scholarly journals Is There a Difference in The “Out-Of-Pocket” Costs of Cancer Treatment When Comparing Patients From The Brazilian National Health System With Patients Enrolled in Clinical Research Protocols?

2021 ◽  
Author(s):  
Thiago Artioli ◽  
Karine Corcione Turke ◽  
Aline Hernandez Marquez Sarafyan ◽  
Beatriz Boos Ortolani ◽  
Ingrid Victoria Maria Biondo Edle von Schmadel ◽  
...  
Keyword(s):  
Health System ◽  
Cancer Treatment ◽  
National Health ◽  
National Health System ◽  
Indirect Costs ◽  
Tertiary Hospital ◽  
Cross Sectional ◽  
Oral Medications ◽  
Research Protocols ◽  
Out Of Pocket Costs

Abstract Introduction: Economic burden of cancer treatment does not fall only on the Brazilian National Health System (“SUS”) but also on patients. Nonreimbursed indirect costs include noncovered oral medications, food, transportation, and others. Our study compares out-of-pocket costs of cancer treatment between patients from the SUS and patients enrolled in research protocols. Methods Observational, cross-sectional and analytical study conducted in 2021. Patients undergoing chemotherapy were divided into 2 groups: patients from a tertiary hospital affiliated with the SUS and patients enrolled in research protocols at a research center. The primary outcome was the evaluation of out-of-pocket costs using a socioeconomic questionnaire to identify the cost and time spent by patients during treatment. This study was approved by the Research Ethics Committee. Results 195 patients were included, of whom 165 (84.6%) were treated by the SUS and 30 (15.4%) by research protocols. Of the total, 61% were female, and the mean age of the patients was 57 years. The median total out-of-pocket costs of SUS patients was Brazilian reais (R$) 453.80 (US$ 78.92), and that of patients who were enrolled in research protocols was R$ 448.00 (US$ 77.91) (P = 0.317). A comparison of the groups by multivariate analysis showed that only the time spent by patients on chemotherapy and radiotherapy was significantly different, being higher in the SUS group (OR 2.58, 95% CI 1.03–6.50). Conclusion Total out-of-pocket spending by SUS patients is similar in magnitude to that by patients in research protocols, although the reasons for the spending are different.

scholarly journals Weight and height of people living with HIV/AIDS attended by the Brazilian National Health System

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
Keyword(s):  
Health Status ◽  
Health System ◽  
National Health ◽  
National Health System ◽  
Reference Population ◽  
Average Weight ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Living With Hiv ◽  
Hiv Aids

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.

scholarly journals The Impact of Cancer Treatment “Out-of-Pocket” Costs on the Mental Health of Chemotherapy Patients: A Comparative Study

2021 ◽  
Author(s):  
Thiago Artioli ◽  
Karine Corcione Turke ◽  
Aline Hernandez Marquez Sarafyan ◽  
Beatriz Boos Ortolani ◽  
Ingrid Victoria Maria Biondo Edle von Schmadel ◽  
...  
Keyword(s):  
Mental Health ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Depression Scale ◽  
Tertiary Hospital ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Unified Health System ◽  
The Impact ◽  
Out Of Pocket Costs

Abstract Introduction: Anxiety and depression are prevalent comorbidities in cancer patients. Although cancer treatment is funded by the Brazilian Unified Health System (SUS), economic burden is also borne by patients through out-of-pocket costs. Our study sought to evaluate the impact of out-of-pocket costs of cancer treatment on depression, anxiety and stress levels in cancer patients.Methods: Observational, cross-sectional and analytical study conducted in 2021. Patients undergoing chemotherapy were being treated at tertiary hospital affiliated with the SUS and enrolled in research protocols at research center. To evaluate out-of-pocket costs, we used a socioeconomic questionnaire to identify costs and time spent by patients. Primary outcomes were prevalence of depression and anxiety, as determined by the Hospital Anxiety and Depression Scale (HADS), and prevalence of stress, as determined using a stress thermometer.Results: 195 patients were included. Among included patients, 61% were female, and mean age was 57 years. Patients' median overall out-of-pocket costs was R$ 453.80 (US$ 78.92). Based on the HADS, 62.1% of patients had possible or probable depression/anxiety. There was no correlation between overall out-of-pocket spending and levels of depression/anxiety. However, when stratified by cost-time variables, there was a negative correlation between spending on telephones and HADS (rho = -0.140; P = 0.049) and positive correlations between spending on medications (rho = 0.140; P = 0.05) and time spent purchasing medications (rho = 0.157; P = 0.029) with HADS.Conclusion: Although overall spending was not directly correlated with mental health, specific costs impacted levels of anxiety, depression and stress.

