RESUMO
OBJETIVO: Describir la tendencia temporal de osteoartritis (OA) según egresos hospitalarios considerando ubicación anatómica, distribución por sexo, edad, condiciones más frecuentes, y ubicación geográfica en Chile entre los años 2012 y 2018. METODOLOGÍA: Estudio descriptivo, retrospectivo, poblacional, que analizó las bases de datos públicas del Departamento de Estadísticas e Información en Salud (DEIS) del Ministerio de Salud de Chile, en particular los registros con codificación de M15 a M19. Se calcularon las tasas por 100 mil egresos hospitalarios, así como también el porcentaje de OA según las categorías analizadas. RESULTADOS: Se encontraron 11.622.605 egresos hospitalarios entre 2012 y 2018. El número total de egresos hospitalarios por OA fue de 78.700. Se observó que la distribución por sexo fue similar a lo largo de los años ( 40% y 60% en hombres y mujeres, respectivamente). El rango de edad más afectado fue el de 65 a 79 años, cuya tasa promedio fue de 2.046 por 100 mil egresos; además, fue el grupo que presentó el mayor aumento (60%) en su tasa de 2012 a 2018. La Región Metropolitana (291,7 egresos) y de Valparaíso (89,6 egresos) presentaron las tasas más altas. La cadera (56,6%) y la rodilla (31%) fueron las ubicaciones más frecuentes de casos de OA, con distribución similar por sexo, edad y geografía en comparación a los egresos totales por OA. CONCLUSIONES: Los egresos hospitalarios por OA en Chile aumentaron entre 2012 y 2018, preferencialmente en casos de OA en las articulaciones de cadera y rodilla en el grupo de mujeres de edad avanzada de la zona centro del país. NIVEL DE EVIDENCIA: Estudio descriptivo.
OBJECTIVE: To describe the temporal trends of osteoathritis (OA) according to hospital discharges considering anatomical location, distribution by gender, age, more frequent conditions, and geographic location in Chile between 2012 and 2018. METHODOLOGY: A retrospective, descriptive and population study which analyzed the public databases of the Department of Health Statistics and Information (Departamento de Estadísticas e Información en Salud, DEIS, in Spanish) of the Ministry of Health of Chile, in particular the records with codes M15 through M19. Rates per 100 thousand hospital discharges were calculated, as well as the percentage of OA according to the categories analyzed. RESULTS: A total of 11,622,605 hospital discharges were found between 2012 and 2018. The total number of hospital discharges due to OA was of 78,700. The distribution by gender was similar over the years ( 40% and 60% among men and women respectively). Adults aged between 65 and 79 years were the most affected, and their average rate was of 2,046 per 100 thousand discharges. It was also the group that presented the highest increase (60%) in rate from 2012 to 2018. The Metropolitan Region (291.7 discharges) and Valparaíso (89.6 discharges) presented the highest rates in Chile. The hip (56.6%) and knee (31%) were the most frequent locations of OA, which presented similar distribution by gender, age and geography when compared with the total discharges due to OA. CONCLUSIONS: Hospital discharges due to OA in Chile increased between 2012 and 2018, preferentially in cases of hip and knee-joint OA in the group of elderly women in the central area of the country. LEVEL OF EVIDENCE: Descriptive study.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Osteoartrite/epidemiologia , Alta do Paciente , Avaliação de Resultados em Cuidados de Saúde , Osteoartrite do Quadril/epidemiologia , Epidemiologia Descritiva , Prevalência , Distribuição por Sexo , Distribuição por Idade , Osteoartrite do Joelho/epidemiologiaRESUMO
OBJECTIVE: To determine what contribution the Standard Days Method® (SDM) makes to the contraceptive mix offered by regular health services in areas of Peru where contraceptive prevalence rates (CPR) are already high. METHODS: SDM was added to the family planning methods offered by the Ministry of Health in two provinces in Peru in September 2002. Retrospective interviews were conducted in March-June 2004 with 1 200 women who had chosen SDM as their contraceptive method and had used it for 2-20 months. Data were also obtained from the databases of the participating health services. The evaluation covered SDM demand, whether or not clients were switching to SDM from other modern methods, and SDM continuation and effectiveness. RESULTS: Demand for SDM stabilized at 6% of all new family planning users. Most users had not been using any reliable contraception at the time they started using SDM. About 89% of those who began using SDM at least 6 months before the interview were still using it at 6 months. The 12-month typical use pregnancy rate was estimated to be around 10.0 per 100 women years. CONCLUSIONS: Adding SDM to a program's existing contraceptive method mix can increase coverage even in an already high-CPR setting. Most women who choose SDM do not switch from any other modern family planning method. Continuation compares well with other modern user-directed methods. SDM effectiveness, when offered in regular service delivery circumstances, compares well to efficacy trial findings.
Assuntos
Comportamento Contraceptivo , Métodos Naturais de Planejamento Familiar , Adulto , Comportamento Contraceptivo/psicologia , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepcionais Femininos , Anticoncepcionais Orais , Coleta de Dados , Uso de Medicamentos , Feminino , Humanos , Métodos Naturais de Planejamento Familiar/psicologia , Métodos Naturais de Planejamento Familiar/estatística & dados numéricos , Paridade , Peru , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Esterilização Tubária/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVE: To determine what contribution the Standard Days Method® (SDM) makes to the contraceptive mix offered by regular health services in areas of Peru where contraceptive prevalence rates (CPR) are already high. METHODS: SDM was added to the family planning methods offered by the Ministry of Health in two provinces in Peru in September 2002. Retrospective interviews were conducted in March-June 2004 with 1 200 women who had chosen SDM as their contraceptive method and had used it for 2-20 months. Data were also obtained from the databases of the participating health services. The evaluation covered SDM demand, whether or not clients were switching to SDM from other modern methods, and SDM continuation and effectiveness. RESULTS: Demand for SDM stabilized at 6 percent of all new family planning users. Most users had not been using any reliable contraception at the time they started using SDM. About 89 percent of those who began using SDM at least 6 months before the interview were still using it at 6 months. The 12-month typical use pregnancy rate was estimated to be around 10.0 per 100 women years. CONCLUSIONS: Adding SDM to a program's existing contraceptive method mix can increase coverage even in an already high-CPR setting. Most women who choose SDM do not switch from any other modern family planning method. Continuation compares well with other modern user-directed methods. SDM effectiveness, when offered in regular service delivery circumstances, compares well to efficacy trial findings.
