scholarly journals Trends and Hospital Mortality in Myocardial Revascularization Procedures Covered by the Brazilian Unified Health System in Rio de Janeiro State from 1999 to 2010

2017 ◽  
Author(s):  
Christina Grüne de Souza e Silva ◽  
Carlos Henrique Klein ◽  
Paulo Henrique Godoy ◽  
Nelson Albuquerque de Souza e Silva
Keyword(s):  
Hospital Mortality ◽  
Health System ◽  
Rio De Janeiro ◽  
Myocardial Revascularization ◽  
Unified Health System ◽  
Revascularization Procedures ◽  
Janeiro State

scholarly journals The Quest to Extend Health Services to Vulnerable Substance Users in Rio de Janeiro, Brazil in the Context of an Unfolding Economic Crisis

2016 ◽  
Vol 47 (3) ◽  
pp. 477-488 ◽  
Author(s):  
Noa Krawczyk ◽  
Deanna Kerrigan ◽  
Francisco Inácio Bastos
Keyword(s):  
Health Services ◽  
Health System ◽  
Economic Crisis ◽  
Rio De Janeiro ◽  
Crack Cocaine ◽  
Access To Health Services ◽  
Government Programs ◽  
Substance Users ◽  
Unified Health System ◽  
Harsh Criticism

Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation’s most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care.

scholarly journals Child with special health needs at one hospital of the brazilian unified health system Criança com necessidades de saúde especiais de um hospital do sistema único de saúde

2021 ◽  
Vol 13 ◽  
pp. 1296-1302
Author(s):  
Catarina Cosmo de Oliveira Carvalho ◽  
Thais Guilherme Pereira Pimentel ◽  
Ivone Evangelista Cabral
Keyword(s):  
Health System ◽  
Rio De Janeiro ◽  
Health Needs ◽  
Unified Health System ◽  
Healthcare Needs ◽  
Special Health

Objetivos: determinar e analisar necessidades de saúde especiais entre crianças hospitalizadas em hospital de alta complexidade, no Rio de Janeiro. Método: estudo transversal e descritivo desenvolvido com 21 familiares de crianças hospitalizadas em unidade intensiva e enfermarias de cuidados agudos, na rede de atenção de alta complexidade. Em 2019, aplicou-se o children with special healthcare needs Screener  (CS Screener®) -  versão brasileira na entrevista com 21 familiares. Resultados: as crianças hospitalizadas (21/36) apresentaram necessidades e demandas de serviços de saúde relacionadas à doenças e transtornos comportamentais correspondendo a 76,19%. O cuidado da criança dependia do Sistema Único de Saúde e de Assistência social. Quatro possuíam dispositivos tecnológicos implantados; oito eram acompanhadas por especialistas na atenção psicossocial e educação especial. Conclusão: essas crianças se reinternavam frequentemente, ocupando a maioria dos leitos hospitalares do Sistema Único de Saúde, principal referência para a continuidade dos cuidados de enfermagem e uso contínuo de medicamentos.  

scholarly journals Pattern of Live Births in Rio de Janeiro State, Brazil, According to Robson Groups and the Kotelchuck Index Classification - 2015/2016

2020 ◽  
Vol 42 (07) ◽  
pp. 373-379
Author(s):  
Luciana Leite de Mattos Alcantara ◽  
Núbia Karla de Oliveira Almeida ◽  
Renan Moritz Varnier Rodrigues de Almeida
Keyword(s):  
Prenatal Care ◽  
Pregnant Women ◽  
Rio De Janeiro ◽  
Maternal Age ◽  
Descriptive Analysis ◽  
The State ◽  
Live Births ◽  
Robson Classification ◽  
Unified Health System ◽  
Janeiro State

Abstract Objective To investigate the patterns of hospital births in the state of Rio de Janeiro (RJ), Brazil, between 2015 and 2016; considering the classification of obstetric characteristics proposed by Robson and the prenatal care index proposed by Kotelchuck. Methods Data obtained from the Information System on Live Births of the Informatics Department of the Brazilian Unified Health System (SINASC/DATASUS, in the Portuguese acronym) databases were used to group pregnant women relatively to the Robson classification. A descriptive analysis was performed for each Robson group, considering the variables: maternal age, marital status, schooling, parity, Kotelchuck prenatal adequacy index and gestational age. A logistic model estimated odds ratios (ORs) for cesarean sections (C-sections), considering the aforementioned variables. Results Out of the 456,089 live births in Rio de Janeiro state between 2015 and 2016, 391,961 records were retained, 60.3% of which were C-sections. Most pregnant women (58.6%) were classified in groups 5, 2 or 3. The percentage of C-sections in the Robson groups 1, 2, 3, 4, 5 and 8 was much higher than expected. Prenatal care proved to be inadequate for women who subsequently had a vaginal delivery, had an unfavorable family structure and a lower socioeconomic status (mothers without partners and with lower schooling), compared with those undergoing cesarean delivery. For a same Robson group, the chance of C-section increases when maternal age rises (OR = 3.33 for 41–45 years old), there is the presence of a partner (OR = 1.81) and prenatal care improves (OR = 3.19 for “adequate plus”). Conclusion There are indications that in the state of RJ, from 2015 to 2016, many cesarean deliveries were performed due to nonclinical factors.

