Configuration of Health Care Networks in the SUS: analysis based on primary and hospital care components.

This study seeks to point out the different configurations of Health Care Networks in primary care (AB) and Hospital Care (AH), dimensioned based on coverage, quality, and resolvability characteristics in health macro-regions. Cross-sectional study used the cluster analysis and segmented 103 macro-regions into different profiles of coverage, quality and resolubility: group 1 (high coverage/AB and medium/AH; low quality AB-AH with high resolubility); group 2 (high coverage/AB and low/AH; low quality AB-AH with medium resolubility) and group 3 (high coverage/AB and medium/AH; high quality AB-AH with high resolubility). Coverage in AB was classified as high for 100% of the Brazilian population and in AH low to 9.

[Assessment of the coordination of primary healthcare: comparison of PMAQ-AB (Brazil) and international references].

This study aimed to compare the results obtained with the coordination of care through the Brazilian National Program for Improvement of Access and Quality of Basic Care (PMAQ-AB), with the parameters adopted by the Care Coordination Measures Atlas and the European Observatory on Health Systems and Policies. A cross-sectional study was performed using the dataset from the third cycle of the PMAQ-AB. Three typologies of coordination of care were created: PMAQ-AB, Atlas, and Observatory.

Why does mental health care not follow the structuring of primary care?

Objective: To verify if primary care teams with better structured primary health care (PHC) attributes could offer better mental health (MH) care.

Methods: Cross-sectional study based on data from the external evaluation of the second cycle of the Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB - Access and Quality Improvement of Primary Care Program), involving 31,587 primary care teams, between 2013 and 2014. Two typologies were built: quality of mental health care (dependent variable) and PHC structuring according to essential attributes (independent variable).

The Budget Impact of Monoclonal Antibodies Used to Treat Metastatic Colorectal Cancer in Minas Gerais, Brazil.

Introduction: Biological medicines have increased the cost of cancer treatments, which also raises concerns about sustainability. In Brazil, three monoclonal antibodies (mAbs)-bevacizumab, cetuximab, and panitumumab-are indicated for the treatment of metastatic colorectal cancer (mCRC) but not currently funded by the Unified Health System (SUS). However, successful litigation has led to funding in some cases.

National Program for the Evaluation of Health Services (PNASS) 2015-2016: an analysis on Brazil's hospitals.

Aim: The present work aims to evaluate the performance of hospitals participating on the National Program for the Evaluation of Health Services (Programa Nacional de Avaliação de Serviços de Saúde - PNASS, 2015-2016).

Methods: This is a descriptive cross-sectional quantitative study, which measured the performance of hospitals participating in the program, using data from the first PNASS 2015-2016 evaluation instrument. The processes evaluation questionnaire used in hospitals had 102 items, 17 criteria, grouped into four blocks or dimensions.

Cost Analysis of Cancer in Brazil: A Population-Based Study of Patients Treated by Public Health System From 2001-2015.

Objectives: The aim of this study was to evaluate the federal government expenditures with oncological care, for the most incident cancer types among the Brazilian population, using registries of all patients treated by the Brazilian National Health Service (SUS) between 2001 and 2015. We adopted the formal healthcare sector perspective in this study, with the costs per patient estimated by the reimbursement price paid by the Ministry of Health to service providers.

Methods: The costs were adjusted by the follow-up time for each patient.

Risk factors associated with antineoplastic chemotherapy-induced nausea and vomiting.

Objective: To estimate the incidence and to evaluate risk factors for antineoplastic nausea and vomiting with high and moderate emetogenic chemotherapy in adult patients in the first treatment cycle.

Methods: Prospective cohort study with follow-up of 269 adults during the first cycle of antineoplastic chemotherapy. The incidence of nausea and vomiting was evaluated in the acute phase (0-24 hours), in the late phase (24 hours-5th day) and in the total phase (0-5th day).

[Coordination of care and quality of healthcare for women and children in the PMAQ].

The study aimed to identify the association between coordination of care and quality of healthcare for women and children in primary healthcare in Brazil. A cross-sectional study was performed with data from 30,523 teams that participated in the Program for Improvement in Access and Quality of Basic Care (PMAQ) in 2013. Logistic regression was performed, in which the dependent variable was quality of healthcare for women and children and the independent variable was level of coordination of care.

