Articoli di riviste: "Brazil's Health System"

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Demo, Maria Laura Orlandi, Larissa Chaiane Orth e Chaiana Esmeraldino Mendes Marcon. "Brazil's health-care system". Lancet 394, n. 10213 (novembre 2019): 1992. http://dx.doi.org/10.1016/s0140-6736(19)32630-3.

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Watts, Jonathan. "Brazil's health system woes worsen in economic crisis". Lancet 387, n. 10028 (aprile 2016): 1603–4. http://dx.doi.org/10.1016/s0140-6736(16)30249-5.

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Qi, Yanling, e Changwei Li. "What Can We Learn from Brazil's Health Care System?" Innovation 1, n. 1 (maggio 2020): 100002. http://dx.doi.org/10.1016/j.xinn.2020.04.002.

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Cornwall, Andrea, e Alex Shankland. "Engaging citizens: Lessons from building Brazil's national health system". Social Science & Medicine 66, n. 10 (maggio 2008): 2173–84. http://dx.doi.org/10.1016/j.socscimed.2008.01.038.

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Hennigan, T. "Economic success threatens aspirations of Brazil's public health system". BMJ 341, n. 29 1 (29 novembre 2010): c5453. http://dx.doi.org/10.1136/bmj.c5453.

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Hanley, Jaclyn. "Does Brazil's Decentralized System Improve Primary Care with the Family Health Program?" Clinical Social Work and Health Intervention 7, n. 4 (17 dicembre 2016): 41–45. http://dx.doi.org/10.22359/cswhi_7_4_06.

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Freitas-Júnior, Ruffo, Debora Melo Gagliato, João Wesley Cabral Moura Filho, Pollyana Alves Gouveia, Rosemar Macedo Sousa Rahal, Régis Resende Paulinelli, Luis Fernando Pádua Oliveira et al. "Trends in breast cancer surgery at Brazil's public health system". Journal of Surgical Oncology 115, n. 5 (6 febbraio 2017): 544–49. http://dx.doi.org/10.1002/jso.24572.

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Buss, P., e P. Gadelha. "Health care systems in transition: Brazil: Part I: An outline of Brazil's health care system reforms". Journal of Public Health 18, n. 3 (1 settembre 1996): 289–95. http://dx.doi.org/10.1093/oxfordjournals.pubmed.a024508.

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Lopes, Thiago Jambo Alves, Milena Simic e Evangelos Pappas. "EPIDEMIOLOGY OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN BRAZIL'S PUBLIC HEALTH SYSTEM". Revista Brasileira de Medicina do Esporte 22, n. 4 (agosto 2016): 297–301. http://dx.doi.org/10.1590/1517-869220162204159074.

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ABSTRACT Introduction: Several studies have reported on the epidemiology of Anterior Cruciate Ligament Reconstruction (ACLR) in Europe and North America; however, there is currently no data relating to Brazil. Objective: To describe the incidence of ACLR in Brazil and investigate temporal trends and differences between age and sex groups. Methods: All reported ACLR cases in the public hospital system between January 2008 and December 2014 were extracted from the Information Technology Department of the Brazilian Ministry of Health. Linear regression analysis was used to assess changes in ACLR incidence in the overall population and among sex and age groups, hospitalization time, and health care costs. Results: A total of 48,241 ACLR were reported from 2008-2014 with an overall incidence of 3.49 per 100,000 persons/year. Males accounted for 82% of the procedures. The incidence of ACLR increased by 56% among males (p=0.01) and by 112% among females (p=0.001). The mean hospitalization time decreased from 2.4 days in 2008 to 1.8 day in 2014 (R2 = 0.883, p= 0.002). The total cost across all years was US$56 million, with a mean of US$1,145 per ACLR. Conclusion: Although the total incidence of ACLR in Brazil is lower compared to other countries, it has increased over the years, especially in females. The creation of an ACLR registry is necessary in the future, for more accurate control and new investigations.

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Gadelha, CAG, MF De La Roca Soares e F. Kamia. "The Brazilian health economicindustrial complex perspective: health as a strategic option for BRICS development". BRICS Health Journal 1, n. 1 (7 ottobre 2024): 5–19. https://doi.org/10.47093/3034-4700.2024.1.1.5-19.

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The Health Economic-Industrial Complex (HEIC) is recognized as a fundamental pillar for the Welfare State, essential for ensuring universal health access and reducing the vulnerability of Brazil's Unified Health System. This paper argues that the HEIC must be positioned as a key vector in the national development strategy, linking the reconstruction of Brazil's economy with social development, science, technology, innovation, and environmental sustainability. These strategies collectively work towards building a dynamic, just, and democratic Brazil. Furthermore, it presents how Brazil, under Lula Presidency, incorporated HEIC in a set of public policies aiming to strengthen the production and innovation in health to increase the Brazilian Health System resilience and increase health access to Brazilian population. Furthermore, the paper explores how the principles of the HEIC can be adapted to the BRICS context. By leveraging this model, BRICS nations can address global health disparities and enhance their capacity to produce vaccines, treatments, diagnostics, and other critical health technologies. Ultimately, this paper advocates for the bold reimagining of the HEIC as a transformative force in BRICS countries capable of driving structural changes in both national and global health landscapes, promoting a healthier, more equitable, and sustainable society.

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Baer, Werner, Antonio Carlos Campino e Tiago Cavalcanti. "Condições e política de saúde no Brasil: uma avaliação das últimas décadas". Economia Aplicada 4, n. 4 (1 dicembre 2000): 763–85. http://dx.doi.org/10.11606/1980-5330/ea145234.

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This article describes the health situation of Brazil's population, the Brazilian health system, and their implication for the development process. Although there were substantial improvements in the last decades, Brazil still has an epidemiological pattern where infectious and parasitic diseases, due to lack of adequate sanitary infrastructure, are still prevalent. This pattern is closely associated with Brazil's highly concentrated income distribution. While the middle and upper income classes can buy health plans and use the type of health care which is similar to that used in advanced industrial countries, the urban poor and the rural population have limited access to public health services, with are mostly quite precarious.

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Macinko, James, e Matthew J. Harris. "Brazil's Family Health Strategy — Delivering Community-Based Primary Care in a Universal Health System". New England Journal of Medicine 372, n. 23 (4 giugno 2015): 2177–81. http://dx.doi.org/10.1056/nejmp1501140.

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Barbosa-Lima, Ricardo, Geissiane Felizardo Vivian, Lincoln Max Rocha Alba, Kaisa Silva Nascimento De Gois, Vivian Aparecida Tomaz, Murilo Correzola Pinto, Flávia Freire Ramos-Silva e Glebson Moura Silva. "Bacilloscopy for leprosy in Brazil's public health system between 2013 and 2022". REVISTA CIÊNCIAS EM SAÚDE 13, n. 4 (28 dicembre 2023): 38–45. http://dx.doi.org/10.21876/rcshci.v13i4.1458.

