Health survey in a peruvian health system (ENSSA): design, methodology and general results / Encuesta de salud en un sistema sanitario peruano (ENSSA): diseño, metodología y resultados generales

ABSTRACT OBJECTIVE To report the design, methodology and initial results of the National Socioeconomic Survey of Access to Health of the EsSalud Insured. RESULTS There were interviews in 25,000 homes, surveying 79,874 people, of which 62,659 were affiliated to EsSalud. The insured people are mainly males (50.6%) with a higher technical education level (39.7%). The insured population has mostly independent (95.0%) and own (68.1%) home. Only 34.5% of the insured practice some sport or physical exercise; 14.0% of the population suffers from a chronic disease; 3.5% have diabetes; and 7.1%, arterial hypertension. In the last three months, 35.4% of the members needed medical attention; of these, only 73.1% received health care and the remaining 10.9% were treated in pharmacies or non-formal health care services. RESULTS The 25,000 homes were interviewed, surveying 79,874 people, of which 62,659 were affiliated to EsSalud. The insured people are mainly males (50.6%) with a higher technical education level (39.7%). The insured population has mostly independent (95.0%) and own (68.1%) home. Only 34.5% of the insured practice some sport or physical exercise; 14.0% of the population suffers from a chronic disease; 3.5% have diabetes; and 7.1%, arterial hypertension. In the last three months, 35.4% of the members needed medical attention; of these, only 73.1% received health care and the remaining 10.9% were treated in pharmacies or non-formal health care services. CONCLUSIONS This survey is the first performed in the population of EsSalud affiliates, applied at the national level, and has socio-economic and demographic data of the insured, their distribution, risk factors of health, prevalence of health problems and the degree of access to health services.

RESUMEN OBJETIVO Reportar el diseño, metodología y resultados iniciales de la Encuesta Nacional Socioeconómica de Acceso a la Salud de los Asegurados de EsSalud. MÉTODOS La Encuesta se ejecutó en los 24 departamentos del país. Los temas investigados fueron: características de la vivienda y miembros del hogar, educación, salud, empleo e ingreso y gastos del hogar. Se realizó un tipo de muestreo bi-etápico: la unidad primaria de muestreo estuvo conformada por conglomerados compuestos por una manzana dentro del ámbito de cobertura del centro asistencial; la unidad secundaria de muestreo fueron viviendas particulares donde habitaba al menos un asegurado a EsSalud. Se analizaron los datos de 62,659 afiliados y se muestran porcentajes ajustados por el factor de expansión. Para las comparaciones, se utilizó la prueba de chi-cuadrado. RESULTADOS Se entrevistaron 25000 viviendas, encuestándose a 79,874 personas, de las cuales 62,659 eran afiliados a EsSalud. Los afiliados son principalmente varones (50.6%) con un nivel de educación técnico superior (39.7%). La población afiliada cuenta mayoritariamente con vivienda independiente (95.0%) y propia (68.1%). Solo el 34.5% de los asegurados practica algún deporte o ejercicio físico. El 14.0% de la población padece de alguna enfermedad crónica; el 3.5% presenta diabetes; y el 7.1%, hipertensión arterial. En los últimos tres meses, el 35.4% de los afiliados necesitaron atención médica; de estos, solo el 73.1% recibieron atención sanitaria y el 10.9% restante se atendieron en farmacias o servicios no formales de atención en salud. CONCLUSIONES Esta encuesta es la primera realizada en la población de afiliados a EsSalud, aplicada a nivel nacional, y cuenta con datos socioeconómicos y demográficos de los asegurados, su distribución, factores de riesgo de la salud, prevalencia de los problemas de salud y el grado de acceso a los servicios de salud.

