Cerci Neto Alcindo, Ferreira Filho Olavo Franco, Bueno Tatiara, Talhari Maria Amélia
Breathe, Londrina Program, Londrina, Brazil.
J Bras Pneumol. 2008 Sep;34(9):639-45. doi: 10.1590/s1806-37132008000900002.
To evaluate the relationship between the reduction in the number of asthma-related hospital admissions and the changes occurring after the intervention performed in the health care system of the city of Londrina, Brazil.
In 2003, an intervention was performed in the local health care system (Family Health Clinics). The steps adopted were as follows: development of a protocol based on the III Brazilian Consensus on Asthma Management; access to free inhaled corticosteroids for patients; training of health professionals; and implementation of educational measures, especially for the community. The authorizations for hospital admissions of patients diagnosed with asthma alone between 2002 and 2005 in the city of Londrina were analyzed.
The mean age was 14.3 +/- 0.5 years, without gender predominance. The number of hospital admissions fell more markedly in 2005 than in the previous years studied. This decline was more pronounced at the Family Health Clinics where professional training occurred earlier. The post-intervention (2004-2005) rate of asthma-related hospital admissions (120/100,000 inhabitants) was significantly lower than the pre-intervention (2002-2003) rate (178/100,000 inhabitants; p < 0.01).
The admission curve showed a tendency toward a reduction after 2003, and, aside from the intervention performed, no other factors that would explain the results obtained were identified. The rate at which the number of hospital admissions decreased was in direct proportion to the length of time elapsed since the intervention (greater decreases over time). We conclude that the intervention performed in the local health care system was responsible for the data presented.
评估巴西隆德里纳市医疗保健系统实施干预措施后,哮喘相关住院人数的减少与所发生变化之间的关系。
2003年,在当地医疗保健系统(家庭健康诊所)实施了一项干预措施。采取的步骤如下:根据巴西哮喘管理第三次共识制定方案;为患者提供免费吸入性糖皮质激素;培训卫生专业人员;实施教育措施,特别是针对社区的教育措施。分析了2002年至2005年期间隆德里纳市仅被诊断为哮喘的患者的住院授权情况。
平均年龄为14.3±0.5岁,无性别优势。2005年的住院人数比之前研究的年份下降得更明显。在更早进行专业培训的家庭健康诊所,这种下降更为显著。干预后(2004 - 2005年)哮喘相关住院率(120/10万居民)显著低于干预前(2002 - 2003年)的率(178/10万居民;p < 0.01)。
2003年后住院曲线呈下降趋势,除了所实施的干预措施外,未发现其他能解释所得结果的因素。住院人数下降的速率与干预后经过的时间长度成正比(随着时间推移下降幅度更大)。我们得出结论,当地医疗保健系统实施的干预措施是所呈现数据的原因。