Relação entre o número de consultas do pré-natal e desfechos adversos perinatais em pacientes de baixo risco

RESUMO Objetivo: Avaliar os impactos do número de consultas realizadas no acompanhamento de pré-natal na rede básica sobre os desfechos adversos. Metodologia: Estudo de corte transversal, foram selecionadas aleatoriamente puérperas de risco habitual com mais de 18 anos que fizeram pré-natal na rede pública de Joinville-SC, com gestação única. Os desfechos avaliados foram prematuridade, número de cesarianas, internação de UTI neonatal e baixo peso ao nascer. O cálculo da razão de chance teve intervalo de confiança de 95%. Resultados: Comparamos as características e desfechos materno-fetais de pacientes que fizeram 5 consultas ou menos (n=109), puérperas com 6 ou 7 consultas (n=146) e pacientes que realizaram 8 (n=430). Dos resultados do perfil materno, foram significativos, os resultados socioeconômicos como idade, gestações anteriores, escolaridade, raça, estado civil, profissão, número de pessoas na casa e remuneração. Do recém-nascido encontramos diferenças no capurro e peso, ambos maiores em pacientes com mais de 8 consultas. No cálculo da razão de chance ajustado encontramos redução na prematuridade nas pacientes que fizeram 6 ou 7 consultas (0,26 IC95% 0,073-0,928) e nas que realizaram 8 ou mais (0,06 IC95% 0,016-0,229). Não encontramos diferença no número de cesarianas, baixo peso ao nascer e na internação de UTI neonatal em nenhuma das populações. Conclusão: A realização de 6 ou 7 consultas de pré-natal reduz 74% as chances de prematuridade, enquanto a realização de 8 ou mais consultas diminuiu em 94%. ABSTRACT Objetive: Evaluate the impacts of the number of prenatal consultations during medical follow-up in the basic health care system over adverse outcomes. Methodology: Cross-sectional cohort study, selected randomly puerperal women with habitual risk with at least 18 year old who did prenatal care in the public health care system in Joinville-SC, with single pregnancy. The adverse outcomes evaluated were prematurity, number of caesarean sections, neonatal ICU admission and low birth weight. The odds ratio calculation had a confidence interval of 95%. Results: We compared characteristics and maternal-fetal outcomes of patients with 5 consultations or less (n=109), puerperal women with 6 or 7 consultations (n=146) and patients with 8 (n=430). Of the maternal profile results found, were significant, the socioeconomic results like age, number of pregnancy, schooling, race, marital status, profession, number of people living in the house and salary. Of the newborns, we found differences in the capurro and weight; both were higher in patients with more than 8 consultations. In the adjusted odds ration calculation we found reduction in prematurity who did 6 or 7 consultations (0,26 CI95% 0,073-0,928) and in the 8 or more consultations group (0,06 CI95% 0,016-0,229). We did not found difference in the number of caesarean sections, low birth weight and neonatal ICU admissions in any of the populations. Conclusion: The realization of 6 or 7 prenatal consultations reduces in 74% the chances of prematurity, while the realization of 8 or more consultations reduces it in 94%.

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Distribution of mammograms and mammography offering in relation to the parametric care of the Public Health Care System in Pernambuco

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042018000300009 ◽

2018 ◽

Vol 18 (3) ◽

pp. 609-618

Author(s):

Maria Tatiane Alves da Silva ◽

Valdecir Barbosa da Silva Júnior ◽

Jorgiana de Oliveira Mangueira ◽

Garibaldi Dantas Gurgel Junior ◽

Eliane Maria Medeiros Leal

Keyword(s):

