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The Brazilian Family Health Program and secondary stroke and myocardial infarction prevention: a 6-year cohort study

Norberto L Cabral1, Selma Franco, Alexandre Longo

  • 1Department of Medicine, University of Região de Joinville, Univille, Santa Catarina, Brazil. nlcabral@terra.com.br

American Journal of Public Health
|October 20, 2012
PubMed

Insights

Brazil's Family Health Program (FHP) significantly reduced deaths from secondary stroke and myocardial infarction compared to non-FHP care. This public health model demonstrates superior effectiveness in cardiovascular disease patient outcomes.

Area of Science:

  • Public Health
  • Cardiovascular Medicine
  • Health Services Research

Background:

  • Cardiovascular diseases, including stroke and myocardial infarction, represent a significant global health burden.
  • Effective healthcare models are crucial for managing chronic conditions and secondary prevention.
  • Brazil's Family Health Program (FHP) is a large-scale public healthcare initiative aiming to improve primary and secondary care access.

Purpose of the Study:

  • To compare the incidence of recurrent or fatal cardiovascular disease in patients managed by Brazil's Family Health Program (FHP) versus non-FHP care models.
  • To evaluate the effectiveness of the FHP in secondary prevention of stroke and myocardial infarction.

Main Methods:

  • A cohort study followed outpatients discharged after a first stroke from 2005 to 2010.
  • Data sources included public hospital records, death certificates, and outpatient monitoring.
  • Outcomes assessed were stroke recurrence, myocardial infarction, and all-cause mortality.

Main Results:

  • Patients in FHP care experienced a lower incidence of stroke or myocardial infarction (30.1%) compared to non-FHP care (36.2%).
  • Mortality rates were significantly lower in the FHP group (37.9%) versus non-FHP (54.3%).
  • FHP use was associated with a 42% lower hazard of death from all causes (HR=0.58), with an absolute risk reduction of 16.4%.

Conclusions:

  • Family Health Program (FHP) care is more effective than non-FHP care in preventing death following secondary stroke and myocardial infarction.
  • The FHP model demonstrates significant public health benefits in reducing cardiovascular mortality.
  • Findings support the expansion and strengthening of the FHP for improved patient outcomes.
Abstract

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