弹性和卫生系统的表现: ambulatory care-sensitive 慢性病的入院情况
Marla Presa Raulino Schilling1, Margareth Crisóstomo Portela1, Mariana Vercesi de Albuquerque1
1Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Fiocruz). R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil. marla_presa_raulino@hotmail.com.
这项研究开发了一种方法,通过对巴西慢性初级保健敏感疾病 (HPCSC) 的住院情况来比较市镇. 更好的初级卫生保健 (PHC) 覆盖率与更少的HPCSC住院病例有关,提高了卫生系统的弹性.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
背景情况:
- 巴西的统一卫生系统 (SUS) 面临着弹性方面的挑战.
- 初级卫生保健 (PHC) 对于协调医疗保健和加强系统至关重要.
- 需要标准化指标来评估和比较各市镇的医疗保健绩效.
研究的目的:
- 开发一种方法来比较巴西的市政当局基于住院治疗的慢性初级保健敏感条件 (HPCSC).
- 评估巴西不同地区的PHC覆盖率和HPCSC率之间的关系.
- 提供一个工具,用于持续监测PHC的表现,以提高SUS的弹性.
主要方法:
- 使用SUS医院生产数据进行横截面研究.
- 多层次建模应用于每个巴西地区.
- 风险调整用于估计市政分类中观察到和预测的HPCSC住院病人的比例.
主要成果:
- 开发了一种方法来根据HPCSC住院率 (高于预期,高于预期或低于预期) 将市镇分类.
- 在PHC覆盖范围和HPCSC之间的关联因地区而异.
- 拥有更高PHC (医生和护士) 可用性的市镇在HPCSC方面表现较差的比例较低.
结论:
- PHC对于建立SUS弹性至关重要.
- 拟议的方法允许持续监测PHC的性能.
- 这种监测可以指导及时采取行动和战略,特别是在卫生危机期间.
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