Avaliação do processo de atendimento a pacientes portadores de doença crônico-degenerativa em uma unidade básica de saúde
Autor(a) principal: | |
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Data de Publicação: | 1993 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/24002 |
Resumo: | The efficacy of health actions, related to arterial hypertension and used as a strategy to decrease morbi-mortality due to cardiovascular diseases, in accordance with the "risk approach" and carried out in a Primary Health Care Clinic is assessed. These actions are based on the detection of arterial hypertension in the adult population attended at the Clinic and on the control of blood pressure levels in hypertensive individuals in which other known risk factors continue to be controlled, as well as on further treatment of eventual complications. Data relating to the 3,793 patients who were attended at least once by doctors of the adult sector of a training health-center located in S. Paulo county (Brazil) during the period from June 1990 to May 1991, inclusive, were evaluated. This evaluation was made according to each diagnosis undertaken as well as to the concentration of each type of consultation whether occasional, or follow-up. Of these 3,793 patients analysed, 839 presented arterial hypertension and/or diabetes, and were grouped into four categories: the exclusively hypertensive, the hipertensive with other associated chronic diseases (except diabetes), the diabetic and the diabetic with arterial hypertension. The results of this study brougth the following aspects to light: 1) The low coverage of hypertensive individuals and diabetics being attended by the health service when only the population attended by the health service is taken into consideration. 2) The incidence of patients diagnosed as hypertensive in occasional consultations who did not return to the health service for medical follow-up indicates the difficulties involved in attracting such individuals permanently. This loss is due to both the non-appearance of patients at the consultations programmed for their follow-up as well the lack of the follow-up program on the part of the health service. 3) With regard to these that fulfilled the follow-up program, the concentration of medical consultations and the concentration of absences presented satisfactory proportions, compatible with the proposal of quartely medical consultations. 4) The category of exclusively hypertensive individuals presented a lower concentration of attendance at consultations and a higher proportion of absences per consultation planned than did the others categories. Finally, the limitations of the actions based on the risk approach for the control of Chronic Degenerative Diseases are discussed. |
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Avaliação do processo de atendimento a pacientes portadores de doença crônico-degenerativa em uma unidade básica de saúde Evaluation of management of patients with chronic degenerative diseases in a primary health clinic Outcome and process assessment (health care)Hypertension^i2^spreventProgram evaluationPrimary health careAvaliação de processos e resultados (cuidados de saúde)Hipertensão^i1^sprevenAvaliação de programas The efficacy of health actions, related to arterial hypertension and used as a strategy to decrease morbi-mortality due to cardiovascular diseases, in accordance with the "risk approach" and carried out in a Primary Health Care Clinic is assessed. These actions are based on the detection of arterial hypertension in the adult population attended at the Clinic and on the control of blood pressure levels in hypertensive individuals in which other known risk factors continue to be controlled, as well as on further treatment of eventual complications. Data relating to the 3,793 patients who were attended at least once by doctors of the adult sector of a training health-center located in S. Paulo county (Brazil) during the period from June 1990 to May 1991, inclusive, were evaluated. This evaluation was made according to each diagnosis undertaken as well as to the concentration of each type of consultation whether occasional, or follow-up. Of these 3,793 patients analysed, 839 presented arterial hypertension and/or diabetes, and were grouped into four categories: the exclusively hypertensive, the hipertensive with other associated chronic diseases (except diabetes), the diabetic and the diabetic with arterial hypertension. The results of this study brougth the following aspects to light: 1) The low coverage of hypertensive individuals and diabetics being attended by the health service when only the population attended by the health service is taken into consideration. 