Desempenho da solicitação do perfil lipídico entre os setores público e privado

Abstract

OBJECTIVE:To evaluate the performance of lipid profi le screening according to the mode of fi nancing of medical appointments -public or private. METHODS:A population-based cross-sectional study was carried out with a multi-stage sampling strategy. The study included 3,136 adults (≥ 20 years old) from the city of Pelotas, Southern Brazil, in 2006. The following indicators were calculated: coverage (proportion of screened individuals among those meeting screening criteria), focus (proportion of individuals meeting screening criteria among those who were tested), screening errors (tests in individuals not meeting screening criteria -overscreening -and no screening of individuals meeting the screening criteria -underscreening), and screening ratio (ratio between number of individuals who met screening criteria and the number who failed to meet screening criteria among all individuals tested). Bivariate analyses were performed using Chi-squared tests. 95% confi dence intervals (95% CI) were calculated for all parameters assessed. RESULTS:General coverage was 73.0% (95%CI: 70.8;75.2), and focus was 67.2% (95% CI: 64.7;69.3). In the public sector, compared to the private/ health plan sector, coverage was lower (65.2% vs. 82.2%; p<0.001), focus was higher (74.7% vs. 62.3%; p<0.001), overscreening was lower (33.1% vs. 56.4%; p<0.0001), and underscreening was higher (34.8% vs. 17.8%; p<0.0001). Screening ratio was higher in the public (1.97) than in the private sector (1.46). CONCLUSIONS:The evaluation of adequacy of lipid profi le requests among the population can provide important information regarding the following of protocols for screening and following-up dyslipidemias in different healthcare systems and, within a same system, between different modes of fi nancing. Evaluations of this type provide an opportunity to diagnose inequalities and plan efforts to ensure greater equity of care.

Utilização de serviços médicos no sistema público de saúde no Sul do Brasil

“…In 2005, 43.8% of healthcare plan coverage was estimated among adult individuals in the city. 4 The present study did not fi nd differences in medical services utilization between sexes. This datum disagrees with the largest part of national and international studies on the use of public or private health services, which report higher utilization of medical consultations among women.…”

Usuários de planos de saúde: morbidade referida e uso de exames preventivos, por inquérito telefônico, Brasil, 2008

“…Essa condição pode explicar a maior oportunidade de acesso ao diagnóstico junto à população coberta por planos 39 . Com isso, podemos supor que a diferença encontrada de maior diagnóstico de dislipidemia em pacientes com planos, pode ocorrer em função da maior oportunidade de diagnóstico e não da diferença real nas prevalências da população com e sem planos de saúde.…”

Saúde suplementar no Brasil: abordagens sobre a articulação público/privada na assistência à saúde

“…Dos 25 trabalhos selecionados para leitura do texto integral, oito textos foram excluídos: as teses de Andreazzi 22 , Aciole 23 e Santos 24 que, em duplicidade, têm seu conteúdo contemplado em artigos dos mesmos autores 18,25,26 , o artigo de Conill & Ugá 27 que é um editorial de apresentação de edição temática sobre saúde suplementar, a dissertação de Oliveira 28 que é um trabalho de pesquisa epidemiológica com uma população de beneficiários de plano de saúde e os artigos de Barbosa 29 , Costa 30 e Duro et al 31 que tratam, respectivamente, do modelo de reforma gerencial de hospitais públicos, de mudanças políticas relacionadas com o processo de globalização do capital financeiro e de um estudo populacional para avaliação do desempenho do rastreio do perfil lipídico conforme fonte de financiamento de consultas médicas.…”