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Search Results: 1 - 10 of 596291 matches for " Andréa D Bertoldi "
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Desigualdades na utiliza??o e no acesso a servi?os odontológicos: uma avalia??o em nível nacional
Barros,Aluísio J. D.; Bertoldi,Andréa D.;
Ciência & Saúde Coletiva , 2002, DOI: 10.1590/S1413-81232002000400008
Abstract: to study the utilization and access to dental services in brazil, and assess differentials across socioeconomic strata, data from the pesquisa nacional por amostragem de domicílios, 1998 (pnad/ibge), was used. the analysis, adjusted for the sampling design, showed a low level of utilization of dental services. among children 0-6 years of age, 77% had never seen a dentist, and among adults 20-49 years, 4%. in the latter group, the proportion of people that had never been to the dentist in the poorest 20% was 16 times higher than in the richest 20%. the proportion of people visiting a dentist in the year before the interview was greatest in the group 0-6 years of age, rich children presenting a prevalence 5 times higher than the poor ones. about 4% of those who sought dental care did not get it. the proportion was 8% among the poorest compared to 1% among the richest. most of the attendances (68%) was paid by the national health system among the poorest, while 63% of them were directly paid by the richest. great inequalities were found in the access and utilization of dental services, maximal exactly among the groups showing smaller access or utilization. the participation of the national health system in dental care is much lower than in medical care.
Desigualdades na utiliza o e no acesso a servi os odontológicos: uma avalia o em nível nacional
Barros Aluísio J. D.,Bertoldi Andréa D.
Ciência & Saúde Coletiva , 2002,
Abstract: Para avaliar a situa o de utiliza o e acesso aos servi os de odontologia no Brasil e estudar diferenciais entre os estratos socioecon micos, utilizaram-se dados da Pesquisa Nacional por Amostragem de Domicílios (PNAD) de 1998, realizada pelo IBGE. A análise, que levou em conta o desenho amostral, indicou um nível baixo de utiliza o de servi os odontológicos. Setenta e sete por cento das crian as de 0-6 anos e 4% dos adultos de 20-49 anos nunca haviam consultado um dentista. Entre estes adultos, comparando-se os 20% mais pobres com os 20% mais ricos, observou-se que o número de desassistidos era 16 vezes maior entre os primeiros. No grupo de 0-6 anos, as crian as ricas consultaram o dentista cinco vezes mais do que as pobres no ano anterior à entrevista. Cerca de 4% dos que procuraram atendimento odontológico n o o obtiveram, 8% dos quais entre os mais pobres e 1% entre os mais ricos. A maioria (68%) dos atendimentos do grupo mais pobre foi financiada pelo SUS, enquanto 63% deles foram pagos pelos mais ricos. As maiores desigualdades no acesso e na utiliza o de servi os odontológicos foram encontradas, exatamente, nos grupos de menor acesso ou utiliza o. A participa o do SUS nos atendimentos odontológicos é muito mais baixa do que na aten o médica.
Can mothers rely on the Brazilian health system for their deliveries? An assessment of use of the public system and out-of-pocket expenditure in the 2004 Pelotas Birth Cohort Study, Brazil
Aluísio JD Barros, Iná S Santos, Andréa D Bertoldi
BMC Health Services Research , 2008, DOI: 10.1186/1472-6963-8-57
Abstract: All deliveries occurring in the city of Pelotas, Brazil, during 2004, were recruited for a birth cohort study. All mothers were interviewed just after birth and three months later. Comprehensive data on the pregnancy, delivery, birth conditions and newborn health were collected, along with detailed information on expenses related to the delivery.The majority of the deliveries (81%) were financed by the public health system, a proportion that increased to more than 95% among the 40% poorest mothers. Less than 1% of these mothers reported some out-of-pocket expenditure. Even among those mothers covered by a private health plan, nearly 50% of births were financed by the SUS. Among the 20% richest, a third of the deliveries were paid by the SUS, 50% by private health plans and 17% by direct payment.The public health system offered services in quantity and quality enough to attract even beneficiaries of private health plans and spared mothers from the poorest strata of the population of practically any expense.Health costs in low and middle income countries can be an important source of expenditure and it has been shown that they can consume a high proportion of family income, up to catastrophic proportions. Brazil was identified as one of the countries with the highest proportion of households suffering from catastrophic health expenditure in a study comparing 59 countries[1]. This study showed that 10% of Brazilian households spent more than 40% of their capacity to pay (as catastrophic expenditure was defined), compared to 6% in Argentina and Colombia, 1.5% in Mexico, 0.5% in the US and practically zero in France and the UK. The only country with a similar result was Vietnam. Such a result is surprising given that Brazil offers comprehensive and free health services to all citizens through its national health system, the SUS (acronym for what could be translated into English as Unified Health System).The SUS was created in 1988, within the new Constitution, to offer f
Perfil da utiliza??o de antimicrobianos em um hospital privado
Rodrigues,Fernanda d'Athayde; Bertoldi,Andréa Damaso;
Ciência & Saúde Coletiva , 2010, DOI: 10.1590/S1413-81232010000700033
Abstract: the antimicrobials are one of the groups of the most prescribed drugs in hospitals and which cause a great concern for the suitability of their use. the profile of the antimicrobials utilized in a private hospital in the countryside of rio grande do sul state was described and the quantity of each antimicrobial consumed was analyzed. all the prescriptions of patients who utilized antimicrobials while they were hospitalized in the period from march to june 2006 were analyzed. the antimicrobial consumption was expressed in defined daily dose (ddd) in 100 day-beds. the antimicrobial utilization analysis were done generally speaking and divided by age groups and by medical clinics. during the studying period the antimicrobial use prevalence was of 52.4 % (ic 95 % 49.2 - 55.7). the cephalosporins were the most utilized (43.4 %), followed by the penicillins (16.3 %), fluoroquinolones (13.0 %) and aminoglycosides (9.7 %). the high consumption of antimicrobials during the studying period is the result of the absence of a policy for controlling the drugs prescribed in hospital and the lack of protocols of antimicrobial use. in order to exist a control of antimicrobial consumption the hospitals must assume a surveillance policy on the prescriptions of this drug group.
