Cross-border healthcare and prognosis of HIV infection in the triple border Brazil-Paraguay-Argentina

Datos Bibliográficos

ID5167232
AutoresRicardo Zaslavsky (0000-0002-6175-4573, Universidade Federal da Integração Latino-Americana, Brazil; Secretaria Municipal de Saúde de Foz do Iguaçu, Brazil, autor de correspondencia), Barbara Niegia Garcia De Goulart (0000-0002-2502-5883, Universidade Federal do Rio Grande do Sul), Patricia Klarmann Ziegelmann (0000-0002-2851-2011, Universidade Federal do Rio Grande do Sul)
Año2019
Volumen35
Número9
Páginase00184918-e00184918
Fecha de publicación2019-01-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaCadernos de Saude Publica (JOURNAL)
Identificadores de la revistaISSN: 0102-311X • E-ISSN: 1678-4464
EditorialFapUNIFESP (SciELO) (PUBLISHER)
DOI10.1590/0102-311x00184918
PMID31508700
OpenAlexW2971913555
SCIELO_PIDS0102-311X2019001105004
IdiomaEN
Referencias citadas28

The act of crossing an international border for healthcare is a reality in border areas and the flow is in the direction of the city with more human and healthcare resources. Although several prognostic factors related to HIV+ patients are known, the prognostic value of this type of mobility for long term care is still neglected. This study compares the prognosis of HIV patients from three groups, one involved in regional mobility, another in cross-border mobility in search for healthcare and the reference group which is composed by patients living in the same city of the health facility. This is a retrospective cohort study using medical records from a healthcare service in Brazil. Following survival analysis with log-rank test and Cox proportional hazard models, overall survival had no significant difference between patients who were involved in regional (HR = 1.03; 95%CI: 0.69-1.54; p = 0.89) or international (HR = 1.07; 95%CI: 0.58-1.97; p = 0.83) mobility and those who were not. This lack of difference was kept when adjusted for known prognostic factors. In this retrospective cohort study, exposure to both regional and international migration did not have a significant association with the risk of death by any cause in crude or adjusted analyses for already known prognostic factors. This is the first study to consider the prognostic role of cross-border healthcare for HIV patients. Despite these findings, the need of monitoring the extent and the clinical and demographic characteristics of healthcare demand originated in the other side of the border and the use of these data for decision making in health management is emphasized

Cohort · Family medicine · Hazard ratio · Health care · Medical record · Political science · Proportional hazards model · Retrospective cohort study · Demography · HIV, Drug Use, Sexual Risk · HIV/AIDS oral health manifestations · HIV/AIDS Research and Interventions · Internal Medicine · Medicine