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- ItemAcesso aberto (Open Access)Assessing morbidity in the paediatric community(Faculdade de Saúde Pública da Universidade de São Paulo, 1999-08-01) Escuder, Maria Mercedes Loureiro; Silva, Nilza Nunes da [UNIFESP]; Pereira, Júlio Cesar Rodrigues; Puccini, Rosana Fiorini [UNIFESP]; Herrman, Anneliese A [UNIFESP]; Secretaria da Saúde; Universidade de São Paulo (USP); Instituto Dante Pazzanese de Cardiologia; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: Morbidity information is easily available from medical records but its scope is limited to the population attended by the health services. Information on the prevalence of diseases requires community surveys, which are not always feasible. These two sources of information represent two alternative assessments of disease occurrence, namely demand morbidity and perceived morbidity. The present study was conceived so as to elicit a potential relationship between them so that the former could be used in the absence of the latter. METHODS: A community of 13,365 families on the outskirts of S. Paulo, Brazil, was studied during the period from 15/Nov/1994 to 15/Jan/1995. Data regarding children less than 5 years old were collected from a household survey and from the 2 basic health units in the area. Prevalence of diseases was ascertained from perceived morbidity and compared to estimates computed from demand morbidity. RESULTS: Data analysis distinguished 2 age groups, infants less than 1 year old and children 1 to less than 5. The most important groups of diseases were respiratory diseases, diarrhoea, skin problems and infectious & parasitical diseases. Basic health units presented a better coverage for infants. Though disease frequencies were not different within or outside these units, a better coverage was found for diarrhoea and infectious & parasitical diseases in the infant group, and for diarrhoea in the older age group. Equivalence between the two types of morbidity was found to be limited to the infant group and concerned only the best covered diseases. The odds of a disease being seen at the health service should be of at least 4:10 to ensure this equivalence. CONCLUSION: It was concluded that, provided that health service coverage is good, demand morbidity can be taken as a reliable estimate of community morbidity.
- ItemAcesso aberto (Open Access)Desigualdades sociais e uso de serviços de saúde: evidências de análise estratificada(Faculdade de Saúde Pública da Universidade de São Paulo, 2000-02-01) Silva, Nilza Nunes da [UNIFESP]; Pedroso, Glaura César [UNIFESP]; Puccini, Rosana Fiorini [UNIFESP]; Furlani, Wellington de Jesus [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: The study aims to identify children who are not benefited by local health programs, looking for to characterize the excluded segment of the population in order to broaden the access to and use of the main actions provided by local health programs. METHODS: A sample of 465 children aged less than 1 year was studied, living in the year of 1996 in Embu, a city of the metropolitan area of S. Paulo, Brazil. Our hypothesis was that there is a higher availability of private health care resources among families who haven't been using the local health program. The statistical analysis consisted of stratified association analysis to study the heterogeneity between and intra four strata of families defined by different socialeconomic conditions. RESULTS: Although only 85.4% of the study children were enrolled in local health services, 91.2% of them were being benefited by main health care actions. The analysis of differences intra strata revealed that our hypothesis was only corroborated in one stratum. It is in the stratum 3, which concentrates the peripheral population, where we could find children who have not been using the local health program in Embu city. CONCLUSIONS: In the same social segment it was detected some inner heterogeneity among families related to the availability of private resources for their children health care.
- ItemAcesso aberto (Open Access)Perfil do idoso em área metropolitana na região sudeste do Brasil: resultados de inquérito domiciliar(Faculdade de Saúde Pública da Universidade de São Paulo, 1993-04-01) Ramos, Luiz Roberto [UNIFESP]; Rosa, Tereza Etsuko Da C.; Oliveira, Zélia M.; Medina, Maria Célia G.; Santos, Francisco Roberto Goncalves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Secretaria de Estado da Saúde Instituto de Saúde Núcleo de GerontologiaA multicentre study concerned with the health needs of the elderly population living in urban areas and coordinated by the Panamerican Health Organization was undertaken in 6 Latin-American countries. In Brazil, 1,602 elderly residents (of 60 years of age and over) in the District of S. Paulo, constituting a multistage random sample stratified by socioeconomic status, participated in a household survey using a multidemensional functional assessment questionnaire. The results showed a highly deprived population (70% had a per capita income of less than US$ 100 per month), living mostly in multigenerational households (59% were living with children and/or grandchildren), with a high prevalence of chronic physical illnesses (only 14% referred no illness) and psychiatric disorders (27% were considered psychiatric cases), a high proportion of them showing a loss of autonomy (47% needed help in performing at least one of the activities of daily living). The results are put into perspective concerning future needs in terms of specialized health services and social support for the growing population of elderly people in Brazil.