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Objective: To evaluate the annual number of skin smear microscopies for leprosy performed in the Unified Health System (SUS) in the last decade. Methods: An ecological, longitudinal, retrospective, and quantitative study was conducted using data from the Ambulatory Information System (SIA/SUS). The number of skin smear microscopies for leprosy per 100,000 residents was estimated for Brazil and its five macroregions, between 2013 and 2022, with a significance level (a) of 5%. Results: More than 1.3 million skin smear microscopies were reported in the last decade in the SUS. The median annual incidence was 67 skin smear microscopies for leprosy per 100,000 residents, with the maximum observed in 2013 (82) and the minimum in 2022 (46). Annual incidences in the North, Central-West, and Northeast macro-regions were significantly higher than the national estimate, whereas in the South and Southeast, they were lower (p <0.05). The temporal trend was considered decreasing for the national estimate (p = 0.002), with an annual percentage variation of -5.6% (95%CI = -3.8%; -8.2%). However, after disregarding the years of the COVID-19 pandemic (2020-2022), the trend became stationary (p = 0.181). Furthermore, the incidence during the pre-pandemic period was significantly higher compared with the third year after the advent of the pandemic in all macro-regions of Brazil (p <0.05). Conclusion: It was possible to conclude that the SUS performed a significant number of skin smear microscopies for leprosy in the last ten years, but there are macro-regional disparities in Brazil and a significant impact of the COVID-19 pandemic.

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Lopes, Tatiana Coelho, Joaquim Antônio César Mota e Suelene Coelho. "Perspectives from a home based neonatal care program in Brazil's Single Health System". Revista Latino-Americana de Enfermagem 15, n. 4 (agosto 2007): 543–48. http://dx.doi.org/10.1590/s0104-11692007000400004.

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This study aimed to report aspects of how mothers undertake home care of their infants while the latter are kept in a neonatal home care program. It was based on a qualitative approach and institutional analysis related to the gender category was used as theoretical reference frameworks. Data collection was carried out through semistructured interviews with eleven mothers after discharge from the program. Discourse analysis showed that the mothers assessed this form of care as essential, innovative and positive. It is thus considered an effective intervention from a child-integrated-care perspective, since interference of the team in the everyday lives of these women and their children encompassed not only the clinical aspect but affected other dimensions of their lives. It established a partnership with them and helped the mothers to build greater autonomy in caring for their children. However, there is a need for interinstitutional space, which will create the potential for basic health care actions.

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Castro, Marcia C., Adriano Massuda, Gisele Almeida, Naercio Aquino Menezes-Filho, Monica Viegas Andrade, Kenya Valéria Micaela de Souza Noronha, Rudi Rocha et al. "Brazil's unified health system: the first 30 years and prospects for the future". Lancet 394, n. 10195 (luglio 2019): 345–56. http://dx.doi.org/10.1016/s0140-6736(19)31243-7.

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Teixeira, Maria Glória, Maria C. N. Costa, Luís P. F. Souza, Estela M. R. Nascimento, Maurício L. Barreto, Neusa Barbosa e Eduardo Hage Carmo. "Evaluation of Brazil's public health surveillance system within the context of the International Health Regulations (2005)". Revista Panamericana de Salud Pública 32, n. 1 (luglio 2012): 49–55. http://dx.doi.org/10.1590/s1020-49892012000700008.

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Rauber, Ricardo H. "Avian influenza and Brazilian poultry production – Current situation and prevention strategies. Proceeding of The First International Avian Influenza Summit, University of Arkansas- October 16-17, 2023"". First International Avian Influenza Summit. The University of Arkansas. October 16-17, 2023 3, n. 1 (ottobre 2023): 14. http://dx.doi.org/10.51585/gtop.2023.1.0017.

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Highly Pathogenic Avian Influenza (HPAI), particularly caused by the influenza virus A genus, is a paramount concern for global poultry health. The strains associated with HPAI are known to precipitate mortality rates exceeding 90\%. Beyond the immediate and catastrophic impact on poultry, the emergence of HPAI strains disrupts international poultry trade, leading countries to impose trade bans and shake consumer confidence. By September 19th, 2023, Brazil had reported 106 confirmed outbreaks of HPAI. Most of these incidents were linked to wild birds, totaling 103 cases, while backyard chickens accounted for the remaining three. Notably, most of these outbreaks are situated in coastal regions. However, an exception that demanded attention was the HPAI detection in backyard chickens in Bonito, Mato Grosso do Sul. State-wise analysis reveals differential prevalence patterns. São Paulo and Rio Grande do Sul have documented cases far from their primary poultry hubs. In juxtaposition, Espírito Santo's proximity to the outbreak areas heightens its risk profile. The southern broiler-producing regions, which account for a significant 64\% of Brazil's total production and a whopping 79\% of exports, currently face diminished immediate threats due to their inland geographies. Nevertheless, the episode in Bonito-MS underscores the escalating risks even in regions previously considered low-threat and amplifies the call for perpetual vigilance. Brazil's approach to HPAI defense is structured and well-planned, not a result of hasty improvisation or last-minute measures. It's a result of a long-standing commitment and rigorous planning. The country's legal framework for HPAI prevention has evolved since the 1994 introduction of the National Poultry Health Plan. Successive years saw further tightening of regulations, climaxing with the 2013 National Contingency Plan for Avian Influenza, which underwent revision in 2023. Brazil’s strategy to ward off HPAI is deeply rooted in stringent biosecurity measures. Farms are mandated to erect physical barriers, strictly regulate vehicular and human movement, and uphold rigorous cleaning and disinfection standards. Farm personnel are also trained in and adhere to meticulous personal hygiene protocols. Simultaneously, comprehensive waste management practices are firmly in place. Additionally, the Brazilian government plays a proactive role. Border surveillance, active monitoring of avian populations, and the deployment of passive surveillance within commercial flocks manifest the government's unwavering dedication to the poultry sector. One of Brazil's trump cards against diseases like HPAI is its vertically integrated poultry production model. This modus operandi permits companies and cooperatives to oversee every production stage. Such centralized oversight minimizes financial risks, guarantees consistent quality, and facilitates the swift roll-out of biosecurity directives. Traceability, a cornerstone for rapid disease containment, is inherently assured in this system. The private sector in Brazil not only meets governmental biosecurity standards but frequently surpasses them. It's common to see the integration of extended quarantine durations, intensified disinfection routines, and stringent farm access controls. The commitment to a tiered biosecurity mechanism across diverse poultry production stages is a testament to the industry's intent to ensure a holistic health foundation. Brazil's comprehensive and adaptive approach to HPAI is commendable. The country's strategic alignment between governmental regulations and private sector commitment, especially in the face of recent outbreaks, underscores Brazil's unwavering focus on safeguarding its poultry industry. While the road ahead demands continuous vigilance, Brazil's current strategies and learnings provide valuable insights for global stakeholders.

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Caron, Eduardo, Fernando Lefèvre e Ana Maria Cavalcanti Lefèvre. "In the final analysis, are we a consumer society or not? Implications for health". Ciência & Saúde Coletiva 20, n. 1 (gennaio 2015): 145–53. http://dx.doi.org/10.1590/1413-81232014201.18812013.

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In this paper, the question of Brazil's insertion today as a country with the characteristics of modern consumer societies is discussed, focusing on the commercialization of the health sector, the segmentation of the health system and the contradictions of the rights to health care in the social context in question. Some research data on these issues broadcast in the National News Bulletins of Globo TV during the year of 2012 are presented, in which the high technology private hospital as a consumer icon, the underfunding of the public health system and the rejection of a poor and deprived Unified Health System are analyzed.

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Thumé, Elaine, Luiz Augusto Facchini, Grace Wyshak e Paul Campbell. "The Utilization of Home Care by the Elderly in Brazil's Primary Health Care System". American Journal of Public Health 101, n. 5 (maggio 2011): 868–74. http://dx.doi.org/10.2105/ajph.2009.184648.

