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Os inquéritos nacionais de saúde: pertinência e validade na produção do conhecimento de base para planeamento de políticas de saúde no âmbito das doenças crónicas não transmissíveis
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Como resultado de uma evolução nos perfis epidemiológicos mundiais, as Doenças Crónicas Não Transmissíveis (DCNT’s) apresentam-se como “um dos maiores desafios para o desenvolvimento sustentável neste século”, devido à estreita ligação entre a saúde e o desenvolvimento humano.
São elas atualmente responsáveis por mais de 60% das mortes em todo o mundo e esta taxa tende a aumentar na medida em que o desenvolvimento económico avança, e é principalmente imputável ao envelhecimento da população.
Para que se possam planear políticas públicas eficazes para a prevenção e controle das DCNT’s, é fundamental que as decisões políticas sejam norteadas por conhecimentos com base em evidência, advindo da análise das informações produzidas por dados confiáveis.
Numa perspectiva de escassez de recursos, é importante o aproveitamento de instrumentos que, através de uma metodologia rígida, produza dados fiáveis – uma vez que estes levantamentos têm elevados custos financeiros e devem ser maximizadas as suas potencialidades –, propondo-se então a utilização dos Inquéritos Nacionais de Saúde (IqNS´s) exatamente por possuírem estas características.
Neste panorama, o objetivo do presente estudo é comparar os dados
autoreportados pela população portuguesa acerca das suas características demográficas, de saúde e sobre a utilização de serviços de saúde, com outras fontes de dados, promovendo uma reflexão sobre a pertinência e validade dos IqNS´s na produção de conhecimento de base para o planeamento de políticas públicas no âmbito das DCNT’s.
A metodologia utilizada para esta comparação é a de estudos exploratórios sobre dados secundários, numa abordagem descritiva de tendência temporal, analisando dados demográficos como idade, sexo e escolaridade, bem como a prevalência de Diabetes Melittus (DM), hipertensão arterial (HTA) e utilização de serviços de saúde relativos à
população portuguesa residente no continente.
Apesar das dificuldades em padronizar as informações dos estudos de maneira a serem comparáveis com os IqNS´s, os resultados apontaram consistência na tendência temporal dos valores autoreportados nos inquéritos relativos às variáveis estudadas, com censos demográficos, estudos de prevalência de DM e HTA e médias de utilização de consultas médicas.
No entanto, os resultados demonstraram que estas doenças são
subdiagnosticadas (no caso dos diabéticos, mais de 90%, e no caso dos hipertensos, mais de 75% dos doentes que foram diagnosticados nos estudos, desconheciam o facto), advindo do desconhecimento o relato negativo quanto a existência das doenças nos IqNS´s.
A introdução do exame físico no processo de inquirição possibilitaria aos pesquisadores buscar toda a informação necessária para estudos epidemiológicos dentro dos IqNS´s, poupando recursos do Estado e das instituições com outros levantamentos.
Assim, as previsões sobre o avanço das doenças e sobre os impactos socioeconómicos, bem como o planeamento de políticas de saúde, não seriam só promotoras de ganhos de vida, mas de ganhos de qualidade de vida numa população que já vivencia o envelhecimento.
As a result of developments in global epidemiological profiles, Chronic Noncommunicable Diseases (NCD's) are presented as "one of the greatest challenges to sustainable development in this century", due to the close link between health and human development. They are currently responsible for over 60% of deaths worldwide and this rate tends to increase the extent to which economic development progresses, and is mainly attributable to an aging population. To be able to plan effective public policies for prevention and control of NCD’s, it is essential that policy decisions are guided by knowledge based on evidence, arising from the analysis of information produced by reliable data. In view of shortage of resources, it is important that the use of instruments, through a rigid methodology produces reliable data –since these surveys have high financial costs and should be maximized its potential –, then proposing the use of National Health Surveys (NHS´s) by exactly possess these characteristics. Against this background , the objective of this study is to compare the selfreported data the Portuguese population about their demographic characteristics, health and the use of health services, with other data sources, promoting reflection on the appropriateness and validity of NHS´s in the production of base knowledge for the planning of public policies within the NCD's. The methodology used for this comparison is the exploratory studies on secondary data, a descriptive approach to temporal trends, analyzing demographic data such as age, sex and education level, as well as the prevalence of diabetes, hypertention and use of health services for the population Portuguese resident on the continent. Despite the difficulties in standardizing the information from the studies so as to be comparable with NHS´s, the results indicated consistency in the temporal trend of self-reported values, concerning the variables studied, with censuses, prevalence studies about diabetes and hypertention, and averages of use medical appointments. However, the results demonstrated that diseases are underdiagnosed (in the case of diabetics, more than 90%, and in the case of hypertension, more than 75% of patients who were diagnosed in the study were unaware of the fact) arising from lack of knowledge about the negative reporting of the diseases in NHS´s. The introduction of physical examination in the inquiry process would enable researchers to seek all necessary information for epidemiological studies within the NHS´s, saving state resources and institutions with other surveys. Thus, predictions about the progress of the disease and the socio-economic impacts, as well as the planning of health policies, would not only be promoting gains in life, but improvements in quality of life in a population already experiencing aging.
As a result of developments in global epidemiological profiles, Chronic Noncommunicable Diseases (NCD's) are presented as "one of the greatest challenges to sustainable development in this century", due to the close link between health and human development. They are currently responsible for over 60% of deaths worldwide and this rate tends to increase the extent to which economic development progresses, and is mainly attributable to an aging population. To be able to plan effective public policies for prevention and control of NCD’s, it is essential that policy decisions are guided by knowledge based on evidence, arising from the analysis of information produced by reliable data. In view of shortage of resources, it is important that the use of instruments, through a rigid methodology produces reliable data –since these surveys have high financial costs and should be maximized its potential –, then proposing the use of National Health Surveys (NHS´s) by exactly possess these characteristics. Against this background , the objective of this study is to compare the selfreported data the Portuguese population about their demographic characteristics, health and the use of health services, with other data sources, promoting reflection on the appropriateness and validity of NHS´s in the production of base knowledge for the planning of public policies within the NCD's. The methodology used for this comparison is the exploratory studies on secondary data, a descriptive approach to temporal trends, analyzing demographic data such as age, sex and education level, as well as the prevalence of diabetes, hypertention and use of health services for the population Portuguese resident on the continent. Despite the difficulties in standardizing the information from the studies so as to be comparable with NHS´s, the results indicated consistency in the temporal trend of self-reported values, concerning the variables studied, with censuses, prevalence studies about diabetes and hypertention, and averages of use medical appointments. However, the results demonstrated that diseases are underdiagnosed (in the case of diabetics, more than 90%, and in the case of hypertension, more than 75% of patients who were diagnosed in the study were unaware of the fact) arising from lack of knowledge about the negative reporting of the diseases in NHS´s. The introduction of physical examination in the inquiry process would enable researchers to seek all necessary information for epidemiological studies within the NHS´s, saving state resources and institutions with other surveys. Thus, predictions about the progress of the disease and the socio-economic impacts, as well as the planning of health policies, would not only be promoting gains in life, but improvements in quality of life in a population already experiencing aging.
Descrição
Palavras-chave
Saúde pública Inquéritos Doenças crónicas não transmissíveis
Contexto Educativo
Citação
Editora
Instituto de Higiene e Medicina Tropical