Epidemiologia e Servicos de Saude最新文献

{"title":"Temporal trend of mortality due to Parkinson's disease in older people in Brazil, 2002-2021.","authors":"Thamara Hubler Figueiró, Viviane Nogueira de Zorzi, Eleonora d'Orsi, Cassiano Ricardo Rech, Danúbia Hillesheim","doi":"10.1590/S2237-96222024v33e2024532.en","DOIUrl":"10.1590/S2237-96222024v33e2024532.en","url":null,"abstract":"<p><strong>Objective: </strong>To describe the epidemiological profile and analyze the temporal trend of deaths due to Parkinson's disease among the elderly in Brazil from 2002 to 2021.</p><p><strong>Methods: </strong>Descriptive and temporal trend study using data from the Mortality Information System. Annual percent change (APC) and 95% confidence intervals (95% CI) were estimated using the Prais-Winsten regression model.</p><p><strong>Results: </strong>Among the 57,723 deaths, there was a higher frequency in males (54.7%), individuals aged ≥ 80 years (57.7%), and White individuals (75.0%). Mortality trends increased in both males (APC = 3.32; 95%CI 2.49; 4.16) and females (APC = 2.81; 95%CI 1.80; 3.82); across all age groups, particularly ages 70-79 (APC = 4.93; 95%CI 2.98; 6.91); and in all Brazilian regions, especially the Northeast (APC = 6.79; 95%CI 4.35; 9.30).</p><p><strong>Conclusion: </strong>Deaths due to Parkinson's disease were more frequent among males and the oldest age groups, with an increasing mortality trend observed over the period.</p><p><strong>Main results: </strong>An increasing trend in mortality due to Parkinson's disease was found among elderly people of both sexes, of all age groups and in all Brazilian regions in the period.</p><p><strong>Implications for services: </strong>The increase in mortality due to Parkinson's disease implies greater demand for health care services and, consequently, contributes to the financial burden related to diagnosis and treatment of people with the disease.</p><p><strong>Perspectives: </strong>Investing in research and technologies for timely diagnosis, treatment and health recovery are crucial. Furthermore, the need exists to promote health policies that guarantee equitable access to specialized services.</p>","PeriodicalId":51473,"journal":{"name":"Epidemiologia e Servicos de Saude","volume":"33 ","pages":"e2024532"},"PeriodicalIF":2.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatio-temporal evolution of stroke mortality in Minas Gerais, Brazil, 1980-2021.","authors":"Daniel Hideki Bando, Francisco Chiaravalloti Neto, Alfredo Pereira de Queiroz","doi":"10.1590/S2237-96222024v33e20240017.en","DOIUrl":"10.1590/S2237-96222024v33e20240017.en","url":null,"abstract":"<p><strong>Objective: </strong>To analyze spatio-temporal evolution of stroke mortality in Minas Gerais state, Brazil, 1980-2021.</p><p><strong>Methods: </strong>Ecological study with aggregated data by micro-region. Segmented linear regression was used for trend analysis; maps with rates per five-year period and scan statistics were used for spatial analysis.</p><p><strong>Results: </strong>There were 392,521 stroke-related deaths (rate of 52.6/100,000-year). All rates (crude, adjusted, by age group) showed a decreasing trend, less so in the crude rate (Annual Percent Change [APC] = -0.70) and a faster decrease in the 20-39 age group (APC = -4.48). A high-rate cluster was identified in the southern region (1980-1999; Relative Risk [RR] = 2.06), and a low-rate cluster in the northwest (2008-2021; RR = 0.59). The most significant decrease occurred in the south (APC = -3.64).</p><p><strong>Conclusion: </strong>Stroke mortality showed a decreasing trend. Clusters and areas with higher rates identified in the northeast in recent years require attention by service managers.</p><p><strong>Main results: </strong>Decreasing trend in stroke mortality, a cluster was found in the south with high rates (1980-1999; relative risk [RR] = 2.06) and another in the northwest with low rates (2008-2021; RR = 0.59).</p><p><strong>Implications for services: </strong>For health service managers, greater attention is suggested in the micro-regions and respective municipalities in the northeast that have presented a higher risk of mortality from stroke in recent years, with the aim of improving the regulation of health care service and network regulation, as well as optimizing access to these services.