Publications by authors named "Débora Castanheira Pires"

2 Publications

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Impact of COAP on access to primary care in Ceará and Mato Grosso do Sul through the analysis of interrupted time series.

Rev Saude Publica 2021 10;55:20. Epub 2021 May 10.

University of Massachusetts Medical School. Department of Surgery. Division of Thoracic Surgery. Worcester, Massachusetts, USA.

Objective: To analyze the impact of implementing the Contrato Organizativo de Ação Pública (COAP - Public Action Organizational Contract) on the expansion of access to primary care in the states of Ceará and Mato Grosso do Sul.

Methods: We used the interrupted time series method to analyze the effect of COAP on primary care coverage (PCCov) and on avoidable hospitalization rates. To analyze the effects of increased PCCov on avoidable hospitalizations, we used non-segmented time series models.

Results: The results showed that implementing COAP had a positive impact on increased coverage in both cases, with did not happen in the control states. However, this impact was not reflected in the decrease in hospitalizations due to primary care sensitive conditions (HPCSC) or for acute preventable causes. When we analyzed the effects of the increase in PCCov on avoidable hospitalizations between 2009 and 2016, we observed that coverage had a positive impact on the decrease in the rate of HPCSC only in Ceará, although hospitalizations have a significant trend to decrease in time both in this state and in Mato Grosso do Sul, except for acute respiratory infections.

Conclusions: The COAP continues to be the regulatory instrument of regionalization force, however, the results obtained by adhering to it in the expansion of primary care in Ceará and Mato Grosso do Sul makes us question whether the contractual model, as predicted, is the best instrument for advancing regionalization in the Brazilian Unified Health System.
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http://dx.doi.org/10.11606/s1518-8787.2021055003001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8064654PMC
May 2021

[Factors associated with arterial hypertension: a systematic review].

Cien Saude Colet 2020 Jun 5;25(6):2271-2282. Epub 2018 Oct 5.

Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900, Rio de Janeiro, RJ, Brasil.

A systematic review of demographic, socioeconomic, behavioral and anthropometric factors associated with hypertension. We included observational studies, of populations aged 18 or older, from the past ten years, published in English, Portuguese or Spanish from Pubmed, Web of Science, Scopus and Lilacs bases. The most found factors related to the greater chance of having hypertension were age and the Body Mass Index (BMI). Other factors associated with the disease were: gender (male), education (lower education), income (lower income) and waist circumference (high). Never having smoked, never having consumed alcohol and white skin color were characteristics related to a lower chance of having hypertension. As demonstrated, demographic, socioeconomic, behavioral and anthropometric characteristics are important factors associated with a greater chance of having hypertension in the adult population. However, while most of the factors associated with it are amenable to intervention, broader health promotion policies will be needed to reduce socioeconomic inequalities in the prevalence of the disease.
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http://dx.doi.org/10.1590/1413-81232020256.26972018DOI Listing
June 2020