Antônio Carlos Gomes do Espírito Santo

Prevalência de obesidade e fatores associados em mulheres idosas

OBJECTIVE: To analyze the prevalence of obesity in elderly women and its association with socio-demographic, biochemical and hypertension variables. MATERIAL AND METHODS: By means of a cross sectional study, 188 outpatient women, 60 to 89 years-old were assessed. Obesity was defined by a BMI > 30Kg/m2 (WHO, 1998). The parameters examined were age, education, marital status, fasting glycemia, total cholesterol, high and low density cholesterol lipoproteins, triglycerides and presence or absence of blood hypertension. Data analysis was performed by Pearsons Chi-square or Exact Test of Fisher and Multivariate Analysis of Logistic Regression, estimating the probability of obesity. RESULTS/CONCLUSIONS: Among eldery women, 25.6% were obese. Obesity was present in the age ranges of 60 to 69 and 70 to 79 years, and positively associated (p= 0.050) to fasting glycemia > 126mg/dL, with increased risk (Odds= 1.76) for elder diabetic, compared to non-diabetics women. The highest probability for obesity, around 18%, was observed in women younger than 70 years-old, triglycerides > 200gm/dL, diabetic and hypertensive, emphasizing the role of associated morbidity.

Avaliação da qualidade da atenção básica utilizando a doença respiratória da infância como traçador, em um distrito sanitário do município de São Paulo

OBJECTIVES: to assess quality of the primary care using respiratory diseases as a tracer. METHODS: the evaluative approach is based on Donabedians referencial connected to Kessners tracers methodology. The sample is formed by 768 children from 0 to 5 years old, presenting respiratory symptoms, attended at seven basic health units from the Sanitary District of Brasilândia, in the city of Sao Paulo, State of Sao Paulo, Brazil. Medical registrations and interviews with mothers or responsibles were the information sources. RESULTS: more accurate child medical examination evidences significant association with favorable evolution, mainly on moderate clinical forms. Although aspects related to the accessibility demonstrated by the health team seem to influence decisively on care quality evaluated by users, mainly the medical doctor. Mothers education level appears to have no influence in the favorable evolution. CONCLUSIONS: the tracer methodology has the potentiality to facilitate the critical analysis of the health care. It is important to focus on the outcome of the health care. The children respiratory diseases are important tracer for the quality assessment on health services.

Despesa pública municipal com saúde em Pernambuco, Brasil, de 2000 a 2007

In order to assess the impact of macro-political measures implemented in the latter half of the 1990s on the increase in public spending on health and the possible reduction in allocation inequity, a descriptive, quantitative, cross-sectional study was carried out involving 184 municipalities in the state of Pernambuco, Brazil. Data from the Public Health Budget Information System was used, with the selected indicator being spending on health per inhabitant under the responsibility of the municipality. The correlations of this variable with the municipal Human Development Index, population size and value of the municipal budget per capita were analyzed. It was seen that, although the mean increase in municipal spending on health is 190.76%, the value per capita has remained relatively low - at around R

Financiamento, gasto e oferta de serviços de saúde em grandes centros urbanos do estado de São Paulo (Brasil)

183.79 - which is below the national and macro-regional averages. Both spending on health per capita and growth percentages are distributed irregularly among health regions as well as among municipalities within a single region. In conclusion, there is marked allocation inequity among municipalities with regard to the distribution of public resources for health, despite the macro-political measures adopted to reduce this inequity.

Confiabilidade dos dados relativos ao cumprimento da Emenda Constitucional nº. 29 declarados ao Sistema de Informações sobre Orçamentos Públicos em Saúde pelos municípios de Pernambuco, Brasil

Challenges to implantation of SUS doutrinary and operative principles in great urban centers, have stimulated the developing of strategies focused on cities over 100.000 inhabitants and had raised researches on this setting. This article approaches health financing and expenditure evolution in Sao Paulo cities over 500.000 inhabitants, excluded the state capital, from 2000 to 2006. These data were compared with health services production. The main data sources were Seade Foundation, Siops and Datasus database. Conclusions pointed out to an increase in health expenditure higher than global income and expense increasing. The low PSF coverage and the increasing of middle and high complexity procedures production found in this study might reflect the tradictional medical-assistance model reproduction. Indicators dissimilarity presented by different cities bring up the necessity of case studies, as simple as multiple ones, in order to better understand and to identify the determinants of these differences.