[Budget impact of the incorporation of second-line drug treatment for diabetic macular edema in the Brazilian Unified National Health System from the perspective of the Minas Gerais State Health Department, Brazil].

The study's objective was to perform budget impact assessment for the incorporation of second-line intravitreal antiangiogenic therapy for diabatic macular edema in the scope of the Brazilian Unified National Health System (SUS) in Minas Gerais state, Brazil, discussing the incorporation's state budget feasibility. The budget impact assessment was performed as a deterministic method according to Ministry of Health guidelines. The study included patients with probable first-line treatment failure in a five-year timeline for all the technologies assessed.

(Un)Equitable distribution of health resources and the judicialization of healthcare: 10 years of experience in Brazil.

Background: Equity has been acknowledged as a required principle for the fulfilment of the universal right to health once it seeks to tackle avoidable and unfair inequalities among individuals. In Brazil, a country marked by iniquities, this principle was adopted in the Brazilian National Health System (SUS) organization. But the phenomenon known as judicialization of healthcare, anchored in the argument of universality of the right, has been consolidated as a health policy parallel to the SUS.

Comparative Effectiveness and Safety of Monoclonal Antibodies (Bevacizumab, Cetuximab, and Panitumumab) in Combination with Chemotherapy for Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis.

Background: The last decade has seen the increasing use of biological medicines in combination with chemotherapy containing 5-fluorouracil/oxaliplatin or irinotecan for the treatment of metastatic colorectal cancer (mCRC). These combinations have resulted in increased progression-free survival (PFS) in patients with mCRC; however, there are remaining concerns over the extent of their effect on overall survival (OS). Published studies to date suggest no major differences between the three currently available monoclonal antibodies (MoAbs); however, there are differences in costs.

Factors associated with the receipt of pensions among older adults: ELSI-Brazil.

Objective: To describe the prevalence of receipt of pensions and associated factors in a nationally representative sample of the Brazilian population aged 50 years and over.

Methods: We used data from 9,130 participants from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline survey. The outcome variable was receipt of pensions from any source.

The long-term costs for treating multiple sclerosis in a 16-year retrospective cohort study in Brazil.

Background: Multiple Sclerosis (MS) is a disease that appreciably impacts on the quality of life of patients and is associated with high expenditure. MS is a chronic multifactorial disease, characterized by inflammation, demyelination and axonal loss. The Brazilian public health system provides pharmacological treatment as well as hospital and outpatient care for patients with relapsing-remitting and secondary progressive multiple sclerosis.

[Profile of spending on the treatment of rheumatoid arthritis for patients of the Unified Health System in the state of Minas Gerais - 2008-2013].

Rheumatoid arthritis (RA) is a chronic condition that affects about 1% of the adult population. In a historical cohort of Minas Gerais State, 11,573 RA patients registered in the Outpatient Information System (SIA) between 2008 and 2013 were identified. For this study we adopted the public funding body's perspective and the values were adjusted by the national inflation index (IPCA) of December 2015.

[Integration of primary care in the healthcare network: analysis of the components in the external evaluation of the PMAQ-AB].

This cross-sectional study examined the integration of primary care in the healthcare network of the Brazilian Unified National Health System (SUS), using the Gradual Response Model of Item Response Theory. Based on data from 17,202 teams that participated in the National Program for Access and Quality Improvement in Primary Care (PMAQ-AB, 2012), we measured gradients of integration to identify the teams' profile by level of integration. The results show that the items pertaining to matrix support measures (medical consultations, case discussions, shared clinical action, joint elaboration of therapeutic projects, permanent educational activities, work process discussions, interventions in the territory, and visits with primary care professionals) improved the performance of primary care teams.

Care coordination in PMAQ-AB: an Item Response Theory-based analysis.

Objective: Analyze the quality of the National Program for Primary Care Access and Quality Improvement variables to evaluate the coordination of primary care.

