Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFMA |
Texto Completo: | https://tedebc.ufma.br/jspui/handle/tede/tede/3977 |
Resumo: | Objective: To go through the relationship between the implementation of the National Oral Health Policy (PNSB) and mortality rates from mouth cancer, estimating future trends and understanding the association between the Bolsa Família Program (PBF) and mortality rates from mouth cancer. Materials and Methods: This one is quite an ecological study with secondary data from deaths caused by mouth cancer obtained from the Mortality Information System. Plus, the outcome for both articles was the mortality rate due to oral cancer, standardized by gender and age, collected from IBGE, per 100,000 inhabitants. In addition, regarding the first article, the Autoregressive Integrated Moving Average (ARIMA) was used during the years 1996 to 2019. Regarding the second one, deaths caused by mouth cancer from 2005 to 2017 were included. The analysis units of the referred thesis were federative units as well as the Brazilian macro-regions. Furthermore, the exogenous variable included in the time series analysis of the first article was the PNSB, classified as "yes" from 2005. The modeling Box and Jenkins, ARIMA (time analysis, trend prediction with a 5-year horizon and estimation of the regression coefficient - CR) was considered. The independent variable of the second article is the coverage of the PBF, calculated as the ratio between the number of families receiving the benefit and those which should potentially receive it. The covariates included in the model were socioeconomic and health service coverage. What’s more, coroplethic maps and Space Time Cube analysis were made to analyze the space-time distribution of PBF coverage and mortality rates due to mouth cancer between 2005 and 2017. Linear regression analysis with mixed effects with random interception was used, estimating angular coefficients () and respective Confidence Intervals of 95% (95% CI) (=0.05). Results: The global and southern mortality rates have shown a stationary trend; while the rates in other regions required 1 differentiation in the treatment of the time series. The prediction models estimated an increase in those for the North and Northeast regions, a decrease for the Southeast and the stability of the rates predicted for Brazil and the South region. The implementation of the PNSB has contributed to the increase in the mortality rate due to oral cancer in the Northeast Region (CR=0.854677; p=6.642.10-6), meanwhile, for the other macro-regions and for Brazil, the inclusion of this exogenous variable in the model had no effect. In the second article, there was a trend of increase in PBF coverage and stability for the mortality rate for the federative units, except Maranhão, Goiás and Minas Gerais. In the adjusted analysis, the highest coverage of the PBF was associated with lower mortality rates from oral cancer (:-2.10; IC95%: -3,291 -0.9185). Conclusion: In view of the products carried out by this thesis, it is possible to conclude that the trends of the observed and predicted rates presented different behaviors in the Brazilian territory and the implementation of the PNSB has not yet resulted in a decrease in mortality from oral cancer, while the PBF contributes to the decrease of the outcome studied, therefore it can be recommended the expansion and implementation of social and health policies with a view to preventing avoidable deaths from this disease. |
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THOMAZ, Erika Bárbara Abreu Fonsecahttp://lattes.cnpq.br/3644251156905353THOMAZ, Erika Bárbara Abreu FonsecaVISSOCI, João Ricardo Nickenighttp://lattes.cnpq.br/6713653199076364LUCENA, Edson Hilan Gomes dehttp://lattes.cnpq.br/7047172432384185PINHO, Judith Rafaelle OliveiraTONELLO, Aline Sampierihttp://lattes.cnpq.br/5113457092920989http://lattes.cnpq.br/8344007467410783COSTA, Elisa Miranda2022-08-16T19:23:46Z2021-09-09COSTA, Elisa Miranda. Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil. 2021. 142 f. Tese (Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2021.https://tedebc.ufma.br/jspui/handle/tede/tede/3977Objective: To go through the relationship between the implementation of the National Oral Health Policy (PNSB) and mortality rates from mouth cancer, estimating future trends and understanding the association between the Bolsa Família Program (PBF) and mortality rates from mouth cancer. Materials and Methods: This one is quite an ecological study with secondary data from deaths caused by mouth cancer obtained from the Mortality Information System. Plus, the outcome for both articles was the mortality rate due to oral cancer, standardized by gender and age, collected from IBGE, per 100,000 inhabitants. In addition, regarding the first article, the Autoregressive Integrated Moving Average (ARIMA) was used during the years 1996 to 2019. Regarding the second one, deaths caused by mouth cancer from 2005 to 2017 were included. The analysis units of the referred thesis were federative units as well as the Brazilian