</p><p><strong>Perspectives: </strong>It is necessary to monitor the spatio-temporal evolution of stroke mortality and conduct new studies on different scales (for example, on the municipal scale) and methodologies (for example, multilevel analysis), to estimate risk factors and the social context of vulnerable populations.</p>","PeriodicalId":51473,"journal":{"name":"Epidemiologia e Servicos de Saude","volume":"33 ","pages":"e20240017"},"PeriodicalIF":2.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and factors associated with body image dissatisfaction among school student: National School Health Survey, 2019.","authors":"Ingride Sousa Linhares, Osmar de Oliveira Cardoso, Jesusmar Ximenes Andrade, Fernando Ferraz do Nascimento, Malvina Thais Pacheco Rodrigues, Márcio Dênis Medeiros Mascarenhas","doi":"10.1590/S2237-96222024v33e20231441.en","DOIUrl":"10.1590/S2237-96222024v33e20231441.en","url":null,"abstract":"<p><strong>Objective: </strong>To estimate prevalence and analyze factors associated with body image dissatisfaction among Brazilian adolescent school students.</p><p><strong>Methods: </strong>Cross-sectional study with data from the 2019 National School Health Survey (PeNSE). Prevalence of self-reported body image dissatisfaction and respective 95% confidence intervals (95%CI) and its association with individual characteristics were estimated via odds ratios (OR) and 95% CI using logistic regression.</p><p><strong>Results: </strong>Of the 159,245 students, 30.2% (95%CI 29.2;31.1) reported body image dissatisfaction, which was associated with all factors analyzed. Likelihood of dissatisfaction was greater among females (OR = 3.86; 95%CI 3.45;4.32), having internet at home (OR = 8.68; 95%CI 6.83;11.03), thinking that no one cares about them (OR = 3.02; 95%CI 2.60;3.50), that life is not worth it (OR = 3.27; 95%CI 2.88;3.72) and feeling irritated (OR = 2.87; 95%CI 2.53;3.26).</p><p><strong>Conclusion: </strong>Body image dissatisfaction is associated with various factors and requires an intersectoral approach.</p><p><strong>Main results: </strong>Prevalence of body image dissatisfaction was 30.2%. The greatest likelihood of dissatisfaction was more related to being female, having internet at home, frequently feeling that no one cares about them, that life is not worth it, and feeling irritated.</p><p><strong>Implications for services: </strong>We suggest that projects be carried out in schools encouraging physical activity, less screen time and good eating habits, in addition to providing psychological support to students, in order to guide care for their mental health.</p><p><strong>Perspectives: </strong>Projects are needed to encourage and instruct good physical and psychological health practices at school, involving the entire school community, training of education professionals and encouragement of adolescent mental health self-care.</p>","PeriodicalId":51473,"journal":{"name":"Epidemiologia e Servicos de Saude","volume":"33 ","pages":"e20231441"},"PeriodicalIF":2.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health technology assessment in the Brazilian National Health System: profile of CONITEC exclusion recommendations, 2012-2023.","authors":"Francielli Salles Pinheiro, Stéfani Sousa Borges, Fernanda d'Athayde Rodrigues","doi":"10.1590/S2237-96222024v33e20240057.en","DOIUrl":"10.1590/S2237-96222024v33e20240057.en","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the recommendations for exclusion of health technologies in the Brazilian National Health System (SUS), made by the National Commission for the Incorporation of Technologies in the Brazilian National Health System (CONITEC) from 2012 to 2023, and to identify the disinvestment criteria used.</p><p><strong>Methods: </strong>Documentary, descriptive and retrospective analysis of CONITEC reports that assessed technology exclusion requests.</p><p><strong>Results: </strong>We identified 24 reports on 74 technologies, whereby the requests predominantly involved medications (95.9%). CONITEC favorably recommended 95% of the exclusions, prioritizing the absence of registration with the National Health Surveillance Agency and the existence of therapeutic alternatives.