2) The incidence of patients diagnosed as hypertensive in occasional consultations who did not return to the health service for medical follow-up indicates the difficulties involved in attracting such individuals permanently. This loss is due to both the non-appearance of patients at the consultations programmed for their follow-up as well the lack of the follow-up program on the part of the health service. 3) With regard to these that fulfilled the follow-up program, the concentration of medical consultations and the concentration of absences presented satisfactory proportions, compatible with the proposal of quartely medical consultations. 4) The category of exclusively hypertensive individuals presented a lower concentration of attendance at consultations and a higher proportion of absences per consultation planned than did the others categories. Finally, the limitations of the actions based on the risk approach for the control of Chronic Degenerative Diseases are discussed. Avalia-se o desempenho de ações de saúde desenvolvidas em uma unidade básica de saúde, relativas ao controle da hipertensão arterial sistêmica (HAS) enquanto estratégia de redução de morbi-mortalidadc por doença cardiovascular baseada no "enfoque de risco". Estas ações estruturam-se a partir da detecção da hipertensão arterial na população adulta atendida no serviço e do controle dos níveis pressóricos nos indivíduos portadores de HAS, incluindo outros fatores de risco conhecidos, bem como tratamento de eventuais complicações. Analisaram-se 3.793 usuários que compareceram pelo menos uma vez à consulta médica no serviço de Assistência ao Adulto de um Centro de Saúde-Escola, do Município de São Paulo (Brasil), no período de 1º de junho de 1990 a 31 de maio de 1991. Para cada um dos usuários foram considerados os diagnósticos realizados, bem como a concentração de cada modalidade de consulta realizada (pronto-atendimento e consulta agendada). Destes, 839 eram portadores de hipertensão arterial e/ou diabete e foram agrupados em quatro categorias: os exclusivamente hipertensos, os hipertensos com outra doença crônica associada (exceto diabete), os diabéticos e os diabéticos com hipertensão arterial. Os resultados deste estudo mostraram: 1) baixa cobertura de indivíduos hipertensos e diabéticos em atendimento no serviço, quando se considera a população atendida pelo Centro de Saúde; 2) a existência de pacientes diagnosticados como hipertensos em consultas de pronto-atendimento, que não retornaram ao Centro de Saúde para seguimento médico programático, apontando para dificuldades na captação efetiva destes indivíduos. Esta "perda" deveu-se tanto a faltas dos pacientes às consultas agendadas para seu seguimento quanto ao não agendamento de consultas de seguimento por parte do serviço; 3) para os pacientes que aderiram ao seguimento, a concentração de consultas médicas e a concentração de faltas apresentaram números compatíveis com a proposta de agendamento trimestral; 4) a categoria dos exclusivamente hipertensos apresentou, quando comparada com as demais, menor concentração de consultas e maior proporção de faltas por consulta agendada. Discutem-se os limites das ações baseadas no "enfoque de risco" para controle de doenças crónico-degenerativas em população. Universidade de São Paulo. Faculdade de Saúde Pública1993-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/2400210.1590/S0034-89101993000600009Revista de Saúde Pública; Vol. 27 No. 6 (1993); 463-471 Revista de Saúde Pública; Vol. 27 Núm. 6 (1993); 463-471 Revista de Saúde Pública; v. 27 n. 6 (1993); 463-471 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/rsp/article/view/24002/25967Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessSala, ArnaldoCohen, Diane D.Dalmaso, Ana S. W.Lima, Ângela M. M.Teixeira, Ricardo R.2012-05-29T16:15:04Zoai:revistas.usp.br:article/24002Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-05-29T16:15:04Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Avaliação do processo de atendimento a pacientes portadores de doença crônico-degenerativa em uma unidade básica de saúde Evaluation of management of patients with chronic degenerative diseases in a primary health clinic |
title |
Avaliação do processo de atendimento a pacientes portadores de doença crônico-degenerativa em uma unidade básica de saúde |
spellingShingle |
Avaliação do processo de atendimento a pacientes portadores de doença crônico-degenerativa em uma unidade básica de saúde Sala, Arnaldo Outcome and process assessment (health care) Hypertension^i2^sprevent Program evaluation Primary health care Avaliação de processos e resultados (cuidados de saúde) Hipertensão^i1^spreven Avaliação de programas |
