scholarly journals Epidemiological profile of Brazilian oncological patients seen by a reference oncology center of the public health system and who migrate in search of adequate health care

2018 ◽  
Vol 64 (9) ◽  
pp. 814-818 ◽  
Author(s):  
Daniel I.G. Cubero ◽  
Cláudia Vaz de Melo Sette ◽  
Beatriz de Camargo Preto Piscopo ◽  
Camila Ribeiro de Arruda Monteiro ◽  
Jean Henri Maselli Schoueri ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Social Impact ◽  
Public Health System ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Postal Code ◽  
Cross Sectional ◽  
Epidemiological Profile ◽  
Concentration Of Care

SUMMARY INTRODUCTION Structural disparities between different Brazilian regions in public health system cause patients to migrate in search of better conditions to treat their diseases. Besides patient’s discomfort, there is a concentration of care in large centres, causing overload to current capacity. OBJECTIVE To evaluate migratory flow and associated factors in a reference service in oncology. METHODS Cross-sectional study conducted at a referral oncology service in Great ABC region of São Paulo. Patients were interviewed, and clinical and demographic data collected. RESULTS Between March-July 2016, 217 patients were included. Analysis showed a divergence between the postal code registered in the medical record and that recorded during the interview in approximately 10% of cases. Of these, 42.9% were residents of other states. Search for treatment motivated most patients to seek service outside their city. CONCLUSION Results reflect the informal search for medical care outside the home area. Besides the direct impact on patients’ quality of life, migratory flow has an economic-social impact because these patients place a burden and impose costs on services of cities where they do not perform their responsibilities as citizens. Confirmation of the existence of a significant migratory flow demonstrates the need to discuss restructuring public health policies.

scholarly journals Frequency and Severity of Adverse Drug Reactions to Medications Prescribed for Alzheimer’s Disease in a Brazilian City: Cross-Sectional Study

2020 ◽  
Vol 11 ◽  
Author(s):  
Tânia Regina Ferreira ◽  
Luciane Cruz Lopes ◽  
Cristiane de Càssia Bergamaschi
Keyword(s):  
Public Health ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Health System ◽  
Psychiatric Disorders ◽  
Public Health System ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Drug Reactions ◽  
Cross Sectional

Background: There is lack of national studies that assess the risks associated with the drugs provided under the Brazilian public health system for treating Alzheimer’s disease. Then, this study determined the prevalence and severity of self-reported adverse drug reactions (ADRs) prescribed to patients with Alzheimer’s disease in the Brazilian public health system.Methods: A cross-sectional study was carried out based on public data from the MEDEX system (information on dispensing data, known as exceptional dispensing medications) and interviews with patients and/or caregivers who get access to Alzheimer’s drugs at a public pharmacy in a large Brazilian city, between July and September 2017, inquiring about ADRs and serious adverse events (SAEs).Results: The subjects were asked about ADRs and SAEs related to the use of donepezil, galantamine, rivastigmine and memantine. Out of 285 patients enrolled on the database, 250 participated in the study (87.7%). Among the participants, approximately 63.0% were female, 70.3% aged ≥75 years and 70.3% had comorbidities. Overall, 209 patients (83.6%) reported at least one ADR (total 1,149 ADRs) and rivastigmine was associated with the largest number of ADRs per patient (7.9 ADRs/patient). The predominant adverse effects were psychiatric disorders with common frequency (57.1%) and mild severity (89.0%). Six patients (2.4%) had SAEs that required hospitalization. The use of antipsychotics was the variable associated with ADR (OR = 4.95; 95% CI: 1.45–16.93; p = 0.011).Conclusion: There was a large number of reported ADRs and most of them were of common frequency and mild severity, being mainly related to psychiatric disorders. Considering the fragility of these patients, it is important to improve safety-related care in the use of drugs for treating this disease.

scholarly journals The costs of overweight and obesity-related diseases in the Brazilian public health system: cross-sectional study

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Luciana Bahia ◽  
Evandro Silva Freire Coutinho ◽  
Laura Augusta Barufaldi ◽  
Gabriela de Azevedo Abreu ◽  
Thainá Alves Malhão ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Periodontitis in individuals with diabetes treated in the public health system of Belo Horizonte, Brazil

2010 ◽  
Vol 13 (1) ◽  
pp. 118-125 ◽  
Author(s):  
Aline Mendes Silva ◽  
Andréa Maria Duarte Vargas ◽  
Efigênia Ferreira e Ferreira ◽  
Mauro Henrique Nogueira Guimarães de Abreu
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Clinical Attachment Loss ◽  
Cross Sectional ◽  
The Public ◽  
Patients With Diabetes ◽  
Belo Horizonte