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Bigoni, Alessandro, Ana Maria Malik, Renato Tasca, Mariana Baleeiro Martins Carrera, Laura Maria Cesar Schiesari, Dante Dianezi Gambardella e Adriano Massuda. "Brazil's health system functionality amidst of the COVID-19 pandemic: An analysis of resilience". Lancet Regional Health - Americas 10 (giugno 2022): 100222. http://dx.doi.org/10.1016/j.lana.2022.100222.

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Prado, Mariana Mota. "The Debatable Role of Courts in Brazil's Health Care System: Does Litigation Harm or Help?" Journal of Law, Medicine & Ethics 41, n. 1 (2013): 124–37. http://dx.doi.org/10.1111/jlme.12009.

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The 1988 Brazilian Constitution establishes a right to health in two of its provisions. The first provision provides a relatively long list of social rights, which includes not only the right to health, but also the right to the determinants of health such as education, food, employment, and shelter (Art. 6). The second provision (Art. 196) recognizes the two components of the right to health, namely: (i) factors that are likely to affect a person’s health, such as access to clean water, sanitation and nutrition; and (ii) medical care or health services. This second provision establishes that the right to health “shall be guaranteed by means of social and economic policies aimed at reducing the risk of illness and other hazards and by the universal and equal access to actions and services for its promotion, protection and recovery.” It also enumerates state obligations, the first and most important one being the duty of the Brazilian state to guarantee the right to health to every citizen.

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Huerta, C., e A. Libanore. "PND113 MIGRAINE IN BRAZIL'S PUBLIC HEALTH SYSTEM: AN INPATIENT AND OUTPATIENT HISTORICAL ANALYSIS FROM DATASUS". Value in Health 23 (maggio 2020): S281. http://dx.doi.org/10.1016/j.jval.2020.04.1002.

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Martins, Andréa Maria Eleutério de Barros Lima, João Gabriel Silva Souza, Desireé Sant'Ana Haikal, Alfredo Maurício Batista de Paula, Efigênia Ferreira e. Ferreira e Isabela Almeida Pordeus. "Prevalence of oral cancer self-examination among elderly people treated under Brazil's Unified Health System: household health survey". Ciência & Saúde Coletiva 20, n. 4 (aprile 2015): 1085–98. http://dx.doi.org/10.1590/1413-81232015204.00542014.

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The aim of this study was to examine the prevalence of oral cancer self-examinationamong the elderly and confirm whether prevalence was higher among users of the dental services provided by Brazil's Unified Health System (SUS, acronym in Portuguese). A transversal study of elderly people aged between 65 and 74 years living in a large-sized Brazilian municipality was conducted using simple random sampling. Logistic regression was conducted and results were corrected for sample design and unequal weighting using the SPSS(r) software. The study assessed 740 individuals. A total of 492 met the inclusion criteria, of which 101 (22.4%) reported having performed an oral cancer self-examination. Prevalence was higher among users of the dental services provided by the SUS, higher-income individuals, people with higher levels of education, individuals that used a removable dental prosthesis, and people who had not experienced discomfort attributed to oral condition, and lower among people who sought regular and periodic dental treatment and individuals who did not have a drinking habit. This type of self-care should be encouraged by public health policies which respond to the needs of the elderly, with emphasis on users of private and philanthropic services, and other services outside the public health network.

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Vieira-Machado, Cristiani, e Luciana Dias de Lima. "Brazil’s Unified Health System: the fight for a universal right in an unequal country". Salud Pública de México 66, n. 5, sept-oct (17 settembre 2024): 726–31. http://dx.doi.org/10.21149/16309.

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This article analyzes Brazil's Unified Health System (SUS), established by the 1988 Constitution. The article initially presents the previous trajectory of national health policy and the context of democratization in the 1980s, which favored health reform and created a public, universal, and comprehensive health system. It then explores the advances and contradictions recorded in more than three decades of implementation of the SUS. The main advances observed were the creation of institutional mechanisms compatible with the federative arrangement and social participation, political and administrative decentralization, the national expansion of access to health, changes in the health care model, including strengthening primary care, and improvements in health indicators. On the other hand, the persistence of structural problems and disputes between different health agendas, with differences between governments, led to contradictions in financing and public-private relations in health. Despite the differences between countries, the analysis of the Brazilian case provides lessons on the challenges in building universal health systems in Latin America.

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Pinto Junior, Vitor Laerte, José Cerbino Neto e Gerson Oliveira Penna. "The evolution of the federal funding policies for the public health surveillance component of Brazil's Unified Health System (SUS)". Ciência & Saúde Coletiva 19, n. 12 (dicembre 2014): 4841–49. http://dx.doi.org/10.1590/1413-812320141912.05962013.

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Health surveillance (HS) is one of the key components of the Brazilian Unified Health System (SUS). This article describes recent changes in health surveillance funding models and the role these changes have had in the reorganization and decentralization of health actions. Federal law no. 8.080 of 1990 defined health surveillance as a fundamental pillar of the SUS, and an exclusive fund with equitable distribution criteria was created in the Basic Operational Norm of 1996 to pay for health surveillance actions. This step facilitated the decentralization of health care at the municipal level, giving local authorities autonomy to plan and provide services. The Health Pact of 2006 and its regulation under federal decree No. 3252 in 2009 bolstered the processes of decentralization, regionalization and integration of health care. Further changes in the basic concepts of health surveillance around the world and in the funding policies negotiated by different spheres of government in Brazil have been catalysts for the process of HS institutionalization in recent years.

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Sousa, Maria-Sharmila, Mabel Figueiró, Aline Silva, Everton Silva, Marcus Silva, Viviane Pereira e Jorge Barreto. "PP162 Bridging Brazil's Know-Do Gap On Social Engagement In Health Technology Assessment". International Journal of Technology Assessment in Health Care 34, S1 (2018): 129–30. http://dx.doi.org/10.1017/s0266462318002866.

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Introduction:Social engagement in health encompasses the idea of involving (parts of) society as full partners in the decision-making regarding both development and implementation of health technologies. Evidence shows that patient engagement is linked with fewer adverse events, better patient self-management, fewer diagnostic tests, decreased use of healthcare services and shorter lengths of stay in hospitals. Matching the escalating healthcare requirements to face the ongoing societal and economic challenges regarding access and coverage to (new) health technologies is not an easy task for health providers.Methods:We conducted a systematic review (CRD42017068714) designed to address the institutional implementation of social engagement by the Brazilian Ministry of Health. All systematic reviews were evaluated using the new version of AMSTAR and, once all findings are synthesized, we will use the GRADE-CERQual approach to assess for confidence.Results:From 399 publications that met the inclusion criteria, 80 described the implementation of social engagement during the development and implementation of (new) health technologies at various levels (local, regional, national, supranational), countries and for different health technologies and social actors. The remaining 319 publications constitute case studies describing barriers and enablers to implementing social engagement in HTA and coverage decision-making processes. By mapping barriers and facilitators, we explored effectiveness and sustainability, further observing how citizen science-based strategies can ultimately reform health service delivery by innovating the social engagement in health technology development and implementation.Conclusions:This systematic review addresses the know-do gap on social engagement in health technology development and implementation, from a global perspective, as a way of improving the Brazilian Ministry of Health's HTA activities and enabling a Brazilian strategy to reform health service delivery. Enabling social engagement as early as possible, during all the stages of the development cycle, grants a more effective and sustainable health care system.