title_short |
Avaliação do processo de atendimento a pacientes portadores de doença crônico-degenerativa em uma unidade básica de saúde |
title_full |
Avaliação do processo de atendimento a pacientes portadores de doença crônico-degenerativa em uma unidade básica de saúde |
title_fullStr |
Avaliação do processo de atendimento a pacientes portadores de doença crônico-degenerativa em uma unidade básica de saúde |
title_full_unstemmed |
Avaliação do processo de atendimento a pacientes portadores de doença crônico-degenerativa em uma unidade básica de saúde |
title_sort |
Avaliação do processo de atendimento a pacientes portadores de doença crônico-degenerativa em uma unidade básica de saúde |
author |
Sala, Arnaldo |
author_facet |
Sala, Arnaldo Cohen, Diane D. Dalmaso, Ana S. W. Lima, Ângela M. M. Teixeira, Ricardo R. |
author_role |
author |
author2 |
Cohen, Diane D. Dalmaso, Ana S. W. Lima, Ângela M. M. Teixeira, Ricardo R. |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Sala, Arnaldo Cohen, Diane D. Dalmaso, Ana S. W. Lima, Ângela M. M. Teixeira, Ricardo R. |
dc.subject.por.fl_str_mv |
Outcome and process assessment (health care) Hypertension^i2^sprevent Program evaluation Primary health care Avaliação de processos e resultados (cuidados de saúde) Hipertensão^i1^spreven Avaliação de programas |
topic |
Outcome and process assessment (health care) Hypertension^i2^sprevent Program evaluation Primary health care Avaliação de processos e resultados (cuidados de saúde) Hipertensão^i1^spreven Avaliação de programas |
description |
The efficacy of health actions, related to arterial hypertension and used as a strategy to decrease morbi-mortality due to cardiovascular diseases, in accordance with the "risk approach" and carried out in a Primary Health Care Clinic is assessed. These actions are based on the detection of arterial hypertension in the adult population attended at the Clinic and on the control of blood pressure levels in hypertensive individuals in which other known risk factors continue to be controlled, as well as on further treatment of eventual complications. Data relating to the 3,793 patients who were attended at least once by doctors of the adult sector of a training health-center located in S. Paulo county (Brazil) during the period from June 1990 to May 1991, inclusive, were evaluated. This evaluation was made according to each diagnosis undertaken as well as to the concentration of each type of consultation whether occasional, or follow-up. Of these 3,793 patients analysed, 839 presented arterial hypertension and/or diabetes, and were grouped into four categories: the exclusively hypertensive, the hipertensive with other associated chronic diseases (except diabetes), the diabetic and the diabetic with arterial hypertension. The results of this study brougth the following aspects to light: 1) The low coverage of hypertensive individuals and diabetics being attended by the health service when only the population attended by the health service is taken into consideration. 2) The incidence of patients diagnosed as hypertensive in occasional consultations who did not return to the health service for medical follow-up indicates the difficulties involved in attracting such individuals permanently. This loss is due to both the non-appearance of patients at the consultations programmed for their follow-up as well the lack of the follow-up program on the part of the health service. 3) With regard to these that fulfilled the follow-up program, the concentration of medical consultations and the concentration of absences presented satisfactory proportions, compatible with the proposal of quartely medical consultations. 4) The category of exclusively hypertensive individuals presented a lower concentration of attendance at consultations and a higher proportion of absences per consultation planned than did the others categories. Finally, the limitations of the actions based on the risk approach for the control of Chronic Degenerative Diseases are discussed. |
publishDate |
1993 |
dc.date.none.fl_str_mv |
1993-12-01 |
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://www.revistas.usp.br/rsp/article/view/24002 10.1590/S0034-89101993000600009 |
url |
https://www.revistas.usp.br/rsp/article/view/24002 |
identifier_str_mv |
10.1590/S0034-89101993000600009 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/24002/25967 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 27 No. 6 (1993); 463-471 Revista de Saúde Pública; Vol. 27 Núm. 6 (1993); 463-471 Revista de Saúde Pública; v. 27 n. 6 (1993); 463-471 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221776470343680 |