scholarly journals HOSPITAL ADMISSIONS FOR STROKE IN THE BRAZILIAN NATIONAL HEALTH SYSTEM: EPIDEMIOLOGICAL FINDINGS FROM 2019-2020

2021 ◽  
Author(s):  
Mariana Guelli ◽  
Tulio Loyola Correa
Keyword(s):  
Health System ◽  
National Health ◽  
Skin Color ◽  
Hospital Admissions ◽  
Age Groups ◽  
National Health System ◽  
National Database ◽  
Cross Sectional ◽  
Unified Health System ◽  
Time Period

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.

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 ◽  
...  
Keyword(s):  
Health System ◽  
National Health ◽  
User Satisfaction ◽  
Strong Association ◽  
National Health System ◽  
Quality Of Healthcare ◽  
Outcome Variable ◽  
Individual Factors ◽  
Cross Sectional ◽  
Factors Associated

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.

scholarly journals Effectiveness of education at work in a health program: a strategy for vocational training and lifelong learning

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
Keyword(s):  
Health System ◽  
Lifelong Learning ◽  
National Health ◽  
Vocational Training ◽  
Health Program ◽  
National Health System ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Electronic Questionnaire

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.

scholarly journals Non-psychiatrist prescriptions within the Brazilian National Health System represents a risk to patients in the use of psychotropic pharmacotherapies

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 ◽  
...  
Keyword(s):  
Health System ◽  
National Health ◽  
Computer Technology ◽  
Medical Records ◽  
National Health System ◽  
Cross Sectional Study ◽  
Age Group ◽  
Cross Sectional ◽  
Elder Patients ◽  
Psychotropic Medicines

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.

scholarly journals Socio-economic and cultural factors associated with smoking prevalence among workers in the National Health System in Belo Horizonte

2015 ◽  
Vol 18 (2) ◽  
pp. 385-397 ◽  
Author(s):  
Luiz Fábio Machado Barbosa ◽  
Carla Jorge Machado
Keyword(s):  
Health System ◽  
National Health ◽  
Health Workers ◽  
National Health System ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Final Model ◽  
Significance Level ◽  
Stratified Sample ◽  
Belo Horizonte

OBJECTIVE: To identify factors related to smoking among health workers of the National Health System in Belo Horizonte, Minas Gerais, Brazil. METHODS: A cross-sectional study based on a survey conducted between September 2008 and January 2009 with a stratified sample. Data on sociodemographic, health, employment, and work characteristics were analyzed. Poisson regression models with robust variance and estimation of unadjusted and adjusted prevalence ratios were used to establish associations at a 5% significance level for inclusion in the final model. RESULTS: In 1,759 questionnaires analyzed, in which the question related to smoking was answered, the overall prevalence of smoking was 15.7%. Reasonable relationship between requirements and available resources remained negatively correlated to smoking in the final model (PR = 0.75; 95%CI 0.58 - 0.96). The variables that remained positively associated with smoking were being male (PR = 1.75; 95%CI 1.36 - 2.25) and the following positions: community health workers (PR = 2.98; 95%CI 1.76 - 5.05), professionals involved in monitoring (PR = 3.86; 95%CI 1.63 - 5.01), administrative and other general services workers (PR = 2.47; 95%CI 1.51 - 4.05); technical mid-level workers (PR = 2.23; 95%CI 1.31 - 3.78), including nurses and practical nurses (PR = 2.07; 95%CI 1.18 - 3.64). CONCLUSION: Specific occupational subgroups were identified and should be prioritized in smoking cessation and prevention programs.

