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Brazil's health care system

Noemia Teixeira de Siqueira-Filha, Maria de Fatima Militao de Albuquerque, Laura Cunha Rodrigues, Rosa Legood, Andreia Costa Santos
OBJECTIVE: The objective of this study was to measure the costs of people living with HIV (PLHIV) as well as active tuberculosis (TB/HIV), latent tuberculosis infection (LTBI/HIV) or without TB (HIV/AIDS). METHODS: We analysed the costs through the entire pathway of care during the prediagnosis and treatment periods from the Brazilian public health system perspective. We applied a combination of bottom-up and top-down approaches to capture and estimate direct medical and non-medical costs...
March 15, 2018: Sexually Transmitted Infections
Débora Stephanie Ribeiro, Fernanda Mendes Lages Ribeiro, Suely Ferreira Deslandes
The aim of this article is to analyze how professionals in the mental health teams of the juvenile detention system in Rio de Janeiro, Brazil, perceive the relations with the external Network of Psychosocial Care in dealing with mental health issues in adolescents serving time in juvenile detention centers. Nine interviews were held with mental health professionals in the system, and the results were presented with Fairclough's critical discourse analysis as the reference. The results were organized in three parts: the relationship between the juvenile detention system's mental health teams and the external services, difficulties experienced by the teams from the detention centers and the external network's services, and prospects and proposals...
March 12, 2018: Cadernos de Saúde Pública
Katherine Rouleau, Monique Bourget, Patrick Chege, Francois Couturier, Paula Godoy-Ruiz, Paul H Grand'Maison, Melanie Henry, Kerling Israel, Videsh Kapoor, Hendra Kurniawan, Louella Lobo, Mahamane Maiga, Samantha Pereira Franca, Lynda Redwood-Campbell, Jamie Rodas, Raman Sohal, Dawit Wondimagegn, Robert Woolard
BACKGROUND AND OBJECTIVES: There is a limited evidentiary base on the development of family medicine in different contexts and countries. The lack of evidence impedes our ability to compare and characterize family medicine models and identify areas of success that have led to the effective provision of care. This paper offers a comparative compilation and analysis of the development of family medicine training programs in seven countries: Brazil, Canada, Ethiopia, Haiti, Indonesia, Kenya, and Mali...
March 8, 2018: Family Medicine
Aletheia Soares Sampaio, Ana Lucia Ribeiro de Vasconcelos, Clarice Neuenschwander Lins de Morais, George Tadeu Nunes Diniz, Anna Lígia de Castro Figueiredo, Sílvia Maria Lucena Montenegro
INTRODUCTION: The functioning of the immune system during pregnancy is altered in both human immunodeficiency virus (HIV)-infected and uninfected women. Unfavorable socioeconomic conditions have been indicative of higher morbidity and mortality and worsening of the immune system. The aim of this study was to correlate social status with levels of interleukin (IL)-10 (non-inflammatory) and interferon-gamma (IFN-γ; inflammatory) cytokines. METHODS: A cross-sectional study was conducted with three groups of women: 33 pregnant HIV-infected (G1); 40 non-pregnant, HIV-infected (G2); and 35 pregnant, HIV-uninfected...
January 2018: Revista da Sociedade Brasileira de Medicina Tropical
Maurílio de Souza Cazarim, Leonardo Régis Leira Pereira
INTRODUCTION: Only 20% of patients with systemic arterial hypertension (SAH) have blood pressure within recommended parameters. SAH has been the main risk factor for morbidity and mortality of cardiovascular diseases, which affects the burden of the Public Health System (PHS). Some studies have shown the effectiveness of Pharmaceutical Care (PC) in the care of hypertensive patients. OBJECTIVE: To perform a cost-effectiveness analysis to compare SAH treatment with PC management and conventional treatment for hypertensive patients offered by the PHS...
2018: PloS One
Milton L Wainberg, Karen McKinnon, Andrea Norcini-Pala, Olivia K Hughes, Ezra Schrage, Whitney Erby, Claudio G Mann, Francine Cournos
OBJECTIVE: Persons with mental illness have higher HIV infection rates than the general population. Little is known about whether care systems for this population are effectively participating in global efforts to end AIDS as a public health threat. This study examined treatment-as-usual HIV risk reduction services within public mental health settings. METHODS: The authors interviewed 641 sexually active adults attending eight public psychiatric clinics in Rio de Janeiro about participation in a sexual risk reduction program, HIV testing, HIV knowledge, and sexual behaviors...
