Banca de DEFESA: Geraldo Marques da Costa

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : Geraldo Marques da Costa
DATE: 23/09/2022
TIME: 14:00
LOCAL: A definir
TITLE:

Mortality study of the elderly population in Federal District

KEY WORDS:

Aged; Primary Health Care; Mortality; Aging; Family Health.

PAGES: 1000
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: Aging is a worldwide phenomenon. In Brazil, this situation increases care pressure within the scope of the Unified Health System (SUS) since the elderly are more affected by morbidities, requiring hospitalization, exams, medication and, eventually, progressing to death. Thus, aging overloads the health system and increases the demand for resources. In the national reality, one of the places where the elderly receive care is primary care. Primary care is offered in two main models: the traditional model of primary care with focal specialists and based on segmented care across life cycles. And the family health strategy model, based on person-centered care, with an enrolled population and teams responsible for people's comprehensive health care. It is known that primary care coverage can impact the health indicators of the population, especially in conditions sensitive to primary care. Objective: To analyze the mortality profile of the elderly population, aged 60 or over, as well as to verify mortality due to conditions sensitive to primary care and the influence of social, economic and health conditions, between 2008 - 2018 in the Federal District.Methodology: Longitudinal, descriptive and analytical study aimed at analyzing the mortality of the elderly population aged 60 years and over in the Federal District. Deaths that occurred in people aged 60 years or older, occurring in the Federal District, between 2008 and 2018 were investigated. The deaths were grouped by sociodemographic characteristics: sex, age, race/color, marital status, address, and region health, schooling. A description of the underlying cause of death was performed, ranking the main causes and the trend of mortality was studied using the jonckheere-terpstra test. Data were compared with the coverage of primary care disaggregated into primary care and family health strategy. Mortality rates due to conditions sensitive to primary care were calculated and compared with the evolution of primary care coverage in the Federal District. Finally, deaths were associated with age at the time of death, sex, marital status, education, race/color, death due to a condition sensitive to primary care, population coverage of primary care services. The Urban Welfare Index (IBEU) was used, comprising the following dimensions: mobility, environmental and housing conditions, infrastructure and collective services in order to analyze issues related to the place of residence of the elderly Results: During the study period, there were 85,835 deaths among the elderly in the Federal District. The mean age was 76.51. Most deaths occurred among 80 years of age or older. Male sex predominated. The main causes of death were acute myocardial infarction (6.6%); pneumonia (5.2%); stroke (4.1%); malignant neoplasm of the bronchi or lungs (3%) and chronic obstructive pulmonary disease (2.6%). Higher mortality among men (p<0.001), from cardiovascular causes (p=0.006), and in older elderly (p<0.001) was statistically significant. Among the deaths studied, those that occurred in elderly people living in the Federal District were 70,503. The risk of dying from conditions sensitive to primary care decreased, notably after 2017. Population coverage by primary care increased in the period, with the increase in the family health strategy being more pronounced in 2017 and 2018. In the analytical study, it was noted The factors associated with the mortality of the elderly due to conditions sensitive to primary care were found to be male, lower income and lower education. It was also observed that living in a place with the worst IBEU presented a response gradient with higher mortality. Increased primary care coverage was also associated with lower mortality. Conclusions: It was concluded that most deaths were from cardiovascular causes. Being an elderly man and older age were related to higher mortality. A descriptive analysis of the risk of dying from sensitive conditions was performed compared with coverage by primary care. A decrease in the risk of dying of elderly people from conditions sensitive to primary care was evidenced. In the investigation by statistical correlation, the study showed an association between male gender, age, income and education, and IBEU with lower mortality due to conditions sensitive to primary care, these associations showed a response gradient. The study also found that increased coverage of the elderly population was associated with lower mortality from sensitive conditions.

BANKING MEMBERS:
Externa à Instituição - BEATRIZ APARECIDA OZELLO GUTIERREZ - USP
Interno - 1225317 - EDGAR MERCHAN HAMANN
Interno - 1681340 - EVERTON NUNES DA SILVA
Presidente - 2221672 - HELENA ERI SHIMIZU
Externo à Instituição - HENRIQUE SALMAZO DA SILVA - UCB