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Impact of distance education on primary health care indicators in central Brazil: An ecological study with time trend analysis

OBJECTIVE: The objective of this study was to verify whether the inclusion of professionals who completed a specialized distance learning course in family health teams is associated with rates of hospitalization for primary healthcare-sensitive conditions and better monitoring of chronic conditions...

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Autores principales: Moraes dos Santos, Mara Lisiane, Zafalon, Edilson José, Bomfim, Rafael Aiello, Kodjaoglanian, Vera Lucia, Mendonça de Moraes, Silvia Helena, do Nascimento, Debora Dupas Gonçalves, Santos, Carlos Antonio de Souza Telles, de Souza, Albert Schiaveto, De-Carli, Alessandro Diogo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435161/
https://www.ncbi.nlm.nih.gov/pubmed/30913272
http://dx.doi.org/10.1371/journal.pone.0214485
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author Moraes dos Santos, Mara Lisiane
Zafalon, Edilson José
Bomfim, Rafael Aiello
Kodjaoglanian, Vera Lucia
Mendonça de Moraes, Silvia Helena
do Nascimento, Debora Dupas Gonçalves
Santos, Carlos Antonio de Souza Telles
de Souza, Albert Schiaveto
De-Carli, Alessandro Diogo
author_facet Moraes dos Santos, Mara Lisiane
Zafalon, Edilson José
Bomfim, Rafael Aiello
Kodjaoglanian, Vera Lucia
Mendonça de Moraes, Silvia Helena
do Nascimento, Debora Dupas Gonçalves
Santos, Carlos Antonio de Souza Telles
de Souza, Albert Schiaveto
De-Carli, Alessandro Diogo
author_sort Moraes dos Santos, Mara Lisiane
collection PubMed
description OBJECTIVE: The objective of this study was to verify whether the inclusion of professionals who completed a specialized distance learning course in family health teams is associated with rates of hospitalization for primary healthcare-sensitive conditions and better monitoring of chronic conditions in municipalities within the state of Mato Grosso do Sul, Brazil. METHODS: Negative binomial regression models with fixed effects were used for the 79 municipalities in the state, with repeated observations for the selected years (2009–2015). For our reference, the parameter “Municipality Ratio” was the number of professionals who completed the course divided by the total number of PHC professionals in the municipality. This ratio has been cumulative over the years. No reference values were found in the scientific literature, so three cutoff points were used for tertile distribution: T3:high (0.35–1.00), T2:intermediate (0.02–0.33), and T1:Low (0.00–0.01). In order to avoid capturing biased results, the analysis was also performed for the years before the specialization course was offered (2009 and 2010). RESULTS: Indicators of the share of hospitalizations for primary care-sensitive conditions (overall rate and specific rates for asthma, gastroenteritis, and heart failure) decreased during the study period when related to a high and intermediate proportion of professionals who completed the specialization course, and the same was seen for indicators of chronic conditions (diabetic and hypertensive patients) who were registered, monitored and group care. CONCLUSION: The specialization course impacted important indicators related to the attributions of primary health care professionals, considering that decreases in hospitalizations for primary care sensitive causes (overall rate of sensitive causes, specific rates for asthma, gastroenteritis and heart failure) were seen in the territories where professionals who completed this course worked, along with increased registration and monitoring of diabetic and hypertensive patients.
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spelling pubmed-64351612019-04-08 Impact of distance education on primary health care indicators in central Brazil: An ecological study with time trend analysis Moraes dos Santos, Mara Lisiane Zafalon, Edilson José Bomfim, Rafael Aiello Kodjaoglanian, Vera Lucia Mendonça de Moraes, Silvia Helena do Nascimento, Debora Dupas Gonçalves Santos, Carlos Antonio de Souza Telles de Souza, Albert Schiaveto De-Carli, Alessandro Diogo PLoS One Research Article OBJECTIVE: The objective of this study was to verify whether the inclusion of professionals who completed a specialized distance learning course in family health teams is associated with rates of hospitalization for primary healthcare-sensitive conditions and better monitoring of chronic conditions in municipalities within the state of Mato Grosso do Sul, Brazil. METHODS: Negative binomial regression models with fixed effects were used for the 79 municipalities in the state, with repeated observations for the selected years (2009–2015). For our reference, the parameter “Municipality Ratio” was the number of professionals who completed the course divided by the total number of PHC professionals in the municipality. This ratio has been cumulative over the years. No reference values were found in the scientific literature, so three cutoff points were used for tertile distribution: T3:high (0.35–1.00), T2:intermediate (0.02–0.33), and T1:Low (0.00–0.01). In order to avoid capturing biased results, the analysis was also performed for the years before the specialization course was offered (2009 and 2010). RESULTS: Indicators of the share of hospitalizations for primary care-sensitive conditions (overall rate and specific rates for asthma, gastroenteritis, and heart failure) decreased during the study period when related to a high and intermediate proportion of professionals who completed the specialization course, and the same was seen for indicators of chronic conditions (diabetic and hypertensive patients) who were registered, monitored and group care. CONCLUSION: The specialization course impacted important indicators related to the attributions of primary health care professionals, considering that decreases in hospitalizations for primary care sensitive causes (overall rate of sensitive causes, specific rates for asthma, gastroenteritis and heart failure) were seen in the territories where professionals who completed this course worked, along with increased registration and monitoring of diabetic and hypertensive patients. Public Library of Science 2019-03-26 /pmc/articles/PMC6435161/ /pubmed/30913272 http://dx.doi.org/10.1371/journal.pone.0214485 Text en © 2019 Moraes dos Santos et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Moraes dos Santos, Mara Lisiane
Zafalon, Edilson José
Bomfim, Rafael Aiello
Kodjaoglanian, Vera Lucia
Mendonça de Moraes, Silvia Helena
do Nascimento, Debora Dupas Gonçalves
Santos, Carlos Antonio de Souza Telles
de Souza, Albert Schiaveto
De-Carli, Alessandro Diogo
Impact of distance education on primary health care indicators in central Brazil: An ecological study with time trend analysis
title Impact of distance education on primary health care indicators in central Brazil: An ecological study with time trend analysis
title_full Impact of distance education on primary health care indicators in central Brazil: An ecological study with time trend analysis
title_fullStr Impact of distance education on primary health care indicators in central Brazil: An ecological study with time trend analysis
title_full_unstemmed Impact of distance education on primary health care indicators in central Brazil: An ecological study with time trend analysis
title_short Impact of distance education on primary health care indicators in central Brazil: An ecological study with time trend analysis
title_sort impact of distance education on primary health care indicators in central brazil: an ecological study with time trend analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435161/
https://www.ncbi.nlm.nih.gov/pubmed/30913272
http://dx.doi.org/10.1371/journal.pone.0214485
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