Luz Carlos de Castro, Junger Washington Leite, Cavalini Luciana Tricai
Universidade Federal Fluminense, Niterói, RJ, Brazil.
Rev Assoc Med Bras (1992). 2010 Jul-Aug;56(4):452-6. doi: 10.1590/s0104-42302010000400019.
To analyze the association between prehospital components of the National Urgent Care Policy (Política Nacional de Atenção às Urgências, PNAU)--the Family Health Strategy (Estratégia de Saúde da Família, ESF) and the Mobile Emergency Care Service (Serviço de Atendimento Móvel de Urgência, SAMU)--and indicators of morbidity and mortality from stroke and acute myocardial infarction (AMI) in the elderly population in preselected municipalities of the State of Minas Gerais, Brazil.
A longitudinal ecological study was carried out. Data analysis was performed using a series of multilevel regression models. Health indicators were analyzed from 2001 to 2007.
Statistically significant associations were found between indicators of ESF coverage and presence of SAMU with indicators of stroke and AMI mortality, for both sexes, except for male AMI. Regarding hospital admission rates, the most consistent effects were identified for female AMI.
The heterogeneity of the results points to an incipient stage of PNAU, which does not allow the observation of clear effects. This finding may also suggest that this policy has not yet been able to achieve its goals concerning the elderly. Further evaluation of PNAU is essential for the establishment of strategies that can enhance its effectiveness.
分析巴西米纳斯吉拉斯州预选城市老年人群中,国家紧急护理政策(Política Nacional de Atenção às Urgências, PNAU)的院前组成部分——家庭健康战略(Estratégia de Saúde da Família, ESF)和移动紧急护理服务(Serviço de Atendimento Móvel de Urgência, SAMU)与中风和急性心肌梗死(AMI)发病率及死亡率指标之间的关联。
开展一项纵向生态学研究。使用一系列多层次回归模型进行数据分析。对2001年至2007年的健康指标进行分析。
除男性AMI外,ESF覆盖指标和SAMU的存在与中风和AMI死亡率指标之间在两性中均发现有统计学意义的关联。关于住院率,女性AMI的影响最为一致。
结果的异质性表明PNAU尚处于初期阶段,无法观察到明显效果。这一发现也可能表明该政策尚未实现其针对老年人的目标。对PNAU进行进一步评估对于制定能够提高其有效性的策略至关重要。