Controle glicêmico de pacientes diabéticos tipo 2 nos serviços público e privado de Saúde

Panarotto, Daniel; Träsel, Henrique de Araújo Vianna; Oliveira, Michele Salibe de; Gravina, Lívia Brancher; Teles, Alisson Roberto

doi:10.1590/s0004-27302009000600007

Cited by 13 publications

(5 citation statements)

References 21 publications

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“…A retrospective cohort study was carried out in Southern Brazil involving 80 patients treated in a SUS outpatient clinic and 277 patients treated at a private clinic. Patients receiving treatment from SUS generally showed worse metabolic control, although only the values of HbA1c and total cholesterol were statistically different between the two groups [50]. However, due to the small sample size and the regional coverage of this study, these findings are not representative of the whole Brazilian population.…”

Section: Resultsmentioning

confidence: 87%

Epidemiology, management, complications and costs associated with type 2 diabetes in Brazil: a comprehensive literature review

Bertoldi

Kanavos

França

et al. 2013

Globalization and Health

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BackgroundWith an estimated 74% of all deaths attributable to non-communicable diseases (NCDs) in 2010, NCDs have become a major health priority in Brazil. The objective of the study was to conduct a comprehensive literature review on diabetes in Brazil; specifically: the epidemiology of type 2 diabetes, the availability of national and regional sources of data (particularly in terms of direct and indirect costs) and health policies for the management of diabetes and its complications.MethodsA literature search was conducted using PubMed to identify articles containing information on diabetes in Brazil. Official documents from the Brazilian government and the World Health Organization, as well as other grey literature and official government websites were also reviewed.ResultsFrom 2006 to 2010, an approximate 20% increase in the prevalence of self-reported diabetes was observed. In 2010, it was estimated that 6.3% of Brazilians aged 18 years or over had diabetes. Diabetes was estimated to be responsible for 278,778 years of potential life lost for every 100,000 people. In 2013, it is estimated that about 7% of patients with diabetes has had one or more of the following complications: diabetic foot ulcers, amputation, kidney disease, and fundus changes. The estimated annual direct cost of diabetes was USD $3.952 billion in 2000; the estimated annual indirect cost was USD $18.6 billion. The two main sources of data on diabetes are the information systems of the Ministry of Health and surveys. In the last few years, the Brazilian Ministry of Health has invested considerably in improving surveillance systems for NCDs as well as implementing specific programmes to improve diagnosis and access to treatment.ConclusionsBrazil has the capacity to address and respond to NCDs due to the leadership of the Ministry of Health in NCD prevention activities, including an integrated programme currently in place for diabetes. Strengthening the surveillance of NCDs is a national priority along with recognising the urgent need to invest in improving the coverage and quality of mortality data. It is also essential to conduct regular surveys of risk factors on a national scale in order to design effective preventive strategies.

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Section: Resultsmentioning

confidence: 87%

Epidemiology, management, complications and costs associated with type 2 diabetes in Brazil: a comprehensive literature review

Bertoldi

Kanavos

França

et al. 2013

Globalization and Health

View full text Add to dashboard Cite

show abstract

“…Two studies, both quantitative, looked at the impact of healthcare type/setting on diabetes outcomes. A Brazilian cohort study compared those attending a public and private clinic [ 81 ]. While both groups showed improvements across all clinical parameters, patients receiving public healthcare had significantly higher mean HbA1c and mean cholesterol than private care patients.…”

Section: Resultsmentioning

confidence: 99%

Assessing the influence of health systems on Type 2 Diabetes Mellitus awareness, treatment, adherence, and control: A systematic review

