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由公共卫生系统的一家肿瘤学参考中心接待的、为寻求适当医疗保健而迁移的巴西肿瘤患者的流行病学概况。

Epidemiological profile of Brazilian oncological patients seen by a reference oncology center of the public health system and who migrate in search of adequate health care.

作者信息

Cubero Daniel I G, Sette Cláudia Vaz de Melo, Piscopo Beatriz de Camargo Preto, Monteiro Camila Ribeiro de Arruda, Schoueri Jean Henri Maselli, Tavares Heloísa Duarte de Andrade, Argani Igor Luiz, Garcia Marília Arrais, Passarela Karoline, Del Giglio Auro

机构信息

. ABC School of Medicine (Faculdade de Medicina do ABC - FMABC), Santo André, São Paulo, Brasil.

出版信息

Rev Assoc Med Bras (1992). 2018 Sep;64(9):814-818. doi: 10.1590/1806-9282.64.09.814.

Abstract

INTRODUCTION

Structural disparities between different Brazilian regions in public health system cause patients to migrate in search of better conditions to treat their diseases. Besides patient's discomfort, there is a concentration of care in large centres, causing overload to current capacity.

OBJECTIVE

To evaluate migratory flow and associated factors in a reference service in oncology.

METHODS

Cross-sectional study conducted at a referral oncology service in Great ABC region of São Paulo. Patients were interviewed, and clinical and demographic data collected.

RESULTS

Between March-July 2016, 217 patients were included. Analysis showed a divergence between the postal code registered in the medical record and that recorded during the interview in approximately 10% of cases. Of these, 42.9% were residents of other states. Search for treatment motivated most patients to seek service outside their city.

CONCLUSION

Results reflect the informal search for medical care outside the home area. Besides the direct impact on patients' quality of life, migratory flow has an economic-social impact because these patients place a burden and impose costs on services of cities where they do not perform their responsibilities as citizens. Confirmation of the existence of a significant migratory flow demonstrates the need to discuss restructuring public health policies.

摘要

引言

巴西不同地区公共卫生系统存在结构差异,导致患者为寻求更好的疾病治疗条件而迁移。除了给患者带来不便外,医疗资源还集中在大型医疗中心,导致现有医疗能力不堪重负。

目的

评估肿瘤学参考服务中的迁移流动情况及相关因素。

方法

在圣保罗大ABC地区的一家肿瘤转诊服务机构开展横断面研究。对患者进行访谈,并收集临床和人口统计学数据。

结果

2016年3月至7月期间,共纳入217例患者。分析显示,约10%的病例中,病历记录的邮政编码与访谈时记录的邮政编码存在差异。其中,42.9%为其他州的居民。寻求治疗促使大多数患者到所在城市以外的地方就医。

结论

研究结果反映了患者在家庭所在地区以外寻求医疗服务的非正式行为。迁移流动除了对患者生活质量有直接影响外,还具有经济社会影响,因为这些患者给他们未履行公民责任的城市的医疗服务带来负担并产生费用。确认存在大量迁移流动表明有必要讨论公共卫生政策的调整。

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