ABSTRACT
Abstract Background Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality statistics in Brazil and worldwide. The evaluation of the temporal and spatial distribution of mortality due to CVD is essential to support actions aimed at monitoring the implementation of health policies. Objectives To analyze the temporal trend of mortality due to CVD from 2009 to 2019, as well as the main causes of death according to gender and age group in nine cities of Rio Grande do Sul (RS). Methods This is an ecological study based on data from the Mortality Information System. The rates were stratified according to gender, age group and cause, which were composed of ischemic heart diseases (IHD), cerebrovascular diseases and hypertensive diseases (HD). Prais-Winsten regression was used for time trend estimates. Results Three out of the nine cities analyzed showed a significant reduction in the overall mortality rates due to CVD in the timeframe evaluated (p<0.05). When the cause of death was analyzed, there was a decreasing trend in mortality due to IHD in Caxias do Sul, Ijuí and Porto Alegre. In these cities and also in Passo Fundo and Uruguaiana, there was a decrease in mortality due to cerebrovascular diseases. The cities of Ijuí, Porto Alegre and Santa Maria recorded an increase in hypertensive disease mortality rates. In most cities, there was an increase in rates related to greater age and male sex. Conclusion Heterogeneity was observed in the trend of mortality due to CVD throughout the historical series, which may be related to the execution of public policies and the control of cardiovascular risk factors in the evaluated territories.
ABSTRACT
Estudar a prevalência de continuidade interpessoal na atenção à saúde e seus determinantes. Foi realizado um estudo transversal de base populacional com 3.133 indivíduos com 20 anos ou mais da zona urbana de Pelotas, Rio Grande do Sul, Brasil. A análise multivariável foi realizada através de regressão de Poisson, tendo no primeiro nível variáveis sócio-econômicas e demográficas e no nível proximal, variáveis assistenciais e de necessidades em saúde. A prevalência de continuidade interpessoal na atenção à saúde foi de 43,7 por cento (IC95 por cento: 42,0-45,5). Sexo feminino, idades avançadas, maior renda, consulta no último ano, relato de doença crônica e não consultarem no sistema público de saúde apresentaram maior continuidade interpessoal na atenção à saúde. Entre os que consultam em unidades básicas de saúde, sexo feminino, aumento da idade e o Programa Saúde da Família estiveram associadas com continuidade interpessoal na atenção à saúde. Alguns grupos vulneráveis, como aqueles de baixa renda e usuários do sistema público de saúde, apresentaram menores prevalências do desfecho.
This study focused on the prevalence of interpersonal continuity of care and its determinants. A cross-sectional population-based study was conducted with 3,133 individuals 20 years or older in Pelotas, Rio Grande do Sul State, Brazil. Multivariate analysis used Poisson regression, with the first level representing socioeconomic and demographic variables and the proximal level including health care and health needs variables. Prevalence of interpersonal continuity of care was 43.7 percent (95 percentCI: 42.0-45.5). Female gender, higher age, higher income, consultation during the previous year, report of chronic disease, and consultation outside the public health system showed higher interpersonal continuity of care. Among individuals that consulted in public primary health care services, female gender, age, and the Family Health Program were associated with interpersonal continuity of care. Some vulnerable groups (low-income and users of the public health system) showed low prevalence of the outcome.