Stroke and Myocardial Infarction: Effects of the “Hiperdia” and “Mais Médicos” Programs on the Hospitalizations Trends in Brazil

Abstract

Background: Stroke and acute myocardial infarction (AMI) are cardiovascular diseases commonly characterized by the development of atheromatous plaques associated with major complications and high mortality rates.Objective: To identify an epidemiological trend in hospitalizations due to stroke and AMI and to analyze the relationship between health programs applied in Primary Health Care, gender and the Federative Unit.Methods: Ecological study with a time series design between 1998 and 2018, collecting data from all federal units in Brazil stratified by, gender and place of residence. There were analyzed Hospitalization Authorizations (AIH) for stroke and MI, consulting the Hospital Admissions System (SIH) of the Informatics Department of the National Health Service with p <0.05.Results: From 1998 to 2018, the rate of hospitalization for AMI increased in Brazil approximately 42.58 events per 100 thousand inhabitants annually (p<0.001), while hospitalizations for stroke declined 32.17 cases (p=0.03). This pattern was observed in both sexes in AMI and stroke. There is also evidence of the effect of the Hiperdia (p<0.001) and Mais Médicos (p=0.001) program in reducing stroke and Hiperdia cases in mitigating the evolution of AMI cases (p = 0.0001). Conclusion:Although these diseases remain as an important cause of death, stroke hospitalization has reduced significantly in the period evaluated. National programs as the Hiperdia and Mais Médicos showed an impact in the acute cases of strokes and AMI.

Public Health Programs and Cardiovascular Diseases

“…However, this was an organizational flow and capacitation program, which may have limited its ability to demonstrate an impact on the outcomes during the study period. 8 Finally, the findings reported by Santos et al should encourage the development and expansion of primary health care programs in the country, mainly in more vulnerable areas. Promoting an equal access to healthcare should be considered an essential condition for cardiovascular risk reduction and occur in parallel with measurements aimed at improving quality of life and reducing social disparities.…”

“…On the other hand, the hospitalizations for stroke decreased in all federated states, except for Amazonas and Roraima. 8 The authors also showed that the "Mais Médicos" program, and specially the "Hiperdia" program contributed to the reduction in hospitalizations for stroke. However, although the same effect was not observed on the rate of hospitalizations for acute myocardial infarction, these programs attenuated the progression in the number of cases.…”

“…Using data from the hospital information system of the Department of Informatics of the Brazilian national unified health system (SIH-DATASUS), Santos et al, 8 evaluated the time course of the number of hospitalizations by sex and federated states during the mentioned period. 8 Except for Amapa, where hospitalization rates had a stable pattern over time, rates of hospitalization for acute myocardial infarction increased in all federated states. On the other hand, the hospitalizations for stroke decreased in all federated states, except for Amazonas and Roraima.…”

“…5 Evidently, to be a member of a supplemental health plan does not guarantee access to healthcare, but when used as an indirect marker of income, it reflects the huge degree of health inequalities observed in the country. Therefore, nationwide public health programs that include more vulnerable areas are of paramount importance, as reported by Santos et al, 8 DOI: https://doi.org/10.36660/ijcs.20210196…”

Análise comparativa entre taxa de mortalidade, internações e gastos hospitalares referentes ao AVC nos anos de 2011 e 2021 no Piauí e no Brasil

“…Em divergência ao aumento de internações, alguns estudos que ocorreram dentro ou próximo ao intervalo de tempo analisado, indicam que o número de internações no país reduziu, como Santos et al (6) , que relatou redução das internações por AVC de 1998 a 2018. Além desse estudo, Lopes, JM et al (7) observou, de 1998 a 2012, queda nas internações por AVC isquêmico a partir de 2002 (uma redução de 73,64% de 1998 a 2005), ano da implantação do programa Hiperdia.…”