</p><p><strong>Conclusion: </strong>Low demand for exclusions compared to incorporations reveals challenges in identifying obsolescence and resistance to exclusion of technologies. The sustainability of the SUS requires greater monitoring of incorporated technologies, to optimize resources and promote the efficiency of the health system.</p><p><strong>Main results: </strong>The study identified that demands for exclusion of technologies in the Brazilian National Health System (Sistema Único de Saúde - SUS) are significantly lower than demands for incorporation, highlighting the need to pay greater attention to the disinvestment process, in order to guarantee the sustainability of the health system.</p><p><strong>Implications for services: </strong>The findings of this study point to the importance of structuring disinvestment assessment methods, with the aim of improving monitoring of health technology obsolescence and promoting more efficient allocation of resources in the SUS.</p><p><strong>Perspectives: </strong>We suggest that criteria be established for the periodic re-assessment of incorporated technologies, in order to guarantee regular reviews and the fluidity of CONITEC's work in assessing health technologies.</p>","PeriodicalId":51473,"journal":{"name":"Epidemiologia e Servicos de Saude","volume":"33 ","pages":"e20240057"},"PeriodicalIF":2.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of psychiatric medications and associated factors among people receiving care at a transgender outpatient clinic in Southern Brazil, 2021-2022.","authors":"Bruna Dos Passos Gimenes, Adalvane Nobres Damaceno, Andrei Fernandes da Rocha, Guilherme Lamperti Thomazi, Gabriela Tizianel Aguilar","doi":"10.1590/S2237-96222024v33e2024170.especial.en","DOIUrl":"10.1590/S2237-96222024v33e2024170.especial.en","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prevalence of psychiatric medication use and sociodemographic factors, including gender identity, age, race/skin color, education level, formal employment, and access to Primary Health Care (PHC) centers, among individuals receiving care at a transgender outpatient clinic in Southern Brazil.</p><p><strong>Methods: </strong>: This was a cross-sectional study using administrative data from the information systems of the Municipal Health Department of Porto Alegre, the capital city of Rio Grande do Sul state, collected between 2021 and 2022.</p><p><strong>Results: </strong>: This study analyzed 629 records of individuals who accessed the outpatient clinic and found a 29% prevalence (95%CI 25;32) of psychiatric medication use, with the most frequent class being psychoanaleptics (45%), especially fluoxetine (31%).</p><p><strong>Conclusion: </strong>In addition to a trend toward mixed-race race/skin color and incomplete elementary school, transgender people aged 40 to 49 years and with access to a Primary Health Care center were more likely to use psychiatric medications.</p><p><strong>Main results: </strong>Prevalence of 29% (95%CI 25;32) of psychiatric medication use was observed, with a higher likelihood among individuals aged 40 to 49 years, with access to primary healthcare centers. Low education level and mixed-race/skin color showed significant effect sizes. The most frequently dispensed drug class was psychoanaleptics (45%), with fluoxetine (31%) standing out.</p><p><strong>Implications for services: </strong>This study can be replicated in other transgender outpatient clinics across Brazil and should contribute to broadening the discussion on mental healthcare for the transgender population.</p><p><strong>Perspectives: </strong>The findings highlight the importance of interdisciplinary approaches to healthcare and underscore the need to assess the effectiveness of public mental health policies for the transgender population.</p>","PeriodicalId":51473,"journal":{"name":"Epidemiologia e Servicos de Saude","volume":"33 spe1","pages":"e2024170"},"PeriodicalIF":2.