Análise da tendência de mortalidade por acidente vascular cerebral e a sua associação com o acompanhamento na atenção primária no estado da Paraíba

Abstract

Stroke is a sensitive problem in primary health care, as it can be controlled through care and monitoring by a team from the Family Health Strategy. One possibility for the assessment of primary care has been the analysis of data on rates of admissions for primary care-sensitive conditions (ACSC). The present research presents as an innovative character the construction of a database with remarkable utility for the management of public health services, with state coverage, and may contribute to the reduction of hospitalization rates for cerebrovascular accident according to the diagnosis groups, thus enabling the strengthening of health at the level of primary health care. Given this perspective, the aim of the study was to analyze the trend of Mortality from Stroke and its association with monitoring in primary care in its Ischemic, Hemorrhagic and unspecified (NE) manifestations, for the State of Paraíba in the period 2009 to 2019. The present work is an epidemiological, ecological, descriptive, exploratory and inferential study, involving secondary data from individuals affected by stroke. The sampling grid is composed of hospital admission data of patients admitted with a stroke diagnosis and who died in the study scenarios in the state of Paraíba. These data were made available by the Informatics Department of the Unified Health System (DATASUS). The data collected came from a secondary database extracted from the Information System on Authorization for Hospital Admissions (SIH-SUS). These data were made available by the Ministry of Health, in DBC file format, through DATASUS, using the TabWin32 software. For analysis, the statistical tool of mediation model was used through the R Software, version 3.4.3. In the vast majority of patients who died, they had a diagnosis of stroke-NE, totaling 3,704 (53%) patients. In 2018 and 2019, the number of consultations decreased respectively from 565,608 to 516,894, but the number of deaths of patients admitted to hospitals in the state of Paraíba initially decreased to 535 deaths and in the following year there was a significant increase of 623 deaths. It is concluded that the study showed that stroke is still a matter of concern for health managers and public institutions, so that the research helps to better target the decision-making process at the level of primary health care, providing improvements in the quality of the system in the state of Paraíba and reduction of mortality from this health problem.