serviços participantes deste estudo. Apesar de previsto na normatização do sistema público de saúde que a porta de entrada preferencial à rede deve ser pela Atenção Primária à Saúde, esse fluxo foi observado em somente um serviço. Há necessidade de padronização do modelo organizacional de acesso aos serviços que oferecem tratamento cirúrgico pelo Sistema Único de Saúde aos indivíduos portadores de obesidade.Palavras-chave: Obesidade. Cirurgia bariátrica. Acesso aos serviços de saúde. Organização e administração. Sistema Único de SaúdePublicly funded surgical treatment of obesity: A study on the access in nine services in the State of São PauloAbstractThe paper researched the accessibility to bariatric surgery centers in the public health system in the State of Sao Paulo, Brazil. A case series study with a qualitative approach. Semi-structured interviews were conducted in person with nine chiefs of bariatric surgical units that had performed 50 or more procedures publicly funded in 2013. Five were in the interior of the State, five were of private non-profit nature and seven were teaching hospitals. The analyzes pointed out categories according to integration with the public health network and type of access. Of the four services weakly integrated to the health system, three were open access and one performed self-screening; of the five centers strongly integrated into the health network, four received patients referred by regulatory bodies and one from a Primary Health Care Unit. Although the governmental obesity care policy states that the preferential access of patients are the Primary Health Care Units, in this study it was observed in only one service. There is a need for standardization of the organizational model of access to services that offer publicly funded surgical care to individuals with obesity.Keywords: Obesity. Bariatric surgery. Health services accessibility. Organization and administration. Unified Health System.


2021 ◽  
Author(s):  
Lorena G Barberia ◽  
Natália de P. Moreira ◽  
Brigina Kemp ◽  
Maria Amelia de Sousa Mascena Veras ◽  
Marcela Zamudio ◽  
...  

Abstract Background: Surveillance efforts are critical to pandemic control, especially where the state is the primary health provider, such as Brazil. When public health testing guidelines limit RT-PCRs, there are reductions in detection efforts aimed at early recognition, isolation, and treatment of those infected with the virus.Methods: We conducted an interrupted time series analysis with a segmented regression model using publicly available data to analyze if changes in the state’s guidelines improved RT-PCR testing outcomes in Brazil’s most affluent and largest state, São Paulo, from March 2020 to June 2021. Results: The São Paulo state’s policy guidelines have changed substantially over time. In the first months, the public health system restricted RT-PCR testing to hospitalized cases. Testing was expanded to permit symptomatic testing of non-hospitalized persons only in July 2020. In September 2020, there was a review of the national surveillance guidelines and case definition was expanded to permit case confirmation based on clinical, laboratory and image data criteria other than an RT-PCR test. In February 2021, policies were revised to instruct public health agencies to increase epidemiological monitoring with genomic data. Results show an uneven improvement in testing outcomes following these changes across the state’s regional health departments. Conclusions: Evidence suggests that lower RT-PCR testing and genomic surveillance efforts are associated with areas characterized by a higher population concentration and a greater reliance of the population on the public health system.


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