Generic drugs in Brazil: known by many, used by few
Bertoldi, Andréa D.;Barros, Aluísio J. D.;Hallal, Pedro C.;
Cadernos de Saúde Pública , 2005, DOI: 10.1590/S0102-311X2005000600029
Abstract: this study evaluated knowledge and use of generic drugs in a population-based sample of adults from a southern brazilian city. the outcomes were: the proportion of generics in total medicines used; theoretical and practical knowledge about generics; and strategies used to buy medicines on medical prescriptions. the recall period for drug utilization was 15 days. the proportion of generics in total medicines was 3.9%. while 86.0% knew that generics cost less and 70.0% that the quality is similar to brand name medicines, only 57.0% knew any packaging characteristics that distinguish generics from other medicines. the highest proportion of generic drug utilization was in the antimicrobial pharmacological group. a brand name medicine (with a brand similar to the generic name) was mistakenly classified as a generic through photos by 48.0% of the interviewees. among subjects who bought medicines in the 15-day period, 18.9% reported buying a generic, but this result should be interpreted with caution, because the population frequently fails to differentiate between generics and other medicines.
Utiliza??o de medicamentos para tratamento de infec??es respiratórias na comunidade
Berquó,Laura S; Barros,Aluísio J D; Lima,Rosangela C; Bertoldi,Andréa D;
Revista de Saúde Pública , 2004, DOI: 10.1590/S0034-89102004000300004
Abstract: objective: this study describes the utilization of drugs to treat respiratory tract infections in a community setting. the description of antimicrobial and non-antimicrobial drugs use is important to design interventions aimed at improving treatment strategies for these common illnesses. methods: in a population-based cross-sectional study, 6145 individuals living in an urban area in southern brazil were inquired about the use of drugs for the treatment of respiratory tract infections in the 30 days previous to the interview. the pearson chi-square test was used for statistical analyses. results: the global prevalence of respiratory infections treated with drugs was 6.3%. the prevalence was higher for children under 4 years of age (18%) and lower for the elderly (3%; p<0.001). fifty-nine percent of the individuals used antimicrobials to treat respiratory infections. "sore throat" was the main clinical condition associated with drug use (41%). amoxicilin was the antimicrobial drug most frequently used (38%), while non-steroidal antiinflamatory drugs were the most frequent among the non-antimicrobial drugs (27%). conclusions: antimicrobials were used in nearly 60% of the respiratory tract infections treated with some drug, even though they are mostly viral in their origin. the indiscriminate use of these drugs not only raises the costs of treatments, but may also lead to the emergence of bacterial resistance against the antimicrobials.
Utiliza??o dos servi?os de saúde pela popula??o coberta pela Estratégia de Saúde da Família
Fernandes,Léia Cristiane L; Bertoldi,Andréa D; Barros,Aluísio J D;
Revista de Saúde Pública , 2009, DOI: 10.1590/S0034-89102009005000040
Abstract: objective: to analyze health service use patterns in communities covered by the estratégia de saúde da família (family health strategy). methods: population-based cross-sectional study with a sample of 2,988 individuals, of all ages, living in areas covered by the estratégia de saúde da família, in the city of porto alegre, southern brazil, between july and september 2003. pre-coded questionnaires about demographic, socioeconomic and health information were applied to all residents of selected households. prevalence ratios and 95% confidence intervals were calculated and chi-square tests were applied in the analyses. poisson regression was used in the multivariable analysis to control for potential confounding factors. results: females, persons aged 60 years or older, white, with better socioeconomic level, without health care plan coverage and with poor health self-perception were more likely to use the local family health unit. regarding users of other health services, a similar pattern for sex, age and health self-perception was observed. however, greater use was found among people with better socioeconomic level and with health care plan coverage. conclusions: use of a local family health unit was greater among people from a lower socioeconomic level and without health care plan coverage, revealing the poorer individuals to be the priority of governmental actions. model changes made to health care with the implementation of the estratégia saúde da família tend to progressively improve the health conditions of the poorer population, with consequent reduction of health inequalities.
