Public care for breast cancer women in the state of Rio de Janeiro, Brazil

Detalhes bibliográficos
Autor(a) principal: Brito, Cláudia
Data de Publicação: 2005
Outros Autores: Portela, Margareth Crisóstomo, Vasconcellos, Mauricio Teixeira Leite de
Tipo de documento: Artigo
Idioma: por
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/31953
Resumo: OBJECTIVE: New policies on oncology care implemented in the Brazilian Unified Health System (SUS) in November 1999 established substantial changes to cancer treatment in affiliate units. The objective was to describe the profile of these cancer services and their users after the implementation of new policies. METHODS: A descriptive study was carried out on breast cancer care in health services covered by SUS in the state of Rio de Janeiro, from 1999 to 2002. Data was collected in the healthcare units from outpatient registries and from the patients' high-complexity cancer procedure authorizations and their medical records. A random sample of 310 medical records of breast cancer women treated in 15 cancer health units was analyzed. Data analysis was performed using the percentile distribution of data according to categories of interest and the Chi-square test to assess the association between variables. RESULTS: The study results show the predominance of breast cancer care in highly complex units (81.3%); public units (73.5%); and in the capital of the state (78.1%). There was also seen an imbalance among health units regarding patient attendance, where only one of them served 70% of women sampled. The use of interventions varied between patients with and without health insurance in lower complexity health services; non-insured patients were associated to lower use of interventions. It was also found underutilization of recommended interventions as well as utilization of contraindicated interventions. The characterization of population studied showed that 43.9% of the women were given a cancer diagnosis with no perspective of cure and 68.4% lived in cities having SUS-affiliated services. CONCLUSIONS: These results indicate relevant differences among health units and point out to the need of practical recommendations to the Brazilian national policy for cancer control.
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spelling Public care for breast cancer women in the state of Rio de Janeiro, Brazil Assistência oncológica pelo SUS a mulheres com câncer de mama no Estado do Rio de Janeiro Breast neoplasms^i2^stherHealth servicesQuality assurancehealth carePolicymakingNeoplasias mamárias^i1^steraServiços de saúdeGarantia da qualidade dos cuidados de saúdeFormulação de políticas OBJECTIVE: New policies on oncology care implemented in the Brazilian Unified Health System (SUS) in November 1999 established substantial changes to cancer treatment in affiliate units. The objective was to describe the profile of these cancer services and their users after the implementation of new policies. METHODS: A descriptive study was carried out on breast cancer care in health services covered by SUS in the state of Rio de Janeiro, from 1999 to 2002. Data was collected in the healthcare units from outpatient registries and from the patients' high-complexity cancer procedure authorizations and their medical records. A random sample of 310 medical records of breast cancer women treated in 15 cancer health units was analyzed. Data analysis was performed using the percentile distribution of data according to categories of interest and the Chi-square test to assess the association between variables. RESULTS: The study results show the predominance of breast cancer care in highly complex units (81.3%); public units (73.5%); and in the capital of the state (78.1%). There was also seen an imbalance among health units regarding patient attendance, where only one of them served 70% of women sampled. The use of interventions varied between patients with and without health insurance in lower complexity health services; non-insured patients were associated to lower use of interventions. It was also found underutilization of recommended interventions as well as utilization of contraindicated interventions. The characterization of population studied showed that 43.9% of the women were given a cancer diagnosis with no perspective of cure and 68.4% lived in cities having SUS-affiliated services. CONCLUSIONS: These results indicate relevant differences among health units and point out to the need of practical recommendations to the Brazilian national policy for cancer control. OBJETIVO: A nova política de assistência oncológica do Sistema Único de Saúde, implantada em novembro de 1999, propôs modificações substanciais na forma de credenciamento das unidades de tratamento. O objetivo do estudo foi descrever o perfil do atendimento ao câncer de mama e de suas usuárias, após a implantação dessa nova política. MÉTODOS: Foi realizado um estudo descritivo sobre o tratamento do câncer de mama nas unidades credenciadas pelo Sistema Único de Saúde, no Estado do Rio de Janeiro, de 1999 a 2002. As informações foram obtidas a partir das unidades de atendimento, por meio da ficha de cadastro ambulatorial do Sistema Único de Saúde, e das pacientes, pelas autorizações de procedimentos de alta complexidade em oncologia e de prontuários. Foi analisada uma amostra aleatória simples de 310 prontuários, provenientes das 15 unidades credenciadas. Para a análise dos dados utilizou-se a distribuição percentual dos dados pelas categorias de interesse e o teste chi2 para avaliar a associação entre variáveis. RESULTADOS: Houve predomínio do tratamento nos Centros de Alta Complexidade Oncológica (81,3%); em unidades públicas (73,5%) e localizadas na capital do Estado (78,1%). Observou-se má distribuição dos atendimentos em relação às unidades credenciadas, com 70% dos tratamentos sendo executados por apenas uma única unidade assistencial. O perfil de uso das intervenções terapêuticas variou nas unidades isoladas credenciadas