Yasmim Dos Anjos Ribeiro, Ana Carolina Silva Gonçalves, Danilo Lemes Naves Gonçalves, Luciana Saraiva da Silva
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引用次数: 0
Abstract
Background: Chronic kidney disease (CKD) is frequently diagnosed at advanced stages, resulting in high morbidity, mortality, and substantial economic burdens due to increased healthcare utilization and system costs. The relationship between CKD diagnosis and healthcare utilization remains unexplored in Brazilian population-based studies. Therefore, this study aimed to analyze the associations between health service utilization indicators and the presence of CKD in the Brazilian population.
Methods: This was a cross-sectional study with a sample of 90,846 participants from the 2019 National Health Survey. Sociodemographic, clinical, and behavioral variables were collected. CKD was defined by self-reported prior diagnosis. The indicators of use of health services were a search for a health service or professional in the last two weeks, impairment of usual activities due to illness in the last two weeks, and hospitalizations for 24 h or more in the last 12 months. Other variables related to the use of health services, such as having health insurance, the time since the last consultation, and the type of health service most used, were also assessed. Logistic regression analysis was carried out to assess the associations between indicators of health service use and CKD.
Results: CKD increased the chance of hospitalization in the last 12 months by 3.16 times (OR 3.16; 95% CI 2.76-3.62) and the chance of impairment in usual activities due to illness by 3 times (OR 2.99; 95% CI 2.63-3.40). In addition, the presence of CKD increased the chance of the individual seeking health services 2.5 times in the last two weeks (OR 2.50; 95% CI 2.23-2.81), with primary health care (42.5%), private clinics or private outpatient clinics (21.2%) and emergency care units (17.2%) being the most sought-after services.
Conclusion: CKD tripled the chance of hospitalization in the last 12 months and impaired usual activities due to illness, doubling the population's search for health services in the last two weeks. Primary health care has proven to be the leading health service for individuals with CKD.
背景：慢性肾脏疾病（CKD）经常在晚期被诊断出来，导致高发病率和死亡率，并且由于医疗保健利用和系统成本的增加而造成巨大的经济负担。在巴西基于人群的研究中，CKD诊断和医疗保健利用之间的关系仍未被探索。因此，本研究旨在分析巴西人群中卫生服务利用指标与CKD存在之间的关系。方法：这是一项横断面研究，样本来自2019年全国健康调查的90846名参与者。收集了社会人口学、临床和行为变量。CKD由自我报告的先前诊断来定义。使用保健服务的指标是：在过去两周内寻找保健服务或专业人员，在过去两周内因病损害日常活动，以及在过去12个月内住院24小时或更长时间。还评估了与使用保健服务有关的其他变量，例如是否有健康保险、上次咨询的时间以及最常使用的保健服务类型。采用Logistic回归分析评估卫生服务使用指标与慢性肾病之间的相关性。结果：CKD使近12个月内住院的机会增加了3.16倍(OR 3.16；95% CI 2.76-3.62)，因疾病导致日常活动受损的几率增加了3倍(OR 2.99；95% ci 2.63-3.40)。此外，CKD的存在使个体在过去两周内寻求医疗服务的机会增加了2.5倍(OR 2.50；95%可信区间2.23-2.81)，其中初级卫生保健（42.5%）、私人诊所或私人门诊诊所（21.2%）和急诊护理单位（17.2%）是最受欢迎的服务。结论：CKD在过去12个月内使住院的机会增加了两倍，并因疾病而损害了日常活动，使人口在过去两周内寻求卫生服务的人数增加了一倍。初级卫生保健已被证明是CKD患者的主要卫生服务。
期刊介绍：
rchives of Public Health is a broad scope public health journal, dedicated to publishing all sound science in the field of public health. The journal aims to better the understanding of the health of populations. The journal contributes to public health knowledge, enhances the interaction between research, policy and practice and stimulates public health monitoring and indicator development. The journal considers submissions on health outcomes and their determinants, with clear statements about the public health and policy implications. Archives of Public Health welcomes methodological papers (e.g., on study design and bias), papers on health services research, health economics, community interventions, and epidemiological studies dealing with international comparisons, the determinants of inequality in health, and the environmental, behavioural, social, demographic and occupational correlates of health and diseases.
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