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Bessa, Jordana, e Naieli Bonatto. "Apgar Scoring System in Brazil's Live Births Records: Differences between Home and Hospital Births". Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 41, n. 02 (12 dicembre 2018): 076–83. http://dx.doi.org/10.1055/s-0038-1675572.

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Objective To promote informed choice for women and to compare home and hospital births in relation to the Apgar score. Methods Mother's profile and Apgar score of naturally born infants (without forceps assistance) in Brazil between 2011 and 2015, in both settings—hospital or home—were collected from live birth records provided by the Informatics Department of the Unified Health System (DATASUS, in the Portuguese acronym). For the analysis, were included only data from low-risk deliveries, including gestational time between 37 and 41 weeks, singleton pregnancy, at least four visits of prenatal care, infants weighing between 2,500 g, and 4,000 g, mother age between 20-40 years old, and absence of congenital anomalies. Results Home birth infants presented significantly higher risk of 0-5 Apgar scores, both in 1 minute (6.4% versus 3%, odds ratio [OR] = 2.2, confidence interval [CI] IC 2–2.4) and in 5 minutes (4.8% versus 0.4%, OR = 11.5, CI 10.5–12.7). Another finding is related to recovery estimates when from an initially bad 1-minute Apgar (< 6) to a subsequently better 5-minute Apgar (> 6). In this scenario, home infants had poorer recovery, Apgar score was persistently < 6 throughout the fifth minute in most cases (71% versus 10.7%, OR 20.4, CI 17–24.6). Conclusion The results show worse Apgar scores for babies born at home, compared with those born at the hospital setting. This is a pioneer and preliminary study that brings attention concerning differences in Apgar score related to home versus hospital place of birth in Brazil.

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Diegoli, H., P. Magalhaes, J. Safanelli, V. Nagel, V. G. Venâncio, R. S. Menegatti, C. H. C. Moro e A. L. Longo. "PND20 BUDGET IMPACT ANALYSIS OF INCORPORATING MECHANICAL THROMBECTOMY FOR TREATMENT OF ACUTE ISCHEMIC STROKE IN BRAZIL'S PUBLIC HEALTHCARE SYSTEM". Value in Health 23 (maggio 2020): S262. http://dx.doi.org/10.1016/j.jval.2020.04.913.

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Matos, Guacira Corrêa de, Suely Rozenfeld e Monica Martins. "Human albumin use at hospitals in the Metropolitan Region of Rio de Janeiro, Brazil". Cadernos de Saúde Pública 26, n. 5 (maggio 2010): 981–90. http://dx.doi.org/10.1590/s0102-311x2010000500020.

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The study analyzes the use of human albumin in hospitals in Rio de Janeiro, Brazil, using inpatient data from the information system of Brazil's health system between 1999 and 2001. Death was the main outcome as patients died in 32% of admissions in which human albumin was used as compared with 4% of all admissions in the same period and region. The Charlson Comorbidity Index was included for risk adjustment. Human albumin was used in 10,111 in-patients more than 1 year old. 87,774 50-ml bottles of 20% human albumin were consumed at a cost of US$ 1,755. The main diagnoses were neoplasms (29.1%), diseases of the digestive system (17.5%) and circulatory system (16%). Death rate increased with age, public ownership of the hospital, clinical services (as opposed to surgical services), length of stay and use of intensive care. Death was associated with use of more than four bottles of human albumin (PR: 1.30; 99%CI: 1.23-1.37), adjusted for severity and speciality. The results are cause for concern as they may be related to poor compliance with guidelines, excess of risk to patients and unnecessary expenses for the public health system.

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de Camargo, Kenneth Rochel. "Celebrating the 20th Anniversary of Ulysses Guimarães’ Rebirth of Brazilian Democracy and the Creation of Brazil's National Health Care System". American Journal of Public Health 99, n. 1 (gennaio 2009): 30–31. http://dx.doi.org/10.2105/ajph.2008.147868.

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Alencar Junior, F. O., L. Dias, L. L. Nascimento-Costa, R. Mascarenhas e R. A. Fernandes. "PAM6 COMPLEMENTARY AND INTEGRATIVE THERAPIES IN BRAZIL'S UNIFIED HEALTHCARE SYSTEM (SUS) IN 2017: AN UNDERREPORTING CASE". Value in Health Regional Issues 19 (ottobre 2019): S10—S11. http://dx.doi.org/10.1016/j.vhri.2019.08.051.

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Melo, Marina, Felippe Lazar Neto, Mateus Trinconi Cunha e Gilberto Castro. "Comparison of lung cancer clinical trials treatment options and standard practice in Brazilian national health system over the last decade." Journal of Clinical Oncology 41, n. 16_suppl (1 giugno 2023): e18678-e18678. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.e18678.

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e18678 Background: New cancer drugs for metastatic non-small cell (NSCLC) and small cell lung cancer (SCLC) have been approved worldwide in the past decade, but expensive pricing has led to unequal access. Despite being categorized as an upper-middle income country, Brazil's public health system is underfunded and has faced difficulties in incorporating new cancer treatments, which is concerning as two-thirds of the population depend on the public health system for their cancer-related medical needs. We hypothesized that the disparity between the standard of care (SOC) provided in developed nations and the prevailing practices in Brazil's public healthcare system is widening. Methods: We conducted a search of the ClinicalTrials.gov database from January 1st, 2012 to December 31th, 2021, for all phase III clinical trials on metastatic lung cancer that had at least one clinical site located in Brazil. We collected data on the experimental arm therapies, planned outcomes, and control arm therapies (used as a proxy for the standard of care worldwide). We then compared the control-arm drug therapy at the trial's start date with the standard practice for lung cancer in the Brazilian Unified Health System (SUS) at that time, using available governmental protocols on lung cancer (PCDT) and recent approvals from the technology health assessment committee (CONITEC). Additionally, we assessed the potential eligibility of patients treating in SUS for second-line therapy trials based on prior required treatments to trial enrollment. We analyzed two time periods: 2012-2016 and 2017-2021. Results: Out of 86 screened trials, 64 were included. 86% of them were on NSCLC, and 67% on first-line settings. Almost half had a biomarker inclusion criterion for enrollment. Immunotherapy was studied most frequently (52%), followed by targeted therapies (36%) and antibody-conjugate drugs (ADC) (9.4%). PD(L)1 was the target of 33% of drug therapies. Compared to 2012-2017, in the 2018-2021 period we observed an increase in available clinical trials (24 vs 40) with similar rates of NSCLC (83% vs. 88%, p = 0.7) and first-line therapies (68 vs 67%, p > 0.9). The proportion of trials with control group therapies better than the standard practice available at the time increased from 8.3% to 38% in the recent time-period (p = 0.011). Among second-line therapy trials, the proportion of trials with mandatory previous therapy unavailable in SUS rose numerically from 12% to 54% (p = 0.085). Conclusions: While the number of trials increased over time, there was a rising proportion of control group therapies better than available standard practice in Brazil. The widening difference between drug therapies in clinical trials and standard cancer treatments creates difficult ethical quandaries for oncologists enrolling patients, and also impacts patient eligibility in advanced settings.

