ANA PAULA SCOLEZE FERRER
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- Assessment of access to primary health care among children and adolescents hospitalized due to avoidable conditions(2016) FERRER, Ana Paula Scoleze; GRISI, Sandra Josefina Ferraz ElleroIntroduction: Hospitalizations for ambulatory care-sensitive conditions (HACSC) are considered an indicator of the effectiveness of primary health care (PHC). High rates of HACSC represent problems in the access or the quality of health care. In Brazil, HACSC rates are high and there are few studies on the factors associated with it. Objective: To evaluate the access to PHC offered to children and adolescents hospitalized due to ACSC and analyze the conditioning factors. Method: Cross-sectional study with a quantitative and qualitative approach. Five hundred and one (501) users (guardians/caregivers) and 42 professionals of PHC units were interviewed over one year. Quantitative data were obtained using Primary Care Assessment Tool validated in Brazil (PCATool-Brazil), while qualitative data were collected by semi-structured interview. The independent variables were: age, maternal education, family income, type of diagnosis, and model of care offered, and the dependent variables were access and its components (accessibility and use of services). Results: Sixty-five percent (65.2%) of hospitalizations were ACSC. From the perspective of both users and professionals, access and its components presented low scores. Age, type of diagnosis, and model of care affected the results. Conclusion: The proportion of HACSC was high in this population. Access to services is inappropriate due to: barriers to access, appreciation of the emergency services, and attitude towards health needs. Professional attitudes and opinions reinforce inadequate ideas of users reflecting on the pattern of service use.
- Glycemic control strategies and the occurrence of surgical site infection: a systematic review(2016) DOMINGOS, Caroline Maria Herrero; IIDA, Luciana Inaba Senyer; POVEDA, Vanessa de BritoObjective: To analyze the available evidence in the scientific literature on the relationship between glycemic control strategies performed and the occurrence of surgical site infection in adult patients undergoing surgery. Method: This is a systematic review, through the CINAHL, Medline, LILACS, Cochrane Database of Systematic Reviews, and EMBASE, which included 8 studies. Results: Despite the diversity of tested interventions, studies agree that glycemic control is essential to reduce surgical site infection rates and should be kept between 80 and 120 mg/dl during the perioperative period. Insulin continuous infusion during surgery was the most tested and seems to get better results in reducing surgical site infection rates and success in glycemic control compared to other strategies. Conclusion: Strict glycemic control during the perioperative benefits the recovery of surgical patients, especially for the successful implementation of the measure the performance of the nursing team.
- Rollout of community-based family health strategy (programa de saude de familia) is associated with large reductions in neonatal mortality in Sao Paulo, Brazil(2016) BRENTANI, Alexandra; GRISI, Sandra Josefina Ferraz Ellero; TANIGUCHI, Mauro T.; FERRER, Ana Paula Scoleze; BOURROUL, Maria Lucia de Moraes; FINK, GuntherRationale: Several recent studies suggest that Brazil's Estrategia Saude de Familia (Family Health Strategy-FHS) has contributed to declines in mortality at the national and regional level. Comparatively little is known whether this approach is effective in urban populations with relatively easy access to health services. Objectives: To use detailed medical data collected as part of Sao Paulo's Western Region project to examine whether the FHS program had an impact on child health in Sao Paulo, Brazil. Results: No associations were found between FHS and birth weight (OR 1.03, 95% CI 0.93-1.29), gestational length (OR 0.98, 95% CI 0.83-1.15) or stillbirth (OR 1.51, 95% CI 0.75-3.03). FHS eligibility was associated with a 42% reduction in the odds of child mortality (OR 0.58, 95% CI 0.34, 0.91), with largest effect sizes for the early neonatal period (OR 0.18, 95% CI 0.04-0.79). Conclusions: Community based health delivery platforms may be a highly effective way to reduce neonatal mortality in urban areas of low and middle income countries, even when access to general health services is almost universal. (C) 2016 The Authors.