Self-rated health is an important indicator used to measure health perception. This study aimed to investigate the association between self-rated health and social and demographic factors, health behavior, and morbidity. This was a cross-sectional study based on data from a national health survey. The sample consisted of 12,324 individuals from Brazil's five major geographic regions. Regression analyses were conducted to verify the association between the outcome and the following independent variables: gender, age, income, education, race, marital status, smoking, alcohol consumption, physical activity, chronic illnesses, and body mass index. Increasing age, low education and income, smoking, sedentary habits, chronic illness, and obesity were the factors most strongly associated with worse self-rated health. The identification of population attributes associated with worse self-rated health can help trace a profile of individuals more prone to seeking health services.

The HAI is the major preventable AEs, as observed in other developing countries. Despite the limitations of the study, the characterization of preventable AEs indicates that known and effective actions available to reduce HAI, such as hand hygiene, to prevent pressure ulcers, to encourage adherence to protocol and clinical guidelines and to create continuing education programs for health professionals, should compose the list of priorities of hospital managers and health professionals involved in the care of hospitalized patients.

No abstract

Características dos eventos adversos na atenção primária à saúde no Brasil Características de los eventos adversos en la atención primaria de salud en Brasil

BackgroundAdverse events are considered a major international problem related to the performance of health systems. Evaluating the occurrence of adverse events involves, as any other outcome measure, determining the extent to which the observed differences can be attributed to the patient's risk factors or to variations in the treatment process, and this in turn highlights the importance of measuring differences in the severity of the cases. The current study aims to evaluate the association between deaths and adverse events, adjusted according to patient risk factors.MethodsThe study is based on a random sample of 1103 patient charts from hospitalizations in the year 2003 in 3 teaching hospitals in the state of Rio de Janeiro, Brazil. The methodology involved a retrospective review of patient charts in two stages - screening phase and evaluation phase. Logistic regression was used to evaluate the relationship between hospital deaths and adverse events.ResultsThe overall mortality rate was 8.5%, while the rate related to the occurrence of an adverse event was 2.9% (32/1103) and that related to preventable adverse events was 2.3% (25/1103). Among the 94 deaths analyzed, 34% were related to cases involving adverse events, and 26.6% of deaths occurred in cases whose adverse events were considered preventable. The models tested showed good discriminatory capacity. The unadjusted odds ratio (OR 11.43) and the odds ratio adjusted for patient risk factors (OR 8.23) between death and preventable adverse event were high.ConclusionsDespite discussions in the literature regarding the limitations of evaluating preventable adverse events based on peer review, the results presented here emphasize that adverse events are not only prevalent, but are associated with serious harm and even death. These results also highlight the importance of risk adjustment and multivariate models in the study of adverse events.

No abstract

Resumo: O objetivo foi analisar as barreiras de acesso aos serviços de saúde existentes em cinco Regiões de Saúde do Brasil. Foram analisadas as respostas obtidas a partir da aplicação de questionários semiestruturados a gestores, prestadores e, em número mais restrito, a profissionais de saúde do Sistema Único de Saúde, tendo como referência as dimensões: Acessibilidade Geográfica, Disponibilidade e Aceitabilidade. Foram verificadas as especificidades em relação às barreiras de acesso nas regiões consideradas, já outras como a localização e tempo gasto no trajeto foram barreiras em quase todas elas quando foi considerado o cuidado ao acidente vascular cerebral. Quando à Disponibilidade, foram observadas questões relacionadas à insuficiência de médicos, tempo de espera prolongado e problemas relativos à integração, em todas as regiões. Quanto à Aceitabilidade, destacou-se a crença dos usuários de não possuir problemas de saúde. As Regiões de Saúde situadas no Sul e Sudeste do país registraram menor quantidade e diversidade de barreiras, revelando a persistência de desigualdades regionais. Embora os resultados não representem o conjunto do Brasil, permitem apontar questões relevantes sobre o processo de regionalização do sistema de saúde no país.

No abstract