Problematização de temáticas de promoção da saúde do idoso a partir de uma vivência dramatúrgica

The present study analyzes the reliability of data on compliance with Constitutional Amendment 29 (CA29) reported to the Public Healthcare Budget Information System (known as SIOPS) by municipalities in the State of Pernambuco, Brazil. A quantitative, analytical cross-sectional study was conducted using the years 2000 to 2005 as the reference. Invoices audited by the State Accounts Court were used as the parameter for determining reliability of the percentage of compliance with CA29 as reported to SIOPS, using the intraclass correlation coefficient (ICC) to measure data agreement. The results show a mismatch between the databases, suggesting slight to moderate agreement between the SIOPS data and those from the State Accounts Court. The low degree of agreement may result from lack of consensus among municipalities regarding definition of health-related revenues and expenses or the existence of different criteria used by SIOPS and the State Accounts Court for calculating the CA29.

Participação dos entes federados no financiamento da saúde bucal de atenção básica: estudo no município da Vitória de Santo Antão, Pernambuco

Este artigo apresenta o relato de uma experiencia de ensino-aprendizagem tendo como tematica a promocao da saude do idoso no contexto familiar, utilizando uma abordagem pedagogico-construtivista, seguindo-se uma linha problematizadora, optando-se por uma estrategia pautada na construcao coletiva de um texto dramaturgico, na sua encenacao e discussao. Participaram da experiencia docentes pesquisadores, tecnicos e alunos de graduacao estagiarios do Nucleo de Atencao ao Idoso da Universidade Federal de Pernambuco, alem de dirigentes, tecnicos e usuarios dos Centros de Convivencia de Idosos mantidos pela Prefeitura de Recife. Avaliou-se a experiencia como capaz de integrar os conteudos em questao, articulando os saberes de diferentes disciplinas e profissoes da saude, alem de permitir o dialogo nao apenas utilizando a expressao verbal, mas tambem corporal das concepcoes trazidas pelos diversos atores envolvidos. Considera-se que uma construcao teorica partilhada pelo aparelho formador e pelo aparelho utilizador de profissionais de saude foi obtida mediante a conjugacao do conhecimento acumulado sobre os conteudos e das observacoes resultantes do relacionamento entre aquelas instâncias.

O processo de avaliacao da Iniciativa Hospital Amigo da Crianca sob o olhar dos avaliadores

O objetivo deste estudo foi mensurar o percentual de participacao dos entes federados (Uniao, Estado e Municipio) no financiamento das acoes e servicos de saude bucal na atencao basica no municipio da Vitoria de Santo Antao, Pernambuco, no ano de 2010 a partir da apuracao dos custos. Utilizou-se a metodologia do custeio por absorcao, tendo sido os custos agrupados em blocos: recursos humanos, recursos materiais e pensos com finalidade odontologica, custos prediais e manutencao de equipamentos. Foram consultados os repasses federais e estaduais atraves dos sistemas de informacao de acesso publico (fundo nacional de saude e fundo estadual de saude) para se estimar a participacao dos governos no custeio das acoes e servicos de saude bucal na atencao basica. De um total de R

Percepção dos profissionais sobre a coordenação entre níveis de atenção à saúde em dois municípios pernambucanos de grande porte

1.340.307,80 (um milhao, trezentos e quarenta mil, trezentos e sete reais e oitenta centavos) referentes ao custo total, 37,5% foram relativos a recursos financeiros federais e 62,5% aos municipais, nao sendo observada a participacao estadual. Constata-se que o municipio continua sendo o principal provedor do custeio da saude bucal na atencao basica, direcionando a necessidade de uma articulacao interfederativa mais efetiva que assegure o financiamento tripartite.

Avaliação da responsividade de um serviço de saúde público sob a perspectiva do usuário idoso

OBJECTIVES: to sound out the opinion of assessors of the Brazilian Child-Friendly Hospital Initiative (IHAC) as to the reliability of the information gathered by the evaluation system. METHODS: a descriptive, cross-sectional, quantitative study was carried out base on primary data obtained by way of semi-structured questionnaires applied by email. Inclusion criterion: assessor who participated in at least one overall evaluation and/or re-evaluation between 2006 and 2011. Thirty-five completed questionnaires were received. The data were analyzed using Epi Info Windows 2.000 Version 3.5.1. RESULTS: 77% of the assessor responded that the results of the evaluation of the IHAC partially corresponded to the reality on the ground in the hospitals evaluated. Lengthy, less than clear, repetitive questions in formal language, lack of knowledge of certain procedures on the part of professionals who do not carry them out, and the duration of earlycontact con during childbirth were the weaknesses identified. CONCLUSIONS: the results of the evaluation of the IHAC are partially reliable but do not reflect the real situation in the hospitals evaluated. There is a need to improve data collection tools so as to make them clearer and more concise, to provide better training and more careful selection of assessors.