In hospital care for diabetic foot: a comparison between the estimated cost and the SUS reimbursement

This study aimed to analyze costs for treating patients with diabetic foot cared by the public Brazilian Health System (SUS), comparing the estimated cost with the amount of SUS reimbursement. A cohort prospective study carried out in hospitals that provide services for the Unified Health System in Sergipe, involving 109 hospitalization episodes of patients with diabetes and foot ulcers. We follow these patients day by day and estimated the hospital direct cost and the SUS reimbursement. All patients had type 2 diabetes and the majority of ulcers (64,2%) were classified as Wagner 4 or 5. Forty-three (39,4%) healed without amputation and fifty-two (47,7%) healed with amputation. Fourteen (12,8%) patients died. Hospital direct cost ranged from R$943.72 to R$ 16,378.85; with an average of R$4,461.04. The SUS reimbursement varied from R$ 96.95 to R$2,410.18, with an average of R$ 633.97, usually seven times low. Smaller difference between costs occurred in patients from the Beneficent hospital and higher rates occurred in those treated with minor amputation.Foram seguidas 109 internações de pacientes com diabetes e ulcerações nos pés na rede do Sistema Único de Saúde (SUS) em Sergipe, com o objetivo de estimar o custo direto hospitalar e comparar com os valores do desembolso do SUS. Os dados foram coletados desde a admissão até a alta ou o óbito dos casos incluídos, sendo anotadas as características clínicas dos pacientes e os desfechos das internações. Foram calculados o custo direto estimado e o desembolso do SUS. Todos eram portadores de diabetes tipo 2 e a maioria das ulcerações (64,2%) foram classificadas como Wagner 4 ou 5. Evoluíram com alta sem amputação 43 pacientes (39,4%) e 52 (47,7%) com alta após amputação. Evoluíram para óbito 14 pacientes (12,8%). O custo estimado variou de R$943,72 a R$ 16.378,85, com média de R$4.461,04. O valor do desembolso do SUS variou de R$ 96,95 a R$2.410,18, com média de R$ 633,97, cerca de sete vezes inferior. As menores defasagens entre os custos ocorreram nos pacientes assistidos no Hospital Beneficente e as maiores naqueles tratados com amputações menores.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo (UNIFESP)Centro Paulista de Economia da SaúdeUNIFESPSciEL

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

Desfechos e custos diretos relacionados a pacientes com diabetes e pes ulcerados assistidos na rede hospitalar do SUS em Sergipe

BV UNIFESP: Teses e dissertaçõe

“Faça o que eu digo, não o que eu faço?” Um Estudo sobre a Transmissão Valorativa entre Pais e Filhos

