Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, Brazil
Autor(a) principal: | |
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Data de Publicação: | 1998 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1056 |
Resumo: | A historical cohort study was conducted in three public AIDS referral services in Belo Horizonte, Minas Gerais, to assess the relationship between health care utilization and patient survival following AIDS diagnosis. A review of medical and laboratory records was performed for HIV-infected patients seeking care for the first time in 1989-92. Among 291 patients initially categorized as "A" [asymptomatic, acute HIV, or persistent generalized lymphadenopathy-PGL] or "B" [symptomatic, non-"A", or AIDS-indicator conditions] (CDC, 1992) and who progressed to AIDS, 57.0% died. Mortality rate was 34.9/1.000 person-months. Overall median survival time following AIDS diagnosis was 14.3 months. Multivariate analysis showed that lack of AZT use (RR = 1.87; 95% CI = 1.34-2.61), advanced initial staging (RR = 1.68; 95% CI = 1.20-2.35), 9 or more inpatient days (RR = 1.55; 95% CI = 1.11-2.17), and intervals between outpatient visits longer than 6 months (RR = 0.30; 95% CI = 0.16-0.56) were associated with death. The analysis suggests that: Patients who used health services more often had poorer prognosis; Patients who received AZT survived longer than those who did not; and Variables used to assess health care utilization actually express the end of a process involving seeking and obtaining care. |
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Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, BrazilAIDSSurvivalHealth CareHIVA historical cohort study was conducted in three public AIDS referral services in Belo Horizonte, Minas Gerais, to assess the relationship between health care utilization and patient survival following AIDS diagnosis. A review of medical and laboratory records was performed for HIV-infected patients seeking care for the first time in 1989-92. Among 291 patients initially categorized as "A" [asymptomatic, acute HIV, or persistent generalized lymphadenopathy-PGL] or "B" [symptomatic, non-"A", or AIDS-indicator conditions] (CDC, 1992) and who progressed to AIDS, 57.0% died. Mortality rate was 34.9/1.000 person-months. Overall median survival time following AIDS diagnosis was 14.3 months. Multivariate analysis showed that lack of AZT use (RR = 1.87; 95% CI = 1.34-2.61), advanced initial staging (RR = 1.68; 95% CI = 1.20-2.35), 9 or more inpatient days (RR = 1.55; 95% CI = 1.11-2.17), and intervals between outpatient visits longer than 6 months (RR = 0.30; 95% CI = 0.16-0.56) were associated with death. The analysis suggests that: Patients who used health services more often had poorer prognosis; Patients who received AZT survived longer than those who did not; and Variables used to assess health care utilization actually express the end of a process involving seeking and obtaining care.Para analisar a relação entre utilização de cuidados de saúde e sobrevida de pacientes com AIDS foram revisados registros médicos de pacientes soropositivos admitidos nos serviços de referência para AIDS em Belo Horizonte/MG, entre 1989-92. Dos 291 pacientes que evoluíram para AIDS, 57,0% faleceram. O coeficiente de mortalidade foi de 34,9/1.000 pessoas-mês. A mediana do tempo de sobrevida global foi de 14,3 meses. A análise multivariada mostrou que indivíduos que não utilizaram AZT (RR = 1,87; IC 95% = 1,34-2,61), que foram classificados como estadiamento inicial "B" [sintomáticos, não AIDS] (RR = 1,68; IC 95% = 1,20-2,35) e que tiveram nove ou mais dias de internação hopitalar (RR = 1,55; IC 95% = 1,11-2,17) apresentaram maior risco de evoluírem para óbito. Já indivíduos que registraram pelo menos um intervalo maior de seis meses entre consultas (RR = 0,30; IC 95% = 0,16-0,56) apresentaram menor risco de evoluirem para óbito. Os resultados sugerem: Indivíduos com piores resultados na saúde tendem a utilizar mais os serviços e os mais complexos; Pessoas que utilizaram AZT sobreviveram mais tempo; Os marcadores de utilização adotados expressam o final de um processo de busca e obtenção da atenção.Reports in Public HealthCadernos de Saúde Pública1998-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1056Reports in Public Health; Vol. 14 No. 4 (1998): October/DecemberCadernos de Saúde Pública; v. 14 n. 4 (1998): Outubro/Dezembro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1056/2102https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1056/2103Acurcio, Francisco de AssisCesar, Cibele CominiGuimarães, Mark Drew Croslandinfo:eu-repo/semantics/openAccess2024-03-06T15:26:13Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/1056Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:01:18.414367Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, Brazil |
title |
Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, Brazil |
spellingShingle |
Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, Brazil Acurcio, Francisco de Assis AIDS Survival Health Care HIV |
title_short |
Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, Brazil |
title_full |
Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, Brazil |
title_fullStr |
Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, Brazil |
title_full_unstemmed |
Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, Brazil |
title_sort |
Health care utilization and survival among patients with AIDS in Belo Horizonte, Minas Gerais, Brazil |
author |
Acurcio, Francisco de Assis |
author_facet |
Acurcio, Francisco de Assis Cesar, Cibele Comini Guimarães, Mark Drew Crosland |
author_role |
author |
author2 |
Cesar, Cibele Comini Guimarães, Mark Drew Crosland |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Acurcio, Francisco de Assis Cesar, Cibele Comini Guimarães, Mark Drew Crosland |
dc.subject.por.fl_str_mv |
AIDS Survival Health Care HIV |
topic |
AIDS Survival Health Care HIV |
description |
A historical cohort study was conducted in three public AIDS referral services in Belo Horizonte, Minas Gerais, to assess the relationship between health care utilization and patient survival following AIDS diagnosis. A review of medical and laboratory records was performed for HIV-infected patients seeking care for the first time in 1989-92. Among 291 patients initially categorized as "A" [asymptomatic, acute HIV, or persistent generalized lymphadenopathy-PGL] or "B" [symptomatic, non-"A", or AIDS-indicator conditions] (CDC, 1992) and who progressed to AIDS, 57.0% died. Mortality rate was 34.9/1.000 person-months. Overall median survival time following AIDS diagnosis was 14.3 months. Multivariate analysis showed that lack of AZT use (RR = 1.87; 95% CI = 1.34-2.61), advanced initial staging (RR = 1.68; 95% CI = 1.20-2.35), 9 or more inpatient days (RR = 1.55; 95% CI = 1.11-2.17), and intervals between outpatient visits longer than 6 months (RR = 0.30; 95% CI = 0.16-0.56) were associated with death. The analysis suggests that: Patients who used health services more often had poorer prognosis; Patients who received AZT survived longer than those who did not; and Variables used to assess health care utilization actually express the end of a process involving seeking and obtaining care. |
publishDate |
1998 |
dc.date.none.fl_str_mv |
1998-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1056 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1056 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1056/2102 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/1056/2103 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 14 No. 4 (1998): October/December Cadernos de Saúde Pública; v. 14 n. 4 (1998): Outubro/Dezembro 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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