scholarly journals Clinical Presentation of the SARS-CoV-2 Virus Infection and Predictive Validity of the PCR Test in Primary Health Care Worker Patients of the Spanish National Health System

2022 ◽  
Vol 11 (1) ◽  
pp. 243
Author(s):  
Esperanza Romero-Rodríguez ◽  
Luis A. Pérula-de Torres ◽  
Jesús González-Lama ◽  
Celia Jiménez-García ◽  
Rafael A. Castro-Jiménez ◽  
...  
Keyword(s):  
Virus Infection ◽  
Health System ◽  
National Health ◽  
National Health System ◽  
Predictive Capacity ◽  
Cross Sectional ◽  
Family Doctors ◽  
Spanish National Health System ◽  
The Impact ◽  
Pcr Test

Background: Despite the impact that the SARS-CoV-2 virus infection has presented in Spain, data on the diagnostic capacity of the symptoms associated with this infection are limited, especially among patients with mild symptoms and who are detected in the primary care field (PC). The objective of the present study was to know the associated symptoms and their predictive criterial validity in SARS-CoV-2 infection among professionals working in PC. Methods: A cross-sectional, multicenter study was carried out in the Spanish National Health System, through an epidemiological survey directed to patients who underwent the PCR test for SARS-CoV-2 in the PC setting. Results: A total of 1612 patients participated, of which 86.6% were PC healthcare professionals, and of these, 67.4% family doctors. Hyposmia, with a sensitivity of 42.69% (95% CI: 37.30–48.08) and a specificity of 95.91% (95% CI: 94.78–97.03), and ageusia with a sensitivity of 39.47% (34.15–44.80) and a specificity of 95.20% (93.98–96.41) were the symptoms with the highest criteria validity indexes. Conclusions: This study identifies the specific symptoms of loss of smell or taste as the most frequently associated with SARS-CoV-2 infection, essential in the detection of COVID-19 given its high frequency and predictive capacity.

Sedentary behaviour is associated with diabetes mellitus in adults: findings of a cross-sectional analysis from the Brazilian National Health System

2018 ◽  
Vol 41 (4) ◽  
pp. 742-749 ◽  
Author(s):  
Ítalo Ribeiro Lemes ◽  
Xuemei Sui ◽  
Bruna Camilo Turi-Lynch ◽  
Duck-chul Lee ◽  
Steven N Blair ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Health System ◽  
Sedentary Behaviour ◽  
Chronic Diseases ◽  
National Health ◽  
Smoking Status ◽  
National Health System ◽  
Tv Viewing ◽  
Cross Sectional ◽  
Adjusted Model

Abstract Background Sedentary behaviour (SB) may contribute to the development of several chronic diseases, such as hypertension, diabetes mellitus (DM) and all-cause mortality. The aim of this study is to investigate the association between different domains of SB with diabetes among adult users of the Brazilian National Health System (NHS). Methods Cross-sectional study from the primary care system of the Brazilian NHS in the city of Bauru, Brazil. SB, physical activity (PA), DM and other chronic diseases were assessed by face-to-face interviews and medical records. As potential confounders in the adjusted model, we used gender, age, economic status, smoking status, hypertension, hypercholesterolaemia and PA. Results The study was composed of 147 men and 410 women. The fully adjusted model showed that Brazilian adults spending ≥3 h per day in television viewing (OR = 1.61 [95% CI: 1.11–2.33]) and overall SB (OR = 1.60 [95% CI: 1.09–2.36]) had increased prevalence of DM compared to those spending &lt;3 h per day. Conclusions TV viewing and overall SB was associated with higher prevalence of DM in Brazilian adults from the NHS, even after controlling for potential confounders including PA.

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