Avaliação do processo de atendimento a pacientes portadores de doença crônico-degenerativa em uma unidade básica de saúde

Detalhes bibliográficos
Autor(a) principal: Sala, Arnaldo
Data de Publicação: 1993
Outros Autores: Cohen, Diane D., Dalmaso, Ana S. W., Lima, Ângela M. M., Teixeira, Ricardo R.
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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spelling 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
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