Respiratory health care reorganization in the city of Pindamonhangaba-SP: joint actions of primary and secondary care to reduce morbidity, mortality, and referral in the public health system, through matrix support (collaborative care)

Abstract

Respiratory diseases have high prevalence and incidence rates in Brazil and in the world. Acute Respiratory Infections (IRAs), asthma, chronic obstructive pulmonary disease (COPD) and tuberculosis are examples of diseases that afflict large numbers of individuals each year, are responsible for high rates of morbidity and mortality, and significant social and financial costs. Despite the lack of national epidemiological data, it is estimated that the incidence of asthma in the population is approximately 10%. As an example, localized Brazilian programs that identify uncontrolled asthmatic patients and include them in follow-up and drug treatment have been successfully confirmed in reducing hospitalizations and reducing direct and indirect costs for patients and SUS. Patients with chronic obstructive pulmonary disease (COPD) are underdiagnosed or evaluated as having heart disease. Epidemiological study in the city of São Paulo in two moments showed prevalence 16 percent in people over 40 years of age, and lack of knowledge of diagnosis in 70 percent. Recent data indicate that 71.1% of the Brazilian population seeks public health care facilities to be attended. Primary care actions are lacking. The system is not yet effectively organized in regionalized networks and has very fragile regulatory systems. Specialized attention, in particular to consultations and examinations with specialists, has a repressed demand and difficulty of access. (AU)