cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.12210566.v1
title: Relationship between corporate classification of service providers and quality of primary healthcare in Brazil

description: This study aims to investigate a potential association between different categories of service providers in primary healthcare in Brazil and the quality of care provided, as measured by the Program for Improvement of Access and Quality of Basic Care (PMAQ). The study adopted a quantitative design with a descriptive and inferential approach via logistic regression. A total of 4,469 Brazilian municipalities (counties) were analyzed. The results showed that there was no association between type of service provider (public vs. private) and the score obtained in the certification process (p-value &gt; 0.05). Larger and more socioeconomically dynamic municipalities concentrated the largest proportions of municipalities with primary care services managed by private providers (23.2%). They also received the highest certification scores. Finally, for both categories (public and private), most municipalities obtained intermediate scores (from 50 to 69.99). We thus found that the quality of care in basic healthcare in Brazil, as measured by the PMAQ, is not associated with the type of provider involved in management of the service when the data are analyzed at the municipal level. Private providers and the highest scores in the certification process are concentrated in larger municipalities and those with the best socioeconomic indicators.
DOI: 10.6084/m9.figshare.14280654
title: The Civil Registry in the first four months of the Covid-19 pandemic in Brazil: a comparative study between deaths by month of occurrence and by month of registration

description: Abstract The Civil Registry provides information on demographic studies on mortality, fertility and nuptiality. Questions have been raised about death registration when the causes of death are related to Covid-19. Notification may be delayed. Based on information provided by the Civil Registry of deaths, stratified by two groups - date of registration and date of occurrence - by Covid-19, this study compares these groups by city categories (capital, metropolitan region, interior), over March, April, May and June 2020, occurring in the first four months of the pandemic in Brazil. The magnitude and meaning of the differences in death records between the two groups were assessed. Graphs and linear regression analyses were used for comparisons. The findings indicate a different behavior of deaths per month of registration compared to deaths per month of occurrence between March and June. It is important to identify such a difference in behavior since, for the very short-term monitoring of the pandemic, deaths from registry data anticipate deaths whose records will still be adequately available by occurrence data. Such variation occurs mainly due to the systematic correction and updating of the information. As for the city categories, the biggest difference between deaths by month of occurrence and registration was observed for the municipalities in the interior, in line with the spread of the epidemic towards the interior in the month of May.
DOI: 10.6084/m9.figshare.14280656
title: Factors associated with time interval between the onset of symptoms and first medical visit in women with breast cancer

description: Women presenting with advanced breast cancer tumors are common in Brazil. Little is known about factors contributing to the delay in seeking care. The aim of this study was to identify factors associated with longer time intervals between the onset of breast cancer symptoms and the first medical visit in the Federal District, Brazil. The analysis included 444 symptomatic women with incident breast cancer, interviewed between September, 2012 and September, 2014, during their admission for breast cancer treatment in nine public hospitals in the Federal District. Patients with metastatic disease at diagnosis were not included in this study. The outcome was time interval between symptom onset and the first medical visit, whether &gt; 90 (34% of patients) or ≤ 90 days. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). In the multivariate analysis, the &gt; 90 day interval was significantly associated with patients not performing mammography and/or breast ultrasound in the two years prior to breast cancer diagnosis (OR = 1.97; 95%CI: 1.26-3.08), and with more advanced stages (OR = 1.72; 95%CI: 1.10-2.72). Furthermore, there was a lower chance of delay in patients with higher levels of education (OR = 0.95; 95%CI: 0.91-0.99). A relatively high proportion of breast cancer patients in the Brazilian Federal District experienced delay to attend the first medical consultation after the symptoms onset. Increasing breast cancer awareness, especially among women with low educational levels and those not participating in mammography screening programs could contribute to reduce this delay.
DOI: 10.6084/m9.figshare.14280653.v1
title: Risk stratification for prediction of spread and severity by Covid-19 in Brazilian federation units

description: Abstract Objectives: To perform risk stratification for dissemination and mortality by COVID-19 from Brazilian federal units (FU), based on characteristics identified as risk situations. Methods: Social, demographic and health indicators were selected and underwent principal components analysis. Then, it was possible to divide the FUs by cluster analysis. Based on the factor load of the components created, a final score for the UF was obtained and they were then stratified with regard to the risk of dissemination and mortality by COVID-19. Findings: Components created refer to assistance, health (including risk factors), demographic and social conditions. These components allowed for the final classification of the 27 FU, with a difference in order with regard to the potential for dissemination and mortality. Conclusions: We believe risk stratification may be a measure to support public health, defining areas with the greatest potential for damage and on that basis, allow for the creation of priority intervention strategies.
DOI: 10.6084/m9.figshare.14280656.v1
title: Factors associated with time interval between the onset of symptoms and first medical visit in women with breast cancer

