Departamento de Saúde Coletiva, Universidade Estadual de Londrina, PR, Brasil.
Arq Bras Cardiol. 2009 Dec;93(6):597-601, 645-50.
The reduction in morbidity and mortality rates from diseases of the circulatory system (DCS) is one of the greatest challenges in primary care, and the implementation of the Family Health Program provides access to the multisectoral and integrated measures required for dealing with these diseases.
To analyze DCS mortality and hospitalization rates before and after the implementation of the Family Health Program, in Londrina, Paraná.
This was an ecological study, comparing DCS, cerebrovascular disease (CbVD) and ischemic heart disease (IHD) mortality rates and hospitalization rates by the SUS, in residents of Londrina, in two 4-year periods: 1997 to 2000, and 2002 to 2005. The data were obtained from the Mortality Information System and the Hospital Information System of the SUS. The ratios between the rates were calculated for both periods at 95% confidence interval.
The DCS was the first cause of death in the city, in both quadrennia. The CbVD and IHD accounted for more than 63% of DCS deaths. In comparing the two quadrennia, there was a reduction in CbVD mortality rates, which was significant only for subjects over 59 years, in both genders, and the hospitalization rates increased by 10%. For IHD, no significant change occurred in mortality rates, and there was a 40% increase in hospitalization rates.
The significant reduction only in CbVD mortality in the elderly suggests the need for expanding health assistance coverage to different population groups and the development of preventive and health promotion measures.
降低循环系统疾病(DCS)的发病率和死亡率是基层医疗的最大挑战之一,而家庭健康计划的实施则为处理这些疾病所需的多部门和综合措施提供了途径。
分析在巴西南部城市隆德里纳实施家庭健康计划前后 DCS、脑血管病(CbVD)和缺血性心脏病(IHD)的死亡率和住院率。
这是一项生态研究,比较了 1997 年至 2000 年和 2002 年至 2005 年期间,通过 SUS 登记的隆德里纳居民的 DCS、CbVD 和 IHD 死亡率和住院率。数据来自死亡率信息系统和 SUS 医院信息系统。在两个时期内,使用 95%置信区间计算比率。
在这两个 4 年期间,DCS 都是该市的首要死因。CbVD 和 IHD 占 DCS 死亡人数的 63%以上。在比较两个时期时,CbVD 死亡率有所下降,但仅在 59 岁以上的男女中具有统计学意义,住院率增加了 10%。对于 IHD,死亡率没有显著变化,但住院率增加了 40%。
仅在老年人群中 CbVD 死亡率显著下降表明,需要扩大卫生援助覆盖范围,涵盖不同人群,并制定预防和促进健康的措施。