OBJETIVO: Definir la contribución del Método de Días Fijos® (MDF) a la combinación de métodos anticonceptivos que ofrecen los servicios de salud en dos provincias del Perú, donde las tasas de prevalencia de anticoncepción ya son altas. MÉTODOS: El MDF se agregó a los métodos de planificación familiar ofrecidos por el Ministerio de Salud en dos provincias en el Perú en septiembre del 2002. Entre marzo y junio del 2004, se llevaron a cabo entrevistas retrospectivas a 1 200 mujeres que habían escogido este método anticonceptivo y lo habían usado durante un período de 2 a 20 meses. Se obtuvo también información a partir de las bases de datos de los servicios de salud que participaron en el estudio. Se recogieron datos para determinar la demanda del MDF, si las usuarias hicieron la transición del MDF a otros métodos modernos por el de los días fijos y con la continuidad del uso del método y su eficacia. RESULTADOS: La demanda del MDF se estabilizó en 6 por ciento de todas las nuevas usuarias de planificación familiar. La mayoría de ellas no estaba utilizando otro método de anticoncepción en el momento de comenzar a usar este método. Cerca de 89 por ciento de las mujeres que habían empezado a usar el MDF al menos 6 meses antes de la entrevista, todavía lo estaban usando 6 meses después. Se calculó que la tasa de embarazo con un uso típico del método durante 12 meses fue alrededor de 10,0 por 100 años-mujer. CONCLUSIONES: La adición del MDF a las opciones de métodos anticonceptivos propuestos por un programa puede aumentar la cobertura, incluso en entornos que ya cuentan con una alta tasa de prevalencia de anticoncepción. La mayoría de las mujeres que eligieron el MDF no había usado antes otro método moderno de planificación familiar. La continuación de su uso es comparable con la continuación de otros métodos modernos que dependen del usuario. La eficacia del MDF, cuando se ofrece en un contexto de prestación de servicios regulares es comparable con los resultados que se obtuvieron en el estudio de eficacia.
Assuntos
Humanos , Feminino , Gravidez , Adulto , Adulto Jovem , Comportamento Contraceptivo , Métodos Naturais de Planejamento Familiar , Comportamento Contraceptivo/psicologia , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepcionais Femininos , Anticoncepcionais Orais , Coleta de Dados , Uso de Medicamentos , Métodos Naturais de Planejamento Familiar/psicologia , Métodos Naturais de Planejamento Familiar , Paridade , Peru , Taxa de Gravidez , Estudos Retrospectivos , Esterilização Tubária , Adulto JovemRESUMO
OBJECTIVE: To determine when after discontinuing the use of combined oral contraceptives (COC) women can start using the Standard Days Method (SDM)-a fertility awareness-based family-planning method that is appropriate only for women for whom most menstrual cycles last 26-32 days. METHODS: We reviewed data from the medical records of women who attended the Human Reproduction Unit at the University of Campinas, Brazil, between October 16, 1979, and May 5, 2006. The study population comprised women younger than 40 years of age who had recently switched from COC to copper intrauterine devices and whose clinical records contained the information necessary for determining the length of the first menstrual cycle immediately after discontinuing COC. RESULTS: In total, 47.2% of the 2845 women included in the study had a first post-COC cycle of 26-32 days; 40.5% had a second cycle within that range. CONCLUSION: A first post-COC cycle within the 26-32-day range did not predict a second cycle within range. Women discontinuing COC should not start using the SDM in their first or second post-COC cycle, even if the first cycle falls within the stated range. Instead, they should use a backup method until they meet the necessary eligibility criteria.
Assuntos
Comportamento Contraceptivo , Anticoncepcionais Orais Combinados/administração & dosagem , Dispositivos Intrauterinos de Cobre , Ciclo Menstrual/efeitos dos fármacos , Adolescente , Adulto , Brasil , Anticoncepção/métodos , Feminino , Humanos , Estudos Retrospectivos , Adulto JovemAssuntos
Anticoncepção , Métodos Naturais de Planejamento Familiar , Comportamento Contraceptivo , Peru , Anticoncepção , Métodos Naturais de Planejamento Familiar , Comportamento Contraceptivo , Comportamento Contraceptivo , Anticoncepcionais Femininos , Anticoncepcionais Orais , Coleta de Dados , Uso de Medicamentos , Paridade , Taxa de Gravidez , Adulto Jovem , Métodos Naturais de Planejamento Familiar , Estudos Retrospectivos , Esterilização TubáriaRESUMO
This article presents an evaluation framework developed to assess the first-level effects of introducing the Standard Days Method (SDM) in Peru Ministry of Health clinics. Four questions are asked: 1) To what extent do providers routinely achieve SDM service delivery standards? 2) Is the time invested in SDM delivery consistent with program norms? 3) How does SDM delivery compare with delivery of established methods? and 4) How does SDM introduction affect delivery of established methods? A study at 62 clinics demonstrated the framework's usefulness. The Standard Days Method introduction had positive overall effects on the quality of care but provider training needed adjustments.