description: Women presenting with advanced breast cancer tumors are common in Brazil. Little is known about factors contributing to the delay in seeking care. The aim of this study was to identify factors associated with longer time intervals between the onset of breast cancer symptoms and the first medical visit in the Federal District, Brazil. The analysis included 444 symptomatic women with incident breast cancer, interviewed between September, 2012 and September, 2014, during their admission for breast cancer treatment in nine public hospitals in the Federal District. Patients with metastatic disease at diagnosis were not included in this study. The outcome was time interval between symptom onset and the first medical visit, whether &gt; 90 (34% of patients) or ≤ 90 days. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). In the multivariate analysis, the &gt; 90 day interval was significantly associated with patients not performing mammography and/or breast ultrasound in the two years prior to breast cancer diagnosis (OR = 1.97; 95%CI: 1.26-3.08), and with more advanced stages (OR = 1.72; 95%CI: 1.10-2.72). Furthermore, there was a lower chance of delay in patients with higher levels of education (OR = 0.95; 95%CI: 0.91-0.99). A relatively high proportion of breast cancer patients in the Brazilian Federal District experienced delay to attend the first medical consultation after the symptoms onset. Increasing breast cancer awareness, especially among women with low educational levels and those not participating in mammography screening programs could contribute to reduce this delay.
DOI: 10.6084/m9.figshare.14280657
title: Contributions from the Critical Success Factors model to analysis of the management of Product Development Partnerships in a government laboratory

description: Abstract: Product Development Partnerships (PDP) are one of the measures used by the Brazilian government to incentivize innovation policy, to expand the population’s access to strategic medicines, and to reduce the country’s technological dependence by strengthening the national pharmaceutical manufacturing base. The study aimed to identify the Critical Success Factors (FCS in Portuguese) for the implementation of these partnerships, using as the reference one of the largest Brazilian government pharmaceutical laboratories. FCS are seen as key areas in which the results must be satisfactory in order to ensure successful performance in the organization or project. The methodological strategies included literature review, analysis of internal documents, and semi-structured interviews with key actors. We analyzed the partnerships approved for this public laboratory from 2009 to May 2018. The study enabled a critical view of the phases in a PDP and identification of specific critical factors for this type of project. The findings reveal persistent organizational challenges for increasing the executability of partnerships, which can serve as a reference for other government laboratories that have PDP agreements under way or that intend to submit proposals for them.
DOI: 10.6084/m9.figshare.14280659
title: Life expectancy free of multimorbidity among Brazilian older adults: National Health Survey, 2013

description: Abstract This study aims to analyze differences in life expectancy with and without multimorbidity (two or more chronic conditions) among older adults in Brazilian states, according to sex and age. Data from the Mortality Information System and population projections from the Brazilian Bureau of Geography and Statistics were used to create life tables for all states by sex. Information on the prevalence of multimorbidity was obtained from the 2013 National Health Survey (PNS). The Sullivan method was used to estimate life expectancy with and without multimorbidity and the proportion of expected life years with multimorbidity. The sample of older adults in the PNS included 11,697 subjects whose mean age was 70.08 years (SD ± 0.09). The proportion of expected years with multimorbidity increases with age (53.6% at age 60, and 57.3% at age 75). Women have higher life expectancy than men, but they live with multimorbidity more years. At age 60, Brazilian women expect to live, on average, 13.5 years with multimorbidity and men 8.3 years. There are major differences in life expectancy with multimorbidity across states – varying from 8.2 to 14.2 years (at age 60). It is important to consider these differences when defining priorities for public policies and public health interventions.
DOI: 10.6084/m9.figshare.12210407.v1
title: Assessment of the impact of prenatal, childbirth, and neonatal care on avoidable neonatal deaths in Pernambuco State, Brazil: an adequacy study

description: This study aimed to assess the impact of programs for prenatal, childbirth, and neonatal care (Mother Owl and Stork Network) on avoidable neonatal mortality in Pernambuco State, Brazil, using the adequacy approach. We analyzed the trend in avoidable neonatal mortality and the impact of these programs on avoidable neonatal mortality in four health regions in the state from 2000 to 2016. The Mortality Information System (SIM) and the Information System on Live Births (SINASC) and official documents were used as the data sources. Deaths were classified according to the Brazilian List of Avoidable Causes of Deaths Via Interventions by the Unified National Health System. Linear regression and joinpoint methods were used to analyze tendencies and identifying turning points in the neonatal mortality curves. There was a sharp drop in avoidable neonatal mortality in the state, especially in early neonatal mortality. Except for the I-Recife region, where there was a downturn in the mortality curves after implementation of the Stork Network, there was no association between the turning points in the curves and the periods with the programs’ implementation in the regions. Other factors appear to have led to the improvement of these indicators, such as the expansion of the high-risk network. Strengthening this network can thus help reduce avoidable neonatal deaths, especially early deaths.
DOI: 10.6084/m9.figshare.14280657.v1
title: Contributions from the Critical Success Factors model to analysis of the management of Product Development Partnerships in a government laboratory