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Matida, Luiza Harunari, Alberto Novaes Ramos Jr., José Eduardo Cajado Moncau, Luiz Francisco Marcopito, Heloisa Helena de Sousa Marques, Regina Célia Menezes Succi, Marinella Della Negra e Norman Hearst. "AIDS by mother-to-child transmission: survival analysis of cases followed from 1983 to 2002 in different regions of Brazil". Cadernos de Saúde Pública 23, suppl 3 (2007): S435—S444. http://dx.doi.org/10.1590/s0102-311x2007001500011.

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Antiretroviral therapy contributes to decreasing morbidity and mortality, and ultimately to increasing survival. In Brazil, there are regional differences in HIV epidemiology regarding pregnant women and children with HIV/AIDS. This study evaluates survival time after AIDS diagnosis in 914 children infected by mother-to-child transmission, reported between 1983 and 1998 and followed until 2002, in Brazil's five regions. Time between birth and HIV diagnosis decreased over the years, mainly in the South and Southeast Regions. There was a significant improvement in survival; more than 75% of cases were still living four years after diagnosis in the 1997-1998 group. This Brazilian study demonstrates that even with regional inequalities in health care infrastructure it is possible for a developing country to establish an effective system of universal and free access to antiretroviral therapy that produces a significant increase in survival for children with AIDS.

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Gabrielle Novais Manzoli, Maria Conceição Moares Lima, Leticia de Alencar Pereira Rodrigues, Afrânio Ferreira Evangelista e Bruna Aparecida Souza Machado. "Market Analysis for Implementing Good Laboratory Practices at the SENAI Institute of Innovation in Advanced Health Systems (ISI-SAS) of SENAI CIMATEC". JOURNAL OF BIOENGINEERING, TECHNOLOGIES AND HEALTH 7, n. 2 (20 luglio 2024): 178–81. http://dx.doi.org/10.34178/jbth.v7i2.391.

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Good Laboratory Practices (GLP) comprise a quality system encompassing organizational processes and conditions under which non-clinical safety studies for human health and the environment are planned, developed, monitored, recorded, archived, and reported. The objective of this work was to analyze the market to guide decision-making regarding the implementation of GLP at CIMATEC's ISI-SAS, following NIT-Dicla-035, with a focus on achieving Conformity with the Principles of Good Laboratory Practices recognized by Cgcre of Inmetro. This study showed that the prevalence of Test Facilities in Brazil's South and Southeast regions became evident. Most companies that responded to the questionnaire expressed interest in GLP studies, particularly cytotoxicity. By comparing the requirements of NIT-Dilca-035 with the structure of ISI-SAS, it was determined that implementing GLP in this sector is feasible, leading to the initiation of Good Laboratory Practices implementation in this area.

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Aleixo, Sabina B., Jose Zago Pulido, Narelle Parmanhane, Ana Arlete Sartoli e Ana Paula Siller. "Insight into quality of life: Understanding the experience of patients with cancer in southern Brazil's public healthcare system." Journal of Clinical Oncology 42, n. 16_suppl (1 giugno 2024): e23223-e23223. http://dx.doi.org/10.1200/jco.2024.42.16_suppl.e23223.

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e23223 Background: This study explores the quality of life of individuals undergoing cancer treatment in the southern region of Brazil within the public healthcare system. Recognizing the potential negative impacts of both the disease and its treatment on patients' well-being, there is a pressing need to comprehensively assess their quality of life. The study aims to understand the challenges faced by these individuals in various well-being dimensions. Methods: Data collection occurred from August 1, 2023, to December 31, 2023, approved by the Ethics and Research Committee (Opinion Number: 6,136,833). Quality of life was assessed using the Brazilian version of the Medical Outcome Survey Short-Form 36 (SF-36), a validated instrument comprising 11 questions. Inclusion criteria included individuals over 18, of any gender, residing in the southern region if the state of Espirito Santo, diagnosed with cancer, and receiving treatment at the public healthcare reference oncology center. Exclusion criteria encompassed those under 18, non-residents of southern region, lacking a cancer diagnosis and undergoing oncohematological treatments. Among 263 eligible participants, 21 were excluded for not meeting inclusion criteria and 16 invited individuals chose not to participate, resulting in a final sample of 226 individuals. Results: The composition of the participant pool comprised 71.6% women and 28.4% men. The evaluation of quality of life utilized the SF-36 instrument, which explores various domains: Functional Capacity, Limitation due to Physical Aspects, Pain, General Health Status, Vitality, Social Aspects, Emotional Aspects, and Mental Health.Functional Capacity saw 44.20% facing significant difficulties, 32.80% experiencing mild difficulties, and 23% reporting no hindrance in daily activities. Physical limitations due to cancer treatment were reported by 61%, while 39% did not face such limitations. Most patients experienced some level of pain; only 24.20% were pain-free. General Health Status varied from excellent (9.10%) to very bad (2%). Vitality fluctuated, with 31% reporting vitality all the time. Regarding the social dimension, most individuals experience interference, while only 37% report no impact.Emotional aspects interfered with daily life for 59% of participants. Conclusions: This research indicates that both physical and emotional aspects are significantly affected in cancer patients from southern Espírito Santo. While physical limitations and pain are prevalent, emotional aspects, including manifestations of anxiety and depression, also play a substantial role in influencing daily life. Understanding these dimensions is vital for developing targeted interventions, especially for vulnerable individuals relying on Brazil's public healthcare system, to enhance the quality of life during cancer treatment.

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Nomelini, Rosekeila Simões, Ana Cristina Macêdo Barcelos, Márcia Antoniazi Michelin, Sheila Jorge Adad e Eddie Fernando Candido Murta. "Utilization of human papillomavirus testing for cervical cancer prevention in a university hospital". Cadernos de Saúde Pública 23, n. 6 (giugno 2007): 1309–18. http://dx.doi.org/10.1590/s0102-311x2007000600006.

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This study aimed to evaluate the performance and cost of using polymerase chain reaction (PCR) and hybrid capture in the detection of cervical intraepithelial neoplasia (CIN) in patients with cytological abnormalities (ASCUS/low-grade squamous intraepithelial lesion - LSIL), and the feasibility of implementing these methods in Brazil's Unified National Health System (SUS). Colposcopy gave a negative predictive value of 92.86% and efficiency of 87.8% for diagnosing CIN. The sensitivity of PCR and hybrid capture for detecting CIN was 83.33% and 66.67%, respectively, and the negative predictive value for diagnosing CIN2/CIN3 was 100% and 94.74%, respectively. The annual cost for 80 patients was lower when all patients with ASCUS/LSIL were referred for colposcopy than when HPV testing was performed and those with positive results were referred for colposcopy. Therefore, at present, it is financially unfeasible for the National Health System to implement HPV testing to screen patients with cytological abnormalities (ASCUS/LSIL). However, considering that large-scale use might make such methods cheaper, PCR should be the chosen method, since it is less expensive, more sensitive, and has a high negative predictive value.

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Mendes da Silva, B., J. Shen, E. Kharitonova, A. Tytula, J. Zawieja, P. Towle, J. Langer e R. Hanley. "EPH68 Introduction of a New Dengue Vaccine (TAK-003) in Brazil's Public Health System: Impact on Public Health and Cost-Effectiveness Across Different Age Groups". Value in Health 27, n. 12 (dicembre 2024): S235. https://doi.org/10.1016/j.jval.2024.10.1198.

