Avaliação da morbidade e mortalidade por doenças crônicas: um estudo com foco no PMAQ-AB

Abstract

Chronic diseases represent a problem of great magnitude and are the main cause of death today. It is pertinent to highlight that Systemic Arterial Hypertension and Diabetes Mellitus are among the main causes of morbidity and mortality due to these diseases. The general objective of this study is to evaluate the indicators of morbidity and mortality in the Northeast of Brazil from Chronic Non-communicable Diseases - specifically Systemic Hypertension and Diabetes Mellitus. This is a retrospective study, whose data were obtained in secondary banks, on actions developed by the Primary Care teams for chronic diseases and obtained in the Portal of the Department of Basic Attention of the Ministry of Health regarding the External Evaluation in cycles 1 and 2 of that program. The data for calculations referring to mortality and morbidity rates were obtained from the Health Information Systems on Mortality and Hospitals, respectively, through the Information System of the Unified Health System. The results showed that 5,549 teams of Basic Care, of the Northeast Region, participated in the improvement program in cycle 1 and, in cycle 2, this number was 10,678. The nurse was the professional who most answered the interview. Most of the teams said to program actions for hypertension, being 90% in cycle 1 and 96.6% in cycle 2. For diabetes were 90.1% and 96.1%. It is expressive the number of teams that referred to request specific tests, to have registered users and to schedule the actions from the stratification of cases for Hypertension and diabetes. The correlation between the morbimortality rates for both diseases presented a heterogeneous distribution and the concentration of these rates even in places with high coverage of Primary Care. The spatial analysis presented a poor autocorrelation for the rates but presented statistical significance (p<0.05) in the majority. On the spatial correlation with the coverage of Basic Attention in some analyzed places, it was possible to observe a significance of 95%. The study concludes that a significant number of Primary Care teams participated in the Basic Attention Improvement program in the Northeast Region. These presented positive answers for most of the questions about the management of hypertension and diabetes. Despite a high coverage of Basic Care and a poor correlation presented, morbidity and mortality indicators were unevenly distributed in the territory of the delimited Region, which reveals a need for state analysis.