The aim of this study was to identify to what extent the values of father/mothers and children are correlated, considering the type of transmission (direct or indirect) and its predictive power. Participants were 204 pairs of parents and children. Among the children, mostly female (54.7%) and with a mean age of 11 years (SD = 1.01). The parents, the majority were mothers (69.6%), with a mean age of 38 years (SD = 7.82). They answered the Basic Values Survey corresponding to their age group and sociodemographic questions. Results showed that the values of the children are influenced more strongly by the values perceived in their parents than by the values that the parents prioritize or aim for their children, presenting significant indicators in the six values subfunctions. In conclusion this is through the process of socialization, the child apprehends the values transmitted by his parents from the observation of their behaviors, emphasizing that the behavior itself is the best way to educate the children. How to cite: Soares, A. K. S., Cavalcanti, T. M., Freire, S. E. A., Rezende, T.A., Ribeiro, M. G. C., & Gouveia, V. V. (2020). “Do What I Say, Not What I Do”? A Study of Value Transmission between Fathers/Mothers and Children. Revista Colombiana de Psicología, 29, 29-44. doi: https://doi.org/10.15446/rcp.v29n1.72405Este estudo objetiva identificar em que medida os valores dos pai/mães e filhos estão relacionados, considerando o tipo de transmissão (direta ou indireta) e seu poder preditivo. Participaram 204 pares de pais e filhos. Dentre as crianças, a maioria era do sexo feminino (54,7%) e com idade média de 11 anos (DP = 1,01). Os pais, a maioria eram mães (69,6%), com idade média de 38 anos (DP= 7,82). Estes responderam o Questionário dos Valores Básicos correspondente ao seu grupo etário e a questões sociodemográficas. Os resultados indicaram que os valores dos filhos são influenciados mais fortemente pelos valores percebidos em seus pais do que pelos valores que os pais priorizam ou almejam para seus filhos, apresentando indicadores significativos nas seis subfunções valorativas. Conclui-se que por meio do processo de socialização, a criança apreende os valores transmitidos por seus pais a partir da observação de seus comportamentos, enfatizando que o próprio comportamento é a melhor forma para educar os filhos.Como citar o artigo: Soares, A. K. S., Cavalcanti, T. M., Freire, S. E. A., Rezende, T.A., Ribeiro, M. G. C., & Gouveia, V. V. (2020). “Faça o que eu digo, não o que eu faço?” Um Estudo sobre a Transmissão Valorativa entre Pais e Filhos. Revista Colombiana de Psicología, 29, 29-44. doi: https://doi.org/10.15446/rcp.v29n1.72405Este estudio objetiva identificar en qué medida los valores de los padres / madres e hijos están relacionados, considerando el tipo de transmisión (directa o indirecta) y su poder predictivo. Participaron 204 pares de padres e hijos. Entre los niños, la mayoría era del sexo femenino (54,7%) y con edad media de 11 años (DP = 1,01). Los padres, la mayoría eran madres (69,6%), con una edad promedio de 38 años (DP = 7,82). Estos respondieron el Cuestionario de los Valores Básicos correspondiente a su grupo de edad ya cuestiones sociodemográficas. Los resultados indicaron que los valores de los hijos son influenciados más fuertemente por los valores percibidos en sus padres que por los valores que los padres priorizan o anhelan para sus hijos, presentando indicadores significativos en las seis subfunciones valorativas. Se concluye que por medio del proceso de socialización, el niño aprende los valores transmitidos por sus padres a partir de la observación de sus comportamientos, enfatizando que el comportamiento mismo es la mejor forma para educar a los hijos. Cómo citar: Soares, A. K. S., Cavalcanti, T. M., Freire, S. E. A., Rezende, T.A., Ribeiro, M. G. C., & Gouveia, V. V. (2020). ¿“Haz lo que digo, no lo que hago”? Un Estudio sobre la Transmisión Valorativa entre Padres/Madres e Hijos. Revista Colombiana de Psicología, 29, 29-44. doi: https://doi.org/10.15446/rcp.v29n1.7240

Prevalence of overweight and associated factors in a metropolitan area in the Northeast of Brazil

Objective: This article aimed to identify the clinical and socio-demographic profile of overweight adults evaluated through survey and anthropometric measurements in the city of Aracaju, Sergipe, Brazil. Methods: Descriptive transversal outline survey-type study in a quantitative analytical approach. The sample was composed of 690 individuals who randomly sought four reference centers in the municipality of Aracaju for abdominal ultrasonography. Anthropometric measurements were taken between July 2013 and July 2014. The following variables were analyzed: age, gender, income, schooling, comorbidities, waist girth and body mass index (BMI). The statistical program Statistical Package for the Social Sciences (SPSS) 22.0 was chosen, and significance level was p<0.05. Results: 494 women (71.6%) and 196 men (28.4%) were analyzed. The average age was 39.4 years, and 42.3 years for obese patients. Regarding BMI, 52.9% of patients presented normal BMI; 31.2% were overweight; 10.4% presented level 1 obesity; 4.5%, level 2; and 1.0%, level 3. The BMI was significantly higher among the hypertensive ones (p=0.001), with poor schooling (p=0.004), and those with higher income (p=0.003). Average waist circumference was 104.94 cm among the obese portion. Conclusion: The observed high prevalence of overweight in the studied adults is in accordance with the national epidemiologic tendency, which allows classifying the situation as a public health problem in the evaluated municipality