macro-regions. Furthermore, the exogenous variable included in the time series analysis of the first article was the PNSB, classified as "yes" from 2005. The modeling Box and Jenkins, ARIMA (time analysis, trend prediction with a 5-year horizon and estimation of the regression coefficient - CR) was considered. The independent variable of the second article is the coverage of the PBF, calculated as the ratio between the number of families receiving the benefit and those which should potentially receive it. The covariates included in the model were socioeconomic and health service coverage. What’s more, coroplethic maps and Space Time Cube analysis were made to analyze the space-time distribution of PBF coverage and mortality rates due to mouth cancer between 2005 and 2017. Linear regression analysis with mixed effects with random interception was used, estimating angular coefficients () and respective Confidence Intervals of 95% (95% CI) (=0.05). Results: The global and southern mortality rates have shown a stationary trend; while the rates in other regions required 1 differentiation in the treatment of the time series. The prediction models estimated an increase in those for the North and Northeast regions, a decrease for the Southeast and the stability of the rates predicted for Brazil and the South region. The implementation of the PNSB has contributed to the increase in the mortality rate due to oral cancer in the Northeast Region (CR=0.854677; p=6.642.10-6), meanwhile, for the other macro-regions and for Brazil, the inclusion of this exogenous variable in the model had no effect. In the second article, there was a trend of increase in PBF coverage and stability for the mortality rate for the federative units, except Maranhão, Goiás and Minas Gerais. In the adjusted analysis, the highest coverage of the PBF was associated with lower mortality rates from oral cancer (:-2.10; IC95%: -3,291 -0.9185). Conclusion: In view of the products carried out by this thesis, it is possible to conclude that the trends of the observed and predicted rates presented different behaviors in the Brazilian territory and the implementation of the PNSB has not yet resulted in a decrease in mortality from oral cancer, while the PBF contributes to the decrease of the outcome studied, therefore it can be recommended the expansion and implementation of social and health policies with a view to preventing avoidable deaths from this disease.RESUMO Objetivo: analisar a relação entre a implantação da Política Nacional de Saúde Bucal (PNSB) e as taxas de mortalidade por câncer de boca, estimando tendências futuras; e compreender a associação entre o Programa Bolsa Família (PBF) e as taxas de mortalidade por câncer de boca. Materiais e Métodos: Este é um estudo ecológico, com dados secundários obtidos de diferentes bases de dados brasileiras de domínio público. As unidades federativas, macrorregiões e Brasil foram as unidades de análise. O desfecho para ambos os artigos foi a taxa de mortalidade por câncer de boca, padronizada por sexo e idade, a cada 100 mil habitantes, cujos dados foram coletados do Sistema de Informação de Mortalidade e do IBGE. Para o primeiro artigo foram considerados dados de 1996 a 2019, realizando-se modelagem Box e Jenkins e análise de série temporal interrompida (ARIMA, Autoregressive Integrated Moving Average) para análise temporal, predição de tendência com horizonte de 5 anos e estimação do coeficiente de regressão (CR). A variável exógena foi a PNSB, classificada como “sim” a partir a partir do ano de 2005). Para o segundo artigo, foram incluídos óbitos por câncer de boca de 2005 a 2017. A variável independente foi a cobertura do PBF, calculada como a razão entre o número de famílias que receberam o benefício e as que potencialmente deveriam receber, já as covariáveis incluídas no modelo de regressão foram as socioeconômicas e as relacionadas as coberturas dos serviços de saúde. Foram confeccionados mapas coropléticos e análise Space Time Cube para analisar a distribuição espaço-temporal da cobertura do PBF e das taxas de mortalidade por câncer de boca, bem como a relação entre esses eventos no tempo e espaço. A análise de regressão linear com efeitos mistos com interceptação randômica foi utilizada, estimando-se coeficientes angulares () e respectivos Intervalos de Confiança de 95% (IC95%) (=0.05). Resultados: As taxas de mortalidade por câncer de boca global e da Região Sul apresentaram tendência estacionária; enquanto as taxas das demais regiões necessitaram de 1 diferenciação no tratamento da série temporal. Nos modelos de predição, observou-se o aumento das taxas de mortalidade por câncer de boca para regiões Norte e Nordeste, diminuição para o Sudeste e estabilidade das taxas previstas para o Brasil e para a região Sul. A implantação da PNSB associou-se ao aumento da taxa de mortalidade por câncer de boca na Região Nordeste (CR=0.854677; p=6.642.10-6 ), enquanto para as demais macrorregiões e para o Brasil, a inclusão desta variável exógena no modelo não apresentou efeito. No segundo artigo, observou-se tendência de aumento para a