Custos relacionados a dor lombar no Sistema Único de Saúde e o papel protetor da atividade física
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Data
2017-09-22
Autores
Zanuto, Everton Alex Carvalho [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Objetivo: Analisar no período de 18 meses de seguimento o custo da dor lombar e fatores associados entre pacientes atendidos na atenção primária do SUS na cidade de Presidente Prudente – SP. Métodos: Estudo de base populacional conduzido em duas Unidades Básicas de Saúde (UBS) da cidade de Presidente Prudente – São Paulo, coorte com duração de 18 meses, cujas informações utilizadas foram adquiridas por meio de entrevista face-a-face. O cálculo amostral revelou a necessidade mínima de 310 adultos com idade igual ou superior a 50 anos, foram avaliados neste estudo a presença de dor lombar crônica (DLC), os custos acarretados por esta patologia no SUS, idade, sexo, etnia, escolaridade, atividade física, índice de massa corporal, atividades ocupacionais, tabagismo e etilismo. Dados categóricos foram expressos em porcentagem, e a associação foi estabelecida através do teste qui-quadrado, e regressão logística binária. A regressão logística (expressa como odds ratio [OR] e intervalo de confiança de 95% [IC95%]) analisou a magnitude de tais associações. Resultados: A maioria dos pacientes avaliados eram do sexo feminino 229 (70%) e com sobrepeso/obesidade 179 (78,2%). Foi encontrada alta prevalência de DLC (21,7%). O exercício físico se manteve como fator de proteção para DLC independente dos demais fatores de confusão (OR= 0.35 [IC95%= 0.15-0.80]), e o ciclismo foi relacionado com redução nos custos (rho= -0.289 [p-valor= 0,049]). A DLC também se associou de maneira independente com os gastos com consultas (OR= 1.91 [1.05-3.48]), gastos totais (2.14 [1.16 – 3.94]) e apresentou altos custos com consultas (Sem DLC US$ 34,25 ± 23,21 e DLC: US$ 39,62 ± 27,25, [p-valor= 0,049]). Conclusão: Em resumo foi identificada alta prevalência de dor lombar entre os pacientes SUS, ao passo que a prática de exercícios físicos no lazer foi fator protetor a este desfecho, pacientes do SUS com DLC possuem maiores custos diretos e indiretos com saúde de forma independente de fatores de confusão como idade e excesso de peso, enquanto que o ciclismo reduz os custos em pessoas com DLC.
Objective: To analyze in 18-months follow-up the cost of low back pain (LBP) and associated factors among patients treated in the primary care of Brazilian National Health System (BNHS-SUS) in the Presidente Prudente – SP. Methods: A population-based study conducted in two Basic Health Units (BHU) in the Presidente Prudente – SP, 18-months follow-up cohort, whose information was acquired through a face-to-face interview. The present study evaluated the presence of chronic low back pain (CLBP), the costs of this pathology in the BNHS – SUS, age, gender, ethnicity, schooling, physical activity, body mass index, occupational activities, smoking and alcoholism. Categorical data were expressed as a percentage, and the association was established through the chi-square test and binary logistic regression. Logistic regression (expressed as odds ratio [OR] and 95% confidence interval [CI 95% ]) analyzed the magnitude of such associations. Results: The majority of the evaluated patients were female 229 (70%) and overweight/ obese 179 (78.2%). It was found a high prevalence of CLBP (21.7%). Physical exercise remained a protective factor for CLBP independent of other confounding factors (OR= 0.35 [CI 95% = 0.15-0.80]), and cycling was related to a reduction in costs (rho= - 0.289 [p-value= 0.049]). The CLBP was also independently associated with the expenses with consultations (OR= 1.91 [1.05-3.48]), total expenses (OR= 2.14 [1.16 - 3.94]) and presented high consultation costs (No CLBP US $ 34.25 ± 23, 21 and CLBP: US $ 39.62 ± 27.25, [p-value = 0.049]). Conclusion: In summary, a high prevalence of low back pain was identified among BNHS-SUS patients, whereas physical exercise during leisure was a protective factor for this outcome, BNHS-SUS patients with CLBP have higher direct and indirect health costs independently of confounding factors such as age and excess weight, while cycling reduces costs in people with CLBP.
Objective: To analyze in 18-months follow-up the cost of low back pain (LBP) and associated factors among patients treated in the primary care of Brazilian National Health System (BNHS-SUS) in the Presidente Prudente – SP. Methods: A population-based study conducted in two Basic Health Units (BHU) in the Presidente Prudente – SP, 18-months follow-up cohort, whose information was acquired through a face-to-face interview. The present study evaluated the presence of chronic low back pain (CLBP), the costs of this pathology in the BNHS – SUS, age, gender, ethnicity, schooling, physical activity, body mass index, occupational activities, smoking and alcoholism. Categorical data were expressed as a percentage, and the association was established through the chi-square test and binary logistic regression. Logistic regression (expressed as odds ratio [OR] and 95% confidence interval [CI 95% ]) analyzed the magnitude of such associations. Results: The majority of the evaluated patients were female 229 (70%) and overweight/ obese 179 (78.2%). It was found a high prevalence of CLBP (21.7%). Physical exercise remained a protective factor for CLBP independent of other confounding factors (OR= 0.35 [CI 95% = 0.15-0.80]), and cycling was related to a reduction in costs (rho= - 0.289 [p-value= 0.049]). The CLBP was also independently associated with the expenses with consultations (OR= 1.91 [1.05-3.48]), total expenses (OR= 2.14 [1.16 - 3.94]) and presented high consultation costs (No CLBP US $ 34.25 ± 23, 21 and CLBP: US $ 39.62 ± 27.25, [p-value = 0.049]). Conclusion: In summary, a high prevalence of low back pain was identified among BNHS-SUS patients, whereas physical exercise during leisure was a protective factor for this outcome, BNHS-SUS patients with CLBP have higher direct and indirect health costs independently of confounding factors such as age and excess weight, while cycling reduces costs in people with CLBP.
Descrição
Palavras-chave
Gastos em saúde, Dor lombar, Índice de massa corporal, Atividade motora, Health expenditure, Low back pain, Body mass index, Motor activity