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Rolim, Estêvão Cubas, Brandon Vidal De Souza, Lucas Carvalho Souza Teles, Felipe Rodrigues Yung, Dayde Lane Mendonça Da Silva e Dais Gonçalves Rocha. "Social media and health promotion: evaluation of effectiveness in promoting hypertension self-care in urban contexts of social iniquities". OBSERVATÓRIO DE LA ECONOMÍA LATINOAMERICANA 21, n. 10 (19 ottobre 2023): 17125–52. http://dx.doi.org/10.55905/oelv21n10-141.

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This paper explores the role of social media in promoting self-care for Systemic Arterial Hypertension (SAH) and addressing health inequities, emphasizing its significance in the context of the COVID-19 pandemic. It calls for a focus on social determinants of health and highlights the global impact of Chronic Non-Communicable Diseases (NCDs), with a particular focus on Brazil's healthcare system. The research, a collaboration between the University of Brasília and the research initiative Escola de Pacientes DF (EP-DF), employs Participatory Community Based Research (CBPR) to evaluate the impact of social media on SAH self-care in urban areas with social inequities. The study includes a scoping review of relevant articles, document analysis of SAH patient testimonials, and knowledge translation for community understanding. Results from the scoping review show positive changes in self-care behaviors due to social media interventions, while acknowledging challenges such as low Functional Health Literacy (FHL), age, education, and internet access. In conclusion, the paper highlights social media's potential in improving healthcare accessibility and equity for SAH and NCDs in vulnerable communities.

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Assis, Simone Gonçalves de, Thiago Pires, Renata Pires Pesce, Joviana Quintes Avanci e Raquel V. C. Oliveira. "Socioeconomic development, family income, and psychosocial risk factors: a study of families with children in public elementary school". Cadernos de Saúde Pública 27, suppl 2 (2011): s209—s221. http://dx.doi.org/10.1590/s0102-311x2011001400009.

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This article aims to evaluate the effects of Brazil's recent economic growth on the monetary income, consumption patterns, and risk exposures of families with children enrolled in the public elementary school system in São Gonçalo, Rio de Janeiro State, Brazil. The article analyzes the following information on families of 447 children that participated in two waves in a longitudinal study: social stratum, per capita family income, evolution in income over a three-year period, and psychosocial factors. The findings showed a 74.8% increase in the families' income, accompanied by an increase in the consumption of material assets and access to health services. This increase should not be interpreted as a guarantee of improved living and health conditions, since it was spent on basic products and needs that do not substantially affect the families' form of social inclusion. Psychosocial risk factors were frequent among the families, but decreased during the study period, which may either reflect the improved family situation or result from the later stage in child development.

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Peregrino, Antonio, Roberto Silva, Alexander Itria, Carlos Silva, Ana Tolentino, Cristiano Marta, Vivian Schutz, Annibal Scavarda e Cristiane De Oliveira. "PP88 Intravenous Medication Delivery System Cost-Effectiveness Analysis". International Journal of Technology Assessment in Health Care 34, S1 (2018): 99. http://dx.doi.org/10.1017/s0266462318002350.

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Introduction:Medication delivery is one of the most common interventions in clinical practice. It requires the direct involvement of nurses and high precision infusion pumps in order to increase the infusion accuracy. Any mistake in the medication delivery process can lead to a medication error, resulting in adverse events with considerable increases in hospital length of stay and cost. Research studies should analyze this area more in emerging countries, as their realities differ from the realities of developed countries, where most of the literature of this area has been developed. This research study analyses this area in Brazil, a leading emerging country. The incorporation of these technologies in health services have caused two major problems: uncertainty around its effectiveness in reducing adverse drug event rates related to infusion dose errors, and the high cost of their inputs. The objective of this study was to analyze the cost-effectiveness of intelligent drug library infusion pumps to reduce adverse drug events during intravenous medication delivery in pediatric and neonatal patients.Methods:Cost-effectiveness was evaluated using a decision-tree framework, considering two scenarios as the base case: the reference one, which uses conventional infusion pumps for intravenous medication delivery with a volume greater than 60 mL, and an alternative one, which uses the drug library infusion pumps. The analysis is with the Unified Health System (Brazil's publicly funded health care system) perspective. The Monte Carlo simulations addressed the uncertainties of the framework. The effectiveness measure was avoidance of adverse drug events.Results:The probabilistic analysis showed the drug library infusion pumps to be more cost-effective than conventional pumps. This ratified what had already been revealed by acceptance curve, which demonstrated that the drug library infusion pumps are more likely to be cost-effective compared to the conventional infusion pumps (with a minimum of the incremental cost-effectiveness of USD 1,501.28).Conclusions:The study demonstrated that the use of the drug library infusion pumps in the pediatric and the neonatal intensive care unit can improve the results of the adverse drug event reduction strategy.

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Agostinis, Giovanni, e Kevin Parthenay. "Exploring the determinants of regional health governance modes in the Global South: A comparative analysis of Central and South America". Review of International Studies 47, n. 4 (17 maggio 2021): 399–421. http://dx.doi.org/10.1017/s0260210521000206.

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AbstractWhat explains the variation in how states collectively deal with public health challenges across different regions? We tackle this puzzle by comparing the regional health governance efforts pursued within the Central American Integration System (SICA) and the Union of South American Nations (UNASUR). We show that Central America's health governance has been driven by external actors, whereas South America's was driven by states within the region, and remained insulated from external actors’ influence. We argue that the explanation for such variation lies in the interplay of state capacity and regional leadership. In Central America, weak state capacity combined with the absence of a regional leader willing to provide governance resources. This opened up space for external actors to contribute actively to regional health governance, complementing the governance of Central American governments. In South America, Brazil's regional leadership mobilised neighbouring states’ capacities by promoting a South-South cooperation agenda based on intra-regional exchanges among national health bureaucracies, which, however, proved vulnerable to intergovernmental conflicts. Through the comparison of Central and South America, the article bridges the gap between global health governance scholarship and comparative regionalism, providing new insights on the determinants and effects of regional health governance modes in the Global South.

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Baracho, Renata Maria Abrantes, Mozart Joaquim Magalhães Vidigal, Marcelo Franco Porto e Beatriz Couto. "Interdisciplinarity in Smart Systems Applied to Rural School Transport in Brazil". Special Issue on Trans- and Inter-Disciplinary Research, Education, and Communication 22, n. 4 (giugno 2024): 52–59. http://dx.doi.org/10.54808/jsci.22.04.52.

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Interdisciplinarity applied to rural transport in Brazil through expert systems is the focus of this paper. Rural school transport is a challenge, considering the size of Brazil, the great diversity of biomes and insufficient infrastructure. Collaboration between areas by interdisciplinarity articulates individual knowledge through the object and by transdisciplinarity requires developing new knowledge, based on an individual area, going beyond and extrapolating with different criteria. The "Transcolar Rural" intelligent transport system has been developed at the UFMG School of Engineering to plan and manage rural school transport by optimizing routes and costs. The system is used in 13 states in Brazil, 500 municipalities and manages the daily transport of more than 400 thousand students in rural areas. Reducing transportation costs allows resources to be reallocated to other educational activities. The project highlights Brazil's limited resources, recognized by the government, to meet the population's health, education and transport priorities. Transparent information helps managers make decisions and supervise citizens, allowing both parties to determine priorities for resource allocation. The Project demonstrates how interdisciplinarity is effective for complex problems. The project comprehensively addresses the challenges of transporting children in Brazil by integrating technology, exact sciences and applied social sciences.

