Perfil epidemiológico e intervenções para o enfrentamento das condições crônicas de municípios da região central do Rio Grande do Sul

Abstract

Chronic health conditions are the leading causes of death in the world, reaching mainly vulnerable populations. The objective of this study was to characterize the population affected by chronic conditions in counties of low demographic densities, belonging to the Entre Rios region (Jari, Mata and Nova Esperança do Sul) covered by the 4th Regional Health Coordination (CRS), in terms of age, sex, race and morbidity (as indicated by ICD-10), as well as propose actions that help combat these health conditions. The research was conducted between november and december 2016 and occurred in three stages: i) collection of information in DATASUS - historical series of 2011-2015; Ii) treatment and analysis of data and iii) elaboration of specific actions pertinent to the chronic conditions. Each countie presented its peculiarity as to the chronic conditions, but coincidences of hospitalizations were found that persisted in the studied period, such as: adult and white men presented diseases of the respiratory, circulatory and digestive systems. The suggested actions are: territorialization, population register, implantation of the embracement, nursing consultations, scheduled consultations and spontaneous demand, use of guidelines and clinical protocols by the health teams, risk stratification to identify the different degrees of risk / vulnerability of users, strengthening health promotion and prevention actions with achievement collective activities and in groups, regular domiciliary visits and case managent for the most complex. Besides that, is necessary permanent education for Family Health Strategy professionals, including the concept of situational strategic planning (concept and method indispensable for coping with chronic conditions), among other in-service professional training processes.