description: Abstract: Product Development Partnerships (PDP) are one of the measures used by the Brazilian government to incentivize innovation policy, to expand the population’s access to strategic medicines, and to reduce the country’s technological dependence by strengthening the national pharmaceutical manufacturing base. The study aimed to identify the Critical Success Factors (FCS in Portuguese) for the implementation of these partnerships, using as the reference one of the largest Brazilian government pharmaceutical laboratories. FCS are seen as key areas in which the results must be satisfactory in order to ensure successful performance in the organization or project. The methodological strategies included literature review, analysis of internal documents, and semi-structured interviews with key actors. We analyzed the partnerships approved for this public laboratory from 2009 to May 2018. The study enabled a critical view of the phases in a PDP and identification of specific critical factors for this type of project. The findings reveal persistent organizational challenges for increasing the executability of partnerships, which can serve as a reference for other government laboratories that have PDP agreements under way or that intend to submit proposals for them.
DOI: 10.6084/m9.figshare.14280662
title: Temporal variation in prevalence, awareness and control of hypertension in urban and rural areas in Northeast Brazil between 2006 and 2016

description: Abstract: To assess the evolution in prevalence, awareness and control of hypertension for over 10 years in Pernambuco State, Northeast Brazil, two cross-sectional studies were conducted based on random samples of households in urban and rural areas, in 2006 and 2015/2016, involving adults aged 20 years or older. Hypertension was defined as systolic blood pressure of at least 140mmHg or diastolic blood pressure of at least 90mmHg as well as the reported use of antihypertensive medication. A logistic regression analysis was conducted to estimate the influence of the social, behavioral and anthropometric determinants on hypertension. Although social and behavioral factors improved in this 10-year period, overweight and abdominal obesity increased. Approximately one third of the adult population of Pernambuco had hypertension in 2006 and this prevalence was maintained in 2015/2016. In rural areas, awareness concerning hypertension rose from 44.8% in 2006 to 67.3% in 2015/2016, and control from 5.3% to 27.1%, so that awareness and control were similar in urban and rural areas in 2015/2016. After an adjustment for potential confounding factors, the likelihood of having hypertension more than doubled among men (OR = 2.03; p &lt; 0.001), middle (OR = 4.41; p &lt; 0.001) and old-age subjects (OR = 14.44; p &lt; 0.001), and those who had abdominal obesity (OR = 2.04; p &lt; 0.001) in urban areas and among middle-aged (OR = 2.56; p &lt; 0.001), less educated individuals (OR = 2.21; p = 0.006) and those who were overweight (OR = 2.23; p &lt; 0.001) in rural areas. Despite the favorable evolution in the management of hypertension in Pernambuco, public health measures focused in vulnerable populations are still required, mainly in rural areas, to improve primary prevention and decrease the disease rate.
DOI: 10.6084/m9.figshare.12210407
title: Assessment of the impact of prenatal, childbirth, and neonatal care on avoidable neonatal deaths in Pernambuco State, Brazil: an adequacy study

description: This study aimed to assess the impact of programs for prenatal, childbirth, and neonatal care (Mother Owl and Stork Network) on avoidable neonatal mortality in Pernambuco State, Brazil, using the adequacy approach. We analyzed the trend in avoidable neonatal mortality and the impact of these programs on avoidable neonatal mortality in four health regions in the state from 2000 to 2016. The Mortality Information System (SIM) and the Information System on Live Births (SINASC) and official documents were used as the data sources. Deaths were classified according to the Brazilian List of Avoidable Causes of Deaths Via Interventions by the Unified National Health System. Linear regression and joinpoint methods were used to analyze tendencies and identifying turning points in the neonatal mortality curves. There was a sharp drop in avoidable neonatal mortality in the state, especially in early neonatal mortality. Except for the I-Recife region, where there was a downturn in the mortality curves after implementation of the Stork Network, there was no association between the turning points in the curves and the periods with the programs’ implementation in the regions. Other factors appear to have led to the improvement of these indicators, such as the expansion of the high-risk network. Strengthening this network can thus help reduce avoidable neonatal deaths, especially early deaths.
DOI: 10.6084/m9.figshare.14280659.v1
title: Life expectancy free of multimorbidity among Brazilian older adults: National Health Survey, 2013

