RESUMEN
OBJECTIVE: To analyze the temporal trend of healthcare services quality indicators to reduce leprosy in Brazil, over a 20-year period. METHODS: This is an epidemiological study with a temporal trend, whose data were extracted from the Notifiable Diseases Information System. Indicators were constructed from the Ministry of Health Technical-Operational Manual that presents the Guidelines for Surveillance, Care and Elimination of Leprosy as a Public Health Problem. For trend analysis of the selected indicators, the Prais-Winsten model was used and the Average Annual Growth Rate (AAGR) was also calculated. RESULTS: In the 20-year time series investigated here, 732,959 cases of leprosy were reported in Brazil. The trend was stationary for: new leprosy cases cure rate (ß=-0.000; p=0.196; AAGR=-0.2), new leprosy cases drop out rate (ß=-0.001; p=0.147; AAGR=-0.4), new leprosy cases contact tracing rate (ß=-0.001; p=0.112; AAGR=1.6), new cases of leprosy with degree physical disability assessment rate among new cases (ß=-0.000; p=0.196; AAGR=-0.2) and cases cured in the year with the degree of physical disability assessed (ß=0.002; p=0.265; AAGR=0.5); while the indicator of recurrence rate among cases reported in the year (ß=0.019; p<0.001; AAGR=0.5) showed an increasing trend. CONCLUSION: Based on the evaluation of indicators to assess the quality of healthcare services to reduce leprosy, it was evident that Brazil has major challenges for its full implementation, with improvements being necessary in the quality of care service offered to the population.
Asunto(s)
Lepra , Indicadores de Calidad de la Atención de Salud , Calidad de la Atención de Salud , Lepra/epidemiología , Lepra/prevención & control , Humanos , Brasil/epidemiología , Calidad de la Atención de Salud/normas , Factores de TiempoRESUMEN
ABSTRACT Objective: To analyze the temporal trend of healthcare services quality indicators to reduce leprosy in Brazil, over a 20-year period. Methods: This is an epidemiological study with a temporal trend, whose data were extracted from the Notifiable Diseases Information System. Indicators were constructed from the Ministry of Health Technical-Operational Manual that presents the Guidelines for Surveillance, Care and Elimination of Leprosy as a Public Health Problem. For trend analysis of the selected indicators, the Prais-Winsten model was used and the Average Annual Growth Rate (AAGR) was also calculated. Results: In the 20-year time series investigated here, 732,959 cases of leprosy were reported in Brazil. The trend was stationary for: new leprosy cases cure rate (β=-0.000; p=0.196; AAGR=-0.2), new leprosy cases drop out rate (β=-0.001; p=0.147; AAGR=-0.4), new leprosy cases contact tracing rate (β=-0.001; p=0.112; AAGR=1.6), new cases of leprosy with degree physical disability assessment rate among new cases (β=-0.000; p=0.196; AAGR=-0.2) and cases cured in the year with the degree of physical disability assessed (β=0.002; p=0.265; AAGR=0.5); while the indicator of recurrence rate among cases reported in the year (β=0.019; p<0.001; AAGR=0.5) showed an increasing trend. Conclusion: Based on the evaluation of indicators to assess the quality of healthcare services to reduce leprosy, it was evident that Brazil has major challenges for its full implementation, with improvements being necessary in the quality of care service offered to the population.
RESUMO Objetivo: Analisar a tendência temporal dos indicadores de qualidade dos serviços de atenção à saúde para redução da hanseníase no Brasil, no período de 20 anos. Métodos: Trata-se de um estudo epidemiológico de tendência temporal, cujos dados foram extraídos do Sistema de Informação de Agravos de Notificação (SINAN). Foram construídos indicadores a partir do Manual Técnico-Operacional, que apresenta as Diretrizes para Vigilância, Atenção e Eliminação da Hanseníase como Problema de Saúde Pública do Ministério da Saúde. Para análise de tendência dos indicadores selecionados, utilizou-se o modelo de Prais-Winsten e calculou-se a Taxa de Incremento Anual (TIA). Resultados: Na série temporal de 20 anos aqui investigada, foram notificados no Brasil 732.959 casos de hanseníase. A tendência mostrou-se estacionária para cura de hanseníase entre os casos novos (β=-0,000; p=0,196; TIA=-0,2); casos de hanseníase em abandono de tratamento entre os casos novos (β=-0,001; p=0,147; TIA=-0,4); contatos examinados de casos novos de hanseníase (β=-0,001; p=0,112; TIA=1,6); casos novos de hanseníase com grau de incapacidade física avaliado no diagnóstico (β=-0,000; p=0,196; TIA=-0,2); e casos curados no ano com grau de incapacidade física avaliada (β=0,002; p=0,265; TIA=0,5); enquanto o indicador casos de recidiva entre os casos notificados no ano (β=0,019; p<0,001; TIA=0,5) apresentou tendência crescente. Conclusão: Com base na avaliação dos indicadores para mensurar a qualidade dos serviços de atenção à saúde para redução da hanseníase, ficou evidente que o Brasil possui grandes desafios para sua execução plena, sendo necessárias melhorias na qualidade do serviço ofertado à população.