Bat diversity of Ilha da Marambaia, Southern Rio de Janeiro State, Brazil (Chiroptera, Mammalia) / Diversidade de morcegos da Ilha da Marambaia, Sul do Rio de Janeiro, Brasil (Chiroptera, Mammalia)

Few sites have been well sampled for bats, and samplings in islands are even scarcer. Therefore, the objectives of the present study were: (1) to list the bat species of Ilha da Marambaia; (2) to compare richness, abundance and biomass of bat guilds found there; (3) to analyse abundance patterns of bat species; and (4) to compare richness, abundance and composition of the bat fauna among different kinds of environment. To capture bats we used mist nets set in five different environments, totalising 3559.2 net-hours, during 37 nights between October 2006 and August 2008. A total of 1,133 captures were accomplished, comprising 34 species from five families. The most abundant species was Molossus molossus. Frugivorous bats exhibited higher richness, abundance and biomass if compared to other guilds. Most species (N = 22) exhibited abundances between 1 to 10 percent of all captures. Sixteen species were restricted to just one of the environments sampled. The high richness may be attributed to sampling carried out in several environments, and to the capture of insectivorous species over water bodies.

Poucos são os locais satisfatoriamente amostrados para morcegos e menos ainda as ilhas. Os objetivos deste estudo foram listar as espécies de morcegos da Ilha da Marambaia, comparar a riqueza, abundância e biomassa das guildas de morcegos encontradas, analisar o padrão de abundância das espécies de morcegos e comparar a riqueza, abundância e composição entre os diferentes ambientes amostrados. O método de amostragem consistiu do uso de redes de neblina armadas em cinco ambientes diferentes, totalizando 3559,2 redes-hora, em 37 noites entre outubro de 2006 e agosto de 2008. Foram obtidas 1.133 capturas, compreendendo 34 espécies de cinco famílias. A espécie mais abundante foi Molossus molossus. Os frugívoros apresentaram maior riqueza, abundância e biomassa. A maior parte das espécies (N = 22) apresentou abundâncias entre 1 e 10 por cento do total de capturas. Dezesseis espécies foram restritas a apenas um dos ambientes amostrados. A elevada riqueza encontrada pode ser atribuída à realização de coletas em vários ambientes, e a captura de espécies insetívoras sobre a água.

The Current Status and the Direction for Development of the Health Interview Survey / 한국역학회지

The Health Interview Survey in the Korean National Health and Nutrition Examination Survey is a major source for planning and evaluating the national health promotion policy. The aim of the study is to find the areas for improvement of the current Health Interview Survey in light of its stated purpose and to propose possible means for the improvement. In terms of the survey content, there were several areas that needed improvement: the lack of comparability across the waves, the limit of the number of questions due to the Nutrition Survey and the Examination Survey, non-availability of seasonal statistics, and the dearth of evidence on socioeconomic position variables. To make improvements in the survey content, there is a need to clarify the purpose of the HIS in the KNANES. Second, more items need to be developed to produce the indicators of the Health Plan 2010. Third, core questions and elective questions should be defined. Fourth, multi-level socioeconomic position indicators need to be developed. In terms of the survey methods, the difficulty of managing interviewers and the inefficiency of data input and processing were found to be the areas for improvement. Possible solutions include a survey through the year and the introduction of the CAPI system. In addition, we suggest that a two-year survey period to better synchronize with the local health interview surveys which should be the major data source for the community health promotion plan.

The World Health Survey: a report on the field experience in Brazil / Pesquisa Mundial de Saúde: relato da experiência de campo no Brasil

This article reports on the field experience with the World Health Survey in Brazil with the aim of collaborating in the development and enhancement of the methodology and analyzing interview questions based on the interviewers' experience. The authors comment on the field experience and application of the questionnaire, based on reports by regional coordinators and interviewers, in order to shed light on the context in which the interviews took place. The article reports on how the respondents grasped and interpreted the questionnaire. The authors propose improvements in interviewer training and simple interview reporting measures aimed at improved logistics with such nationwide survey instruments.

