Avaliação da assistência ao paciente asmático no Sistema Único de Saúde

Silveira, Carla Discacciati; Araújo, Flávia de Barros; Pereira, Luiz Fernando Ferreira; Corrêa, Ricardo de Amorim

doi:10.1590/s1806-37132009000700003

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…The high prevalence of SABA treatment use in our findings may indicate poor adherence to controller medications or potential lack of knowledge about the efficacy of novel therapies in asthma treatment as well as established guidelines for asthma management by physicians in a clinical setting [ 63 , 64 ]. The use frequency of SABA was similar to that of IC, but considerably high compared to IC + LABA combination.…”

Section: Discussionmentioning

confidence: 99%

Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

Flórez-Tanus

Parra

Zakzuk

et al. 2018

World Allergy Organization Journal

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BackgroundAsthma is one of the most common chronic respiratory conditions worldwide. Asthma-related economic burden has been reported in Latin America, but knowledge about its economic impact to the Colombian health care system and the influence of disease severity is lacking. This study estimated direct medical costs and health care resource utilization (HCRU) in patients with asthma according to severity in Colombia.MethodsThis study identified all-age patients who had at least one medical event linked to an asthma diagnosis (CIE-10: J45-J46) between 2004 and 2014. Patients were selected if they had a continuous enrollment and uninterrupted insurance coverage between January 1–2015 and December 31–2015 and were categorized into 4 different severity levels using a modified algorithm based on Leidy criteria. Healthcare utilization and costs were estimated in a 1-year period after the identification period. A Generalized Linear Model (GLM) with gamma distribution and log link was used to analyze costs adjusting for patient demographics.ResultsA total of 20,410 patients were included: 69.5% had mild intermittent, 18.0% mild persistent, 6.9% moderate persistent and 5.5% severe persistent asthma; with mean costs (SD) of $67 (134), $482 (1506), $1061 (1983), $2235 (3426) respectively (p < 0.001). The mean total direct cost was estimated at $331 (1278) per patient. Medication and hospitalization had the higher proportion in total costs (46% and 31% respectively). General physician visits was the most used service (57.2%) and short-acting β-2 agonists the most used medication (24%).ConclusionsHealth services utilization and direct costs of asthma were highly related to disease severity. Nationwide health policies aimed at the effective control of asthma are necessary and would play an important role in reducing the associated economic impact.Electronic supplementary materialThe online version of this article (10.1186/s40413-018-0205-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

Flórez-Tanus

Parra

Zakzuk

et al. 2018

World Allergy Organization Journal

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“…Despite the existing international 22 and national guidelines for asthma, 23 data indicates inadequate application of these recommendations in the SUS, as only 24.2% of prescribed treatment were in accordance with the GINA strategy. 37 These results suggest the need for medical education programs as well as clear referral and counter-referral communication with physician specialists. 38 To date, there have been no specific protocols created for severe asthma management in Brazil.…”

Section: Methodsmentioning

confidence: 98%

An expert review on breaking barriers in severe asthma in Brazil: Time to act

et al. 2021

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Currently, Brazil lacks a national asthma management program and is burdened with nearly 200,000 hospitalizations due to the disease per year and approximately 5 deaths per day. The purpose of this article was to analyze the current issues surrounding severe asthma in Brazil, as the status of diagnosis and treatment is largely unknown, and to provide feasible recommendations to elicit imminent action. A panel of Brazilian medical experts in the field of severe asthma was provided with a series of relevant questions to address prior to a multi-day conference. Within this conference, each narrative was discussed and edited by the entire group. Through numerous rounds of discussion consensus was achieved. In order to overcome barriers to adequate asthma treatment, this panel recommends specific initiatives that can be implemented in the short-term to decrease the burden of severe asthma in Brazil. With increasing healthcare costs and limited resources globally, there is an opportunity to implement these recommendations in other countries in order to achieve adequate asthma care. Severe asthma is a heterogeneous and complex disease with various phenotypes that requires strict attention for diagnosis and management. Although this disease affects only a small proportion of the population with asthma, it poses a great burden to healthcare systems. Thus, barriers to diagnosis, treatment, and management should be overcome as quickly and efficiently as possible.

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Videoaula ou teleconsultoria no aprendizado em otorrinolaringologia do médico de família

Oliveira

Gonçalves

2012

Rev. bras. educ. med.

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OBJETIVO: Comparar diferentes métodos de aprendizagem em Otorrinolaringologia para médicos de família. MÉTODOS: Os médicos foram distribuídos aleatoriamente em três grupos: 12 foram expostos a instruções verbais com uso de videoaulas, 12 a teleconsultoria com especialista, e 13 a ambas as técnicas. Antes e depois das intervenções nos grupos, foi aplicado um questionário com tarefas em Otorrinolaringologia. Comparou-se o número de acertos no questionário com os casos encaminhados da Atenção Primária à Secundária e a concordância entre diagnósticos da Atenção Primária e Secundária. RESULTADOS: Após as intervenções, houve melhora no conhecimento para os grupos exposição verbal com videoaulas (p = 0,002) e teleconsultoria/videoaula (p = 0,001), queda de 16% no número de encaminhamentos da Atenção Primária para a Secundária. Não foi observada em qualquer dos grupos concordância de diagnósticos entre a Atenção Primária e Secundária, com Kappa abaixo de 0,75. CONCLUSÃO: O médico de família aprendeu mais Otorrinolaringologia com instruções verbais em videoaulas do que com teleconsultoria com especialista. No entanto, ele não foi capaz de usar o conhecimento adquirido para fazer diagnósticos concordantes com os do especialista.

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Avaliação da assistência ao paciente asmático no Sistema Único de Saúde

Abstract: The results show that the majority of non-specialized physicians working within the public health care system do not manage the treatment of patients with asthma in accordance with the guidelines. This situation calls for continuing medical education programs that prioritize primary care.

Cited by 4 publications

References 12 publications

Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

Health care costs and resource utilization for different asthma severity stages in Colombia: a claims data analysis

An expert review on breaking barriers in severe asthma in Brazil: Time to act

Videoaula ou teleconsultoria no aprendizado em otorrinolaringologia do médico de família

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