scholarly journals Public-private settlement and hospital mortality per sources of payment

2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Juliana Pires Machado ◽  
Mônica Martins ◽  
Iuri da Costa Leite
Keyword(s):  
Hospital Mortality ◽  
Hospital Admission ◽  
Health System ◽  
Hospital Admissions ◽  
Structural Characteristics ◽  
Information Source ◽  
Healthcare Research ◽  
Administrative Databases ◽  
Unified Health System ◽  
The Mean

ABSTRACT OBJECTIVE To analyze if the adjusted hospital mortality varies according to source of payment of hospital admissions, legal nature, and financing settlement of hospitals. METHODS Cros-ssectional study with information source in administrative databases. Specific hospital admission reasons were selected considering the volume of hospital admissions and the list of quality indicators proposed by the North-American Agency for Healthcare Research and Quality (AHRQ). Were analyzed 852,864 hospital admissions of adults, occurred in 789 hospitals between 2008 and 2010, in Sao Paulo and Rio Grande do Sul, applying multilevel logistic regression. RESULTS At hospital admission level, showed higher chances of death male patients in more advanced age groups, with comorbidity, who used intensive care unit, and had the Brazilian Unified Health System as source of payment. At the level of hospitals, in those located in the mean of the distribution, the adjusted probability of death in hospital admissions financed by plan or private was 5.0%, against 9.0% when reimbursed by the Brazilian Unified Health System. This probability increased in hospital admissions financed by the Brazilian Unified Health System in hospitals to two standard deviations above the mean, reaching 29.0%. CONCLUSIONS In addition to structural characteristics of the hospitals and the profile of the patients, interventions aimed at improving care should also consider the coverage of the population by health plans, the network shared between beneficiaries of plans and users of the Brazilian Unified Health System, the standard of care to the various sources of payment by hospitals and, most importantly, how these factors influence the clinical performance.

scholarly journals Access to and utilization of prenatal care services in the Unified Health System of the city of Rio de Janeiro, Brazil

2013 ◽  
Vol 16 (4) ◽  
pp. 953-965 ◽  
Author(s):  
Rosa Maria Soares Madeira Domingues ◽  
Maria do Carmo Leal ◽  
Zulmira Maria de Araújo Hartz ◽  
Marcos Augusto Bastos Dias ◽  
Marcelo Vianna Vettore
Keyword(s):  
Black Women ◽  
Prenatal Care ◽  
Health System ◽  
Pregnant Women ◽  
Rio De Janeiro ◽  
Cross Sectional ◽  
Care Services ◽  
Unified Health System ◽  
Late Start ◽  
The City

Prenatal care consists of practices considered to be effective for the reduction of adverse perinatal outcomes. However, studies have demonstrated inequities in pregnant women's access to prenatal care, with worse outcomes among those with lower socioeconomic status. The objective of this study is to evaluate access to and utilization of prenatal services in the Sistema Único de Saúde (SUS - Unified Health System) in the city of Rio de Janeiro and to verify its association with the characteristics of pregnant women and health services. A cross-sectional study was conducted in 2007-2008, using interviews and the analysis of prenatal care cards of 2.353 pregnant women attending low risk prenatal care services of the SUS. A descriptive analysis of the reasons mentioned by women for the late start of prenatal care and hierarchical logistic regression for the identification of the factors associated with prenatal care use were performed. The absence of a diagnosis of pregnancy and poor access to services were the reasons most often reported for the late start of prenatal care. Earlier access was found among white pregnant women, who had a higher level of education, were primiparous and lived with a partner. The late start of prenatal care was the factor most associated with the inadequate number of consultations, also observed in pregnant adolescents. Black women had a lower level of adequacy of tests performed as well as a lower overall adequacy of prenatal care, considering the Programa de Humanização do Pré-Natal e Nascimento (PHPN - Prenatal and Delivery Humanization Program) recommendations. Strategies for the identification of pregnant women at a higher reproductive risk, reduction in organizational barriers to services and increase in access to family planning and early diagnosis of pregnancy should be prioritized.