March 1, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Dae Ho Lee, Hiroshi Isobe, Hubert Wirtz, Sabina Bandeira Aleixo, Phillip Parente, Filippo de Marinis, Min Huang, Ashwini Arunachalam, Smita Kothari, Xiting Cao, Nello Donnini, Ann-Marie Woodgate, Javier de Castro
BACKGROUND: Data are scarce regarding real-world health care resource use (HCRU) for non-small cell lung cancer (NSCLC). An understanding of current clinical practices and HCRU is needed to provide a benchmark for rapidly evolving NSCLC management recommendations and therapeutic options. The objective of this study was to describe real-world HCRU for patients with advanced NSCLC. METHODS: This multinational, retrospective chart review study was conducted at academic and community oncology sites in Italy, Spain, Germany, Australia, Japan, South Korea, Taiwan, and Brazil...
March 1, 2018: BMC Health Services Research
Elzo Pereira Pinto Junior, Rosana Aquino, Maria Guadalupe Medina, Marcelo Gurgel Carlos da Silva
This study aimed to assess the effect of the expansion of the Family Health Strategy (FHS) on hospitalizations for primary care sensitive conditions (PCSCs) in children under one year of age. This was a longitudinal ecological study with the use of panel data, for which the analytical units were the 417 municipalities (counties) in Bahia State, Brazil, from 2000 to 2012. Data were obtained from the official health information systems. The hospitalization rate for PCSCs was the outcome and FHS coverage was the principal exposure...
February 19, 2018: Cadernos de Saúde Pública
Beatriz Grinsztejn, Brenda Hoagland, Ronaldo I Moreira, Esper G Kallas, Jose V Madruga, Silvia Goulart, Iuri C Leite, Lucilene Freitas, Luana M S Martins, Thiago S Torres, Ricardo Vasconcelos, Raquel B De Boni, Peter L Anderson, Albert Liu, Paula M Luz, Valdiléa G Veloso
BACKGROUND: PrEP Brasil was a demonstration study to assess feasibility of daily oral tenofovir diphosphate disoproxil fumarate plus emtricitabine provided at no cost to men who have sex with men (MSM) and transgender women at high risk for HIV within the Brazilian public health system. We report week 48 pre-exposure prophylaxis (PrEP) retention, engagement, and adherence, trends in sexual behaviour, and incidence of HIV and sexually transmitted infections in this study cohort. METHODS: PrEP Brasil was a 48 week, open-label, demonstration study that assessed PrEP delivery at three referral centres for HIV prevention and care in Rio de Janeiro, Brazil (Fundação Oswaldo Cruz), and São Paulo, Brazil (Universidade de São Paulo and Centro de Referência e Treinamento em DST e AIDS)...
February 16, 2018: Lancet HIV
Helady Sanders-Pinheiro, Fernando Antonio Basile Colugnati, Elisa Oliveira Marsicano, Sabina De Geest, José Osmar Pestana Medina
BACKGROUND: Non-adherence to immunosuppressive therapy is a prevalent risk factor for poor clinical and after kidney transplantation (KT), and has contributed to the lack of improvement in long-term graft survival over the past decade. Understanding the multilevel correlates and risk factors of non-adherence is crucial to determine the optimal level for planning interventions, namely at the patient, health care provider, KT centre, and health care system level. Brazil, having the largest public transplantation program in the world and with regional differences regarding access to health services and service implementation, is in a unique position to study this multilevel approach...
February 20, 2018: BMC Nephrology
Marcos Pereira Estellita Lins, Sergio Orlando Antoun Netto, Maria Stella de Castro Lobo
The integration of quantitative indicators with qualitative descriptions of context is a noticeable demand from many different scientific disciplines, since it contributes to linking theoretical and practical approaches to problem solving. Amongst them are the problem structuring methods, systems thinking and multimethodology. This work presents a mixed quantitative and qualitative methodological approach to aid formulation and structuring of performance measurement of health care in 5565 Brazilian municipalities...
February 19, 2018: Health Care Management Science
Kelser de Souza Kock, Rosemeri Maurici
AIM: To evaluate the predictive capability of respiratory mechanics for the development of ventilator-associated pneumonia (VAP) and mortality in the intensive care unit (ICU) of a hospital in southern Brazil. METHODS: A cohort study was conducted between, involving a sample of 120 individuals. Static measurements of compliance and resistance of the respiratory system in pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) modes in the 1st and 5th days of hospitalization were performed to monitor respiratory mechanics...
February 4, 2018: World Journal of Critical Care Medicine
Eduardo J Gómez, Sven Jungmann, Agnaldo Soares Lima
BACKGROUND: To date, few studies have assessed how Brazil's universal healthcare system's (SUS, Sistema Único de Saúde) systemic, infrastructural, and geographical challenges affect individuals' abilities to access organ transplantation services and receive quality treatment. DISCUSSION: In this article we evaluated the existing literature to examine the impact that SUS has had on an increasingly important healthcare sector: organ transplantation services. We assess how equity challenges within the transplantation system can be explained by wider problems within SUS...
