ABSTRACT:Objective: To verify the hospitalization trend for primary care sensitive-conditions in Pelotas, Rio Grande do Sul, Brazil from 1998 to 2012. Methods: An ecological study compared hospitalizations rates of the city of Pelotas with the rest of state of Rio Grande do Sul. Analysis was conducted using direct standardization of rates, coefficients were stratified by sex and the Poisson regression was used. Results: Hospitalizations for sensitive conditions decreased in Pelotas and Rio Grande do Sul. In Pelotas, a 63.8% decrease was detected in the period observed, and there was a 43.1% decrease in the state of Rio Grande do Sul. Poisson regression coefficients showed a decrease of 7% in Pelotas and of 4% in the rest of Rio Grande do Sul each year. Conclusion: During the study period, several changes were introduced in the Brazilian Unified Health System ("Sistema Único de Saúde") that may have influenced the results, including changes in administration, health funding, and a complete reworking of primary care through the creation of the Family Health Strategy program ("Estratégia Saúde da Família"). . Since its creation, SUS underwent several modifications such as changes in its organizational structure, funding, primary care models, and the implementation of assorted measures, increasing the need for adequate programs and health actions evaluation 4 . An alternative to primary care evaluation is monitoring the hospitalization rates for primary care-sensitive conditions (HPCSC). Primary care-sensitive conditions are a set of 20 groups of diseases for which treatment at the right time could reduce or eliminate the risk of hospitalization, both by preventing their emergence and by adequately handling the condition 5 . Thus, proper coverage at the primary care level can decrease admission rates as services become more effective. A health care system that could adequately handle diseases prone to ambulatory control would present an appropriate effectiveness level 6,7 . In the same way, studies have shown that primary health care provision can be crucial for improving health condition in the population 8,9 . The Brazilian Ministry of Health (Ministério da Saúde) has published a list of primary care-sensitive diseases in Decree n. 221 of April 17, 2008, in which it is proposed that such indicator would evaluate the effectiveness level of the system and/or of hospital care 10 , thus acknowledging its importance. Based on this list, several inquiries have analyzed the behavior of HPCSC. An ecological study showed that HPCSC decreased by 24% between 1999 and 2007 in Brazil. Such decrease was also observed when comparing this group of
The COVID-19 pandemic has impacted public and private health systems around the world, impairing good practices in women’s health care. However, little is known about the experiences, knowledge, and feelings of Brazilian women in this period. The objective was to analyze the experiences of women, seen at maternity hospitals accredited by the Brazilian Unified Health System (SUS, acronym in Portuguese), regarding health care during pregnancy, childbirth, and postpartum periods, their interpersonal relationships, and perceptions and feelings about the pandemic. This was a qualitative, exploratory research, carried out in three Brazilian municipalities with women hospitalized in 2020, during pregnancy, childbirth, or postpartum period, with COVID-19 or not. For data collection, semi-structured individual interviews (in person, by telephone, or by digital platform) were conducted, recorded and transcribed. The content analysis of thematic modalities was displayed as per the following axes: i) Knowledge about the disease; ii) Search for health care in prenatal, childbirth, and postpartum periods; iii) Experience of suffering from COVID-19; iv) Income and work; and v) Family dynamics and social support network. A total of 46 women were interviewed in São Luís-MA, Pelotas-RS, and Niterói-RJ. Use of media was important to convey information and fight fake news. The pandemic negatively impacted access to health care in the prenatal, childbirth, and postpartum periods, contributing to worsening of the population’s social and economic vulnerabilities. Women experienced diverse manifestations of the disease, and psychic disorders were very frequent. Social isolation during the pandemic disrupted the support network of these women, who found social support strategies in communication technologies. Women-centered care–including qualified listening and mental health support–can reduce the severity of COVID-19 cases in pregnant, parturient, and postpartum women. Sustainable employment and income maintenance policies are essential to mitigate social vulnerabilities and reduce risks for these women.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.