ArticleBMC health services research2026
Amandaba in the Amazon: the role of glycated hemoglobin in the evaluation of health services.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the effectiveness of health care for people with diabetes mellitus in a city in the Eastern Amazon through glycemic control, microalbuminuria, anthropometric measurements, and Primary Health Care (PHC) attributes among the services studied.
methodThis was a cross-sectional study conducted in Family Health Strategy units in Belém, Pará, located east of the Amazon. The initial sample included 230 people with type 2 diabetes aged ≥ 30 years. The second survey sample included 146 individuals.
resultsIn total, 75% of the individuals in both groups reported using PHC services more. Upon receiving the laboratory tests and returning for the appointment, 42.7% of district I did not return, compared to 29% of district II and 22% of district I did not receive the tests, compared to 11% of district II. Seventy percent of the population had HBA1c values ≥7 in both groups; 74% of district II and 62% of district II had fasting blood glucose values > 130 mg/dL; and 70% of the population in both districts had albumin excretion rates < 30 mg/gCr. A BMI of more than 76% of individuals in both groups reached > 24 kg/m2, and women’s waist circumference was ≥ 80 cm for more than 88% of the population in both districts. For the pcatools, 84% of district I and 83% of district II reported going to the BHU when they needed a review appointment; for accessibility, 66% of district I and 56% of district II reported delays when trying to get advice over the phone; longitudinally, 65% of district I and 85% of district II reported care with the same health professionals, with a statistically significant difference (p = 0.017).
conclusionMost of the population in the two districts did not reach the goals of HBA1c or fasting blood glucose, but albuminuria was maintained at the recommended level. More than half were overweight and had a high waist circumference. The item usage had the best performance in PCAtool, despite dissatisfaction with the efficiency and speed of service. Improving accessibility in PHC can lead to improvements in glycemic control and anthropometric measurements in patients with DM2.
trial registrationCAAE 45831221.0.0000.0018.
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