1. Hospitalizations for Cardiovascular Diseases Sensitive to Primary Health Care in Parana State, Brazil: A Bayesian Spatiotemporal Model
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Bonfim, Samile, Massago, Miyoko, Dutra, Amanda de Carvalho, Arruda, Matheus Henrique Beltrame, Oliveira, Fernanda Silva, Thomaz, Erika Barbara Abreu Fonseca, de Souza, Eniuce Menezes, Nihei, Oscar Kenji, and de Andrade, Luciano
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Discrimination in medical care -- Analysis ,Health care disparities -- Analysis ,Primary health care -- Analysis ,Cardiovascular diseases -- Analysis ,Markov processes -- Analysis ,Monte Carlo method -- Analysis ,Health ,Science and technology - Abstract
PURPOSE To analyze spatiotemporal trends in hospitalizations for cardiovascular diseases (CVD) sensitive to primary health care (PHC) among individuals aged 50-69 years in Parana State, Brazil, from 2014 to 2019 and investigate correlations between PHC services and the Social Development Index. METHODS We conducted a cross-sectional ecological study using publicly available secondary data to analyze the municipal incidence of hospitalizations for CVD sensitive to PHC and to estimate the risk of hospitalization for this group of diseases and associated factors using hierarchical Bayesian spatiotemporal modeling with Markov chain Monte Carlo simulation. RESULTS There was a 5% decrease in the average rate of hospitalizations for PHC-sensitive CVD from 2014 to 2019. Regarding standardized hospitalization rate (SHR) according to population size, we found that no large municipality had an SHR >2. Likewise, a minority of these municipalities had SHR values of 1-2 (33%). However, many small and medium-sized municipalities had SHR values >2 (47% and 48%, respectively). A greater Social Development Index value served as a protective factor against hospitalizations, with a relative risk of 0.957 (95% credible interval, 0.929-0.984). CONCLUSIONS The annual risk of hospitalization decreased over time; however, small municipalities had the greatest rates of hospitalization, indicating an increase in health inequity. The inverse association between social development and hospitalizations for CVD sensitive to PHC raises questions about intersectionality in health care. Key words: cardiovascular disease; primary health care; hospitalizations; health care disparities; spatiotemporal analysis; Social Development Index, INTRODUCTION Cardiovascular disease (CVD) leads the rankings of morbidity and mortality worldwide. An estimated 17.9 million people died of CVD in 2019, with more than three-quarters of these deaths occurring [...]
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- 2024
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