February 7, 2018: BMC Health Services Research
Guilherme Oliveira de Arruda, Débora Berger Schmidt, Sonia Silva Marcon
The aim of this study was to identify trends in hospitalization for diabetes mellitus and their correlation with the Family Health Strategy (FHS) coverage in the state of Paraná, by Health District (HD), between 2000 and 2012. It is an ecological study based on secondary data from the Hospital Information System of the Brazilian Unified Health System and the Primary Care Department. There was downward trend for general admission rates (from 10.2 to 9.0/10,000 inhabitants), but upward trend for some HDs. No correlation was observed between admission rates and the FHS coverage for the state...
February 2018: Ciência & Saúde Coletiva
Eugênio Vilaça Mendes
The interview explains the analysis of Eugenio Vilaça Mendes regarding the importance of chronic conditions in the morbidity and mortality profile and its impact on the Unified Health System (SUS) in Brazil. It points out which measures should be prioritized, in the interviewee's view, for the improvement of the SUS in order to qualify the care offered to the patients of these conditions, and finally brings a set of considerations formulated by him regarding the organizaton of access to Primary Care the health...
February 2018: Ciência & Saúde Coletiva
Waleska de Araújo Aureliano
This article analyzes common elements in the trajectory of people affected by rare hereditary diseases in Brazil, focusing on the search for diagnosis and treatment, and the reproducibility in the family. Rare diseases affect 65 people in every 100 thousand. These are usually chronic and degenerative conditions, many incurable or without effective treatment. About 80% of rare diseases are genetic in origin and can be inherited. This fact has important implications for family health care policies, reproduction, and care for clinical conditions that, in some cases, spanned generations...
February 2018: Ciência & Saúde Coletiva
Caroline Madalena Ribeiro, Gulnar Azevedo E Silva
OBJECTIVE: to assess the procedures production of screening, diagnostic investigation and precursor lesions treatment for cervical cancer in the Brazilian National Health System (SUS). METHODS: normative evaluation with calculation of estimates of need based on national screening guidelines in two scenarios: organized (1) and opportunistic (2) screening; data were obtained from the SUS Ambulatory Care Information System and the Cervical Cancer Information System...
February 1, 2018: Epidemiologia e Servicos de Saude: Revista do Sistema Unico de Saude do Brasil
Eliana Amorim de Souza, Reagan Nzundu Boigny, Anderson Fuentes Ferreira, Carlos Henrique Alencar, Maria Leide W Oliveira, Alberto Novaes Ramos
The aim of this study was to analyze operational indicators and time trends in leprosy control from a gender perspective in Bahia State, Brazil, from 2001 to 2014. This was a time series study based on epidemiological data on leprosy from the Brazilian National System of Diseases of Notification, using joinpoint Poisson and polynomial regression. Of the 40,054 new cases of leprosy, 47.1% of the recorded contacts were not examined, with a significant upward trend, especially in women (average annual percentage change - AAPC = 5...
February 5, 2018: Cadernos de Saúde Pública
Rafaela Soares Rech, Fernando Neves Hugo, Jessye Melgarejo do Amaral Giordani, Lúcia Gimenes Passero, Juliana Balbinot Hilgert
The Brazilian network of emergency care, in recent years, has shown significant progress. The objective was to evaluate contextual and individual factors associated with the satisfaction with public emergency health services. This was a cross-sectional multilevel study carried out between June 2011 and January 2012. Data were collected via telephone at the ombudsman's office of the Brazilian Unified National Health System (SUS). Telephone numbers were randomly selected from a telephone company database. Health services, socioeconomic, and individual demographic variables were evaluated, in addition to information about the municipalities...
February 5, 2018: Cadernos de Saúde Pública
Roberta Fernanda da Paz de Souza Paiva, Marcela Fernanda da Paz de Souza
The current study aimed to assess the association between socioeconomic conditions, basic sanitation, and coverage by family health teams and hospitalizations for waterborne diseases. The analysis of socioeconomic conditions and sanitation was based on an ecological study with data from the Brazilian National Household Sample Survey (PNAD) and the Brazilian Health Informatics Departament (DATASUS) database (observations for the States and Federal District) for the year 2013. Associations between family health teams and hospitalization were assessed by simple regressions, with data from DATASUS and the Department of Primary Care of Ministry of Health from 1998 to 2014...
February 5, 2018: Cadernos de Saúde Pública
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