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Luquetti, Daniela Varela, e Rosalina Jorge Koifman. "Quality of reporting on birth defects in birth certificates: case study from a Brazilian reference hospital". Cadernos de Saúde Pública 25, n. 8 (agosto 2009): 1721–31. http://dx.doi.org/10.1590/s0102-311x2009000800008.

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The aim of this study was to evaluate the coverage, validity and reliability of Brazil's Information System on Live Births (SINASC) for birth defects in a hospital in the city of Campinas (São Paulo State). The study population consisted of 2,823 newborn infants delivered in 2004 at the Women's Integrated Health Care Center (CAISM). A birth defect registry (ECLAMC) was used as the gold-standard. All birth defect cases reported at CAISM in 2004 (92 cases) were selected from SINASC data files. All 168 birth defect cases from the same city and year registered at ECLAMC were also retrieved. An underreporting of 46.8% was observed for all birth defects, and 36.4% when considering only the major birth defects. The ascertained sensitivity and specificity were, respectively, 54.2% and 99.8%. The reliability of three and four-digit ICD-10 coding for birth defects was 0.77 and 0.55 respectively (kappa statistic). These results suggest that information provided by birth certificates in Campinas still presents limitations when seeking to ascertain accurate estimates of the prevalence of birth defects, hence indicating the need for improvements in the SINASC database to enable it to portray birth defect prevalence at birth in this city.

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Teixeira, Jane Blanco, Paulo Roberto Borges de Souza Junior, Joelma Higa e Mariza Miranda Theme Filha. "Mortality from Alzheimer's disease in Brazil, 2000-2009". Cadernos de Saúde Pública 31, n. 4 (aprile 2015): 850–60. http://dx.doi.org/10.1590/0102-311x00144713.

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Alzheimer's disease is the most prevalent type of dementia in the elderly worldwide. To evaluate the mortality trend from Alzheimer's disease in Brazil, a descriptive study was conducted with the Mortality Information System of the Brazilian Ministry of Health (2000-2009). Age and sex-standardized mortality rates were calculated in Brazil's state capitals, showing the percentage variation by exponential regression adjustment. The state capitals as a whole showed an annual growth in mortality rates in the 60 to 79 year age bracket of 8.4% in women and 7.7% in men. In the 80 and older age group, the increase was 15.5% in women and 14% in men. Meanwhile, the all-cause mortality rate declined in both elderly men and women. The increase in mortality from Alzheimer's disease occurred in the context of chronic diseases as a proxy for increasing prevalence of the disease in the population. The authors suggest healthcare strategies for individuals with chronic non-communicable diseases

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Ribeiro, Ana, Flávia Corrêa, Arn Migowski, Aline Leal, Sandro Martins, Tainá Raiol, Carla P. Marques et al. "Rethinking Cervical Cancer Screening in Brazil Post COVID-19: A Global Opportunity to Adopt Higher Impact Strategies". Cancer Prevention Research 14, n. 10 (21 settembre 2021): 919–26. http://dx.doi.org/10.1158/1940-6207.capr-21-0110.

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Abstract The World Health Organization global call to eliminate cervical cancer encourages countries to consider introducing or improving cervical cancer screening programs. Brazil's Unified Health System (SUS) is among the world's largest public health systems offering free cytology testing, follow-up colposcopy, and treatment. Yet, health care networks across the country have unequal infrastructure, human resources, equipment, and supplies resulting in uneven program performance and large disparities in cervical cancer incidence and mortality. An effective screening program needs multiple strategies feasible for each community's reality, facilitating coverage and follow-up adherence. Prioritizing those at highest risk with tests that better stratify risk will limit inefficiencies, improving program impact across different resource settings. Highly sensitive human papillomavirus (HPV)-DNA testing performs better than cytology and, with self-collection closer to homes and workplaces, improves access, even in remote regions. Molecular triage strategies like HPV genotyping can identify from the same self-collected sample, those at highest risk requiring follow-up. If proven acceptable, affordable, cost-effective, and efficient in the Brazilian context, these strategies would increase coverage while removing the need for speculum exams for routine screening and reducing follow-up visits. SUS could implement a nationwide organized program that accommodates heterogenous settings across Brazil, informing a variety of screening programs worldwide.

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Barbosa-Júnior, Valdir, Bruna Aparecida Souza Machado, Katharine Hodel, Jéssica Rebouças-Silva, Helena Hora, Luís Alberto Brêda Mascarenhas, Milena Soares e Roberto Badaró. "Analysis of COVID-19 diagnostic test implementation in Brazil: strategies in place at the beginning of the pandemic". Concilium 24, n. 5 (24 marzo 2024): 460–81. http://dx.doi.org/10.53660/clm-2987-24e01.

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The World Health Organization considers the mass testing one of the main tools for controlling the COVID-19 pandemic. The aim of this study was to evaluate the strategies adopted by the Brazilian Federal Government to promote population testing and access to in vitro diagnostic products for COVID-19 within the Unified Health System. Thus, we analyzed the information collected in databases from ANVISA (Brazilian Health Regulatory Agency), the Ministry of Health and Our World in Data on regulatory flexibility for in vitro diagnostic products for COVID-19, the impacts of acquisition and distribution for tests and the pandemic indicators, respectively. Around 65% of the tests registered at ANVISA were from China, while only 17% were Brazilian tests. Of the 441 registered tests, 67.8% were rapid antibody tests. Brazil only carried out 20 million of the 46 million tests planned for 2020 by the Diagnosis to Care Program. The reduced mass testing and the use mainly of rapid tests for antibodies detection may contribute to the underreporting of the disease and to Brazil's position among the countries that test the least and with a high number of cases and deaths presented in the early years of the COVID-19 pandemic.

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Massard da Fonseca, Elize, Francisco Inácio Bastos e Gilberto Lopes. "Increasing Access to Oral Anticancer Medicines in Middle-Income Countries: A Case Study of Private Health Insurance Coverage in Brazil". Journal of Global Oncology 2, n. 1 (febbraio 2016): 39–46. http://dx.doi.org/10.1200/jgo.2015.001917.

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The World Health Organization estimates that approximately 60% of the world’s new annual cancer cases occur in Asia, Africa, and Central and South America, and that 70% of cancer deaths occur in these regions. Although oral chemotherapy is a promising intervention for cancer treatment, given its high cost, it is usually unavailable in middle-income countries. In 2013, after strong lobbying from civil society, Brazil's Congress passed legislation mandating that all private health insurance companies provide access to oral antineoplastic treatment. The decision to scale up the provision of oral chemotherapy was a watershed event in the regulation of private health insurance in Brazil. Until then, private insurers, which cover 25% of the population, were exempted from the provision of pharmaceutical drugs for home care treatments. This article explores the political process involved in regulating the provision of oral chemotherapy medicines by private health insurers. Elements of this successful advocacy case included investment in strategic communication, specialized knowledge of regulatory policy, and the ability to act via democratic channels of political representation. In turn, the receptiveness of government branches such as the Congress and regulating bodies, as well as the Cancer Awareness Month campaign, opened a window of opportunity. However, prospects for expanded access to such medicines in the public health system are bleak in the short term because of the ongoing political and economic crisis.

