cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.19904687
title: Impacts of decentralization in health systems in the state of São Paulo, Brazil

description: ABSTRACT Objective To evaluate a p-median model for health care services accessibility based on decentralization and optimal allocation of Primary Health Care Units in the State of São Paulo, Brazil. Methods Using geographical data of Primary Health Care Units located in the State of São Paulo, potential support and supply facility allocations were simulated by means of a random approach. Several constraints were then imposed on the system to simulate different scenarios. Results were assessed according to geographic disposition. Results Using a fixed number of supply facilities, ten as a constraint, the p-median approach allocated three facilities near the state capital (the area with the highest concentration of Primary Health Care Units), while remaining facilities were spread throughout the west of the state. A second round of tests assessed the impact of fixed costs alone on optimization, ranging from 71 optimal locations with a fixed unit cost to six optimal locations at a cost 300-fold higher. This finding was relevant to decision-making, since it encompassed scenarios in which only the final number of facilities or only the budget was known. A third set of simulations contemplates an intermediate scenario. Conclusion The p-median approach was capable of optimizing a wide range of scenarios with an average running time of less than 2 hours and 30 minutes while considering a large dataset of more than 4,000 locations. In spite of some shortcomings, such as estimation of Euclidean distances, the method is simple yet powerful enough to be considered a useful tool to assist decision makers in the distribution of resources, and facilities across large areas with high number of locations to be supplied.
DOI: 10.6084/m9.figshare.19904687.v1
title: Impacts of decentralization in health systems in the state of São Paulo, Brazil

description: ABSTRACT Objective To evaluate a p-median model for health care services accessibility based on decentralization and optimal allocation of Primary Health Care Units in the State of São Paulo, Brazil. Methods Using geographical data of Primary Health Care Units located in the State of São Paulo, potential support and supply facility allocations were simulated by means of a random approach. Several constraints were then imposed on the system to simulate different scenarios. Results were assessed according to geographic disposition. Results Using a fixed number of supply facilities, ten as a constraint, the p-median approach allocated three facilities near the state capital (the area with the highest concentration of Primary Health Care Units), while remaining facilities were spread throughout the west of the state. A second round of tests assessed the impact of fixed costs alone on optimization, ranging from 71 optimal locations with a fixed unit cost to six optimal locations at a cost 300-fold higher. This finding was relevant to decision-making, since it encompassed scenarios in which only the final number of facilities or only the budget was known. A third set of simulations contemplates an intermediate scenario. Conclusion The p-median approach was capable of optimizing a wide range of scenarios with an average running time of less than 2 hours and 30 minutes while considering a large dataset of more than 4,000 locations. In spite of some shortcomings, such as estimation of Euclidean distances, the method is simple yet powerful enough to be considered a useful tool to assist decision makers in the distribution of resources, and facilities across large areas with high number of locations to be supplied.
DOI: 10.6084/m9.figshare.19904689
title: Efficiency of public spending on primary health care in the municipalities of Rio de Janeiro, Brazil: robust scores and their determinants

description: Abstract Health services, the access to which is a right of all citizens and the duty of the state, must be efficiently provided, as public resources are scarce and there is a growing demand called for by the population. In this context, the objective was to evaluate the efficiency of public spending on Primary Health Care in the municipalities of Rio de Janeiro (n = 70) in 2015. Initially, the jackstrap procedure was used to identify possible outliers, and Data Envelopment Analysis was then applied to calculate robust efficiency scores. In the second stage, the efficiency scores were regressed into non-discretionary variables using the Tobit method, that may affect the efficiency of municipalities. The results show that 63.9% of municipalities efficiently applied ABS resources, however, given the expenses incurred, ABS outputs could have been, on average, 6% higher. In addition, no evidence was found that wealthier, more socially developed and/or populous municipalities, were more (or less) efficient in public spending on ABS than not.
DOI: 10.6084/m9.figshare.19904689.v1
title: Efficiency of public spending on primary health care in the municipalities of Rio de Janeiro, Brazil: robust scores and their determinants

description: Abstract Health services, the access to which is a right of all citizens and the duty of the state, must be efficiently provided, as public resources are scarce and there is a growing demand called for by the population. In this context, the objective was to evaluate the efficiency of public spending on Primary Health Care in the municipalities of Rio de Janeiro (n = 70) in 2015. Initially, the jackstrap procedure was used to identify possible outliers, and Data Envelopment Analysis was then applied to calculate robust efficiency scores. In the second stage, the efficiency scores were regressed into non-discretionary variables using the Tobit method, that may affect the efficiency of municipalities. The results show that 63.9% of municipalities efficiently applied ABS resources, however, given the expenses incurred, ABS outputs could have been, on average, 6% higher. In addition, no evidence was found that wealthier, more socially developed and/or populous municipalities, were more (or less) efficient in public spending on ABS than not.
DOI: 10.6084/m9.figshare.19904695
title: Differences in quality of life and food insecurity between men and women living with HIV/AIDS in the state of Paraíba, Brazil