description: Abstract This study aims to analyze differences in life expectancy with and without multimorbidity (two or more chronic conditions) among older adults in Brazilian states, according to sex and age. Data from the Mortality Information System and population projections from the Brazilian Bureau of Geography and Statistics were used to create life tables for all states by sex. Information on the prevalence of multimorbidity was obtained from the 2013 National Health Survey (PNS). The Sullivan method was used to estimate life expectancy with and without multimorbidity and the proportion of expected life years with multimorbidity. The sample of older adults in the PNS included 11,697 subjects whose mean age was 70.08 years (SD ± 0.09). The proportion of expected years with multimorbidity increases with age (53.6% at age 60, and 57.3% at age 75). Women have higher life expectancy than men, but they live with multimorbidity more years. At age 60, Brazilian women expect to live, on average, 13.5 years with multimorbidity and men 8.3 years. There are major differences in life expectancy with multimorbidity across states – varying from 8.2 to 14.2 years (at age 60). It is important to consider these differences when defining priorities for public policies and public health interventions.
DOI: 10.6084/m9.figshare.14280662.v1
title: Temporal variation in prevalence, awareness and control of hypertension in urban and rural areas in Northeast Brazil between 2006 and 2016

description: Abstract: To assess the evolution in prevalence, awareness and control of hypertension for over 10 years in Pernambuco State, Northeast Brazil, two cross-sectional studies were conducted based on random samples of households in urban and rural areas, in 2006 and 2015/2016, involving adults aged 20 years or older. Hypertension was defined as systolic blood pressure of at least 140mmHg or diastolic blood pressure of at least 90mmHg as well as the reported use of antihypertensive medication. A logistic regression analysis was conducted to estimate the influence of the social, behavioral and anthropometric determinants on hypertension. Although social and behavioral factors improved in this 10-year period, overweight and abdominal obesity increased. Approximately one third of the adult population of Pernambuco had hypertension in 2006 and this prevalence was maintained in 2015/2016. In rural areas, awareness concerning hypertension rose from 44.8% in 2006 to 67.3% in 2015/2016, and control from 5.3% to 27.1%, so that awareness and control were similar in urban and rural areas in 2015/2016. After an adjustment for potential confounding factors, the likelihood of having hypertension more than doubled among men (OR = 2.03; p &lt; 0.001), middle (OR = 4.41; p &lt; 0.001) and old-age subjects (OR = 14.44; p &lt; 0.001), and those who had abdominal obesity (OR = 2.04; p &lt; 0.001) in urban areas and among middle-aged (OR = 2.56; p &lt; 0.001), less educated individuals (OR = 2.21; p = 0.006) and those who were overweight (OR = 2.23; p &lt; 0.001) in rural areas. Despite the favorable evolution in the management of hypertension in Pernambuco, public health measures focused in vulnerable populations are still required, mainly in rural areas, to improve primary prevention and decrease the disease rate.
DOI: 10.6084/m9.figshare.14280663
title: Healthcare Coverage Index in the Psychosocial Care Network (iRAPS) as a tool for critical analysis of the Brazilian psychiatric reform

description: Abstract: Nearly 20 years after the implementation of Brazil’s psychiatric reform, the country has a hybrid model of mental health care, in which asylum services are part of the network that should replace them. This study aimed to critically analyze the supply of mental health services in Brazil in order to verify whether there is actually a replacement of asylum-based services by community-based services. A retrospective longitudinal study was performed on the supply of mental health services in Brazil from 2008 to 2017, building a single database on 5,570 municipalities (counties). As an ancillary tool for critical analysis of the psychiatric reform, we developed the Health Coverage Index for the Psychosocial Care Network (iRAPS, in Portuguese), considering the services legal parametrization. The results showed an increase in the supply of community-based services and a reduction in asylum services. However, the iRAPS tool found that 77% of the Brazilian population lives in areas with low or nonexistent coverage of community services. Small towns, with 16% of the Brazilian population, were those with the greatest increase in iRAPS. Only 439 cities, 7.9% of the total, showed total coverage by the Psychosocial Care Network (RAPS, in Portuguese), expressing only 6.69% of the national population. The metropolises, with 46% of the Brazilian population, did not show an increase in community services. The analysis of the supply of mental health services based on the iRAPS tool showed that the increase in community services did not occur homogeneously across the country.