多发性硬化症治疗覆盖率:基于不平等指标的分析
Gabriela Bittencourt Gonzalez Mosegui1, Cid Manso de Mello Vianna2, Fernando Antoñanzas3
1Universidade Federal Fluminense. Instituto de Saúde Coletiva. Departamento de Saúde e Sociedade. Niterói, RJ, Brasil.
Revista de saude publica
|February 4, 2026
概括
巴西复发性复发性多发性硬化症的治疗覆盖率
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 复发性复发性硬化症 (RRMS) 治疗的准入对于患者的治疗结果至关重要.
- 巴西统一卫生系统 (SUS) 旨在提供公平的医疗保健服务.
- 在医疗保健领域的地域和社会经济差异是一个持续的挑战.
研究的目的:
- 评估2024年SUS内RRMS的第一线药理疗覆盖范围的领土不平等.
- 分析治疗覆盖率,消费和支出方面的区域差异.
- 使用不平等斜率指数 (SII) 和相对不平等指数 (RII) 来量化社会经济不平等.
主要方法:
- 使用行政SUS数据 (门诊程序授权) 的观察性研究.
- 用于确定每日剂量 (DDD) 的消费量和疾病修饰药物的人均支出计算.
- 使用国家人类发展指数 (HDI) 来计算SII和RII的社会经济分析.
主要成果:
- 只有35.3%的符合条件的RRMS患者在2024年接受治疗,区域差异很大 (例如,中西部50.9%,东北34.3%).
- 在覆盖率方面观察到严重的社会经济不平等 (SII=0.2082,RII=2.58).
- 消费不平等 (SII=61.65,RII=2.50) 表明在更高的HDI状态下治疗强度更高,而支出没有显示一致的梯度.
结论:
- 在RRMS治疗覆盖率和SUS内部的公平性方面存在重大限制.
- 与区域社会经济地位相关的结构性不平等影响治疗.
- 综合行政和不平等指标 (SII,RII) 可以为分配正义和卫生系统可持续性的政策提供信息.
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