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with HIV viremia in transgender women and transvestites in five Brazilian capitals, 2019-2021: a multicenter study.","authors":"Claudia Renata Dos Santos Barros, Elaine Monteiro Matsuda, Aline Borges Moreira da Rocha, Giselle Ibete Silva López-Lopes, Norberto Camilo Campos, Luís Fernando de Macedo Brígido, Katia Cristina Bassichetto, Maria Amelia de Sousa Mascena Veras","doi":"10.1590/S2237-96222024v33e2024412.especial.en","DOIUrl":"10.1590/S2237-96222024v33e2024412.especial.en","url":null,"abstract":"<p><strong>Objective: </strong>To analyze factors associated with detectable HIV viremia among transgender women/transvestites (TWT) in five Brazilian capitals.</p><p><strong>Methods: </strong>: This was a cross-sectional study using data from a sample of TWT with HIV-positive serology and detectable viral load (VL), between 2019 and 2021. The dependent and independent variables were, respectively: viral load measurement, socioeconomic/demographic characteristics; alcohol/drug use; and self-perceived mental health. Poisson regression with robust variance was used.</p><p><strong>Results: </strong>: A total of 425 TWT tested positive for HIV and underwent VL measurement, 179 (42.0%) presented detectable viremia. Factors positively associated with detectability were: younger age (PR=2.26; 95%CI 1.13;4.51), poorer housing conditions (PR=2.72; 95%CI 1.30;5.68) and poor/very poor mental health (PR=1.70; 95%CI 1.08;2.66). The use of antiretroviral drugs was a protective factor against detectability (PR=0.29; 95%CI 0.30;0.61).</p><p><strong>Conclusion: </strong>The factors associated with unsuppressed viral load highlight vulnerability related to gender identity that have a negative impact, despite the majority of participants being on antiretroviral therapy (ART).</p><p><strong>Main results: </strong>People aged 20-29 who were homeless or unstable and those who reported poor or very poor mental health were more likely to have a detectable viral load. ARV drug use was a protective factor.</p><p><strong>Implications for services: </strong>The identification of predictors for detectable viral load enables the design of appropriate strategies for monitoring and linking vulnerable people to health services, ensuring effective implementation.</p><p><strong>Perspectives: </strong>It is necessary to develop educational strategies that take into account important social issues to improve awareness about undetectable viral load in HIV prevention among the transgender population, especially among younger people.</p>","PeriodicalId":51473,"journal":{"name":"Epidemiologia e Servicos de Saude","volume":"33 spe1","pages":"e2024412"},"PeriodicalIF":2.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with the completion of syphilis treatment among transgender women and travestis, in five Brazilian capitals, 2019-2021: a multicenter cross-sectional study.","authors":"Luis Fernando Gomes Carreira, Maria A S Veras, Adele Schwartz Benzaken, Rita Suely Bacuri de Queiroz, Edilene Peres Real Silveira, Elaine Lopes de Oliveira, Katia Cristina Bassichetto, Aline Borges Moreira da Rocha, Bow Suprasert, Erin C Wilson, Willi McFarland","doi":"10.1590/S2237-96222024v33e2024294.especial.en","DOIUrl":"10.1590/S2237-96222024v33e2024294.especial.en","url":null,"abstract":"<p><strong>Objective: </strong>To assess the previous history of syphilis in transgender women and travestis (TWTs) and identify factors associated with treatment incompleteness.</p><p><strong>Methods: </strong>: This was a multicenter cross-sectional study conducted between 2019 and 2021, with participants recruited through respondent-driven sampling, in five Brazilian capitals. Dependent variable: \"reported syphilis treatment in the last year\", \"no/incomplete\" or \"complete\". A multivariate-logistic model was used to identify factors associated with completeness.</p><p><strong>Results: </strong>: Of the 1,317 participants, 16.0% reported previous history of syphilis. Of these, 68.9% were Black, 54.6% earned up to 1 minimum wage and 61.1% completed the treatment. Treatment completion was lower in São Paulo (42.7%) and among those who experienced verbal abuse (53.6%; ORa 0.46; 95%CI 0.25;0.85).