entre pacientes cobertas e não cobertas por planos de saúde, com as últimas apresentando menor uso das intervenções consideradas. Foi identificada a subutilização de terapêuticas recomendadas, bem como o uso de intervenções contra-indicadas. A caracterização da população estudada mostrou que 43,9% foram diagnosticadas sem a perspectiva de cura e 68,4% residiam em municípios com serviço oncológico credenciado. CONCLUSÕES: Os resultados mostraram diferenças relevantes entre os tipos de unidades credenciadas e apontam para a necessidade de implantar recomendações práticas para a política nacional de controle do câncer. Universidade de São Paulo. Faculdade de Saúde Pública2005-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/3195310.1590/S0034-89102005000600002Revista de Saúde Pública; Vol. 39 No. 6 (2005); 874-881 Revista de Saúde Pública; Vol. 39 Núm. 6 (2005); 874-881 Revista de Saúde Pública; v. 39 n. 6 (2005); 874-881 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/rsp/article/view/31953/33951Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessBrito, CláudiaPortela, Margareth CrisóstomoVasconcellos, Mauricio Teixeira Leite de2012-07-08T22:48:29Zoai:revistas.usp.br:article/31953Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-07-08T22:48:29Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Public care for breast cancer women in the state of Rio de Janeiro, Brazil
Assistência oncológica pelo SUS a mulheres com câncer de mama no Estado do Rio de Janeiro
title Public care for breast cancer women in the state of Rio de Janeiro, Brazil
spellingShingle Public care for breast cancer women in the state of Rio de Janeiro, Brazil
Brito, Cláudia
Breast neoplasms^i2^sther
Health services
Quality assurance
health care
Policymaking
Neoplasias mamárias^i1^stera
Serviços de saúde
Garantia da qualidade dos cuidados de saúde
Formulação de políticas
title_short Public care for breast cancer women in the state of Rio de Janeiro, Brazil
title_full Public care for breast cancer women in the state of Rio de Janeiro, Brazil
title_fullStr Public care for breast cancer women in the state of Rio de Janeiro, Brazil
title_full_unstemmed Public care for breast cancer women in the state of Rio de Janeiro, Brazil
title_sort Public care for breast cancer women in the state of Rio de Janeiro, Brazil
author Brito, Cláudia
author_facet Brito, Cláudia
Portela, Margareth Crisóstomo
Vasconcellos, Mauricio Teixeira Leite de
author_role author
author2 Portela, Margareth Crisóstomo
Vasconcellos, Mauricio Teixeira Leite de
author2_role author
author
dc.contributor.author.fl_str_mv Brito, Cláudia
Portela, Margareth Crisóstomo
Vasconcellos, Mauricio Teixeira Leite de
dc.subject.por.fl_str_mv Breast neoplasms^i2^sther
Health services
Quality assurance
health care
Policymaking
Neoplasias mamárias^i1^stera
Serviços de saúde
Garantia da qualidade dos cuidados de saúde
Formulação de políticas
topic Breast neoplasms^i2^sther
Health services
Quality assurance
health care
Policymaking
Neoplasias mamárias^i1^stera
Serviços de saúde
Garantia da qualidade dos cuidados de saúde
Formulação de políticas
description OBJECTIVE: New policies on oncology care implemented in the Brazilian Unified Health System (SUS) in November 1999 established substantial changes to cancer treatment in affiliate units. The objective was to describe the profile of these cancer services and their users after the implementation of new policies. METHODS: A descriptive study was carried out on breast cancer care in health services covered by SUS in the state of Rio de Janeiro, from 1999 to 2002. Data was collected in the healthcare units from outpatient registries and from the patients' high-complexity cancer procedure authorizations and their medical records. A random sample of 310 medical records of breast cancer women treated in 15 cancer health units was analyzed. Data analysis was performed using the percentile distribution of data according to categories of interest and the Chi-square test to assess the association between variables. RESULTS: The study results show the predominance of breast cancer care in highly complex units (81.3%); public units (73.5%); and in the capital of the state (78.1%). There was also seen an imbalance among health units regarding patient attendance, where only one of them served 70% of women sampled. The use of interventions varied between patients with and without health insurance in lower complexity health services; non-insured patients were associated to lower use of interventions. It was also found underutilization of recommended interventions as well as utilization of contraindicated interventions. The characterization of population studied showed that 43.9% of the women were given a cancer diagnosis with no perspective of cure and 68.4% lived in cities having SUS-affiliated services. CONCLUSIONS: These results indicate relevant differences among health units and point out to the need of practical recommendations to the Brazilian national policy for cancer control.
publishDate 2005
dc.date.none.fl_str_mv 2005-12-01
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dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/31953
10.1590/S0034-89102005000600002
url https://www.revistas.usp.br/rsp/article/view/31953
identifier_str_mv 10.1590/S0034-89102005000600002
dc.language.iso.fl_str_mv por
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dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/31953/33951
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. 39 No. 6 (2005); 874-881
Revista de Saúde Pública; Vol. 39 Núm. 6 (2005); 874-881
Revista de Saúde Pública; v. 39 n. 6 (2005); 874-881
1518-8787
0034-8910
reponame:Revista de Saúde Pública
instname:Universidade de São Paulo (USP)
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instname_str Universidade de São Paulo (USP)
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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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