cobertura do PBF e estabilidade para a taxa de mortalidade para as unidades federativas, exceto Maranhão, Goiás e Minas Gerais. Na análise ajustada, a maior cobertura do PBF foi associada a menores taxas de mortalidade por câncer de boca (: -2.10; IC95%: -3.291 -0.9185). Conclusão: As tendências das taxas de mortalidade por câncer de boca observadas e preditas apresentaram comportamentos distintos no território brasileiro e a implantação da PNSB ainda não se traduziu em diminuição da mortalidade por câncer de boca, enquanto o PBF contribui para a redução do desfecho estudado. Portanto, recomendamos a expansão e efetivação das políticas sociais e de saúde com vistas à prevenção de óbitos evitáveis por essa doença. O processo de implantação da PNSB precisa ser revisitado, considerando as particularidades dos municípios brasileiros, as iniquidades em saúde, a possibilidade de melhorar a operacionalização da Rede de Atenção à Saúde Bucal e de outras ações para o efetivo controle do câncer de boca.Submitted by Daniella Santos (daniella.santos@ufma.br) on 2022-08-16T19:23:44Z No. of bitstreams: 1 ELISAMIRANDACOSTA.pdf: 3116569 bytes, checksum: ff791812fcccf523548e8977cd6e8a7a (MD5)Made available in DSpace on 2022-08-16T19:23:46Z (GMT). No. of bitstreams: 1 ELISAMIRANDACOSTA.pdf: 3116569 bytes, checksum: ff791812fcccf523548e8977cd6e8a7a (MD5) Previous issue date: 2021-09-09FAPEMACNPqCAPESapplication/pdfporUniversidade Federal do MaranhãoPROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA/CCBSUFMABrasilDEPARTAMENTO DE SAÚDE PÚBLICA/CCBSestudos de séries temporais.neoplasias bucais;mortalidade;Programa de Transferência Condicionada de Renda;sistemas de saúde;time series studies;oral neoplasms;mortality;Conditional Income Transfer Program;health systems.Saúde PúblicaCAPESPrograma bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no BrasilBolsa Familia program, national oral health policy and oral cancer mortality in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFMAinstname:Universidade Federal do Maranhão (UFMA)instacron:UFMAORIGINALELISAMIRANDACOSTA.pdfELISAMIRANDACOSTA.pdfapplication/pdf3116569http://tedebc.ufma.br:8080/bitstream/tede/3977/2/ELISAMIRANDACOSTA.pdfff791812fcccf523548e8977cd6e8a7aMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82255http://tedebc.ufma.br:8080/bitstream/tede/3977/1/license.txt97eeade1fce43278e63fe063657f8083MD51tede/39772022-08-16 16:23:46.709oai:tede2: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Biblioteca Digital de Teses e Dissertaçõeshttps://tedebc.ufma.br/jspui/PUBhttp://tedebc.ufma.br:8080/oai/requestrepositorio@ufma.br||repositorio@ufma.bropendoar:21312022-08-16T19:23:46Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)false |
dc.title.por.fl_str_mv |
Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil |
dc.title.alternative.eng.fl_str_mv |
Bolsa Familia program, national oral health policy and oral cancer mortality in Brazil |
title |
Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil |
spellingShingle |
Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil COSTA, Elisa Miranda estudos de séries temporais. neoplasias bucais; mortalidade; Programa de Transferência Condicionada de Renda; sistemas de saúde; time series studies; oral neoplasms; mortality; Conditional Income Transfer Program; health systems. Saúde Pública CAPES |
title_short |
Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil |
title_full |
Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil |
title_fullStr |
Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil |
title_full_unstemmed |
Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil |
title_sort |
Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil |
author |
COSTA, Elisa Miranda |
author_facet |
COSTA, Elisa Miranda |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
THOMAZ, Erika Bárbara Abreu Fonseca |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3644251156905353 |
dc.contributor.referee1.fl_str_mv |
THOMAZ, Erika Bárbara Abreu Fonseca |
dc.contributor.referee2.fl_str_mv |
VISSOCI, João Ricardo Nickenig |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/6713653199076364 |
dc.contributor.referee3.fl_str_mv |
LUCENA, Edson Hilan Gomes de |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/7047172432384185 |
dc.contributor.referee4.fl_str_mv |
PINHO, Judith Rafaelle Oliveira |
dc.contributor.referee5.fl_str_mv |
TONELLO, Aline Sampieri |
dc.contributor.referee5Lattes.fl_str_mv |
http://lattes.cnpq.br/5113457092920989 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/8344007467410783 |
dc.contributor.author.fl_str_mv |
COSTA, Elisa Miranda |
contributor_str_mv |
THOMAZ, Erika Bárbara Abreu Fonseca THOMAZ, Erika Bárbara Abreu Fonseca VISSOCI, João Ricardo Nickenig LUCENA, Edson Hilan Gomes de PINHO, Judith Rafaelle Oliveira TONELLO, Aline Sampieri |
dc.subject.por.fl_str_mv |
estudos de séries temporais. neoplasias bucais; mortalidade; Programa de Transferência Condicionada de Renda; sistemas de saúde; |
topic |