description: Abstract A prevalence study was conducted to compare quality of life and food insecurity in men and women living with HIV/AIDS. The sample comprised 481 HIV-infected individuals undergoing antiretroviral therapy at a referral hospital in the State of Paraíba, Brazil. Food insecurity and quality of life were assessed using the Brazilian Household Food Insecurity Scale and WHOQOL-HIV Bref, respectively. The results were presented as absolute and relative frequencies and gender differences were tested using the chi-squared test adopting a significance level of 0.05. The findings showed that 40.1% of the sample were women. A higher percentage of women than men had a low income and low education level (65.8% and 72.5%, respectively). Prevalence of food security was lower in women than in men (29.0% compared to 42.7%), and a higher percentage of women than men reported below average quality of life (54.9% compared to 44.4%). The findings reveal that, besides the usual difficulties faced by HIV-infected patients, this group showed a significant level of gender inequality. The management of HIV patient care should consider these important findings, promoting access to care and support services and gender equality so that women can live fairer and more equal lives.
DOI: 10.6084/m9.figshare.19904695.v1
title: Differences in quality of life and food insecurity between men and women living with HIV/AIDS in the state of Paraíba, Brazil

description: Abstract A prevalence study was conducted to compare quality of life and food insecurity in men and women living with HIV/AIDS. The sample comprised 481 HIV-infected individuals undergoing antiretroviral therapy at a referral hospital in the State of Paraíba, Brazil. Food insecurity and quality of life were assessed using the Brazilian Household Food Insecurity Scale and WHOQOL-HIV Bref, respectively. The results were presented as absolute and relative frequencies and gender differences were tested using the chi-squared test adopting a significance level of 0.05. The findings showed that 40.1% of the sample were women. A higher percentage of women than men had a low income and low education level (65.8% and 72.5%, respectively). Prevalence of food security was lower in women than in men (29.0% compared to 42.7%), and a higher percentage of women than men reported below average quality of life (54.9% compared to 44.4%). The findings reveal that, besides the usual difficulties faced by HIV-infected patients, this group showed a significant level of gender inequality. The management of HIV patient care should consider these important findings, promoting access to care and support services and gender equality so that women can live fairer and more equal lives.
DOI: 10.6084/m9.figshare.19904696.v1
title: Strategic analysis of a medical genetics center at a national health research institute in Brazil: challenges for the country’s public health system

description: Abstract Objective: to discuss strategic challenges in complex health organizations sustained by an analysis in a Medical Genetics Center at a National Health Research Institute in Brazil. Method: Démarche Stratégique adapted for use with research institutes, including the policy formulation function. The study used institution’s databases and workshops with key actors between Dec/2014 and Jun/2015. Results: Were defined the segments: clinical diagnosis, lysosomal diseases, osteogenesis imperfecta, genetic counseling, cytogenetics, biochemistry, and genomics. The findings reveal that the segments are aligned with the Institute’s mission when it comes to referral care, although investment is required in strategic areas. The clinical diagnosis, lysosomal diseases, and genomics segments stood out in the scientific output portfolio. The findings show that progress needs to be made with policy implementation and planning to improve access to new technologies, together with investment in training and development, and the strengthening of coordination and collaboration between research institutes and referral services and between the wider healthcare network and research, care, and teaching. The inclusion of the policy formulation dimension was essential to highlight the unique role medical genetics plays in Brazil’s public health system and the importance of developing action plans in the field of public health.
DOI: 10.6084/m9.figshare.19904696
title: Strategic analysis of a medical genetics center at a national health research institute in Brazil: challenges for the country’s public health system

description: Abstract Objective: to discuss strategic challenges in complex health organizations sustained by an analysis in a Medical Genetics Center at a National Health Research Institute in Brazil. Method: Démarche Stratégique adapted for use with research institutes, including the policy formulation function. The study used institution’s databases and workshops with key actors between Dec/2014 and Jun/2015. Results: Were defined the segments: clinical diagnosis, lysosomal diseases, osteogenesis imperfecta, genetic counseling, cytogenetics, biochemistry, and genomics. The findings reveal that the segments are aligned with the Institute’s mission when it comes to referral care, although investment is required in strategic areas. The clinical diagnosis, lysosomal diseases, and genomics segments stood out in the scientific output portfolio. The findings show that progress needs to be made with policy implementation and planning to improve access to new technologies, together with investment in training and development, and the strengthening of coordination and collaboration between research institutes and referral services and between the wider healthcare network and research, care, and teaching. The inclusion of the policy formulation dimension was essential to highlight the unique role medical genetics plays in Brazil’s public health system and the importance of developing action plans in the field of public health.
DOI: 10.6084/m9.figshare.19904698.v1
title: Emergency contraceptive use among women attending Primary Health Care services in three Brazilian capital cities