OBJECTIVE: The aim of the present study was to investigate the prevalence of periodontitis among individuals with diabetes who use the public health system in the city of Belo Horizonte-Minas Gerais, Brazil, and the association of this condition with socioeconomic, behavioral and clinical variables. METHODS: A cross-sectional study was carried out on a calculated sample of 300 individuals with diabetes. Periodontitis was defined as clinical attachment loss (CAL) > 3 mm in two or more non-adjacent teeth or those that exhibited CAL > 5 mm in 30.0% of teeth. All subjects were over 30 years of age and underwent a periodontal examination. Socioeconomic and behavioral characteristics as well as medical history and dental history were obtained from a structured interview. Multivariate analysis was conducted using Poisson regression. RESULTS: Among the individuals with diabetes, 6.7% exhibited good periodontal health, 68.0% exhibited gingivitis and 25.3% exhibited periodontitis. The following variables were associated with periodontitis after adjustment: male (PR 1.67 95% CI 1.12, 2.49), individuals with diabetes for more than eight years (PR 1.63 95% CI 1.63, 2.38), smokers (PR 1.71 95% CI 1.10, 2.65); individuals with more than 12 missing teeth (PR 2.67 95% CI 1.73, 4.15) CONCLUSIONS: Multiple determinants are associated with the prevalence of periodontitis among patients with diabetes.

scholarly journals China's Rural Public Health System Performance: A Cross-Sectional Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (12) ◽  
pp. e83822 ◽  
Author(s):  
Miaomiao Tian ◽  
Da Feng ◽  
Xi Chen ◽  
Yingchun Chen ◽  
Xi Sun ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
System Performance ◽  
Public Health System ◽  
Cross Sectional Study ◽  
Health System Performance ◽  
Sectional Study ◽  
Cross Sectional ◽  
Rural Public Health

VP49 Brazilian Consumer Willingness To Pay For Dengue Vaccine (CYD-TDV)

2017 ◽  
Vol 33 (S1) ◽  
pp. 170-171
Author(s):  
Isabella Godói ◽  
André Santos ◽  
Edna Reis ◽  
Livia Pires de Lemos ◽  
Cristina Brandão ◽  
...  
Keyword(s):  
Public Health ◽  
Willingness To Pay ◽  
Health System ◽  
Public Health System ◽  
Cross Sectional Study ◽  
Pharmaceutical Products ◽  
Dengue Vaccine ◽  
Cross Sectional ◽  
The Public ◽  
Belo Horizonte

INTRODUCTION:Dengue virus is a serious global health problem with an estimated 3.97 billion people at risk for infection worldwide. In December 2015, the first vaccine (CYD-TDV) for dengue prevention was approved in Brazil, developed by Sanofi Pasteur (1). However, given that the vaccine will potentially be paid via the public health system, information is needed regarding consumers willingness to pay for the dengue vaccine in the country, as well as discussions related to the possible inclusion of this vaccine into the public health system at prices suggested by the manufacturer. This was the objective of this research.METHODS:We conducted a cross-sectional study with residents of Greater Belo Horizonte, Minas Gerais, about their willingness to pay for the CYD-TDV vaccine. Respondents had to be over 18 years and not currently have the disease although they may have had dengue in the past (2,3).RESULTS:Five-hundred and seven individuals were interviewed, who were mostly female (62.4 percent), had completed high school (62.2 percent), were working (74.4 percent), had private health insurance (64.5 percent) and did not have dengue (67.4 percent). The maximum median value of consumers willingness to pay for the CYD-TDV vaccine, assuming vaccine efficacy against virologically-confirmed symptomatic dengue illness of approximately 60 percent, is USD33.61 (BRL120.00) for the complete 3-course schedule and USD11.20 (BRL40.00) per dose. At the price currently being assessed by the Brazil's regulatory chamber of pharmaceutical products market (CMED) for Dengvaxia® for three doses, only 17 percent of the population expressed a willingness to pay for the vaccine at this price.CONCLUSIONS:Brazil is currently one of the largest markets for dengue vaccine in the world and the price established is a key issue. The manufacturer should asses the possibility of lowering its price in Brazil to reach a larger audience among the Brazilian population, especially as other public health activities to control the disease will continue.

scholarly journals Characteristics of citizens and their use of teleconsultation in Primary Care in the Catalan public health system before and during COVID: Retrospective Descriptive Cross-Sectional Study (Preprint)

