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生殖和非生殖期巴西女性下生殖道和乳腺肿瘤死亡率的卫生服务、社会经济指标和初级保健覆盖情况。

Health Services, Socioeconomic Indicators, and Primary Care Coverage in Mortality by Lower Genital Tract and Breast Neoplasias in Brazilian Women during Reproductive and Non-Reproductive Periods.

机构信息

Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP 05403-000, Brazil.

Epidemiology and Data Analysis Laboratory, Faculdade de Medicina do ABC (FMABC), Santo André, SP 09060-870, Brazil.

出版信息

Int J Environ Res Public Health. 2020 Aug 11;17(16):5804. doi: 10.3390/ijerph17165804.

Abstract

Women's health assistance at the low-complexity level is focused on the most common diseases and can be affected by primary health care coverage, particularly in areas far away from large urban centers. Thus, in this work, we aim to analyze the relationship between socioeconomic status, health care indicators, and primary care coverage in mortality from neoplasms of the lower genital tract and breast in Brazilian women during reproductive and non-reproductive periods. We conducted an ecological study at the Gynecology Discipline, Medicine School, University of São Paulo. Secondary data were collected from women according to reproductive periods and mortality data from the Mortality Information System based on International Classification of Disease-10th edition regarding breast and lower genital tract neoplasms in 2017. The health service and socioeconomic indicators were obtained from the Informatics Department of the Unified Health System and Brazilian Institute of Geography and Statistics. Our results showed that primary care coverage and health service indicators were not associated with mortality from breast cancer and the female lower genital tract, both in reproductive and non-reproductive periods. Sociodemographic indicators were found to be associated with mortality from breast cancer and the female lower genital tract, with income being associated with reproductive period ( = -0.4; 95% CI, -0.8 to -0.03) and educational level in the non-reproductive period ( = 9.7; 95% CI, 1.5 to 18.0).

摘要

女性低复杂度水平的健康援助主要集中在最常见的疾病上,并受到初级卫生保健覆盖范围的影响,特别是在远离大城市中心的地区。因此,在这项工作中,我们旨在分析社会经济地位、卫生保健指标与初级保健覆盖范围之间的关系,以了解巴西女性在生殖和非生殖期生殖道和乳房下部恶性肿瘤的死亡率。我们在圣保罗大学医学系妇科进行了一项生态学研究。二级数据是根据女性的生殖期和死亡率信息系统收集的,死亡率信息系统基于国际疾病分类第 10 版,涉及 2017 年乳房和生殖道下部恶性肿瘤。卫生服务和社会经济指标是从统一卫生系统信息司和巴西地理与统计研究所获得的。我们的结果表明,初级卫生保健覆盖范围和卫生服务指标与生殖期和非生殖期的乳腺癌和女性生殖道下部恶性肿瘤死亡率均无相关性。社会人口学指标与乳腺癌和女性生殖道下部恶性肿瘤的死亡率有关,收入与生殖期有关( = -0.4;95%置信区间,-0.8 至 -0.03),而教育水平与非生殖期有关( = 9.7;95%置信区间,1.5 至 18.0)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c8/7460456/8580d2ddc562/ijerph-17-05804-g001.jpg

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