24 research outputs found
Structure and work process in primary care and hospitalizations for sensitive conditions
<div><p>ABSTRACT OBJECTIVE The objective of this study is to investigate whether the characteristics of the structure of primary health units and the work process of primary care teams are associated with the number of hospitalizations for primary care sensitive conditions. METHODS In this ecological study, we have analyzed data of Brazilian municipalities related to sociodemographic characteristics, coverage of care programs, structure of primary health units, and work process of primary care teams. We have obtained the data from the first cycle of the Brazilian Program for Improving Access and Quality of the Primary Care, of the Department of Information Technology of the Brazilian Unified Health System, the Brazilian Institute of Geography and Statistics, and the United Nations Development Programme. The associations have been estimated using negative binomial regression coefficients (β) and respective 95% confidence intervals, with a hierarchical approach in three levels (alpha = 5%). RESULTS In the adjusted analysis for the outcome in 2013, in the distal level, the coverage of the Bolsa FamĂlia Program (β = -0.001) and private insurance (β = -0.01) had a negative association, and the human development index (β = 1.13), the proportion of older adults (β = 0.05) and children under the age of five (β = 0.05), and the coverage of the Community Health Agent Strategy (β = 0.002) showed positive association with hospitalizations for primary care sensitive conditions. In the intermediate level, minimum hours (β = -0.14) and availability of vaccines (β = -0.16) showed a negative association, and availability of medications showed a positive association (β = 0.16). In the proximal level, only the variable of matrix support (β = 0.10) showed a positive association. The variables in the adjusted analysis of the number of hospitalizations for primary care sensitive conditions in 2014 presented the same association as in 2013. CONCLUSIONS The characteristics of the structure of primary health units and the work process of the primary care teams impact the number of hospitalizations for primary care sensitive conditions in Brazilian municipalities.</p></div
Fig 2 -
SBE (A) and moderate and severe events (B) by 100,000 inhabitants. Source for base layer: Instituto Brasileiro de Geografia e EstatĂstica [17].</p
Fig 6 -
A) Percentage of cases that antivenom was used. B) Percentage of cases that took more than 3 hours to reach a health facility to care. C) Availability of ICU beds in health facilities supplied with antivenom per 100,000 population. Source for base layer: Instituto Brasileiro de Geografia e EstatĂstica [17].</p
Descriptive characteristics of snakebite envenomation by region in Brazil from 2014–2019.
Descriptive characteristics of snakebite envenomation by region in Brazil from 2014–2019.</p
Data source and selected variables for the analysis.
Data source and selected variables for the analysis.</p
Location and distribution of antivenom health facilities.
Source for base layer: Instituto Brasileiro de Geografia e EstatĂstica [17].</p
Fig 3 -
A) Local Indicator of Spatial Autocorrelation (LISA) showing clusters regarding moderate and severe rates of snakebite envenoming. B) Getis Ord G scores presenting the location of hotspots based on rates of moderate and severe cases. Source for base layer: Instituto Brasileiro de Geografia e EstatĂstica [17].</p
Brazil regions and classification of gross domestic product by municipality.
Source for base layer: Instituto Brasileiro de Geografia e EstatĂstica [17].</p
Performance comparison between Generalized Linear Models using Poisson regression and Geographically Weighted Poisson Regression.
Performance comparison between Generalized Linear Models using Poisson regression and Geographically Weighted Poisson Regression.</p
Association of various sociodemographic and access to care indicators with moderate or severe outcomes after SBE.
Left) Magnitude of association in exponential values. Right) Statistical significance of association according to T-values. Source for base layer: Instituto Brasileiro de Geografia e EstatĂstica [17].</p