</p><p><strong>Conclusion: </strong>In this sample, both the prevalence of self-reported syphilis and the proportion of participants who reported not having started/completed treatment were high. It is essential to identify the barriers faced by TWTs that hinder healthcare access, and identify their needs in order to ensure adequate diagnosis and treatment.</p><p><strong>Main results: </strong>Of the 16% of participants who reported a previous diagnosis of syphilis, only one-third completed the treatment. Residents of São Paulo were less likely to complete it compared to those from other cities, and those who had experienced verbal abuse.</p><p><strong>Implications for services: </strong>There is a need for healthcare professionals to receive training focused on specific needs of TWTs , including respect for their social names, extended opening hours, point-of-care strategy and alternatives for the administration of intramuscular benzathine penicillin injections.</p><p><strong>Perspectives: </strong>It is crucial to develop new, more effective therapeutic methods for syphilis treatment and deepen research on the impacts of discrimination and stigma on transgender women and travestis' access to healthcare, especially diagnosis and treatment of sexually transmitted infections.</p>","PeriodicalId":51473,"journal":{"name":"Epidemiologia e Servicos de Saude","volume":"33 spe1","pages":"e2024294"},"PeriodicalIF":2.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trend and characteristics of notifications of self-inflicted and interpersonal violence in the transgender population in Brazilian municipalities, 2015-2022.","authors":"Kelly Roberta Estrela Marinho Neto, Jeane Tomazelli, Vania Reis Girianelli","doi":"10.1590/S2237-96222024v33e2024296.especial.en","DOIUrl":"10.1590/S2237-96222024v33e2024296.especial.en","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the temporal trend and characteristics of notifications of violence among the transgender population from 2015 to 2022 in Brazilian municipalities.</p><p><strong>Methods: </strong>This was a repeated panel epidemiological study, based on violence incidents reported among the transgender population aged 20 to 59 years, available in the Notifiable Health Conditions Information System. An annual temporal trend analysis was performed by means of generalized linear regression, using the Prais-Winsten method and spatial distribution of notifying municipalities in Brazil.</p><p><strong>Results: </strong>Notifications of violence in the transgender population decreased during the period (1.7%; β = -0.07; p = 0.010), but there was an increase in the number of notifying municipalities (45.8%), self-inflicted violence (28.9%; β = 2.21; p < 0.001) and sexual violence (β = 0.79; p < 0.001). The majority of perpetrators were male and in an affective relationship, especially with transgender women (43.4%; p < 0.001).</p><p><strong>Conclusion: </strong>Notification of violence does not yet fully reflect the reality of this population, but it represents the first step towards visibility and addressing the issue.</p><p><strong>Main results: </strong>Notifications of violence against transgender people accounted for 1.7% of the total. Self-inflicted and sexual violence increased from 2015 to 2022. Almost half of Brazilian municipalities have already been reporting cases of violence against this population.</p><p><strong>Implications for services: </strong>Continuous and high-quality notification will contribute to monitoring and understand violence in this population group, enabling the adaptation of services to meet their specific needs.</p><p><strong>Perspectives: </strong>The development of research on the transgender population will allow for a better understand and guidance of specific health actions for this group. Information on violence against this population is crucial for informing public policies.</p>","PeriodicalId":51473,"journal":{"name":"Epidemiologia e Servicos de Saude","volume":"33 spe1","pages":"e2024296"},"PeriodicalIF":2.