Impact of the Health Gym Program on hospital admissions for stroke in the state of Pernambuco, Brazil

• Autor(a) principal: Renato Barros da Guarda, Flávio
• Data de Publicação: 2023
• Outros Autores: Letícia Silvestre Rodrigues, Bárbara, Niels da Silva, Rafaela, Jackllanny Martins de Faria, Shirlley, Beatriz Costa Silva, Paloma, Elias da Silva Júnior, Redmilson, Kelly da Silva Feitosa, Daíze, Kwame Anokye, Nana, C. Coyte, Peter
• 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/8295
• topic: Avaliação de Programas e Projetos de Saúde; Doença Crônica; Promoção da Saúde; Pontuação de Propensão; Acidente Vascular Cerebral; Evaluación de Programas y Proyectos de Salud; Enfermedad Crónica; Promoción de la Salud; Puntaje de Propensión; Accidente Cerebrovascular; Program Evaluation; Chronic Disease; Health Promotion; Propensity Score; Stroke

This study aimed to evaluate the impact of the Health Gym Program (HGP) on hospital admissions for stroke in the state of Pernambuco, Brazil. This policy impact evaluation used a quasi-experimental approach consisting of a difference-in-differences estimator, weighted by propensity score matching to deal with potential confounding variables. The study comprised socioeconomic, demographic, and epidemiological data from official Brazilian databases from 2010 to 2019. The treatment group was composed of the 134 municipalities that implemented the HGP since 2011. The 51 municipalities that did not were allocated to the comparison group. The nearest neighbor algorithm (N5) was used to pair treatment and comparison group municipalities and create the weights to evaluate the average treatment effect on the treated (ATT) in the difference-in-differences estimator. In 2010, 2,771 people were hospitalized for stroke (0.51% of all hospitalizations) and in 2019, 11,542 (2%). Municipalities that implemented the HGP had 18.37% fewer hospitalizations than their counterparts in the comparison group. The program’s impact in reducing hospitalization rates was incrementally greater among men (ATT: -0.1932) and those aged 71 to 80 years (ATT: -0.1911). All results were statistically significant at the 5% level. The HGP reduced hospitalization for stroke in several population groups, but primarily in those whose underlying prevalence of stroke is highest, reinforcing the importance of public investments in health promotion policies designed to encourage lifestyle changes.