Methods: A cross-sectional study based on data from 17,202 primary care teams that participated in the National Program for Primary Care Access and Quality Improvement in 2012. Based on the Item Response Theory, Samejima's Gradual Response Model was used to estimate the score related to the level of coordination.

Patient survival and risk of death after prostate cancer treatment in the Brazilian Unified Health System.

Objective: Analyze the probability of specific survival and factors associated with the risk of death of patients with prostate cancer who received outpatient cancer treatment in the Brazilian Unified Health System, Brazil.

Methods: Retrospective cohort study using the National Database of Oncology, developed through the deterministic-probabilistic pairing of health information systems: outpatient (SIA), hospital (SIH) and mortality (SIM). The probability of overall and specific survival was estimated by the time elapsed between the date of the first ambulatory treatment, from 2002 to 2003, until the patient's death or the end of the study.

Healthcare financing, decentralization and regional health planning: federal transfers and the healthcare networks in Minas Gerais, Brazil.

The Decrees 4279/10 and 7508/11 established norms to guide health politics, with impacts on funding of the Middle and High Complexity Hospital and Outpatient. To verify the effects on the consolidation of care networks in Minas Gerais, we performed an analytical-descriptive study of the National Health Fund from 2006 to 2014. We observed decentralization of responsibilities, accompanied of resources and innovative financing mechanisms, resulting expansion of the network care model.

Costs of Drug Therapy in Patients with Ankylosing Spondylitis in Brazil.

Introduction: The Brazilian Public Health System offers free-of-charge drug treatment for ankylosing spondylitis (AS) to all Brazilian citizens. We report here the first population-based cohort study on patients with AS in Brazil. The aim of this study was to evaluate the costs of the tumour necrosis factor (anti-TNF) blockers and disease-modifying antirheumatic drugs (DMARDs) that were used in the treatments of patients with AS in Brazil between March 2010 and September 2013.

[Hepatitis C incidence in hemodialysis patients in Brazil from 2000 to 2003].

The study aimed to estimate the incidence of HCV seroconversion in hemodialysis patients in the Brazilian Unified National Health System (SUS). This was a prospective, non-concurrent study using patients' data identified by deterministic and probabilistic record linkage in the SUS information system. The study included 47,079 patients started on hemodialysis between January 1, 2000, and December 31, 2003, followed until seroconversion or conclusion of the study in 2004.

Ten-year kidney transplant survival of cyclosporine- or tacrolimus-treated patients in Brazil.

Background: Cyclosporine and tacrolimus are well established immunosuppressants; however little is known about long term survival rates. The project aim was to compare 10-year graft survival and associated factors among kidney transplant patients within the Brazilian Public Health System (SUS) prescribed either immunosuppressant.

Methods: Analyze a national cohort of kidney transplant recipients within SUS.

Health self-assessment by hemodialysis patients in the Brazilian Unified Health System.

Objective: To examine whether the level of complexity of the services structure and sociodemographic and clinical characteristics of patients in hemodialysis are associated with the prevalence of poor health self-assessment.

Methods: In this cross-sectional study, we evaluated 1,621 patients with chronic terminal kidney disease on hemodialysis accompanied in 81 dialysis services in the Brazilian Unified Health System in 2007. Sampling was performed by conglomerate in two stages and a structured questionnaire was applied to participants.

Budget impact analysis of medicines: updated systematic review and implications.

This evaluation determines whether published studies to date meet the key characteristics identified for budget impact analyses (BIA) for medicines, accomplished through a systematic review and assessment against identified key characteristics. Studies from 2001-2015 on 'budget impact analysis' with 'drug' interventions were assessed, selected based on their titles/abstracts and full texts, and their characteristics checked according to key criteria. Out of 1,984 studies, 92 were subsequently identified for review.

Quality of life of patients with Diabetes Mellitus Types 1 and 2 from a referal health centre in Minas Gerais, Brazil.

Unlabelled: Quality of life (QoL) characteristics are important in patients with diabetes mellitus (DM 1 and 2).

Aim: Evaluate QoL and DM-associated factors among diabetic patients.

Methods: Patients attending a University Hospital were interviewed about their sociodemographic, clinical and QoL characteristics, with QoL measured via the EQ-5D.