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Gestão Baseada na Evidência aplicada à Reabilitação Cardíaca: Estudo da Unidade Local de Saúde de Castelo Branco
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Abstract(s)
A Reabilitação Cardíaca (RC) é uma intervenção multidisciplinar essencial na prevenção
secundária das doenças cardiovasculares (DCV), recomendada pelas principais sociedades
científicas internacionais. No entanto, o acesso desigual a estes programas em Portugal,
especialmente no interior do país, persiste. Este estudo, desenvolvido no âmbito da
Unidade Local de Saúde de Castelo Branco (ULSCB), teve como objetivos principais
estimar o número de utentes com DCV elegíveis para RC entre 2014 e 2023, e analisar
fatores epidemiológicos com potencial influência na sua incidência com base em
princípios da Gestão Baseada na Evidência (GBE).
Recorrendo a uma abordagem observacional, retrospetiva e quantitativa, foram analisados
dados clínicos, ambientais e contextuais - extremos de temperatura, poluição atmosférica
e pandemia por covid-19. Os resultados indicaram um aumento progressivo da incidência
de DCV, particularmente nos últimos três anos do período analisado. Apesar de não se
terem verificado associações estatisticamente significativas entre a incidência de DCV e os
extremos de temperatura ou os níveis de poluição atmosférica, foi observada uma
associação significativa entre os períodos pré-covid, covid e pós-covid, refletindo um
possível impacto da pandemia sobre a saúde cardiovascular na população da ULSCB.
Este estudo reforça a necessidade urgente de implementar um centro de RC na ULSCB,
destacando o papel da GBE na identificação de lacunas e na orientação de decisões
estratégicas. A criação de respostas equitativas e sustentadas é fundamental para melhorar
os resultados em saúde e reduzir as desigualdades no acesso aos cuidados
cardiovasculares.
Cardiac Rehabilitation (CR) is a multidisciplinary intervention essential for the secondary prevention of cardiovascular diseases (CVD), recommended by major international scientific societies. However, unequal access to these programs in Portugal—particularly in inland regions—remains a persistent issue. This study, conducted within the Local Health Unit of Castelo Branco (ULSCB), aimed primarily to estimate the number of CVD patients eligible for CR between 2014 and 2023 and to analyze epidemiological factors potentially influencing its incidence, based on the principles of Evidence-Based Management (EBM). Using an observational, retrospective, and quantitative approach, the study analyzed clinical, environmental, and contextual data — including extreme temperatures, air pollution, and the covid-19 pandemic. The results indicated a progressive increase in the incidence of CVD, particularly in the last three years of the study period. Although no statistically significant associations were found between CVD incidence and either temperature extremes or air pollution levels, a significant association was observed among the pre-covid, covid, and post-covid periods, reflecting a possible impact of the pandemic on cardiovascular health in the ULSCB population. This study reinforces the urgent need to implement a CR center within the ULSCB, highlighting the role of EBM in identifying service gaps and guiding strategic decisionmaking. The development of equitable and sustainable responses is crucial to improving health outcomes and reducing disparities in access to cardiovascular care.
Cardiac Rehabilitation (CR) is a multidisciplinary intervention essential for the secondary prevention of cardiovascular diseases (CVD), recommended by major international scientific societies. However, unequal access to these programs in Portugal—particularly in inland regions—remains a persistent issue. This study, conducted within the Local Health Unit of Castelo Branco (ULSCB), aimed primarily to estimate the number of CVD patients eligible for CR between 2014 and 2023 and to analyze epidemiological factors potentially influencing its incidence, based on the principles of Evidence-Based Management (EBM). Using an observational, retrospective, and quantitative approach, the study analyzed clinical, environmental, and contextual data — including extreme temperatures, air pollution, and the covid-19 pandemic. The results indicated a progressive increase in the incidence of CVD, particularly in the last three years of the study period. Although no statistically significant associations were found between CVD incidence and either temperature extremes or air pollution levels, a significant association was observed among the pre-covid, covid, and post-covid periods, reflecting a possible impact of the pandemic on cardiovascular health in the ULSCB population. This study reinforces the urgent need to implement a CR center within the ULSCB, highlighting the role of EBM in identifying service gaps and guiding strategic decisionmaking. The development of equitable and sustainable responses is crucial to improving health outcomes and reducing disparities in access to cardiovascular care.
Description
Keywords
Doenças Cardiovasculares Extremos de Temperatura Gestão Baseada na Evidência Pandemia Covid-19 Poluição Atmosférica Reabilitação Cardíaca