Public Health ◽

Health Care ◽

Health Care System ◽

Cross Sectional Study ◽

Public Health Care ◽

Public Health Care System ◽

Cross Sectional ◽

The Public ◽

Installed Capacity ◽

Care System

Abstract Objective: to describe the distribution of available mammograms in the Sistema Único de Saúde (SUS) (Public Health Care System) and the mammography offering were carried out by this system, throughout the health regions in Pernambuco State, and compared them with the parametric care recommended by the Ministry of Health. Methods: this is a descriptive cross-sectional study that used secondary mammograms data in December 2016 by the Cadastro Nacional de Estabelecimentos de Saúde (National Registy on Health Establishments); and about mammography performed at SUS in 2016 by the Sistema de Informação Ambulatorial (Ambulatory Information System). The parametric care document No. 1.631/2015 was used as a comparability standard in relation to the distribution of the equipment and the mammography offering. Results: Pernambuco State presented approximately the double amount of mammograms and mammography was performed about 46% below the recommended parameter used in this study. All the health regions presented sufficient quantity of mammograms. However, the use of the installed capacity was less than 50% in all the health regions in the state. Conclusions: this study shows the need for a better use of the installed capacity for mammograms in Pernambuco State taken by the insufficient mammography offering and the poor distribution of the equipment in its territory.

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Low blood neutrophil concentrations among extremely low birth weight neonates: data from a multihospital health-care system

Journal of Perinatology ◽

10.1038/sj.jp.7211603 ◽

2006 ◽

Vol 26 (11) ◽

pp. 682-687 ◽

Cited By ~ 34

Author(s):

R D Christensen ◽

E Henry ◽

S E Wiedmeier ◽

R A Stoddard ◽

D K Lambert

Keyword(s):

Health Care ◽

Birth Weight ◽

Low Birth Weight ◽

Health Care System ◽

Extremely Low Birth Weight ◽

Blood Neutrophil ◽

Care System

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Equity in the use of antiretroviral treatment in the public health care system in urban South Africa

Health Policy ◽

10.1016/j.healthpol.2010.10.016 ◽

2011 ◽

Vol 99 (3) ◽

pp. 261-266 ◽

Cited By ~ 12

Author(s):

Susan Cleary ◽

Sheetal Silal ◽

Stephen Birch ◽

Henri Carrara ◽

Victoria Pillay-van Wyk ◽

...

Keyword(s):

Public Health ◽

South Africa ◽

Health Care ◽

Health Care System ◽

Antiretroviral Treatment ◽

Public Health Care ◽

Public Health Care System ◽

The Public ◽

Urban South ◽

Care System

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Management of COPD within the Brazilian Unified Health Care System in the state of Bahia: an analysis of real-life medication use patterns

Jornal Brasileiro de Pneumologia ◽

10.1590/1806-3713/e20170194 ◽

2019 ◽

Vol 45 (1) ◽

Cited By ~ 4

Author(s):

Charleston Ribeiro Pinto ◽

Antônio Carlos Moreira Lemos ◽

Lindemberg Assunção-Costa ◽

Aramis Tupiná de Alcântara ◽

Laira Lorena Lima Yamamura ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

Pharmacological Treatment ◽

Real Life ◽

The State ◽

Public Health Care ◽

Cross Sectional ◽

Long Acting ◽

Severe Copd ◽

Care System

ABSTRACT Objective: To describe COPD pharmacological treatment patterns in the state of Bahia, Brazil, and to evaluate the extent to which these patterns conform to clinical guidelines for the management of COPD. Methods: This was a cross-sectional study of 441 patients referred from the Public Health Care Network of the state of Bahia to a public referral outpatient clinic of a COPD management program of the Brazilian Unified Health Care System. Individuals with a spirometry-confirmed diagnosis of moderate to very severe COPD were included in the study. Patients were evaluated as to whether they had used any COPD medications in the last seven days. The appropriateness or inappropriateness (undertreatment or overtreatment) of the patient’s pharmacological treatment was evaluated by comparing the patient’s current treatment with that recommended by national and international guidelines. Results: A total of 383 individuals were included in the analysis. Approximately half of the patients (49.1%) used long-acting bronchodilators. These patients were older and had had the disease longer. Of the sample as a whole, 63.7% and 83.0% did not receive pharmacological treatment in accordance with international and national recommendations, respectively. Inappropriateness due to undertreatment was indentified in more than half of the patients. Conclusions: Long-acting bronchodilators are frequently underused in individuals with moderate to very severe COPD within the Brazilian Unified Health Care System in the state of Bahia. Most patients in our sample were treated inappropriately, and undertreatment predominated. Strategies to improve access to long-acting bronchodilators and the quality of COPD pharmacological management are required.

