Silva Luciana Santos Gerosino da, Gonçalves Cláudia Giglio de Oliveira, Soares Vânia Muniz Néquer
Universidade Tuiuti do Paraná, Curitiba, PR, Brazil.
Codas. 2014 May-Jun;26(3):241-7. doi: 10.1590/2317-1782/201420140440.
To evaluate the National Policy on Hearing Health Care (PNASA) based on the coverage of specialized services and diagnostic procedures in hearing health care in Brazil.
This is an evaluation study focused on the coverage of specialized services that offer moderate- and high-complexity diagnostic procedures by region and in Brazil as a whole. We analyzed the data for the period of 2004-2011 collected from the Unified Health System's Informatics Department database (DATASUS), under the link "Information on health" and tabulated using the software Tabwin. While collecting data from this platform, we selected "procedures for diagnostic purposes", and the selected way of organization was "diagnoses in otorhinolaryngology/audiology" of moderate and high complexity. We estimated coverage and evolution of the number of procedures according to the country's five geographic macroregions.
We identified an increase of 113% in service coverage and of 61% in the quantity of moderate- and high-complexity hearing health diagnostic procedures throughout the country. The northern region had an increase of 78% in the number of procedures, higher than all other regions. However, a proportionally larger number of procedures were performed in the southeast. We identified a significant increase in the number of examinations of otoacoustic emissions (OAE) for hearing triage, transient-evoked OAE and distortion product, as well as of diagnostic reassessments of hearing loss in patients older than 3 years.
There has been an increase in services and actions in hearing health care in Brazil since PNASA was implemented, but regional inequalities in the distribution of these services still persist.
基于巴西听力保健专业服务和诊断程序的覆盖情况，对国家听力保健政策（PNASA）进行评估。
这是一项评估研究，重点关注按地区及巴西全国范围提供中等和高复杂性诊断程序的专业服务的覆盖情况。我们分析了2004 - 2011年期间从统一卫生系统信息部数据库（DATASUS）收集的数据，数据链接为“健康信息”，并使用Tabwin软件制成表格。从该平台收集数据时，我们选择了“诊断目的程序”，所选的组织方式为中等和高复杂性的“耳鼻咽喉科/听力学诊断”。我们根据该国五个地理大区估算了程序数量的覆盖范围和变化情况。
我们发现全国范围内服务覆盖范围增加了113%，中等和高复杂性听力健康诊断程序的数量增加了61%。北部地区的程序数量增加了78%，高于所有其他地区。然而，东南部进行的程序数量比例更大。我们发现用于听力分诊的耳声发射（OAE）检查、瞬态诱发耳声发射和畸变产物耳声发射的检查数量，以及3岁以上患者听力损失诊断重新评估的数量都有显著增加。
自PNASA实施以来，巴西听力保健方面的服务和行动有所增加，但这些服务的地区分布不平等现象仍然存在。