description: Abstract Little is known regarding the use of emergency contraception among women from different regions of Brazil. The use of emergency contraception as well as contraceptive methods before and after coitus was analyzed. This cross-sectional study assessed the use of emergency contraception by interviewing 2,051 women aged between 18 and 49 attending 76 basic health units in three capitals: São Paulo-SP, Aracaju-SE and Cuiabá-MT. Aspects associated with the use of emergency contraception were analyzed by means of multiple logistic regression. Over half of the women reported the use of emergency contraception (56.7%). Having a high level of education, being from a more privileged socioeconomic group, having a paid job and having had four or more sexual partners were associated with the use of emergency contraception. Being 35 years of age or older and being in a stable relationship was negatively associated. The last time they used emergency contraception, 53.2% used another method, with the male condom and oral pill being the most frequent. Of those who did not use the method, half adopted the regular method after using it (51.7%). The conclusion drawn is that emergency contraception is widely used and does not appear to affect the use of the regular contraceptive method.
DOI: 10.6084/m9.figshare.19904698
title: Emergency contraceptive use among women attending Primary Health Care services in three Brazilian capital cities

description: Abstract Little is known regarding the use of emergency contraception among women from different regions of Brazil. The use of emergency contraception as well as contraceptive methods before and after coitus was analyzed. This cross-sectional study assessed the use of emergency contraception by interviewing 2,051 women aged between 18 and 49 attending 76 basic health units in three capitals: São Paulo-SP, Aracaju-SE and Cuiabá-MT. Aspects associated with the use of emergency contraception were analyzed by means of multiple logistic regression. Over half of the women reported the use of emergency contraception (56.7%). Having a high level of education, being from a more privileged socioeconomic group, having a paid job and having had four or more sexual partners were associated with the use of emergency contraception. Being 35 years of age or older and being in a stable relationship was negatively associated. The last time they used emergency contraception, 53.2% used another method, with the male condom and oral pill being the most frequent. Of those who did not use the method, half adopted the regular method after using it (51.7%). The conclusion drawn is that emergency contraception is widely used and does not appear to affect the use of the regular contraceptive method.
DOI: 10.6084/m9.figshare.19904699
title: Contextual and individual factors associated with dissatisfaction with dental care in Brazil

description: Abstract The scope of this study was to evaluate the influence of contextual and individual factors associated with dissatisfaction of users of the Unified Health System (SUS) with the care provided by dentists in Primary Health Care. It is a cross-sectional and multilevel study, based on secondary data derived from a national basic research project to assess user satisfaction with the SUS. Data were collected by the Ombudsman’s Department of the SUS by telephone contact with a sample of 35,393 individuals from around the country. Contextual and individual variables were associated with dissatisfaction with the dental service provided by the SUS. For the analysis, Stata version 11.0 software was used together with multilevel random effects logistic regression. A total of 2,331 individuals from 61 municipalities were included in the final sample of satisfaction with the dental service. Only 43% of the participants reported that their claims had been resolved, and a seven times greater chance of dissatisfaction was perceived for those individuals who had unresolved demand in relation to those who resolved it. This research provides input that can subsidize the government in actions aimed at improving access and quality of care provided in dental care.
DOI: 10.6084/m9.figshare.19904699.v1
title: Contextual and individual factors associated with dissatisfaction with dental care in Brazil

description: Abstract The scope of this study was to evaluate the influence of contextual and individual factors associated with dissatisfaction of users of the Unified Health System (SUS) with the care provided by dentists in Primary Health Care. It is a cross-sectional and multilevel study, based on secondary data derived from a national basic research project to assess user satisfaction with the SUS. Data were collected by the Ombudsman’s Department of the SUS by telephone contact with a sample of 35,393 individuals from around the country. Contextual and individual variables were associated with dissatisfaction with the dental service provided by the SUS. For the analysis, Stata version 11.0 software was used together with multilevel random effects logistic regression. A total of 2,331 individuals from 61 municipalities were included in the final sample of satisfaction with the dental service. Only 43% of the participants reported that their claims had been resolved, and a seven times greater chance of dissatisfaction was perceived for those individuals who had unresolved demand in relation to those who resolved it. This research provides input that can subsidize the government in actions aimed at improving access and quality of care provided in dental care.
DOI: 10.6084/m9.figshare.19904702
title: Interculturality in the daily routine of primary health care: The case of the health model in Guainía, Colombia

