RESUMO
BACKGROUND: The implementation of an information system on prescription drug plan that includes the pharmacological classification and the composition of the drugs. In addition to economic data, makes it possible to analyze prescriptions from a pharmacotherapeutic and economic perspective and, accordingly, carry out administrative and information interventions that improve the quality and reduce the cost of prescriptions. METHODS: The study will be conducted at the National Institute of Social Services for Retirees and Pensioners of Argentine (INSSJP), which basically covers the population aged 60 and over. The data source was the computerized billing of the prescriptions, used up to that time only as a mechanism to monitor billing; this was cross-referenced with a database in which the drugs were broken down into therapeutic groups and subgroups with the composition of the active ingredients. Beginning in 1987, a series of periodic monthly reports was issued on container consumption and expenditures, by therapeutic groups and subgroups and by the active ingredients; this was done at the national level and regionally, according to the INSSJP divisions. These reports gave rise to a series of interventions, such as the establishment of a drug formulary and two changes in the system of coverage that attempted to promote the use of single-ingredient drugs of proven efficacy. RESULTS: The 1987 analysis of consumption revealed that the therapeutic group that accounted for the highest container consumption and expenditures was cardiovascular drugs (21% in number of containers and 32% in expenditures) and within this, cerebral and peripheral vasodilators represented 42% of the container consumption and 52% of the expenditures; antihypertensive drugs, 21% and 19%, and coronary drugs, 19% and 22%. The establishment of the drug formulary and the changes in the system of coverage caused a decline in the use of cardiovascular drugs in 1990 in terms of expenditures (19% and 26%); within this category, vasodilators came to represent 27% of the container consumption and 18% of expenditures, while antihypertensive drugs rose to 28% and 35%, and coronary drugs to 27% and 32%. CONCLUSIONS: Implementation of an Information System makes it possible: a) to periodically evaluate the profile of prescriptions at the country and regional levels; b) to appropriately introduce a drug formulary and modifications in the system of coverage; c) to assess the consequences of the interventions carried out.
Assuntos
Idoso , Prescrições de Medicamentos , Uso de Medicamentos , Assistência Ambulatorial , Argentina , Humanos , Sistemas de Informação , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Injuries and accidents are acknowledged as leading causes of mortality among children and adolescents in the developing countries of the world. However, little is known of the extent of non-fatal injuries and of their potential risk factors. The Pan American Health Organization sponsored the first collaborative study to examine morbidity incidence in specified areas of four selected countries in Latin America, and to test the feasibility and practicality of the developed methodology for application in other regions of the world. The study subjects were injured children and adolescents (0-19 years of age) presenting at the study hospitals in the chosen urban centres, as well as injured that were surveyed in households in the catchment area of the hospitals. Falls constituted the most common (40-52%) cause of injury in all areas, and tended to occur in the younger age groups. Motor vehicle injuries were not as frequent (5-24%) as expected from mortality studies. Males outnumbered females 2:1. The home was the most frequent (37-57%) site of injuries, especially for younger ages. Few received medical care at the site of the injury or en route to a hospital, if they went at all. The results found are consistent with those found in other studies in the developed world. The study methodology provides initial valid information for investigating the injury situation in countries with limited resources.
Assuntos
Países em Desenvolvimento , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Estudos de Coortes , Métodos Epidemiológicos , Humanos , Lactente , Recém-Nascido , América Latina , Projetos de Pesquisa , Fatores de Risco , Fatores SexuaisRESUMO
Injuries and accidents are acknowledged as leading causes of morbidity and mortality among children and adolescents in the developing countries of the world. The Pan American Health Organization sponsored a collaborative study in four selected countries in Latin America to study the extent of the problem as well as to examine the potential risk factors associated with selected non-fatal injuries in the countries. The study subjects were injured children and adolescents (0-19 years of age) presenting at the study hospitals in chosen urban centres, as well as injured that were surveyed in households in the catchment areas of the hospitals. Study methods and descriptive frequency results were presented earlier. In this paper, log-linear multivariate regression models are used to examine the potentiating effects within country of several measured variables on specific types of injuries. The significance of risk factors varied between countries; however, some general patterns emerged. Falls were more likely in younger children, and occurred at home. The main risk factor for home accidents was the age of the child. The education of the head of the household was an important risk factor for the type of injury suffered. The likelihood of traffic accident injury varied with time of day and day of the week, but also was more likely in higher educated households. The results found are consistent with those found in other studies in the developed world and suggest specific areas of concern for health planners to address.
Assuntos
Acidentes/mortalidade , Países em Desenvolvimento , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Chile , Estudos Transversais , Cuba , Humanos , Lactente , Recém-Nascido , Fatores de Risco , Venezuela , Ferimentos e Lesões/mortalidadeRESUMO
The Department of Family Medicine of the University of Puerto Rico Medicine School performed a census of the inhabitants 60 years and older in the community of Gurabo. A total of 1,890 elderly were interviewed 51% were female and 49% male. Sixty percent were married and twenty-five percent were widowed. Eighty two percent still lived within a family setting and only seventeen percent lived alone 86% owned their own home despite ninety percent reporting incomes below $400.00 per month. Ninety five percent have access to medical services but 63% receive services in multiples sites. Eighteen percent were functionally impaired, fourteen percent intellectually impaired and five percent had impairment in both areas. Preliminary data show that the latter group had an annual mortality rate of 15% compared to only 3.6% and 1.3% respectively in the other two group. We concluded that: 1) functional and mental impairment are indicators of increased mortality. 2) although access to health care is not a problem this health care is episodic and interrupted being provided in multiple different sites.