Newborn pulse oximetry screening coverage in a nationwide complex survey sample: An assessment of a congenital heart disease early detection program at the regional level in Brazil

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine Pub Date : 2024-09-18 DOI:10.1016/j.ypmed.2024.108141

Arn Migowski , Gustavo Tavares Lameiro da Costa , Helena Cramer Veiga Rey

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引用次数: 0

Abstract

Objectives

To estimate the coverage of newborn pulse oximetry screening (POS) in Brazil, as well as identifies associated factors and the proportion of positive screening results.

Methods

Coverage was estimated based on the most recent National Health Survey (2019). Adjusted marginal prevalence ratios were estimated via poisson regression model with robust variance.

Results

The POS coverage was 66.3 % (95 %CI: 65.5–67.1; N = 3,140,023) and was higher in children born in privately funded hospitals (PFHs) than in the Unified Health System (SUS): 78.1 % (76.7–79.5) versus 61.1 % (60.2–62.1). In the North region, the POS coverage in PFHs (64.9 %, 59.7–70.1) was lower than that in the South (82.5 %, 79.4–85.6) and the Southeast (81.5 %, 79.3–83.6); it was even lower in SUS in the North (44.0 %; 42.4–45.6). After a federal ordinance providing financial resources to postscreening diagnostic, the screening coverage in SUS increased from 57.6 % (56.2–59.1) to 64.6 % (63.3–65.9). The proportion of positive screening tests was 9.2 % (8.9–9.5) in SUS and 7.8 % (7.3–8.3) in PFHs, of which 40.8 % (40.5–41.1) underwent complementary exams in SUS and 57.2 % (56.7–57.7) in PFHs. In the multivariate model, the main independent predictors of POS were the coverage of other newborn screening tests.

Conclusions

Inequalities were found between major regions and healthcare systems. Government financial incentives have reduced this inequality, although the percentage of postscreening complementary exams remains insufficient and unequal. The main independent predictors of screening prevalence were those related to the organization of health services.

查看原文本刊更多论文

全国性复杂调查样本中的新生儿脉搏血氧仪筛查覆盖率：对巴西地区一级先天性心脏病早期检测计划的评估。

目的估算巴西新生儿脉搏氧饱和度筛查（POS）的覆盖率，并确定相关因素和筛查结果呈阳性的比例：方法：根据最新的国家健康调查（2019 年）估算覆盖率。通过带有稳健方差的泊松回归模型估算调整后的边际患病率：POS覆盖率为66.3%（95%CI：65.5-67.1；N=3,140,023），在私人资助医院（PFHs）出生的儿童中，POS覆盖率高于统一卫生系统（SUS）：78.1%（76.7-79.5%）对 61.1%（60.2-62.1%）。在北部地区，PFHs 的 POS 覆盖率（64.9%，59.7-70.1%）低于南部地区（82.5%，79.4-85.6%）和东南部地区（81.5%，79.3-83.6%）；在北部地区的统一卫生系统中，POS 覆盖率甚至更低（44.0%；42.4-45.6%）。在一项为筛查后诊断提供财政资源的联邦法令颁布后，统一卫生系统的筛查覆盖率从 57.6%（56.2-59.1%）上升到 64.6%（63.3-65.9%）。筛查结果呈阳性的比例在统一卫生系统为 9.2%（8.9-9.5），在私人家庭医疗机构为 7.8%（7.3-8.3），其中在统一卫生系统接受辅助检查的比例为 40.8%（40.5-41.1），在私人家庭医疗机构为 57.2%（56.7-57.7）。在多变量模型中，POS 的主要独立预测因素是其他新生儿筛查项目的覆盖率：结论：主要地区和医疗系统之间存在不平等。政府的财政激励措施减少了这种不平等，但筛查后补充检查的比例仍然不足且不平等。筛查普及率的主要独立预测因素与医疗服务组织有关。

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来源期刊

Preventive medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.70

自引率

3.90%

发文量

审稿时长

42 days

期刊介绍： Founded in 1972 by Ernst Wynder, Preventive Medicine is an international scholarly journal that provides prompt publication of original articles on the science and practice of disease prevention, health promotion, and public health policymaking. Preventive Medicine aims to reward innovation. It will favor insightful observational studies, thoughtful explorations of health data, unsuspected new angles for existing hypotheses, robust randomized controlled trials, and impartial systematic reviews. Preventive Medicine''s ultimate goal is to publish research that will have an impact on the work of practitioners of disease prevention and health promotion, as well as of related disciplines.