0246/2015 - Fatores associados a pneumonia em crianças Yanomami internadas por condições sensíveis a atenção primária na região norte do Brasil Associated factors with pneumonia in Yanomami children hospitalized for ambulatory care-sensitive conditions at the North Region of Brazil
Em países em desenvolvimento, a pneumonia é a principal causa de adoecimento e morte na infância, principalmente em grupos vulneráveis. O objetivo deste estudo foi analisar os fatores associados a pneumonia em crianças Yanomami internadas por condições sensíveis à atenção primária (ICSAP). As internações foram divididas em dois grupos: i) pneumonias e ii) demais causas, de acordo com a lista brasileira de ICSAP. Foram estimadas taxas ajustadas de ICSAP e utilizou-se a regressão logística não-condicional para analisar fatores associados. Mais de 90% dos registros foram considerados ICSAP. A taxa padronizada de ICSAP foi 18,6/1000. As chances de internação por pneumonia foram 2,7 (IC: 1,3-5,4) vezes maiores em crianças de 0,1 a 5,9 meses; 1,9 (IC: 1,1-3,3) vezes maiores nas crianças que tiveram a duração da hospitalização variando de 8 a 14 dias; e 3,0 (IC: 1,2-7,5) vezes maiores nas crianças com diagnóstico secundário de desnutrição. O excesso de internações evitáveis é um forte indício da baixa qualidade das ações em terras indígenas e do limitado acesso à atenção primária, contrariando o modelo assistencial proposto pelo subsistema de saúde indígena no Brasil que, em tese, deveria privilegiar tecnologias assistências ancoradas na atenção primária.
Palavras-chave:
pneumonia
internação hospitalar
fatores de risco
saúde indígena
Abstract:
Pneumonia is the leading cause of morbidity and mortality in childhood, mainly in developing countries, especially in vulnerable groups. The aim of this study was to analyze associated factors the pneumonia in Yanomami children hospitalized for ambulatory care-sensitive conditions (ACSC). Hospitalizations were divided into two groups: i) pneumonia and ii) other causes, according to the Brazilian list of ACSC. Hospitalizations adjusted rates were estimated. Factors associated with pneumonia were performed using unconditional logistic regression. Over 90% of the records were considered ACSC. The adjusted rate of ACSC was 18.6/1000. The odds ratio of hospitalization for pneumonia were 2.7 (CI: 1.3-5.4) times higher in children from 0.1 to 5.9 months; 1.9 (CI: 1.1-3.3) times higher in children who had the duration of hospitalization with 8-14 days; and 3.0 (CI: 1.2-7.5) times higher in children with malnutrition as secondary diagnosis. Excess of avoidable hospitalizations is a strong sign of the low quality of actions and limited accessibility to primary care in indigenous territories, contrary assistance model proposed by the indigenous healthcare subsystem in Brazil which, should focus in assists technologies inspired in primary care.
Keywords:
pneumonia
ambulatory care censitive conditions
risk factors
indigenous health services
Associated factors with pneumonia in Yanomami children hospitalized for ambulatory care-sensitive conditions at the North Region of Brazil
Resumo (abstract):
Pneumonia is the leading cause of morbidity and mortality in childhood, mainly in developing countries, especially in vulnerable groups. The aim of this study was to analyze associated factors the pneumonia in Yanomami children hospitalized for ambulatory care-sensitive conditions (ACSC). Hospitalizations were divided into two groups: i) pneumonia and ii) other causes, according to the Brazilian list of ACSC. Hospitalizations adjusted rates were estimated. Factors associated with pneumonia were performed using unconditional logistic regression. Over 90% of the records were considered ACSC. The adjusted rate of ACSC was 18.6/1000. The odds ratio of hospitalization for pneumonia were 2.7 (CI: 1.3-5.4) times higher in children from 0.1 to 5.9 months; 1.9 (CI: 1.1-3.3) times higher in children who had the duration of hospitalization with 8-14 days; and 3.0 (CI: 1.2-7.5) times higher in children with malnutrition as secondary diagnosis. Excess of avoidable hospitalizations is a strong sign of the low quality of actions and limited accessibility to primary care in indigenous territories, contrary assistance model proposed by the indigenous healthcare subsystem in Brazil which, should focus in assists technologies inspired in primary care.
Palavras-chave (keywords):
pneumonia
ambulatory care censitive conditions
risk factors
indigenous health services
Caldart, Raquel Voges, Orellana, Jesem Douglas Yamall, Basta, Paulo, Marrero, Lihsieh. Fatores associados a pneumonia em crianças Yanomami internadas por condições sensíveis a atenção primária na região norte do Brasil. Cien Saude Colet [periódico na internet] (2015/set). [Citado em 24/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/fatores-associados-a-pneumonia-em-criancas-yanomami-internadas-por-condicoes-sensiveis-a-atencao-primaria-na-regiao-norte-do-brasil/15319?id=15319&id=15319
