Adesão ao rastreamento mamográfico em serviços de saúde públicos e privados
Ailton Augustinho Marchi
TESE
Português
T/UNICAMP M332a
[Adherence to mammographic screening in public and private healthcare services]
Campinas, SP : [s.n.], 2010.
84 f : il.
Orientador: Maria Salete Costa Gurgel
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Resumo: Objetivos: Avaliar a adesão e identificar falhas de aderência das mulheres atendidas em serviços de saúde públicos e privados às recomendações dos programas de rastreamento mamográfico. Sujeitos e Métodos: Estudo prospectivo que acompanhou 460 mulheres na cidade de Taubaté, São Paulo,...
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Resumo: Objetivos: Avaliar a adesão e identificar falhas de aderência das mulheres atendidas em serviços de saúde públicos e privados às recomendações dos programas de rastreamento mamográfico. Sujeitos e Métodos: Estudo prospectivo que acompanhou 460 mulheres na cidade de Taubaté, São Paulo, Brasil, das quais 327 foram atendidas em serviços de saúde públicos e 133 em serviços privados, durante o período de cinco anos após a realização de mamografia-índice. Avaliou-se a adesão ao rastreamento mamográfico através do número de mamografias realizadas nesse período e também pelos intervalos de repetição entre os exames, respectivamente em 18, 24 e 30 meses. Analisou-se a frequência de repetição da mamografia e os fatores associados à adesão ao rastreamento mamográfico vigente. Elegeu-se o intervalo de repetição entre as mamografias superior a 30 meses para definir falha de adesão ao rastreamento mamográfico oportunístico. As associações dos desfechos com as variáveis independentes foram estudadas pela técnica de regressão de Cox, com obtenção das razões de risco (RR) e respectivos intervalos de confiança de 95% (IC95%). Resultados: Apesar de mais de 90% das entrevistadas terem repetido pelo menos uma vez o exame de mamografia, a adesão correta às recomendações do rastreamento mamográfico, com a sua repetição a cada 24 meses, revelou taxas muito baixas, ao redor de 30%, na amostra estudada. As falhas de adesão ocorreram em 51,1% das entrevistadas. O acesso público aos serviços de saúde (RR 1,44; IC95% 1,06-1,96), a ausência de rastreio prévio (RR 1,53; IC95% 1,17-2,00) e a frequência esporádica aos serviços médicos (RR 1,41; IC95% 1,05-1,89) foram os fatores associados às falhas de adesão. Conclusões: Ocorreu baixa adesão às recomendações do rastreamento mamográfico do câncer de mama em ambos os segmentos populacionais estudados. As políticas de rastreamento mamográfico com caráter exclusivamente oportunístico ocasionam falhas de adesão constantes e mais comuns entre as mulheres atendidas nos serviços públicos de saúde
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Abstract: Objective: to assess compliance and identify lacks of adherence with the
recommendations for breast cancer screening by mammography. Subject and Methods: Prospective study which follow-up 460 women in the city of Taubaté, São Paulo, Brazil, during five years after perform index... Ver mais Abstract: Objective: to assess compliance and identify lacks of adherence with the
recommendations for breast cancer screening by mammography. Subject and Methods: Prospective study which follow-up 460 women in the city of Taubaté, São Paulo, Brazil, during five years after perform index mammography, 327 of them attended by the public health system and 133 by the private system. The adherence to mammographic screening were assessed through number of underwent mammographies in this period and repeated intervals among the exams at 18, 24 and 30 month, respectively. Prevalence of repeat mammography and predictors associated to adherence to current mammographic screening were analyzed. The repeated interval among mammographies above 30 month was selected to define lack of adherence to opportunistic mammographic screening. The outcomes associations with independent variables were studied by risk ratio (RR) and 95% confidence intervals (95%CI) performed through Cox-regression model. Results: although more than 90% of the studied women repeated the mammography at least once, the rate of correct compliance with the recommendations of mammographic screening, with repetition of the procedure every 24 months, was low, around 30%, in sample studied. The adherence flaws ocurred in about 51.1% of the interviewees and the unequal access to healthcare services, public or private (RR 1.44; 95%CI 1.06-1.96), absence of previous screening (RR 1.53; 95%CI 1.17-2.00), less visiting medical services (RR 1.41; 95%CI 1.05-1.89) were the associated factors to lack of adherence. Conclusion: we concluded that compliance with the recommendations to mammographic screening for breast cancer was low in both studied population segments. The opportunistic model of mammographic screening policies provokes recurrent lack of adherence which is more common among women attended in public healthcare services Ver menos
recommendations for breast cancer screening by mammography. Subject and Methods: Prospective study which follow-up 460 women in the city of Taubaté, São Paulo, Brazil, during five years after perform index... Ver mais Abstract: Objective: to assess compliance and identify lacks of adherence with the
recommendations for breast cancer screening by mammography. Subject and Methods: Prospective study which follow-up 460 women in the city of Taubaté, São Paulo, Brazil, during five years after perform index mammography, 327 of them attended by the public health system and 133 by the private system. The adherence to mammographic screening were assessed through number of underwent mammographies in this period and repeated intervals among the exams at 18, 24 and 30 month, respectively. Prevalence of repeat mammography and predictors associated to adherence to current mammographic screening were analyzed. The repeated interval among mammographies above 30 month was selected to define lack of adherence to opportunistic mammographic screening. The outcomes associations with independent variables were studied by risk ratio (RR) and 95% confidence intervals (95%CI) performed through Cox-regression model. Results: although more than 90% of the studied women repeated the mammography at least once, the rate of correct compliance with the recommendations of mammographic screening, with repetition of the procedure every 24 months, was low, around 30%, in sample studied. The adherence flaws ocurred in about 51.1% of the interviewees and the unequal access to healthcare services, public or private (RR 1.44; 95%CI 1.06-1.96), absence of previous screening (RR 1.53; 95%CI 1.17-2.00), less visiting medical services (RR 1.41; 95%CI 1.05-1.89) were the associated factors to lack of adherence. Conclusion: we concluded that compliance with the recommendations to mammographic screening for breast cancer was low in both studied population segments. The opportunistic model of mammographic screening policies provokes recurrent lack of adherence which is more common among women attended in public healthcare services Ver menos
Costa-Gurgel, Maria Salete, 1956-
Orientador
Zeferino, Luiz Carlos, 1955-
Avaliador
Sarian, Luís Otávio Zanatta, 1974-
Avaliador
Uemura, Gilberto
Avaliador
Conde, Delio Marques
Avaliador
Adesão ao rastreamento mamográfico em serviços de saúde públicos e privados
Ailton Augustinho Marchi
Adesão ao rastreamento mamográfico em serviços de saúde públicos e privados
Ailton Augustinho Marchi
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