Analysis of prehospital care for stroke and acute myocardial infarction in the elderly population of Minas Gerais, Brazil.
OBJECTIVE
To analyze the association between prehospital components of the National Urgent Care Policy (Política Nacional de Atenção às Urgências, PNAU)--the Family Health Strategy (Estratégia de Saúde da Família, ESF) and the Mobile Emergency Care Service (Serviço de Atendimento Móvel de Urgência, SAMU)--and indicators of morbidity and mortality from stroke and acute myocardial infarction (AMI) in the elderly population in preselected municipalities of the State of Minas Gerais, Brazil.


METHODS
A longitudinal ecological study was carried out. Data analysis was performed using a series of multilevel regression models. Health indicators were analyzed from 2001 to 2007.


RESULTS
Statistically significant associations were found between indicators of ESF coverage and presence of SAMU with indicators of stroke and AMI mortality, for both sexes, except for male AMI. Regarding hospital admission rates, the most consistent effects were identified for female AMI.


CONCLUSIONS
The heterogeneity of the results points to an incipient stage of PNAU, which does not allow the observation of clear effects. This finding may also suggest that this policy has not yet been able to achieve its goals concerning the elderly. Further evaluation of PNAU is essential for the establishment of strategies that can enhance its effectiveness.
Luz
Carlos de Castro
Cde C
Universidade Federal Fluminense, Niterói, RJ, Brazil.
Junger
Washington Leite
WL
Cavalini
Luciana Tricai
LT
D000208:Acute Disease; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D004632:Emergency Medical Services / Q000592:standards* / Q000706:statistics & numerical data; D005192:Family Health; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011785:Quality Assurance, Health Care; D020521:Stroke / Q000401:mortality / Q000628:therapy*