Tempo de espera e duração da consulta médica na região metropolitana de Manaus, Brasil: estudo transversal de base populacional, 2015*

Galvão, Taís Freire; Tiguman, Gustavo Magno Baldin; Filho, Douglas Borges da Costa; Silva, Marcus Tolentino

doi:10.5123/s1679-49742020000400014

Cited by 4 publications

(1 citation statement)

References 22 publications

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“…Real-time monitoring of the monthly goal was chosen to facilitate visualization of production and to enable an action plan for achieving that goal. The indicator "waiting time" was chosen because it is one of the items with many complaints in secondary health care units, representing around six to ten percentage points in satisfaction questionnaires 4,9,15 .…”

Section: Methodsmentioning

confidence: 99%

Real-Time Management Dashboard as a tool for process improvement at the Outpatient level in a region of Brazil

Paula

Labriola²,

Camargo³

et al. 2022

Preprint

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Background: Specialized outpatient clinics account for about 30% of the total number of visits in the entire Brazilian health system. The Real-Time Management Dashboard (RTMD) is a tool that has great potential to deal with process errors, improve patient care and reduce costs, but its use is still concentrated in the hospital sector on a small scale. The aim of this study was to study the implementation and results of indicators of waiting for time and achievement of goals with the help of RTMD in a specialized ambulatory care outpatient unit. Method: This is a longitudinal study in which the analysis of waiting time indicators for consultations and exams was carried out in September and October, between 2012 and 2021. Information on user satisfaction with the time of service in the studied period was also evaluated. Results: A total of 277,925 records from 80,432 patients were analyzed. It could be observed that the monitoring of waiting time indicators through the RTMD contributed to better control of the flow of patients within the ambulatory unit with a decrease in the delay rate after the implementation of the immediate action protocol and waiting time classified as excellent by 97.1% of users with respect to the satisfaction rating. In addition, the RTMD contributed to the achievement of consultation and examination goals over the 10-year period of study. Conclusion: The RTMD proved to be a promising tool for the management of processes within medical specialty outpatient clinics. Keywords: Clinical Decision Support; Medical Informatics; Primacy Health Care; Public Health

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Section: Methodsmentioning

confidence: 99%

Real-Time Management Dashboard as a tool for process improvement at the Outpatient level in a region of Brazil

Paula

Labriola²,

Camargo³

et al. 2022

Preprint

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Health services utilization in the Brazilian Amazon: panel of two cross-sectional studies

2022

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OBJECTIVE:To investigate the use of health services among adults living in Manaus, Amazonas. METHODS:This was a panel of two cross-sectional studies conducted in Manaus in 2015 and 2019. Individuals aged ≥ 18 years were selected by probabilistic sampling and interviewed at home. The study outcomes were doctor visits and hospitalizations in the previous 12 months, and unmet surgical needs. Variations between 2015 and 2019 were tested using chi-squared goodness-of-fit test. Poisson regression with robust variance was employed to calculate the prevalence ratios (PR) of the outcomes with 95% confidence intervals (95%CI). RESULTS:The surveys included 5,800 participants in total. Visits to the doctor decreased from 2015 (78.7%) to 2019 (76.3%; p < 0.001), hospital admissions increased from 2015 (7.9%) to 2019 (11.5%; p < 0.001), and unmet surgical needs decreased in the period (15.9% to 12.1%; p < 0.001). These variations were particularly observed in vulnerable individuals -sicker; poorer; non-whites; and those belonging to lower social classes, with less access to education, formal jobs, and health insurance (p < 0.05). Doctor visits were higher in people with fair health status (PR = 1.09; 95%CI 1.06-1.12), health insurance (PR = 1.13; 95%CI 1.09-1.17), and chronic diseases (p < 0.001) but lower in men (PR = 0.87; 95%CI 0.84-0.90) and informal workers (PR = 0.89; 95%CI 0.84-0.94). Hospitalizations were higher in people with worse health statuses (p < 0.001), without partners (PR = 1.27; 95%CI 1.05-1.53), and with multimorbidity (PR = 1.68; 95%CI 1.33-2.12) but lower in men (PR = 0.55; 95%CI 0.44-0.68), older adults (p < 0.001), informal workers (PR = 0.67; 95%CI 0.51-0.89), and unemployed (PR = 0.72; 95%CI 0.53-0.97). Unmet surgical needs were higher in older adults (p < 0.001), middle-class people (PR = 1.24; 95%CI 1.01-1.55), worse health statuses (p < 0.001), and chronic diseases (p < 0.001) but lower in men (PR = 0.76; 95%CI 0.65-0.86).

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Consumption and Lack of Access to Medicines and Associated Factors in the Brazilian Amazon: A Cross-Sectional Study, 2019

2020

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Objective We aimed to investigate the consumption and lack of access to medicines in the adult population of Manaus, Amazonas. Methods A population-based study was conducted in Manaus in 2019. Individuals aged ≥18 years were selected by probabilistic sampling performed in three stages. Study outcomes included the consumption of medicines in the previous fortnight and the lack of access to treatments in those who used any medicine. We calculated the prevalence ratios (PR) for the outcomes with 95% confidence intervals (CI) by Poisson regression with robust variance, considering the complex sampling design. Results Out of the 2,321 participants, 53.2% (95%CI 50.7-55.7%) consumed medicines, of which 14.4% (95% CI 11.9–16.8%) could not obtain appropriate treatments. Analgesics were the most used medicines (557/2,702; 21.4%), whereas antibiotics were the most inaccessible treatments (18/228; 7.9%). Lack of financial resources was the main reason for not accessing treatments (104/228; 45.6%). Consumption was significantly associated with older age (≥60 years: PR = 1.27; 95%CI 1.09–1.49), lower social class (D/E: PR = 0.84; 95%CI 0.72–0.99), lower educational level (p = 0.039), poor health status (PR = 1.30; 95%CI 1.11–1.52), use of health care services (PR = 1.37; 95%CI 1.26–1.49), and chronic diseases (PR = 1.36; 95%CI 1.22–1.52). Lack of access was higher in people with poor health status (PR = 2.46; 95%CI 1.50–4.04) and chronic diseases (PR = 1.84; 95%CI 1.16–2.92). Conclusion Half of Manaus’ population used medicines, which was higher in socially privileged and sicker individuals. Among those, 14 in every 100 could not access drug therapies, which was more frequent in people with poor health and with chronic diseases.

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Tempo de espera e duração da consulta médica na região metropolitana de Manaus, Brasil: estudo transversal de base populacional, 2015*

Cited by 4 publications

References 22 publications

Real-Time Management Dashboard as a tool for process improvement at the Outpatient level in a region of Brazil

Real-Time Management Dashboard as a tool for process improvement at the Outpatient level in a region of Brazil

Health services utilization in the Brazilian Amazon: panel of two cross-sectional studies

Consumption and Lack of Access to Medicines and Associated Factors in the Brazilian Amazon: A Cross-Sectional Study, 2019

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