0306/2019 - Fatores associados ao atraso no tratamento cirúrgico primário de fissuras labiopalatinas no Brasil: Uma análise multinível. Factors associated with delayed primary surgical treatment of cleft lip and palate in Brazil: A multilevel analysis.
Investigou-se o atraso no tratamento cirúrgico primário de fissuras labiopalatinas, no Brasil, no âmbito do SUS e o efeito do contexto sociodemográfico e de indicadores socioeconômicos municipais no acesso a esse tratamento (2009-2013). Utilizaram-se informações das Autorizações de Internação Hospitalar pagas para cirurgias primárias de lábio e de palato e variáveis socioeconômicas municipais (2010). Aplicaram-se os parâmetros adotados pela American Cleft Palate-Craniofacial Association: cirurgia de fissura de lábio (FL) aos 12 meses e de fissura de palato (FP) aos18 meses. Observou-se uma prevalência de 66,4% de atraso para cirurgias de lábio e 71,2% para cirurgias de palato, com piores percentuais nas regiões Norte (83,8% para FL e 86,6% para FP) e Nordeste (69% para FL e 75,2% para FP). Não brancos apresentaram maior prevalência de atraso nas cirurgias de fissuras de lábio com RP = 1,40 (IC 95%: 1,30-1,50) e de fissuras palatinas com RP = 1,27 (IC 95%: 1,21-1,33). A análise multinível identificou influência da cor auto referida e do Índice de Desenvolvimento Humano municipal (IDH-M) no atraso da queiloplastia primária e o IDH-M no atraso da cirurgia de palato. Ficou evidente a determinação social e o efeito de contexto no acesso a essas cirurgias no Brasil.
Palavras-chave:
Fissura labial, Fissura palatina, Cirurgia, Fatores epidemiológicos, Serviços de Saúde.
Abstract:
This study analyzed the delay of the primary surgical treatment of patients with cleft lip and palate in Brazil performed under the Brazilian Health System (SUS), and the effect of the sociodemographic context and municipal socioeconomic indicators on the access to this treatment (2009-2013). It was used datathe Decentralized Hospital Information System related on all hospital authorizations forms paid for primary lip and/or palate surgeries and socioeconomic data (2010). The ages recommended by the American Cleft Palate-Craniofacial Association (12 months for lip surgeries and 18 months for palatal surgeries) were used as parameters. The prevalence of delay of lip primary surgeries was 66.4% and of the palatal surgeries was 71.2%. The North and Northeast regions had the worst percentages of delay. Non-whites had a greater prevalence of delay in cleft palate surgeries with RP = 1.27 (1.21-1.33) and those in cleft lip surgeries with RP = 1.40 (1.30-1.50). The multilevel analysis identified influence of self-reported skin color and Human Development Index (HDI) on the delay of primary surgery of lip, and of HDI and Gini index on the delay of the palate surgery. The importance of social determination on the access to primary surgeries of cleft lip and palate was evident.
Keywords:
Cleft lip, Cleft palate, Surgery, Epidemiologic Factors, Health Services.
Factors associated with delayed primary surgical treatment of cleft lip and palate in Brazil: A multilevel analysis.
Resumo (abstract):
This study analyzed the delay of the primary surgical treatment of patients with cleft lip and palate in Brazil performed under the Brazilian Health System (SUS), and the effect of the sociodemographic context and municipal socioeconomic indicators on the access to this treatment (2009-2013). It was used datathe Decentralized Hospital Information System related on all hospital authorizations forms paid for primary lip and/or palate surgeries and socioeconomic data (2010). The ages recommended by the American Cleft Palate-Craniofacial Association (12 months for lip surgeries and 18 months for palatal surgeries) were used as parameters. The prevalence of delay of lip primary surgeries was 66.4% and of the palatal surgeries was 71.2%. The North and Northeast regions had the worst percentages of delay. Non-whites had a greater prevalence of delay in cleft palate surgeries with RP = 1.27 (1.21-1.33) and those in cleft lip surgeries with RP = 1.40 (1.30-1.50). The multilevel analysis identified influence of self-reported skin color and Human Development Index (HDI) on the delay of primary surgery of lip, and of HDI and Gini index on the delay of the palate surgery. The importance of social determination on the access to primary surgeries of cleft lip and palate was evident.
Palavras-chave (keywords):
Cleft lip, Cleft palate, Surgery, Epidemiologic Factors, Health Services.
Sousa, G.F.T, Oliveira, A.G.R.C. Fatores associados ao atraso no tratamento cirúrgico primário de fissuras labiopalatinas no Brasil: Uma análise multinível.. Cien Saude Colet [periódico na internet] (2019/out). [Citado em ].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/fatores-associados-ao-atraso-no-tratamento-cirurgico-primario-de-fissuras-labiopalatinas-no-brasil-uma-analise-multinivel/17380?id=17380&id=17380
