Atenção à saúde de pessoas com diabetes e hipertensão no Brasil: estudo transversal do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica, 2014 / Atención de salud para personas con diabetes e hipertensión en Brasil: estudio transversal del Programa para Mejorar el Acceso y Calidad de la Atención Primaria, 2014 / Health care for people with diabetes and hypertension in Brazil: cross-sectional study of Program for Improving Access and Quality of Primary Care, 2014

Objetivo:Avaliar a atenção às pessoas com diabetes e hipertensão, comparando as equipes segundo sua participação nos ciclos I e II do Programa de Melhoria do Acesso e da Qualidade (PMAQ), e verificar sua associação com características dos usuários e municípios. Métodos: Estudo transversal, com dados do PMAQ em 2014. Foram utilizadas variáveis de organização da equipe, solicitação de exames e atenção referida pelos usuários. Resultados: Trinta e cinco por cento das equipes apresentaram organização adequada e 88% solicitaram todos os exames. Entre os usuários, 31% tiveram seus pés examinados e 18% referiram ter recebido atenção adequada. Municípios da região Sudeste, com mais de 300 mil habitantes e maior índice de desenvolvimento humano apresentaram melhores indicadores. As equipes participantes dos ciclos I e II mostraram melhores prevalências de organização e solicitação de exames. Conclusão: A atenção à pessoa com diabetes e hipertensão na rede básica de saúde brasileira necessita de melhorias.

Objetivo: Evaluar la atención a personas con diabetes e hipertensión, comparando equipos según participación en los ciclos I y II del Programa de Mejoramiento del Acceso y Calidad (PMAQ) y verificar asociación con características de los usuarios y municipios. Métodos: Estudio transversal con datos del PMAQ, en 2014. Se utilizaron variables de organización del equipo, solicitud de exámenes y atención informada por los usuarios. Resultados: 35% de los equipos presentaron organización adecuada y el 88% solicitó todos los exámenes. Entre los usuarios a 31% se les examinó los pies y 18% informó haber recibido atención adecuada. Municipios del sudeste, con más de 300 mil habitantes e Índice de Desarrollo Humano más alto, presentaron mejores indicadores. Los equipos que participaron en los ciclos I y II mostraron mejor prevalencia de organización y solicitación de exámenes. Conclusión: Es necesario mejorar la atención a personas con diabetes e hipertensión en la atención primaria.

Objective: To assess health care for people with diabetes and hypertension, comparing the teams according to their participation in both cycles I and II of the Program for Improving Primary Health Care Access and Quality (PMAQ), and to verify its association with the characteristics of service users and municipalities. Methods: This was a cross-sectional study using PMAQ data from 2014. The following variables were used: team organization, request for tests and health care reported by service users. Results: Thirty-five percent of the teams presented adequate organization and 88% requested all tests. Among the users, 31% had their feet examined and 18% received adequate health care. Municipalities in the Southeast region, with more than 300,000 inhabitants and the highest human development index, presented the best indicators. The teams that took part in both cycles I and II showed greater prevalence of organization and request for tests. Conclusion: Health care for people with diabetes and hypertension in primary health care in Brazil needs improvement.

Utilization of inpatient health care and its influencing factors among elderlies in Shandong province / 中华医院管理杂志

Objective@#To investigate the utilization of inpatient health care among the elderlies in Shandong province, and to analyze the factors affecting the inpatient services utilization, so as to provide reference for the elderlies to utilize the inpatient services reasonably.@*Methods@#The survey was conducted in Shandong province in August 2017. Multi-stage stratified cluster random sampling method was used to select 7 070 residents aged 60 and above in 6 counties and districts of Shandong province as the objects of the survey. The survey included the basic family and personal information of the elderlies as well as the utilization of hospitalization services. Chi-square test and rank sum test were used for univariate analysis, and logistic regression was applied for influencing factors.@*Results@#The annual hospitalization rate of the elderlies in Shandong province was 18.1%, and 9.6% of those in need of hospitalization failed to enjoy the service. The annual hospitalization rate of the elderlies aged 80 years and over was 19.9%, and 5.5% of the patients in need had not been hospitalized. Among the inpatient institutions, the proportion of township health centers/community health service centers, county-level(district) medical institutions, prefecture-level medical institutions and provincial-level medical institutions was 29.2%, 29.1%, 37.7% and 1.4%, respectively.Factors influencing the utilization of hospitalization services for the elderlies included age, self-assessment of health, physical examination, chronic diseases, type of medical insurance and income level.@*Conclusions@#More attention should be paid to the hospitalization services for the elderlies aged 80 years and over. Effective measures should be taken to guide the elderlies to fully use primary medical resources. The prevention and control of chronic diseases should be strengthened to promote the rational use of inpatient health services among the elderlies. In addition, more attention should be paid to low-income elderlies to meet their hospitalization needs.