2021 ◽  
Author(s):  
Oscar Solans ◽  
Josep Vidal-Alaball ◽  
Pasqual Roig Cabo ◽  
Núria Mora ◽  
Ermengol Coma ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health System ◽  
Rural Areas ◽  
Public Health System ◽  
Descriptive Analysis ◽  
Low Complexity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Predominantly Female

BACKGROUND eConsulta (asynchronous and two-way teleconsultation in Primary Care) is one of the most important telemedicine developments in the Catalan public health system, a service that has been heavily boosted by the outbreak of the pandemic. It is vitally important to know the characteristics of its users in order to be able to meet their needs and have an idea of who is being covered (and who is not) through this service in a context where there is less accessibility to the health system. OBJECTIVE Undertake a descriptive analysis of the profile of the citizens who use the tool and the type of use they make of it to gain an understanding of the elements that characterize their decision to use it, making a distinction between those who used it before and those who have used it since the outbreak of the COVID-19 pandemic METHODS Descriptive observational study based on administrative data. The study differentiates between the pre and during COVID periods, taking as the cut-off point the day the state of emergency was declared in Spain (13 March 2020), and between users who send messages and those who only receive them. The main study variable is the use of the eConsulta service. RESULTS The pandemic has resulted in almost triple the number of unique users in just the first three months observed (220,043/76,598, 2.87). Since the start of the COVID outbreak, although users have continued to be predominantly female, they are systematically younger than before, more actively employed and with less complex pathologies for the two user profiles analysed. There is also a relative decrease in the number of conversations initiated by higher-income urban citizens and an increase in users in rural areas. CONCLUSIONS This study identifies a change in the profile of citizens who use the eConsulta tool, which as a result of the COVID-19 pandemic now has a profile similar to that of the average citizen: actively employed, with low complexity of pathology and who receives more messages proactively from the health professionals through eConsulta. The pandemic has helped to generalize the use of telemedicine as a tool to compensate to some extent for the decline in face-to-face visits, especially in younger citizen profiles.

scholarly journals Vaccination knowledge, attitudes and practices in patients with HIV: a cross-sectional survey

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Rousset ◽  
G Voglino ◽  
E Boietti ◽  
A Corradi ◽  
M R Gualano ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Health System ◽  
Vaccination Coverage ◽  
Public Health System ◽  
Cross Sectional Survey ◽  
Hiv Patients ◽  
Cross Sectional ◽  
Contagion Risk ◽  
High Level

Abstract Background Infectious diseases are more common and severe in patients with HIV, which show different response to vaccines and a diminished protection. It is therefore very important to assess knowledge and attitudes towards vaccination in people with HIV, since precise vaccination coverage and vaccine hesitancy are not well established in this subgroup of patients. Methods A sample of 119 patients with HIV completed a cross-sectional survey. Patients were recruited during their routine medical examination at the infectious diseases clinic in Turin. The survey explored these main areas: demographics and history of HIV infection, vaccination history, attitudes towards vaccination, confidence in the public health system, contagion risk and disease seriousness perception. In this preliminary phase descriptive analysis were conducted. Results Preliminary data show that mean age of the participants was 49.51 years, 80% were males. The median of HIV infection duration was 10 years, while the median of the lymphocyte count was 762.50 cells/mm3. The disease with the highest vaccination coverage was tetanus (88.7%), considered a serious or very serious disease by 85.6% of the participants, despite low or very low contagion risk perception (84.1%). The disease with the lowest vaccination coverage was Herpes Zoster (7.3%), despite high or very high seriousness perception (70%). Furthermore, 99.1% of the participants showed high or very high confidence toward public health system professionals, and the majority of them (59.5%) stated that vaccines are more useful for the community than for the single person. Conclusions Vaccination coverage is still not fully satisfactory regarding diseases considered infrequent or mild. Considering the high level of confidence toward the public health system that has emerged, it is necessary to implement informative and operative strategies about vaccination for European HIV patients, which are particularly at risk regarding infectious diseases. Key messages Vaccination coverage and risk perception in HIV patients is not satisfactory for many diseases and an effort to implement informative strategies in Europe is needed. The role of vaccination in preventing infectious diseases in HIV patients should be recognized and strengthened by relying on the high level of confidence toward European public health systems.

scholarly journals Retrospective study of the distribution of doctors in municipalities of extreme poverty in Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B L O Luizeti ◽  
E M M Massuda ◽  
L F G Garcia
Keyword(s):  
Public Health ◽  
Health System ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Extreme Poverty ◽  
The Public ◽  
The North ◽  
Unified Health System ◽  
Shortage Of Doctors ◽  
Demographic Distribution

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.

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