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The Brazilian Family Health Program and secondary stroke and myocardial infarction prevention: A 6-year cohort study

Author

Listed:
  • Cabral, N.L.
  • Franco, S.
  • Longo, A.
  • Moro, C.
  • Buss, T.A.
  • Collares, D.
  • Werlich, R.
  • Dadan, D.D.
  • Fissmer, C.S.
  • Aragão, A.
  • Ferst, P.
  • Palharini, F.G.
  • Eluf-Neto, J.
  • Fonseca, L.A.M.
  • Whiteley, W.N.
  • Gonçalves, A.R.R.

Abstract

Objectives: We compared the incidence of recurrent or fatal cardiovascular disease in patients using Brazil's government-run Family Health Program (FHP) with those using non-FHP models of care. Methods: From 2005 to 2010, we followed outpatients discharged from city public hospitals after a first ever stroke for stroke recurrence and myocardial infarction, using data from all city hospitals, death certificates, and outpatient monitoring in state-run and private units. Results: In the follow-up period, 103 patients in the FHP units and 138 in the non-FHP units had exclusively state-run care. Stroke or myocardial infarction occurred in 30.1% of patients in the FHP group and 36.2% of patients in non-FHP care (rate ratio [RR] = 0.85;95% confidence interval [CI] = 0.61, 1.18; P =.39); 37.9% of patients in FHP care and 54.3% in non-FHP care (RR = 0.68;95% CI = 0.50, 0.92; P =.01) died. FHP use was associated with lower hazard of death from all causes (hazard ratio [HR] = 0.58; P =.005) after adjusting for age and stroke severity. The absolute risk reduction for death by all causes was 16.4%. Conclusions: FHP care is more effective than is non-FHP care at preventing death from secondary stroke and myocardial infarction.

Suggested Citation

  • Cabral, N.L. & Franco, S. & Longo, A. & Moro, C. & Buss, T.A. & Collares, D. & Werlich, R. & Dadan, D.D. & Fissmer, C.S. & Aragão, A. & Ferst, P. & Palharini, F.G. & Eluf-Neto, J. & Fonseca, L.A.M. & , 2012. "The Brazilian Family Health Program and secondary stroke and myocardial infarction prevention: A 6-year cohort study," American Journal of Public Health, American Public Health Association, vol. 102(12), pages 90-95.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2012.301024_9
    DOI: 10.2105/AJPH.2012.301024
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    Cited by:

    1. Thomas Hone & Valeria Saraceni & Claudia Medina Coeli & Anete Trajman & Davide Rasella & Christopher Millett & Betina Durovni, 2020. "Primary healthcare expansion and mortality in Brazil’s urban poor: A cohort analysis of 1.2 million adults," PLOS Medicine, Public Library of Science, vol. 17(10), pages 1-20, October.

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