description: Abstract Colombia is currently implementing a new health model, which is being tested initially in a region of the Amazon, with the main objective of primary health care with an intercultural approach. It is a cut of a doctoral thesis outlined by the case study methodology, which aimed to understand the daily construction process of primary health care from the perspective of indigenous and health professionals in Guainía, Colombia. Twenty-two indigenous users and 26 health professionals participated in the study, as well as three key participants. The data were collected through semi-structured interviews and direct observation, and were later transcribed and analyzed by Bardin’s thematic content analysis technique. The results show that interculturality, as a permanent process of negotiations and articulations present in the daily lives of indigenous and health professionals, is a fundamental part of the construction of primary health care in Guainía. In it materializes the encounter and exchange of heterogeneous forms of thinking-knowledge, that allow new interpretations and reinventions of knowledge and practices in health, although this process is permeated by conflicts, ambiguities, asymmetries and contradictions.
DOI: 10.6084/m9.figshare.19904702.v1
title: Interculturality in the daily routine of primary health care: The case of the health model in Guainía, Colombia

description: Abstract Colombia is currently implementing a new health model, which is being tested initially in a region of the Amazon, with the main objective of primary health care with an intercultural approach. It is a cut of a doctoral thesis outlined by the case study methodology, which aimed to understand the daily construction process of primary health care from the perspective of indigenous and health professionals in Guainía, Colombia. Twenty-two indigenous users and 26 health professionals participated in the study, as well as three key participants. The data were collected through semi-structured interviews and direct observation, and were later transcribed and analyzed by Bardin’s thematic content analysis technique. The results show that interculturality, as a permanent process of negotiations and articulations present in the daily lives of indigenous and health professionals, is a fundamental part of the construction of primary health care in Guainía. In it materializes the encounter and exchange of heterogeneous forms of thinking-knowledge, that allow new interpretations and reinventions of knowledge and practices in health, although this process is permeated by conflicts, ambiguities, asymmetries and contradictions.
DOI: 10.6084/m9.figshare.19904704
title: Consumption of alcoholic and non-alcoholic beverages: ELSA-Brasil results

description: Abstract The study aims to describe the consumption of alcoholic and non-alcoholic beverages according to sociodemographic, health and location variables. Cross-sectional study with ELSA-Brasil data (2008-2010). A questionnaire was used to collect sociodemographic, food, health data and anthropometry. Descriptive analysis and association with variables of interest were carried out. In the sample, 8% of the total caloric value comes from non-alcoholic beverages (5.6%: sugary drinks), and 4% from alcoholic beverages (2.7%: beer). Consumers of unsweetened and artificially sweetened beverages reported moderate/strong physical activity, former smokers and higher education. The opposite was true for sugary drinks. Eutrophic people reported higher consumption of sugary drinks and those obese, artificially sweetened and beer. Alcohol consumption varied with age (young: beer; elderly: wine/spirits) and education (low education: beer/spirits; higher education: wine). Coffee, natural juice and soda were the most consumed non-alcoholic beverages and beer was the most prevalent alcoholic beverage. Consumption variation was observed according to geographic location. The consumption of sugary and alcoholic beverages is high in Brazil and public health strategies are required.
DOI: 10.6084/m9.figshare.19904704.v1
title: Consumption of alcoholic and non-alcoholic beverages: ELSA-Brasil results

description: Abstract The study aims to describe the consumption of alcoholic and non-alcoholic beverages according to sociodemographic, health and location variables. Cross-sectional study with ELSA-Brasil data (2008-2010). A questionnaire was used to collect sociodemographic, food, health data and anthropometry. Descriptive analysis and association with variables of interest were carried out. In the sample, 8% of the total caloric value comes from non-alcoholic beverages (5.6%: sugary drinks), and 4% from alcoholic beverages (2.7%: beer). Consumers of unsweetened and artificially sweetened beverages reported moderate/strong physical activity, former smokers and higher education. The opposite was true for sugary drinks. Eutrophic people reported higher consumption of sugary drinks and those obese, artificially sweetened and beer. Alcohol consumption varied with age (young: beer; elderly: wine/spirits) and education (low education: beer/spirits; higher education: wine). Coffee, natural juice and soda were the most consumed non-alcoholic beverages and beer was the most prevalent alcoholic beverage. Consumption variation was observed according to geographic location. The consumption of sugary and alcoholic beverages is high in Brazil and public health strategies are required.
DOI: 10.5281/zenodo.6587379
title: Productivity and Parsability

description: A dataset necessary to replicate the study’s findings.
DOI: 10.5281/zenodo.6587378
title: Productivity and Parsability

description: A dataset necessary to replicate the study’s findings.