Acesso ao diagnóstico da tuberculose em serviços de saúde do município de Vitória, ES, Brasil
Acesso ao diagnóstico da tuberculose em serviços de saúde do município de Vitória, ES, Brasil
Data
2014
Autores
Loureiro, Rafaela Borges
Villa, Tereza Cristina Scatena
Ruffino-Netto, Antônio
Peres, Renata Lyrio
Braga, José Ueleres
Zandonade, Eliana
Maciel, Ethel Leonor Noia
Journal Title
Journal ISSN
Volume Title
Publisher
Ciência & Saúde Coletiva
Resumo
Objetivou-se avaliar a acessibilidade ao
diagnóstico da tuberculose nos serviços de saúde
em Vitória (ES). Estudo transversal realizado em
2009 com doentes de tuberculose, utilizando o instrumento Primary Care Assessment Tool. Análise estatística com Teste Qui-quadrado (p < 0,05).
Em relação à porta de entrada, notou-se que o
serviço de saúde mais procurado foi Atenção Básica (37,6%); a maioria dos diagnósticos ocorreu
nas Unidades de Referência do Programa de Controle da Tuberculose (61,3%). Houve evidência de
associação entre primeiro serviço de saúde procurado e fatores tempo de demora na obtenção de
consulta neste (p = 0,0182), hipótese diagnóstica
feita pelo primeiro serviço de saúde procurado (p
= 0,0001), solicitação exame de escarro (p =
0,0003), solicitação exame de Raios-X (p = 0,0159),
encaminhamento para Raios-X em outro serviço
(p = 0,0001), diagnóstico pelo mesmo serviço de
saúde (p = 0,0001), exames realizados no próprio
serviço de saúde que diagnosticou tuberculose (p =
0,0018), proximidade do domicílio (p = 0,0001).
Portanto, a identificação de lacunas importantes
na acessibilidade ao diagnóstico de tuberculose
parece estar relacionada às dificuldades operacionais de organização da atenção à saúde.
This study sought to assess the accessi- bility to the diagnosis of tuberculosis in health services in Victoria, state of Espírito Santo. It featured a cross-sectional study conducted in 2009 of patients with tuberculosis using the Primary Care Assessment Tool and statistical analysis with the Chi-square test (p <0,05). In relation to ini- tial access to care, it was seen that the health service of first access most sought was Primary Care (37.6%), with most diagnoses occurring in the Tuberculosis Control Program Reference Units (61.3%). There was evidence of associati- on between first health service accessed and the factors of time delay in: obtaining consultation at the first health service sought (p = 0.0182); diag- nosis made by the first health service sought (p = 0.0001); request for sputum exam (p = 0,0003); request for X-ray exams (p = 0.0159); referral for X-rays at another institution (p = 0.0001); diag- nosis by the same health service (p = 0.0001); exams conducted by the same health service that initially diagnosed tuberculosis (p = 0.0018); and proximity to the home (p = 0.0001). Therefore, the identification of important gaps in accessibi- lity to diagnosis of tuberculosis seems to be related to the operational difficulties of organization of health care.
This study sought to assess the accessi- bility to the diagnosis of tuberculosis in health services in Victoria, state of Espírito Santo. It featured a cross-sectional study conducted in 2009 of patients with tuberculosis using the Primary Care Assessment Tool and statistical analysis with the Chi-square test (p <0,05). In relation to ini- tial access to care, it was seen that the health service of first access most sought was Primary Care (37.6%), with most diagnoses occurring in the Tuberculosis Control Program Reference Units (61.3%). There was evidence of associati- on between first health service accessed and the factors of time delay in: obtaining consultation at the first health service sought (p = 0.0182); diag- nosis made by the first health service sought (p = 0.0001); request for sputum exam (p = 0,0003); request for X-ray exams (p = 0.0159); referral for X-rays at another institution (p = 0.0001); diag- nosis by the same health service (p = 0.0001); exams conducted by the same health service that initially diagnosed tuberculosis (p = 0.0018); and proximity to the home (p = 0.0001). Therefore, the identification of important gaps in accessibi- lity to diagnosis of tuberculosis seems to be related to the operational difficulties of organization of health care.
Description
Palavras-chave
Tuberculose, Acesso, Acessibilidade, Serviços de saúde, Diagnóstico, Atenção Primária à Saúde, Tuberculosis, Access, Accessibility, Health Services, Diagnosis, Primary health care.
Citação
Loureiro RB, Villa TC, Ruffino-Netto A, Peres RL, Braga JU, Zandonade E, Maciel EL. Acesso ao diagnóstico da tuberculose em serviços de saúde do município de Vitória, ES, Brasil [Access to the diagnosis of tuberculosis in health services in the municipality of Vitoria, state of Espírito Santo, Brazil]. Cien Saude Colet. 2014 Apr;19(4):1233-44. Portuguese. doi: 10.1590/1413-81232014194.01002013.