Banca de DEFESA: ANGELA MARIA DE MEDEIROS SOARES

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
DISCENTE : ANGELA MARIA DE MEDEIROS SOARES
DATA : 02/08/2018
HORA: 08:30
LOCAL: Departamento de Odontologia da UFRN
TÍTULO:

INTERNAÇÕES EM IDOSOS E FATORES CONTEXTUAIS ASSOCIADOS NO NORDESTE BRASILEIRO

PALAVRAS-CHAVES:

Aged; hospitalization; epidemiologic factors

PÁGINAS: 80
GRANDE ÁREA: Ciências da Saúde
ÁREA: Saúde Coletiva
RESUMO:

The present study aimed to investigate the elderly hospitalizations by cause group and by sensitive conditions to basic health (HSCBH), identifying their relationship with contextual factors in the Northeast of Brazil. A cross-sectional ecological study was performed using secondary data from the Hospital Information System of Brazil (SIH-SUS) to describe hospitalization rates by cause group and by HSCBH of the elderly between 2010 and 2015. The dependent variables were the elderly hospitalizations by cause group and by HSCBH. Therefore, the non-hierarchical cluster analysis (K-means) was performed by grouping of municipalities based on the cause group chapters in general admissions and those sensitive to basic care, with 3 Clusters. For the general hospitalization rate, Cluster 1 was characterized by the prevalence of low hospitalization rates, Cluster 2 with a high prevalence of hospitalization rates and Cluster 3 with predominance of intermediate hospitalization rates. In the HSCBH rates, Cluster 1 was classified as intermediate rates, 2 as low rates and 3 high rates. For the association with the dependent variables, were selected 11 independent socioeconomic contextual variables. The variables selected were summarized through the Factor Analysis starting Principal Components Analysis (PCA). Thus, we obtained component 1 that was called "urbanization and its reflexes", the second component being nominated as "favorable socioeconomic context" and the third component titled "little education and dependence of the state". In addition to these variables, we used the GINI Index, HDI, Firjan Index, the average coverage of basic care in municipalities between 2010 and 2015, and the rate of the physician visits among the elderly in basic care during the same period. The total hospitalization rate in the period was 1,212.60, with the greatest number being to circulatory system diseases, followed by respiratory system diseases and infectious/parasitic diseases. The clusters of hospitalization rates differed significantly between contextual factors, so that the municipalities with the highest hospitalization rates presented the highest values for the favorable socioeconomic context, the highest values being related to the few schooling and state dependence of municipalities with lower hospitalization rates. In relation to HSCBH, the total hospitalization rate was 527,524 (43.5% of all hospitalizations), with a higher number of heart failure diseases, followed by cerebrovascular and infectious gastroenteritis. In the association between the rates with the contextual factors, there was a significant difference between all the clusters and the factors. The cluster with the highest admission rates was the one that presented the highest averages for the “favorable socioeconomic contexto” and for “little education and dependence of the state”. The cluster with the lowest hospitalization rates had the highest averages for the "urbanization and its reflexes” factor. In the analysis of the coverage and the rate of physician visits among elderly people in basic care, it was observed that the clusters did not differ significantly, although in the cluster with the highest hospitalization rates, there were the highest number of physician visits among the elderly. About this context, was concluded that in this elderly population there is a predominance of hospitalizations due to diseases of the circulatory system. In the HSCBH, the largest number of hospitalizations is due to heart failure. Regarding the contextual factors, we can conclude that these fators interfere in a significant way in the hospitalizations of the elderly population, being relevant the point of these factors in the construction of the health public policies, taking into account the vulnerabilities of this population and contributing to the improvement of the elderly health  and the reduction of hospitalizations in this population.

MEMBROS DA BANCA:
Presidente - 277398 - KENIO COSTA DE LIMA
Interno - 1149540 - ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
Externo ao Programa - 2330137 - VILANI MEDEIROS DE ARAUJO NUNES
Externo à Instituição - ALBERT ESPELT HERNANDEZ - ASPB
Externo à Instituição - LEANDRO DE ARAUJO PERNAMBUCO - UFPB