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PUK4 THE IMPACT ON COSTS OF TREATING COMPLICATIONS DUE TO CRONIC KIDNEY DISEASE IN PATIENTS UNDERGOING HEMODIALYSIS IN THE PUBLIC HEALTH CARE SYSTEM IN BRAZIL

Value in Health ◽

10.1016/s1098-3015(10)74515-0 ◽

2009 ◽

Vol 12 (7) ◽

pp. A308

Author(s):

MG Saggia

Keyword(s):

Public Health ◽

Health Care ◽

Kidney Disease ◽

Health Care System ◽

Public Health Care ◽

Public Health Care System ◽

The Public ◽

The Impact ◽

Care System

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P03.10. The quality of integrative postgraduate medical education within the public health care system of Germany: the example of anthroposophic hospitals

BMC Complementary and Alternative Medicine ◽

10.1186/1472-6882-12-s1-p263 ◽

2012 ◽

Vol 12 (S1) ◽

Cited By ~ 1

Author(s):

H Peter ◽

S Eberhard ◽

M Siegrist ◽

P Orlow

Keyword(s):

Public Health ◽

Health Care ◽

Medical Education ◽

Health Care System ◽

Postgraduate Medical Education ◽

Public Health Care ◽

Public Health Care System ◽

The Public ◽

Care System

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PCN122 MELODY BRAZIL: CHEMOTHERAPY CHOICES FOR PATIENTS WITH METASTATIC MELANOMA IN THE PUBLIC HEALTH CARE SYSTEM (SUS)

Value in Health ◽

10.1016/j.jval.2011.02.976 ◽

2011 ◽

Vol 14 (3) ◽

pp. A177

Author(s):

R.A. Schmerling ◽

S.D. Stefani ◽

E. Barbosa ◽

E. Asano ◽

M.E. Nita ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Metastatic Melanoma ◽

Health Care System ◽

Public Health Care ◽

Public Health Care System ◽

The Public ◽

Care System

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The need for biokineticists in the South African public health care system

South African Journal of Sports Medicine ◽

10.17159/2078-516x/2016/v28i3a1866 ◽

2017 ◽

Vol 28 (3) ◽

Author(s):

R Evans

Keyword(s):

Public Health ◽

Physical Activity ◽

South Africa ◽

Health Care ◽

Primary Health Care ◽

Health Care System ◽

Public Health Care ◽

The Public ◽

Primary Health ◽

Care System

Background: Noncommunicable diseases (NCDs) are increasingly prevalent within South Africa. Physical inactivity is a significant, independent and modifiable risk factor increasing the prevalence of NCDs.Discussion: The integration of physical activity programmes into the primary health care system through multidisciplinary platforms is thus advocated for and envisioned to be more cost-effective than current practices. However, currently within the primary health care setting of South Africa, there is an absence of health care professionals adequately equipped to develop and implement physical activity programmes. Biokineticists, whose scope of practice is to improve physical functioning and health through exercise as a modality, are ideally suited to developing and implementing physical activity programmes in the public sector. Yet despite their evident demand, the role of the biokineticist is not incorporated into the national public health care system.Conclusion: This short report calls firstly, for the inclusion of biokinetics into the public health care sector, and secondly, for the funding of multidisciplinary community health programmes supporting education, healthy eating and physical activity levels.

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