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the impact of the COVID-19 pandemic on the productivity of teaching hospitals in Brazil.","authors":"Maria Stella de Castro Lobo, Marcos Pereira Estellita Lins, Henrique de Castro Rodrigues, Gabriel Martins Soares","doi":"10.1590/S2237-96222024v33e20231176.en","DOIUrl":"10.1590/S2237-96222024v33e20231176.en","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the influence of the COVID-19 pandemic on the productivity of general teaching hospitals in Brazil, by region and legal entity, and to propose parameters of care.</p><p><strong>Methods: </strong>This was an observational study by means of mathematical modeling with data envelopment analysis and Malmquist index, using data on inputs and healthcare output before (2019) and during (2021) the pandemic.</p><p><strong>Results: </strong>A total of 149 general teaching hospitals were analyzed, 32 of which were considered efficient. There was a decrease in productivity across all regions and legal entity. To bring all inefficient hospitals to the efficiency frontier generated by the model, there is a need to increase output by 2,205,856 (96.5%) hospitalizations and 872,264 (107.4%) surgeries.</p><p><strong>Conclusion: </strong>The decline in hospital productivity resulted from the social commitment of hospitals during the pandemic, with a change in the care delivery pattern. The mathematical model used allows for the generation of parameters to facilitate the efficient recovery of care services after the end of public health emergency, and can be applied to hospital planning.</p><p><strong>Main results: </strong>The COVID-19 pandemic led to a reduction in productivity of general teaching hospitals in Brazil across all regions and in all legal entity types. In order to recover, these hospitals will need to increase their average hospitalizations by 96.5% and surgeries by 107.4%.</p><p><strong>Implications for services: </strong>The study presents a methodology that can be adapted and replicated in the management of healthcare services in the country, by defining an efficiency score and calculating the parameters, in a scenario of care recovery following the end of the public health emergency.</p><p><strong>Perspectives: </strong>Additional qualitative analysis and application of DEA- Malmquist in subsequent years will validate dynamic planning, which considers multiple fluctuations and the influence of new factors and contexts that impact productivity (such as the pandemic).</p>","PeriodicalId":51473,"journal":{"name":"Epidemiologia e Servicos de Saude","volume":"33 ","pages":"e20231176"},"PeriodicalIF":2.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use and filling out of the child health booklet among beneficiaries of the Bolsa Família Program in Salvador-Bahia, Brazil: a cross-sectional study, 2023.","authors":"Claudia Nery Teixeira Palombo, Márcia Maria Carneiro Oliveira, Maria Carolina Ortiz Whitaker, Ráren Paulo da Silva Araújo, Carolina de Jesus Santos, Mariana Cavalcante Brotas Passos, Clariana Vitória Ramos de Oliveira, Ednir Assis Souza","doi":"10.1590/S2237-96222024V33E2024498.EN","DOIUrl":"10.1590/S2237-96222024V33E2024498.EN","url":null,"abstract":"<p><strong>Objective: </strong>To compare child health booklet (CHB) use and filling out among mothers who were or were not Bolsa Família Program (BFP) beneficiaries.</p><p><strong>Methods: </strong>Cross-sectional study with mothers of children <6years attending health centers in Salvador, Bahia, Brazil, between January-February/2023. The CHB was evaluated regarding its use (having a CHB, having it in hand, and having read it) and filling out (growth curves, development monitoring forms, and vaccination completeness). Descriptive statistics and the chi-square test were used.</p><p><strong>Results: </strong>Of the 411 study participants, 66% were BFP beneficiaries. Significant differences were found between the groups regarding CHB use: having a CHB (p < 0.001), having it in hand (p = 0.037), and having read it (p < 0.001). Significant difference in vaccination completeness was found (p = 0.005).</p><p><strong>Conclusion: </strong>There was a significant difference in CHB use and vaccination completeness when comparing mothers who were BFP beneficiaries and those who were not.</p>","PeriodicalId":51473,"journal":{"name":"Epidemiologia e Servicos de Saude","volume":"33 ","pages":"e2024498"},"PeriodicalIF":2.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}