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      Modelo teórico-metodológico baseado na Teoria de Redes Complexas para análise da oferta potencial dos serviços de saúde Translated title: Theoretical-methodological model based on Complex Network Theory for the analysis of the potential provision of health services

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          Abstract

          Resumo O objetivo deste artigo é apresentar um modelo teórico-metodológico como base para a análise da oferta potencial de serviços de saúde pública brasileira a partir de uma abordagem baseada na teoria de redes complexas. O modelo analisou a oferta potencial de serviços de saúde através da relação da distância euclidiana entre setores censitários e serviços/classificadores oferecidos pelos estabelecimentos de saúde, conforme definidos no Cadastro Nacional de Estabelecimentos de Saúde (CNES). São propostos dois tipos de métrica para análise dos relacionamentos: a distância média dos serviços de saúde para com os setores censitários e a importância da unidade de saúde na oferta potencial de cada tipo de serviço com base na centralidade e na disponibilidade deste serviço. Para demonstrar a aplicação do modelo foi construída uma rede com base na Área Metropolitana de Brasília, incluindo o Distrito Federal e 12 municípios do entorno. O modelo demostrou-se capaz de mapear e analisar os dados do CNES com os setores censitários definidos no Censo, abrindo a possibilidade de construção de novas óticas de análise na compreensão da distribuição potencial de recursos e serviços em função de variáveis socioeconômicas, bem como, uma importante ferramenta de gestão informada por evidências.

          Translated abstract

          Abstract The scope of this article is to present a theoretical-methodological model as the basis for the analysis of the potential provision of Brazilian public health services (SUS) using an approach based on complex network theory. The model sought to analyze the potential provision of health services through the relationship of Euclidean distance between census sectors and services offered by health facilities, as defined in the National Register of Health Establishments (CNES). Two types of metrics are proposed for the analysis of the relationship network: the average distance of health services to the census sectors and the importance of the health unit in the potential provision of each type of service based on the centrality and availability of this service. To demonstrate the application of the model, a network was built based in the Metropolitan Area of Brasilia, including the Federal District and 12 surrounding municipalities. The model was able to map and analyze CNES data with census sectors defined in the CENSUS, opening up the possibility of constructing new perspectives of analysis in the understanding of the potential distribution of health resources and services according to socioeconomic variables, as well as an important evidence-based management tool.

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          Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?

          The Behavioral Model of Health Services Use was initially developed over 25 years ago. In the interim it has been subject to considerable application, reprobation, and alteration. I review its development and assess its continued relevance.
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            Spatial accessibility of primary care: concepts, methods and challenges

            Primary care is recognized as the most important form of healthcare for maintaining population health because it is relatively inexpensive, can be more easily delivered than specialty and inpatient care, and if properly distributed it is most effective in preventing disease progression on a large scale. Recent advances in the field of health geography have greatly improved our understanding of the role played by geographic distribution of health services in population health maintenance. However, most of this knowledge has accrued for hospital and specialty services and services in rural areas. Much less is known about the effect of distance to and supply of primary care on primary care utilization, particularly in the U.S. For several reasons the shortage of information is particularly acute for urban areas, where the majority of people live. First, explicit definitions and conceptualizations of healthcare access have not been widely used to guide research. An additional barrier to progress has been an overwhelming concern about affordability of care, which has garnered the majority of attention and research resources. Also, the most popular measures of spatial accessibility to care – travel impedance to nearest provider and supply level within bordered areas – lose validity in congested urban areas. Better measures are needed. Fortunately, some advances are occurring on the methodological front. These can improve our knowledge of all types of healthcare geography in all settings, including primary care in urban areas. This paper explains basic concepts and measurements of access, provides some historical background, outlines the major questions concerning geographic accessibility of primary care, describes recent developments in GIS and spatial analysis, and presents examples of promising work.
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              The structure and dynamics of multilayer networks

              In the past years, network theory has successfully characterized the interaction among the constituents of a variety of complex systems, ranging from biological to technological, and social systems. However, up until recently, attention was almost exclusively given to networks in which all components were treated on equivalent footing, while neglecting all the extra information about the temporal- or context-related properties of the interactions under study. Only in the last years, taking advantage of the enhanced resolution in real data sets, network scientists have directed their interest to the multiplex character of real-world systems, and explicitly considered the time-varying and multilayer nature of networks. We offer here a comprehensive review on both structural and dynamical organization of graphs made of diverse relationships (layers) between its constituents, and cover several relevant issues, from a full redefinition of the basic structural measures, to understanding how the multilayer nature of the network affects processes and dynamics.
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                Author and article information

                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro, RJ, Brazil )
                1413-8123
                1678-4561
                2021
                : 26
                : suppl 2
                : 3791-3804
                Affiliations
                [2] Brasília orgnameFundação Oswaldo Cruz Brazil
                [1] Brasília Distrito Federal orgnameUniversidade de Brasília Brazil deivsonrayner@ 123456gmail.com
                Article
                S1413-81232021001603791 S1413-8123(21)02600003791
                10.1590/1413-81232021269.2.01202020
                72624ebd-db57-47da-890c-5e339fcf183b

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 12 October 2019
                : 26 April 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 14
                Product

                SciELO Brazil

                Categories
                POLÍTICA DE SAÚDE, IMPLEMENTAÇÃO DE PRÁTICAS

                Complex networks,Data science,Public Health,Health care,Access to health services,Saúde,Assistência à Saúde,Acesso aos Serviços de Saúde

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