P6144Trends of mortality in patients with acute coronary syndromes submitted to urgent myocardial revascularization procedures in Brazil

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Moreira ◽  
N A Bittar ◽  
I M Venancio ◽  
N T Silva ◽  
A M S Lima ◽  
...  
Keyword(s):  
Public Health ◽  
Hospital Mortality ◽  
Acute Coronary Syndromes ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Death Rates ◽  
Geographical Regions ◽  
Coronary Syndromes ◽  
Revascularization Procedures ◽  
Related Mortality

Abstract Background Acute Coronary Syndromes (ACS) are the most common and life-threatening manifestation of cardiovascular diseases. This disease burden along with progress in cardiovascular technology has led to substantial growth in the number of cardiovascular procedures performed in ACS management. In Brazil, there are no contemporary data about in-hospital mortality related to urgent myocardial revascularization procedures. Purpose To describe trends in mortality in patients with ACS who underwent urgent myocardial revascularization procedures in Brazil, between 2008 and 2016. Methods Data on hospital admission and in-hospital mortality were obtained from the database of the Brazilian Public Health System (DATASUS) over a nine-years period (2008–2016). All admissions due to ACS were identified using standard ICD codes. Additionally, data about percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) performed as an urgency were retrieved. Trend analyses over the period were performed using Poisson regression. Results Between 2008 and 2016, 472,810 urgent myocardial revascularization procedures were performed, of which 370,018 (78.3%) were PCI and 102,792 (21.7%) were CABG. The in-hospital mortality in patients with ACS submitted to PCI was 3.4%, and 6.8% among those submitted to CABG. There was an increase in the number of PCI procedures from 26,929 in 2008 to 53,542 in 2016 (98%), although the mortality remained stable (3.3% to 3.6%, respectively). CABG procedures also raised 77%, from 9,535 in 2008 to 12,262 in 2016, but the observed related mortality decreased from 8.0% to 6.3%, respectively. However, disparities among Brazilian geographical regions were noted: in 2016, mortality among ACS patients who underwent urgent PCI was lower in Southeast (3.2%) and higher in the Northeast Region (5.9%). The Southeast Region also presented the lowest CABG related mortality (5.7%), whereas the Midwest had the higher death rates (7.8%). Conclusions In this contemporary analysis based on national public health data, there was an increase in the number of urgent myocardial revascularization procedures in patients hospitalized for ACS in Brazil. Despite stable death rates in patients undergoing PCI, CABG-related mortality decreased significantly. Due to the heterogeneity of results among the different geographical Regions of the country, there are still opportunities to improve these national results.

scholarly journals COVID-19 hospitalizations in Brazil’s Unified Health System (SUS)

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243126
Author(s):  
Carla Lourenço Tavares de Andrade ◽  
Claudia Cristina de Aguiar Pereira ◽  
Mônica Martins ◽  
Sheyla Maria Lemos Lima ◽  
Margareth Crisóstomo Portela
Keyword(s):  
Hospital Mortality ◽  
Health System ◽  
Protective Factor ◽  
Secondary Data ◽  
Care Process ◽  
Independent Effect ◽  
Hospital Death ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Unified Health System

Objective To study the profile of hospitalizations due to COVID-19 in the Unified Health System (SUS) in Brazil and to identify factors associated with in-hospital mortality related to the disease. Methods Cross-sectional study, based on secondary data on COVID-19 hospitalizations that occurred in the SUS between late February through June. Patients aged 18 years or older with primary or secondary diagnoses indicative of COVID-19 were included. Bivariate analyses were performed and generalized linear mixed models (GLMM) were estimated with random effects intercept. The modeling followed three steps, including: attributes of the patients; elements of the care process; and characteristics of the hospital and place of hospitalization. Results 89,405 hospitalizations were observed, of which 24.4% resulted in death. COVID-19 patients hospitalized in the SUS were predominantly male (56.5%) with a mean age of 58.9 years. The length of stay ranged from less than 24 hours to 114 days, with a mean of 6.9 (±6.5) days. Of the total number of hospitalizations, 22.6% reported ICU use. The odds on in-hospital death were 16.8% higher among men than among women and increased with age. Black individuals had a higher likelihood of death. The behavior of the Charlson and Elixhauser indices was consistent with the hypothesis of a higher risk of death among patients with comorbidities, and obesity had an independent effect on increasing this risk. Some states, such as Amazonas and Rio de Janeiro, had a higher risk of in-hospital death from COVID-19. The odds on in-hospital death were 72.1% higher in municipalities with at least 100,000 inhabitants, though being hospitalized in the municipality of residence was a protective factor. Conclusion There was broad variation in COVID-19 in-hospital mortality in the SUS, associated with demographic and clinical factors, social inequality, and differences in the structure of services and quality of health care.

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