et al. 2018

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BackgroundType 2 Diabetes Mellitus (T2DM) is reported to affect one in 11 adults worldwide, with over 80% of T2DM patients residing in low-to-middle-income countries. Health systems play an integral role in responding to this increasing global prevalence, and are key to ensuring effective diabetes management. We conducted a systematic review to examine the health system-level factors influencing T2DM awareness, treatment, adherence, and control.Methods and findingsA protocol for this study was published on the PROSPERO international prospective register of systematic reviews (PROSPERO 2016: CRD42016048185). Studies included in this review reported the effects of health systems factors, interventions, policies, or programmes on T2DM control, awareness, treatment, and adherence. The following databases were searched on 22 February 2017: Medline, Embase, Global health, LILACS, Africa-Wide, IMSEAR, IMEMR, and WPRIM. There were no restrictions on date, language, or study designs. Two reviewers independently screened studies for eligibility, extracted the data, and screened for risk of bias. Thereafter, we performed a narrative synthesis. A meta-analysis was not conducted due to methodological heterogeneity across different aspects of included studies. 93 studies were included for qualitative synthesis; 7 were conducted in LMICs. Through this review, we found two key health system barriers to effective T2DM care and management: financial constraints faced by the patient and limited access to health services and medication. We also found three health system factors that facilitate effective T2DM care and management: the use of innovative care models, increased pharmacist involvement in care delivery, and education programmes led by healthcare professionals.ConclusionsThis review points to the importance of reducing, or possibly eliminating, out-of-pocket costs for diabetes medication and self-monitoring supplies. It also points to the potential of adopting more innovative and integrated models of care, and the value of task-sharing of care with pharmacists. More studies which identify the effect of health system arrangements on various outcomes, particularly awareness, are needed.

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“…No nosso conhecimento, até a presente data, a única investigação sobre o tema no nosso meio é um estudo de coorte retrospectiva, comparando 80 pacientes atendidos em ambulatórios do SUS e 277 pacientes em clínicas privadas 14 . Os resultados mostraram pior controle metabólico entre os primeiros 14 , mas a generalização desses resultados é questionada devido à sua circunscrição local e pequeno número de participantes 5 .…”

Section: Introductionunclassified

Uso de serviços de saúde por diabéticos cobertos por plano privado em comparação aos usuários do Sistema Único de Saúde no Município de Belo Horizonte, Minas Gerais, Brasil

et al. 2016

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Resumo: O objetivo do trabalho foi comparar o uso de serviços de saúde, o uso de medicamentos, a cobertura de exames de rastreamento, os atributos da atenção primária em saúde e os comportamentos em saúde de indivíduos (n = 370) com 45 anos ou mais, com diagnóstico médico de diabetes, segundo as fontes de atenção em saúde, assim definidas: afiliados a plano privado de saúde, independentemente do local de residência; residentes em áreas cobertas pela Estratégia Saúde da Família (ESF); cobertos pela unidade básica de saúde (UBS) "tradicional". O estudo utilizou os dados do 2º Inquérito de Saúde de Adultos da Região Metropolitana de Belo Horizonte (2010). Os indicadores de uso de serviços de saúde, o uso de medicamentos, a cobertura de exames de acompanhamento, o consumo abusivo de álcool e o tabagismo atual não diferiram significativamente entre as fontes de atenção. As prevalências da prática insuficiente de exercícios físicos no tempo livre e do sedentarismo no cotidiano foram maiores entre os cobertos pela ESF ou UBS "tradicional". Os atributos da atenção primária em saúde (acesso, integralidade, longitudinalidade e foco familiar) apresentaram melhor desempenho entre os afiliados a plano privado de saúde, mesmo após ajuste por idade, sexo e escolaridade. Os resultados da investigação apontam dois principais desafios para o Sistema Único de Saúde no manejo dos pacientes com diabetes no Município de Belo Horizonte, Brasil: a realização de ações mais efetivas para a promoção da atividade física e a necessidade de reorganização visando à melhoria no desempenho da atenção primária, sobretudo no acesso às consultas médicas.

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Controle glicêmico de pacientes diabéticos tipo 2 nos serviços público e privado de Saúde

Abstract: The variables such as the initial A1c and the frequency of visits, which may be considered as indicators of patients' access to the heath system, have greater impact on the control of diabetes than the place where the patients are treated.

Cited by 13 publications

References 21 publications

Epidemiology, management, complications and costs associated with type 2 diabetes in Brazil: a comprehensive literature review

Epidemiology, management, complications and costs associated with type 2 diabetes in Brazil: a comprehensive literature review

Assessing the influence of health systems on Type 2 Diabetes Mellitus awareness, treatment, adherence, and control: A systematic review

Uso de serviços de saúde por diabéticos cobertos por plano privado em comparação aos usuários do Sistema Único de Saúde no Município de Belo Horizonte, Minas Gerais, Brasil

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