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Spatial and spatio-temporal analysis of preventable hospitalizations by tuberculosis in Ribeirao Preto, SP, (2006-2012)

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Author(s):
Isabela Moreira de Freitas
Total Authors: 1
Document type: Master's Dissertation
Press: Ribeirão Preto.
Institution: Universidade de São Paulo (USP). Escola de Enfermagem de Ribeirão Preto (PCARP/BC)
Defense date:
Examining board members:
Ricardo Alexandre Arcêncio; Francisco Chiaravalloti Neto; Ione Carvalho Pinto
Advisor: Ricardo Alexandre Arcêncio
Abstract

Preventable hospitalizations by tuberculosis constitute an important indicator of inequity for health services access, especially to the Primary Health Care. Thus, the intention is to analyze the spatial distribution of avoidable hospitalizations cases by tuberculosis and the presence of spatiotemporal and spatial clusters of risk to the occurrence of these events. Therefore, it was possible to develop an exploratory and ecological study on admissions recorded in the Hospital Information System of the Hospital das Clínicas of Ribeirão Preto, between January 1, 2006 and December 31, 2012.Only clinical forms considered as preventable were selected according to the Health Ministry Ordinance (A 15.0 -A 17.9, International Classification of Diseases 10).There was data geocoding, and spatial analysis techniques were density of points (Kernel Density Estimation), area (Empirical Bayes Local Rate) and Statistic Scan. It was possible to utilize ArcGis software version 10.2, TerraView version 4.2.2 and SaTScan (TM) for thematic maps construction. There were 169 admissions with geocoding of 159 of them. The majority of admissions occurred in males (n = 134, 79.29%) with a median age of 48 years. The predominant clinical form was pulmonary with confirmation by sputum microscopic examination (n = 66, 39.0%). Also, it was possible to notice a non-random spatial distribution in the municipality, and occurrences of avoidable hospitalizations by tuberculosis concentrated in North and West regions. Statistical scan revealed three spatial clusters for hospitalizations, with one of them located in the north of the municipality (Relative Risk = 3.47, p = 0.001).The second one was in the central region, where it is located one prison unit (Relative Risk of 28.59, p = 0.001) and the latter in the south region, a protected area for hospitalizations (Relative Risk = 0.25, p = p = 0.015).The study findings revealed differences between regions about preventable hospitalizations by tuberculosis, and checking areas more at risk than others. Thereby, it would be necessary to prioritize those areas in terms of health planning and investments (AU)

FAPESP's process: 12/20955-2 - Spatial distribution of tuberculosis hospitalizations and relation of them with social indicators in Ribeirão Preto - SP
Grantee:Isabela Moreira de Freitas
Support Opportunities: Scholarships in Brazil - Master