estudos de séries temporais. neoplasias bucais; mortalidade; Programa de Transferência Condicionada de Renda; sistemas de saúde; time series studies; oral neoplasms; mortality; Conditional Income Transfer Program; health systems. Saúde Pública CAPES |
dc.subject.eng.fl_str_mv |
time series studies; oral neoplasms; mortality; Conditional Income Transfer Program; health systems. |
dc.subject.cnpq.fl_str_mv |
Saúde Pública CAPES |
description |
Objective: To go through the relationship between the implementation of the National Oral Health Policy (PNSB) and mortality rates from mouth cancer, estimating future trends and understanding the association between the Bolsa Família Program (PBF) and mortality rates from mouth cancer. Materials and Methods: This one is quite an ecological study with secondary data from deaths caused by mouth cancer obtained from the Mortality Information System. Plus, the outcome for both articles was the mortality rate due to oral cancer, standardized by gender and age, collected from IBGE, per 100,000 inhabitants. In addition, regarding the first article, the Autoregressive Integrated Moving Average (ARIMA) was used during the years 1996 to 2019. Regarding the second one, deaths caused by mouth cancer from 2005 to 2017 were included. The analysis units of the referred thesis were federative units as well as the Brazilian macro-regions. Furthermore, the exogenous variable included in the time series analysis of the first article was the PNSB, classified as "yes" from 2005. The modeling Box and Jenkins, ARIMA (time analysis, trend prediction with a 5-year horizon and estimation of the regression coefficient - CR) was considered. The independent variable of the second article is the coverage of the PBF, calculated as the ratio between the number of families receiving the benefit and those which should potentially receive it. The covariates included in the model were socioeconomic and health service coverage. What’s more, coroplethic maps and Space Time Cube analysis were made to analyze the space-time distribution of PBF coverage and mortality rates due to mouth cancer between 2005 and 2017. Linear regression analysis with mixed effects with random interception was used, estimating angular coefficients () and respective Confidence Intervals of 95% (95% CI) (=0.05). Results: The global and southern mortality rates have shown a stationary trend; while the rates in other regions required 1 differentiation in the treatment of the time series. The prediction models estimated an increase in those for the North and Northeast regions, a decrease for the Southeast and the stability of the rates predicted for Brazil and the South region. The implementation of the PNSB has contributed to the increase in the mortality rate due to oral cancer in the Northeast Region (CR=0.854677; p=6.642.10-6), meanwhile, for the other macro-regions and for Brazil, the inclusion of this exogenous variable in the model had no effect. In the second article, there was a trend of increase in PBF coverage and stability for the mortality rate for the federative units, except Maranhão, Goiás and Minas Gerais. In the adjusted analysis, the highest coverage of the PBF was associated with lower mortality rates from oral cancer (:-2.10; IC95%: -3,291 -0.9185). Conclusion: In view of the products carried out by this thesis, it is possible to conclude that the trends of the observed and predicted rates presented different behaviors in the Brazilian territory and the implementation of the PNSB has not yet resulted in a decrease in mortality from oral cancer, while the PBF contributes to the decrease of the outcome studied, therefore it can be recommended the expansion and implementation of social and health policies with a view to preventing avoidable deaths from this disease. |
publishDate |
2021 |
dc.date.issued.fl_str_mv |
2021-09-09 |
dc.date.accessioned.fl_str_mv |
2022-08-16T19:23:46Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
COSTA, Elisa Miranda. Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil. 2021. 142 f. Tese (Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2021. |
dc.identifier.uri.fl_str_mv |
https://tedebc.ufma.br/jspui/handle/tede/tede/3977 |
identifier_str_mv |
COSTA, Elisa Miranda. Programa bolsa família, política nacional de saúde bucal e mortalidade por câncer de boca no Brasil. 2021. 142 f. Tese (Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2021. |
url |
https://tedebc.ufma.br/jspui/handle/tede/tede/3977 |
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Universidade Federal do Maranhão |
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PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA/CCBS |
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UFMA |
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DEPARTAMENTO DE SAÚDE PÚBLICA/CCBS |
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Universidade Federal do Maranhão |
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Biblioteca Digital de Teses e Dissertações da UFMA |
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Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA) |
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