Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina

Detalhes bibliográficos
Autor(a) principal: Zaslavsky,Ricardo
Data de Publicação: 2019
Outros Autores: Goulart,Barbara Niegia Garcia de, Ziegelmann,Patricia Klarmann
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Cadernos de Saúde Pública
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2019001105004
Resumo: Abstract: The act of crossing an international border for healthcare is a reality in border areas and the flow is in the direction of the city with more human and healthcare resources. Although several prognostic factors related to HIV+ patients are known, the prognostic value of this type of mobility for long term care is still neglected. This study compares the prognosis of HIV patients from three groups, one involved in regional mobility, another in cross-border mobility in search for healthcare and the reference group which is composed by patients living in the same city of the health facility. This is a retrospective cohort study using medical records from a healthcare service in Brazil. Following survival analysis with log-rank test and Cox proportional hazard models, overall survival had no significant difference between patients who were involved in regional (HR = 1.03; 95%CI: 0.69-1.54; p = 0.89) or international (HR = 1.07; 95%CI: 0.58-1.97; p = 0.83) mobility and those who were not. This lack of difference was kept when adjusted for known prognostic factors. In this retrospective cohort study, exposure to both regional and international migration did not have a significant association with the risk of death by any cause in crude or adjusted analyses for already known prognostic factors. This is the first study to consider the prognostic role of cross-border healthcare for HIV patients. Despite these findings, the need of monitoring the extent and the clinical and demographic characteristics of healthcare demand originated in the other side of the border and the use of these data for decision making in health management is emphasized.
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spelling Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-ArgentinaHIVPrognosisBorder AreasBorder HealthAbstract: The act of crossing an international border for healthcare is a reality in border areas and the flow is in the direction of the city with more human and healthcare resources. Although several prognostic factors related to HIV+ patients are known, the prognostic value of this type of mobility for long term care is still neglected. This study compares the prognosis of HIV patients from three groups, one involved in regional mobility, another in cross-border mobility in search for healthcare and the reference group which is composed by patients living in the same city of the health facility. This is a retrospective cohort study using medical records from a healthcare service in Brazil. Following survival analysis with log-rank test and Cox proportional hazard models, overall survival had no significant difference between patients who were involved in regional (HR = 1.03; 95%CI: 0.69-1.54; p = 0.89) or international (HR = 1.07; 95%CI: 0.58-1.97; p = 0.83) mobility and those who were not. This lack of difference was kept when adjusted for known prognostic factors. In this retrospective cohort study, exposure to both regional and international migration did not have a significant association with the risk of death by any cause in crude or adjusted analyses for already known prognostic factors. This is the first study to consider the prognostic role of cross-border healthcare for HIV patients. Despite these findings, the need of monitoring the extent and the clinical and demographic characteristics of healthcare demand originated in the other side of the border and the use of these data for decision making in health management is emphasized.Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz2019-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2019001105004Cadernos de Saúde Pública v.35 n.9 2019reponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZ10.1590/0102-311x00184918info:eu-repo/semantics/openAccessZaslavsky,RicardoGoulart,Barbara Niegia Garcia deZiegelmann,Patricia Klarmanneng2019-09-04T00:00:00Zoai:scielo:S0102-311X2019001105004Revistahttp://cadernos.ensp.fiocruz.br/csp/https://old.scielo.br/oai/scielo-oai.phpcadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2019-09-04T00:00Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.none.fl_str_mv Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina
title Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina
spellingShingle Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina
Zaslavsky,Ricardo
HIV
Prognosis
Border Areas
Border Health
title_short Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina
title_full Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina
title_fullStr Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina
title_full_unstemmed Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina
title_sort Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina
author Zaslavsky,Ricardo
author_facet Zaslavsky,Ricardo
Goulart,Barbara Niegia Garcia de
Ziegelmann,Patricia Klarmann
author_role author
author2 Goulart,Barbara Niegia Garcia de
Ziegelmann,Patricia Klarmann
author2_role author
author
dc.contributor.author.fl_str_mv Zaslavsky,Ricardo
Goulart,Barbara Niegia Garcia de
Ziegelmann,Patricia Klarmann
dc.subject.por.fl_str_mv HIV
Prognosis
Border Areas
Border Health
topic HIV
Prognosis
Border Areas
Border Health
description Abstract: The act of crossing an international border for healthcare is a reality in border areas and the flow is in the direction of the city with more human and healthcare resources. Although several prognostic factors related to HIV+ patients are known, the prognostic value of this type of mobility for long term care is still neglected. This study compares the prognosis of HIV patients from three groups, one involved in regional mobility, another in cross-border mobility in search for healthcare and the reference group which is composed by patients living in the same city of the health facility. This is a retrospective cohort study using medical records from a healthcare service in Brazil. Following survival analysis with log-rank test and Cox proportional hazard models, overall survival had no significant difference between patients who were involved in regional (HR = 1.03; 95%CI: 0.69-1.54; p = 0.89) or international (HR = 1.07; 95%CI: 0.58-1.97; p = 0.83) mobility and those who were not. This lack of difference was kept when adjusted for known prognostic factors. In this retrospective cohort study, exposure to both regional and international migration did not have a significant association with the risk of death by any cause in crude or adjusted analyses for already known prognostic factors. This is the first study to consider the prognostic role of cross-border healthcare for HIV patients. Despite these findings, the need of monitoring the extent and the clinical and demographic characteristics of healthcare demand originated in the other side of the border and the use of these data for decision making in health management is emphasized.
publishDate 2019
dc.date.none.fl_str_mv 2019-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2019001105004
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2019001105004
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/0102-311x00184918
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
publisher.none.fl_str_mv Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
dc.source.none.fl_str_mv Cadernos de Saúde Pública v.35 n.9 2019
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
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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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