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The determinants of admissions for tuberculosis in Ribeirão Preto: A geo-ecological approach

Grant number: 13/22486-2
Support Opportunities:Scholarships in Brazil - Doctorate
Start date: March 01, 2014
End date: February 28, 2017
Field of knowledge:Health Sciences - Nursing - Public Health Nursing
Principal Investigator:Ricardo Alexandre Arcêncio
Grantee:Marcela Paschoal Popolin
Host Institution: Escola de Enfermagem de Ribeirão Preto (EERP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Known as one of the oldest infectious diseases in the world, TB remains a public health problem and is one of the problems that have strong appeal to the determinants of services and social equity in a territory. These determinants directly affect the population vulnerable to the disease, which can lead to imbalance preventable hospitalizations. Hospitalizations for tuberculosis has grown in recent years, which highlights the weaknesses of health systems to respond to population needs. Thus, this proposal aims to investigate the determinants of admissions for tuberculosis in the city of Ribeirão Preto - SP. The design is characterized as an ecological study, which applies spatial analysis techniques to TB hospitalization data. The research will use data from the Hospital Information System, apply questionnaires to Primary Health Care teams and obtain information from the Information Database per census sector in the urban area of Ribeirão Preto - Demographic Census 2010. The social insertion indicators will be constructed through Main Component Analysis. The ecological unit considered for the research will be the coverage area or territory of PHC. The coverage areas will be categorized according to the population's social class (high, middle and low) and PHC's ability to structure the HCNs, corresponding to level 1, inability to coordinate the health care networks; level 2, basic ability to coordinate the networks, 3, good ability to coordinate the networks and 4, excellent ability for this purpose. Hospitalizations due to TB will be subject to spatial analysis and correlated with the ability of PHC to operate HCNs and social class in the coverage areas. Ward's method of hierarchical cluster analysis will be applied, as well as the construction of maps to analyze the spatial distribution of TB hospitalizations. Autocorrelation coefficients of Moran and Kernell Estimation can contribute to these analyses. Also, multiple correspondence analysis will be applied.

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
POPOLIN, MARCELA PASCHOAL; TOUSO, MICHELLE MOSNA; YAMAMURA, MELLINA; BANDEIRA RODRIGUES, LUDMILA BARBOSA; DA CUNHA GARCIA, MARIA CONCEBIDA; ARROYO, LUIZ HENRIQUE; VIEIRA RAMOS, ANTONIO CARLOS; BERRA, THAIS ZAMBONI; NETO, MARCELINO SANTOS; CRISPIM, JULIANE DE ALMEIDA; et al. Integrated health service delivery networks and tuberculosis avoidable hospitalizations: is there a relation between them in Brazil?. BMC HEALTH SERVICES RESEARCH, v. 16, . (13/22486-2, 12/51235-5)