Utiliza??o de antimicrobianos em uma popula??o urbana
Berquó,Laura S; Barros,Aluísio J D; Lima,Rosangela C; Bertoldi,Andréa D;
Revista de Saúde Pública , 2004, DOI: 10.1590/S0034-89102004000200013
Abstract: objective: the emergence of multiresistant microorganisms has been a concerning matter worldwide in the last decades. indiscriminate use of antibiotics has been associated to this phenomenon. the present study was designed to determine the pattern of antimicrobial drug use in an urban community. methods: a population-based cross-sectional study was carried out and 6,145 subjects of all ages living in the urban area of pelotas, brazil, were interviewed on the use of antimicrobial drugs in the 30 days previous to the interview. results: the overall prevalence of antimicrobial drug use was 8%. it was higher for children under 4 years of age (14%; p<0.001), women (9%; p=0.004) and divorced subjects (10%; p=0.02). the clinical conditions most frequently associated with antimicrobial drug use were respiratory tract infections (50%), urinary tract infections (16%), and dental infections (9%). penicillins (41%), sulphas (17%), and tetracycline (8%) were the most commonly used drugs. conclusions: abuse of last generation antimicrobial drugs, a concern of many experts, was not confirmed in this study. antimicrobial drug use could be further reduced as respiratory illnesses, most frequently associated with their use, are often viral and many patients will not benefit from antimicrobial therapy.
Utiliza??o de medicamentos em adultos: prevalência e determinantes individuais
Bertoldi,Andréa D; Barros,Aluísio J D; Hallal,Pedro C; Lima,Rosangela C;
Revista de Saúde Pública , 2004, DOI: 10.1590/S0034-89102004000200012
Abstract: objective: to study epidemiological patterns of drug utilization and its individual determinants and to classify drugs used into pharmacological groups. methods: in a population-based cross-sectional study, 3,182 subjects aged 20 years or more were selected from an urban area in southern brazil using a multi-stage sampling design. data were collected through home interviews using a structured questionnaire. drug use in the previous 15 days was recorded. crude analysis was performed using the chi-square test for heterogeneity and trend and t-test for means' comparison. the adjusted analysis was carried out using poisson regression. results: the overall prevalence of drug utilization was 65.9%. the highest prevalences of drug use after adjusting for confounding were seen among elderly women in the upper economic class who had ill health self-perception. analgesics, anti-inflammatory and anti-hypertensive drugs were the most frequently used drugs. conclusions: the prevalence of drug use was found to be higher than in other national and international studies. studies focusing on individual determinants of drug utilization can identify those groups with higher use. this knowledge might encourage specific strategies to decrease drug use and lead to restrictive policies concerning drug prescription and sale.
Utiliza o de medicamentos em adultos: prevalência e determinantes individuais
Bertoldi Andréa D,Barros Aluísio J D,Hallal Pedro C,Lima Rosangela C
Revista de Saúde Pública , 2004,
Abstract: OBJETIVO: Estudar os padr es de utiliza o de medicamentos, classificando-os por grupos farmacológicos e verificando os determinantes individuais desse uso. MéTODOS: Delineamento transversal de base populacional. Amostra composta por 3.182 indivíduos com 20 anos de idade ou mais, residentes na regi o urbana do município de Pelotas, RS. O processo de amostragem foi conduzido em múltiplos estágios. O instrumento foi um questionário estruturado, utilizando um período recordatório de 15 dias e aplicado através de entrevistas individuais. Na análise bruta, foram utilizados os seguintes testes: qui-quadrado para compara o de propor es, teste t para compara o de médias e o teste de tendência linear. A análise ajustada foi conduzida através de uma regress o de Poisson. RESULTADOS: A prevalência de uso global de medicamentos foi de 65,9%. Os seguintes grupos apresentaram maiores prevalências de utiliza o de medicamentos após análise ajustada: mulheres, idosos, indivíduos de nível econ mico mais elevado e com pior autopercep o de saúde. Os grupos farmacológicos mais utilizados foram os analgésicos, antiinflamatórios e anti-hipertensivos. CONCLUS ES: A prevalência de uso de medicamentos foi superior às encontradas em outros estudos nacionais e internacionais. O estudo dos determinantes individuais de utiliza o de medicamentos indica os grupos mais sujeitos ao uso excessivo, o que pode embasar estratégias específicas para diminuir a utiliza o nesses grupos, tais como políticas mais restritivas para prescri o e venda de medicamentos.
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