O objetivo deste trabalho é relatar as experiências decampo da Pesquisa Mundial de Saúde no Brasil com ointuito de colaborar com o desenvolvimento e aprimoramentoda metodologia e analisar questões doquestionário confrontando-as com a experiência dosentrevistadores. Comentou-se sobre a experiência decampo e a aplicação do questionário aproveitando-serelatos de coordenadores regionais e dos entrevistadorespara conhecer o contexto em que transcorreramas entrevistas. Foram relatadas as experiências com relaçãoao entendimento e compreensão do questionáriopor parte dos entrevistados. Os autores propõem melhoriasna forma de treinamento dos entrevistadores emedidas simples para que elas possam ser relatadasvisando o aprimoramento da logística na aplicação deinstrumentos desta abrangência territorial.

Sampling design for the World Health Survey in Brazil / Aspectos da amostragem da Pesquisa Mundial de Saúde no Brasil

This paper describes the sample design used in the Brazilian application of the World Health Survey. The sample was selected in three stages. First, the census tracts were allocated in six strata defined by their urban/rural situation and population groups of the municipalities (counties). The tracts were selected using probabilities proportional to the respective number of households. In the second stage, households were selected with equiprobability using an inverse sample design to ensure 20 households interviewed per tract. In the last stage, one adult (18 years or older) per household was selected with equiprobability to answer the majority of the questionnaire. Sample weights were based on the inverse of the inclusion probabilities in the sample. To reduce bias in regional estimates, a household weighting calibration procedure was used to reduce sample bias in relation to income, sex, and age group.

Este artigo descreve o desenho da amostra da PesquisaMundial de Saúde no Brasil. A amostra foi selecionadaem três estágios. No primeiro, os setores censitáriosforam divididos em seis estratos, definidos pela situaçãoe porte populacional dos municípios, e selecionadoscom probabilidade proporcional ao seu númerode domicílios. No segundo estágio, os domicílios foramselecionados com eqüiprobabilidade, seguindo um esquemade amostragem inversa, para assegurar vinteentrevistas realizadas por setor. No último estágio foiselecionado com eqüiprobabilidade um adulto (18 anos ou mais) por domicílio para responder aos principaisquesitos do questionário. A expansão da amostrafoi feita com base nas probabilidades de seleção e,para permitir a obtenção de estimativas regionalizadas,os fatores de expansão foram calibrados para assegurarcoerência com os totais populacionais por gruposde macrorregiões, quintos de renda, sexo e gruposetários, por meio de estimadores de regressão.

An antibody survey as an index of immunity to poliomyelitis among Filipinos (1963)

Sera of 1078 healthy individuals in Manila and neighboring provinces were tested this year (1963) for neutralizing antibodies against each of the three types of polio virus. Individuals tested had not been vaccinated against polio. They ranged in age from 1 month to 25 years and over; the majority were children between 1 to 9 years old: Under 6 months old, 92 were positive for neutralizing antibodies, presumably from the mother through placental transfer. This prevalence rate decreased in the 6-12 month group (61.85), to increase again in age groups 1 to 4 years old. Apparently, these would be the two groups that should be given priority immunization where the vaccine supply is limited. By 5 to 9 years old, 98 were positive for polio antibodies and this rate rose to 100 in the 20-24 year groupThe present study did not include observations on the socio-economic factors in view of the need for detailed consideration of many combined factorsIt was not possible either to determine changing patterns of polio infection as compared to the first work of Hammon (1955) in view of a great difference in the number of individuals tested in these two surveys. (Summary)

Survey Methods on Cancer Epidemic / 예방의학회지

The survey methods for confirming the epidemicity and identifying the possible causes of the cancer epidemic can be different from those for infectious diseases. The procedure for confirming whether the outbreak is epidemic or not is quite different. Household survey for identifying cancer cases and residents actually living at the area should be done. Hospital survey for medical record review should be performed to identify all cancer cases among the residents of the outbreak area and confirming the final diagnoses of the cancer cases. Comparing the level of cancer incidence or mortality with other areas can be done by using poison distribution, or calculating SIR (standard Incidence Ratio) from cumulative incidence rates. Case-control study can be conducted to identify the etiologic factors of the cancer epidemic and to establish strategy for preventing further recurrence of the outbreak.