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Review
. 2020 Nov 2:13:1403-1414.
doi: 10.2147/JMDH.S262900. eCollection 2020.

Stroke Care in Brazil and France: National Policies and Healthcare Indicators Comparison

Rita Nugem  1   2 , Ronaldo Bordin  1 , Christophe Pascal  3 , Anne-Marie Schott-Pethelaz  2 , Beatrice Trombert-Paviot  4 , Vincent Piriou  2 , Philippe Michel  2
Affiliations
Review

Stroke Care in Brazil and France: National Policies and Healthcare Indicators Comparison

Rita Nugem et al. J Multidiscip Healthc. .

Abstract

Objective: To identify the commonalities and discrepancies between national health policies to combat stroke in France and Brazil.

Justification: Both healthcare systems were structured as universal access and comprehensive care attention, hierarchized by the level of care, politically and administratively decentralized. France is an industrialized, high-income country, with health care involving copayment and reimbursement of expenses, and spontaneous demand for services. Brazil is a member of the BRICs, of upper middle income with totally free health care, with an active search for hypertension and diabetes in the general population.

Methods: Data regarding policies, risk factors, and health indicators about stroke care, from 2010 to 2017, were obtained from both countries (publicly accessible information or on request) from the respective Ministries of Health or international agencies.

Results: About acute stroke hospitalizations, on average, Brazil has 0.75 per 1000 annual population hospitalizations versus 1.54 per 1000 in France. Brazil has 0.21 per 1000 population deaths per year versus 0.40 per 1000 in France. The in-hospital mortality rate in Brazil has 139 per 1000 hospitalized people versus 263 in France. The average length of stay of acute hospitalizations was 7.6 days in Brazil versus 12.6 in France. The prevalence of strokes by age group shows from 0 to 39 years old (this rate is stable); 40-59 years (it is increasing in both countries); and 60-79 and 80+ years (this rate has been increasing in France and decreasing in Brazil).

Conclusion: No major differences were found about the health policies and the National Health Plans related to stroke. However, the data directly linked to the period of hospitalization differed substantially between countries. Subsequent studies can be implemented to identify the explanatory factors, notably among the risk factors and actions in primary care, and the moments after hospital care, such as secondary prevention and palliative care.

Keywords: Brazil; France; health care; health policies; risk factors; stroke.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Stroke Flow in a Comprehensive Health Care in Brazil.
Figure 2
Figure 2
Stroke Flow in a Comprehensive Health Care in France.
Figure 3
Figure 3
Stroke Care in Comparation.
See this image and copyright information in PMC

References

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