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ObjectivesWe 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.MethodsFrom 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.ResultsIn 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%.ConclusionsFHP care is more effective than is non-FHP care at preventing death from secondary stroke and myocardial infarction.

Original publication

DOI

10.2105/ajph.2012.301024

Type

Journal article

Journal

American journal of public health

Publication Date

12/2012

Volume

102

Pages

e90 - e95

Addresses

Department of Medicine, University of Região de Joinville, Univille, Santa Catarina, Brazil. nlcabral@terra.com.br

Keywords

Humans, Myocardial Infarction, Incidence, Proportional Hazards Models, Risk Factors, Regression Analysis, Cohort Studies, Program Evaluation, Aged, National Health Programs, Brazil, Female, Male, Stroke, Secondary Prevention