Navegando por Assunto "Acesso aos serviços de saúde"

Agora exibindo 1 - 3 de 3

Acesso aberto (Open Access)
Cuidado ao paciente com Doença Renal Crônica no nível primário: pensando a integralidade e o matriciamento
(2012-11) PENA, Paulo Félix de Almeida; SILVA JÚNIOR, Aluísio Gomes da; OLIVEIRA, Paulo de Tarso Ribeiro de; MOREIRA, Gracyelle Alves Remigio; LIBÓRIO, Alexandre Braga
Chronic kidney disease is a public health problem throughout the world. Early detection and treatment can reduce morbidity, mortality and associated expenditures. The objective of this research is to examine primary healthcare from a physician´s perspective, evaluating the patient´s access to other levels of healthcare. Questionnaires were given to 62 family physicians working in primary healthcare units in the city of Fortaleza. Glomerular filtration rate was measured by only 8.1% of the physicians when evaluating patients with diabetes and 4.8% when evaluating hypertensive patients. The majority of physicians (51.2%) refer patients with slight/moderate Glomerular filtration rate reduction to a nephrologist. On the other hand, 25.8% do not refer patients with advanced chronic kidney disease reduction to a specialist. The gap between these levels of healthcare creates a barrier to user access, prejudicing comprehensive healthcare. The creation of new work processes is urgently required and the matrix process is a viable option to connect these healthcare levels for the care of patients with chronic kidney disease or its main risk factors (diabetes and arterial hypertension).
Acesso aberto (Open Access)
Investigação das internações por sífilis congênita: distribuição espaço-temporal, fluxos e gastos
(Universidade Federal do Pará, 2020-03-16) NERI, Débora Talitha; FERREIRA, Glenda Roberta Oliveira Naiff; http://lattes.cnpq.br/7459094802051187; https://orcid.org/0000-0002-8206-4950; ARAÚJO, Eliete da Cunha; http://lattes.cnpq.br/5906453187927460
In the state of Pará, the high incidence of diagnosis of gestational syphilis in the third trimester of pregnancy and at the time of delivery may be predictors of greater use of hospital services, however, the lack of availability of information on the magnitude and pattern of distribution of hospitalizations in the state do not make it possible to fully estimate the impact of congenital syphilis on the public health system, mainly in the financial aspects, access and sufficiency of quality services. Objective: To investigate hospital admissions for congenital syphilis in Pará, in children under one year old from 2009 to 2018. Methodology: This is an ecological, cross-sectional study with a quantitative approach. Data were collected in the Hospital Information System and Live Birth Information System. Descriptive analyzes of hospitalization rates, lethality, mortality and proportion of expenses were performed. Temporal, spatial analysis and mapping of hospitalization flows for congenital syphilis. Minitab 18®, Joinpoint®, version 4.7.0.0, Terraview 4.2.2, Tabwin 4.1.5 and ArcGis 10.3.1 were used in the analysis of the study. Results: 6,487 hospitalizations for SC were recorded in the 10 years studied, most frequently in the early neonatal period, 94% (6,096) of cases. A gross hospitalization rate for SC in Pará shows an increasing increase with an annual percentage variation of 11.9%. Despite the growth without number of cases and the gross rate of hospitalization, there was a reduction in the lethality rate. As hospitalizations for registered SC resulted in an expense to SUS of R $ 6,014,782.17, with R $ 927.20 being the average expenditure of hospitalizations. A spatial analysis indicates direct spatial autocorrelation in the high-high pattern in the two periods. As for the flow, one Metropolitana I was the only one that received all hospitalizations from its residents in the region itself. Thus, there was a greater absorption of interactions from other regions and a positive balance. Conclusion: The results presented here showed a significant increase in the rate of hospitalization for SC in Pará, in several regions and in all health macro-regions, with a proportional increase in expenses. Despite failures in primary health care, there was an improvement in the quality of tertiary care. The mapping of care networks and flows pointed to the predominance of HI that occurred in the same place of residence as the inpatient. However, it demonstrated differences in the organization and compliance with the foundations of the Cegonha Network, within the health regions and macro-regions, with Macroregion I being the one that most managed to guarantee the resolution of hospital health care.
Acesso aberto (Open Access)
Perspectivas de adolescentes e cuidadores sobre saúde mental e serviços
(Universidade Federal do Pará, 2011-03) RODRIGUES, Silvia Maués Santos; PEDROSO, Janari da Silva; http://lattes.cnpq.br/4096274367867186
Objective: to analyze the concepts and perceptions that adolescents and their caregivers have on mental health and health services in their ecological context and investigate the barriers to access to mental health care experiences. Method: it is an exploratory and analytical study with a convenience sample obtained from October 2009 to June 2010 with 100 adolescents and 100 caregivers in the city of Belem, Brazil, in two public clinical settings, a mental health specialized one and other general, and two school contexts, one public and one private. It was used structured questionnaires to investigate different dimensions involved in health issues, family welfare and living conditions, followed by statistical analysis with technical analysis of variance and correlation. Results: the average age of adolescents was 14.47 (SD 1.90) years, 58% female, the kind of mental health problem reported by the majority were in trouble at school (21.9%), the most frequently professional sought was a psychologist (59.4%). Regarding the concepts of mental health, adolescents and their caregivers gave importance to the behavior of abstaining themselves from drugs; as the conceptions of mental illness, both conceived as something to be seriously considered, both agreed that religion contributes to health/ mental disease and revealed the primacy of the mother in search of help; regarding the coping strategies adolescents similarly dealt with mental health problems in their lives, adolescents and caregivers had a stigmatized vision of health professionals and fear discrimination primarily by peers; regarding the treatment both showed real or imagined conception in favor of therapies as a source of help and privileged position to express their own opinion and in any case, the mother turned out to be the main person who contribute to the search specialized help. The variables that showed the merits of different conceptions of mental health / illness and the strategies employed in maintaining the mental health of the family showed differences between the contexts investigated, with respect to self-concept, the private school students showed higher self-congruence between the real and ideal self compared to other contexts; caregivers showed higher self-congruence in public school. As for the prospects that adolescents have about the family real identifications revealed more frequent in the four contexts with the mother, followed by the grandmother/grandfather; as the model family identification in clinical settings and private schools is higher with the mother, in public school is higher with the father; was observed discrepancy from the perspective of the caregiver about the self concept of the teenager. For most adolescents and caregivers health conditions were rated "good" to "excellent." Self-assessment of well-being of adolescents in the overall sample showed that most of them felt very satisfied, totally full of energy, enjoying themselves and had a good relationship with the teachers; in the view of caregivers, most their teens felt very satisfied with life, used his free time hanging out with friends and gave more importance to feelings of well-being in relation to physical performance. Conclusions: are highlighted similarities and differences between adolescents and caregivers in school and clinical samples that can support preventive health actions in context to the city of Belem.