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Hochman, Gilberto. "Priority, Invisibility and Eradication: The History of Smallpox and the Brazilian Public Health Agenda". Medical History 53, n. 2 (aprile 2009): 229–52. http://dx.doi.org/10.1017/s002572730000020x.

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This article describes three periods in Brazil's modern history when governmental action was (or was not) taken against smallpox: first, when smallpox control became a priority in the Brazilian sanitary agenda from the nineteenth century to the beginning of the twentieth century; second, when it was rendered politically invisible during decades when greater attention was given to yellow fever and malaria control; third, when it reappeared at the centre of Brazilian health policy in the 1960s until its eventual eradication in 1973. Smallpox control in the latter two periods is suffused with paradox. For example, evidence suggests that the nearly fifty-year absence or lack of policies and agencies to deal with smallpox actually favoured the mobilization of local, national and international resources once the eradication programme was launched in 1966; these new approaches were accelerated from 1969 until the completion of eradication in 1973. Equally paradoxical, it was during the specific context of the military regime after 1964 that the Brazilian health system developed the capacity to mobilize existing but dispersed resources and flexibly to innovate, incorporate, and adapt new policies. Another important element in this period was institutional learning based on other vertical programmes such as the malaria eradication campaign. Although the Brazilian smallpox eradication programme was constrained by international agencies and by bilateral co-operation with the United States, the period after 1964 offered opportunities for the realization of a new and wide-ranging national health capacity including the creation of a national system of epidemiological surveillance and a national childhood immunization programme. It also saw the empowerment of young physicians who would later come to occupy key positions in Brazilian public health and in international health organizations.

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Dos Reis Guerra, J. A., D. O. Magro, C. S. R. Coy, D. A. Valverde, E. S. Oliveira, A. B. Quaresma e P. G. Kotze. "P1209 Temporal trends in surgery and hospitalization rates for crohn's disease in Brazil: A population-based study". Journal of Crohn's and Colitis 19, Supplement_1 (gennaio 2025): i2191—i2193. https://doi.org/10.1093/ecco-jcc/jjae190.1383.

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Abstract Background Crohn's Disease (CD) is a chronic inflammatory condition of the gastrointestinal tract, primarily affecting young adults and adolescents. Biological therapies have advanced CD management, reducing hospitalizations and surgeries. Methods This retrospective, population-based study analyzed CD patients treated by the Brazilian Unified Health System (SUS) from 2012 to 2022. Patients were categorized by pharmacological treatment (azathioprine [AZA], infliximab [IFX], adalimumab [ADA]) based on dispensing records. Prevalence data were extracted from the Brazilian Institute of Geography and Statistics. Hospitalizations, surgeries, and prevalence trends were analyzed using TT Disease Explorer® and quantified as annual and average annual percent changes (AAPC). Statistical analysis was conducted in R software. Results From 2012 to 2022, CD prevalence increased 288.07%, from 14.20 to 52.64 cases per 100,000 inhabitants. The proportion of patients treated with AZA decreased from 44.79% to 19.13%, while IFX remained stable and ADA slightly declined (figure 1). In absolute terms, IFX and ADA usage rose by 251.09% and 242.48%, respectively. Hospitalizations dropped by 59.29%, 6.19% to 2.52%, and surgical procedures by 55.08%, 1.09% to 0.49% (figure 2). Conclusion The results indicate that despite the increase in CD prevalence, therapeutic interventions, especially involving biological agents, have been effective in reducing hospitalizations and surgeries. However, the proportional stability in the use of IFX and ADA, despite the absolute increase, suggests challenges in access and implementation of these therapies across Brazil. Additionally, potential coding errors in hospital records may influence data accuracy, possibly underestimating the true burden of hospitalizations and surgeries. Improvements in health record quality are essential to provide more accurate data and promote more efficient public policies.Over 11 years, there was a significant increase in CD prevalence in Brazil, accompanied by a notable reduction in hospitalizations and surgical procedures. Biological therapies have played a crucial role in improving disease management, though the direct relationship between their use and clinical outcomes requires further investigation. Future studies should focus on reference centers to confirm these trends and assist in planning public policies that optimize CD treatment and improve access to effective therapies in Brazil. References Mowat C, Cole A, Windsor A, et al. Guidelines for the management of inflammatory bowel disease in adults. Gut. 2011;60(5):571-607. doi:10.1136/gut.2010.2241542. Quaresma AB, Kaplan GG, Kotze PG. The globalization of inflammatory bowel disease: the incidence and prevalence of inflammatory bowel disease in Brazil. Curr Opin Gastroenterol. 2019;35(4):259-264. doi:10.1097/MOG.00000000000005343. Quaresma AB, Damiao AOMC, Coy CSR, et al. Temporal trends in the epidemiology of inflammatory bowel diseases in the public healthcare system in Brazil: A large population-based study. Lancet Reg Health Am. 2022;13:100298. Published 2022 Jun 9. doi:10.1016/j.lana.2022.1002984. Palacio FGM, de Souza LMP, Moreira JPL, Luiz RR, de Souza HSP, Zaltman C. Hospitalization and surgery rates in patients with inflammatory bowel disease in Brazil: a time-trend analysis. BMC Gastroenterol. 2021;21(1):192. Published 2021 Apr 27. doi:10.1186/s12876-021-01781-x Figure 1: Proportion of patients by therapy used in Brazil's Unified Health System from 2012 to 2022. Figure 2: Proportion of surgeries and hospitalizations among Crohn's Disease cases in Brazil's public healthcare system from 2012 to 2022.

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Marques, Paulo Leonardo Ponte, Antonio Ferreira Rodrigues Junior e Luiza Jane Eyre de Souza Vieira. "VP34 Incorporation Of Medical Equipment In Northeastern Brazil". International Journal of Technology Assessment in Health Care 34, S1 (2018): 168. http://dx.doi.org/10.1017/s0266462318003501.

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Introduction:Improving universal health coverage is a big challenge in many nations. Nevertheless, in countries like Brazil, the Constitution provides for universal access to meet population needs. Medical equipment is indispensable for the diagnosis and treatment of diseases in public and private health services. This study aims to analyze medical diagnostic equipment incorporation in a Brazilian state.Methods:This evaluative research was carried out using data from Brazil's Unified Health System (SUS) and Private Health Services. The research took place in Ceará, Northeastern Brazil. It is the eighth most populous Brazilian state, with 8.8 million inhabitants. Data on the types and quantity of medical devices in the public and private services were collected from August 2005 to August 2017. The results were analyzed by comparing population and normative parameters with technology incorporation in Brazil.Results:A mean of 17.6 +/− 10.6 (SD) devices were incorporated each year in SUS versus 31.7 +/− 15.7 (SD) in the private services. Over a twelve year period, the incorporation of equipment increased 59.7 percent in the public system and 152.6 percent in the private services. The production from these technologies increased to 18.1 percent. Considering both public and private services, tomography equipment coverage exceeds (147.4 percent) the parameter established by the Ministry of Health while magnetic resonance imaging equipment coverage is 90.5 percent.Conclusions:An expressive number of medical devices were incorporated in public and private health services, with higher rates in the latter. Both services presented a downward trend, suggesting that the incorporation of equipment is no longer needed. Such an extra coverage reveals an uncritical incorporation of these devices, that was not based on real needs; therefore, it is necessary to develop an action plan aimed at a better distribution of these devices to allow effective universal coverage.

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