[Public care for breast cancer women in the state of Rio de Janeiro, Brazil].
OBJECTIVE
New policies on oncology care implemented in the Brazilian Unified Health System (SUS) in November 1999 established substantial changes to cancer treatment in affiliate units. The objective was to describe the profile of these cancer services and their users after the implementation of new policies.


METHODS
A descriptive study was carried out on breast cancer care in health services covered by SUS in the state of Rio de Janeiro, from 1999 to 2002. Data was collected in the healthcare units from outpatient registries and from the patients' high-complexity cancer procedure authorizations and their medical records. A random sample of 310 medical records of breast cancer women treated in 15 cancer health units was analyzed. Data analysis was performed using the percentile distribution of data according to categories of interest and the Chi-square test to assess the association between variables.


RESULTS
The study results show the predominance of breast cancer care in highly complex units (81.3%); public units (73.5%); and in the capital of the state (78.1%). There was also seen an imbalance among health units regarding patient attendance, where only one of them served 70% of women sampled. The use of interventions varied between patients with and without health insurance in lower complexity health services; non-insured patients were associated to lower use of interventions. It was also found underutilization of recommended interventions as well as utilization of contraindicated interventions. The characterization of population studied showed that 43.9% of the women were given a cancer diagnosis with no perspective of cure and 68.4% lived in cities having SUS-affiliated services.


CONCLUSIONS
These results indicate relevant differences among health units and point out to the need of practical recommendations to the Brazilian national policy for cancer control.
Brito
Cláudia
C
Departamento de Administração e Planejamento em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil. cbrito@ensp.fiocruz.br
Portela
Margareth Crisóstomo
MC
Vasconcellos
Mauricio Teixeira Leite de
MT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D001943:Breast Neoplasms / Q000188:drug therapy*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006291:Health Policy; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D017150:Public Sector