O estudo “Annual Direct Medical Costs of Diabetic Foot Disease in Brazil: A Cost of Illness Study” publicado recentemente na revista International Journal of Environmental Research and Public Health, faz parte de um grande projeto do Ministério da Saúde para estimativas dos custos do diabetes e das doenças crônicas no Brasil. Foi realizado por pesquisadores da Universidade de Goiás, Universidade do Estado do Rio de Janeiro e Universidade Federal do Rio Grande do Sul entre 2014 e 2017.
Entre as várias complicações crônicas que estão associadas com diabetes mellitus, o “pé diabético” é altamente frequente, estando associado com elevada morbidade, mortalidade e custos significativos para os pacientes, suas famílias e a sociedade.
Responsible Gaming in Australia: Where to Find Help
Responsible gaming is a crucial aspect of the gambling industry, especially in a country like Australia where gambling is deeply ingrained in the culture. With the rise of online gambling platforms and easy access to betting, the need for promoting responsible gaming practices and providing support for individuals facing gambling-related issues has become more pressing than ever. In this article, we delve into the landscape of responsible gaming in Australia, exploring where individuals can find help and resources to address problem gambling.
From the allure of pokies to the excitement of sports betting, Australia boasts a vibrant gambling scene that offers entertainment to many. However, with this entertainment comes the risk of addiction and harm. How can we strike a balance between enjoying the thrill of gambling and ensuring it does not spiral into a problem? Join us as we navigate through the avenues available for those seeking assistance and guidance in maintaining a healthy relationship with gambling in the land down under.
Understanding Problem Gambling in Australia
Australia takes responsible gaming seriously, offering various avenues for individuals seeking help and support for gambling-related issues. One prominent resource is the National Gambling Helpline, which provides confidential assistance to those affected by problem gambling. Operated by Gamblers Help, this helpline offers counseling, information, and referrals to support services.
Another key player in promoting responsible gaming is the Australian Government’s Department of Social Services. This department oversees the delivery of national policies and programs aimed at preventing and addressing problem gambling. Through its website, individuals can access resources, fact sheets, and information on available support services across the country.
Furthermore, state-based organizations like Gambling Help NSW and Gambling Help Queensland offer localized support for residents in these regions. These organizations provide counseling, self-help tools, and community education programs to assist individuals in managing their gambling behaviors and seeking help when needed.
Resources and Support Services for Problem Gamblers
Responsible gaming is a crucial aspect of the gambling industry in Australia, with organizations and resources available to support individuals facing challenges with their gambling habits. If you or someone you know is struggling with problem gambling, seeking help is essential. One reputable source for information and assistance is the website https://www.casinozoid.com/. This platform offers valuable insights into responsible gaming practices, guidance on how to recognize problematic behaviors, and access to support services.
For Australians looking to find help with gambling-related issues, various avenues are accessible. The website https://www.casinozoid.com/ provides a comprehensive list of support services, including helplines, counseling programs, and self-exclusion options. These resources are designed to assist individuals in regaining control over their gambling activities and making informed decisions about their gaming habits.
By promoting responsible gaming practices and raising awareness about the potential risks of excessive gambling, organizations like https://www.casinozoid.com/ play a vital role in safeguarding the well-being of players in Australia. It is crucial for individuals to educate themselves about responsible gaming measures, seek help when needed, and engage with support networks to ensure a safe and enjoyable gaming experience.
Promoting Responsible Gaming Practices
In Australia, responsible gaming is a crucial aspect of the gambling industry, ensuring that individuals engage in gambling activities in a safe and controlled manner. For those who may be struggling with gambling addiction or need assistance, there are various resources available for help. One of the primary avenues for seeking support is through the National Gambling Helpline, which provides confidential counseling and support services to individuals experiencing gambling-related issues.
Additionally, organizations like Gambling Help Online offer online resources, chat support, and self-help tools for those seeking assistance with problem gambling. Many states in Australia also have their own dedicated gambling support services, such as Gambling Help NSW and Gamblers Help Victoria, which provide tailored support and information to individuals in need. By accessing these resources, individuals can take proactive steps towards addressing their gambling concerns and promoting responsible gaming practices.
The Role of Government Regulations in Preventing Gambling Harm
In Australia, responsible gaming is a key focus to ensure the well-being of individuals who may be struggling with gambling-related issues. If you or someone you know is in need of help, there are several resources available to provide support and assistance.
1. National Gambling Helpline: The National Gambling Helpline is a confidential service that offers support and guidance to individuals affected by problem gambling. You can contact them 24/7 on 1800 858 858 or visit their website for more information: National Gambling Helpline.
2. Gambling Help Online: This is a free, confidential service that provides online support and resources for individuals struggling with gambling issues. You can access their live chat service or browse their self-help tools on their website: Gambling Help Online.
3. Local Support Services: Each state and territory in Australia offers local support services for individuals affected by problem gambling. These services may include counseling, support groups, and financial assistance. Contact your state or territory gambling support service for more information.
Community Initiatives and Organizations Addressing Gambling Addiction
Australia takes responsible gaming seriously, offering support and resources for individuals struggling with gambling addiction. The National Gambling Helpline (1800 858 858) provides confidential assistance to those in need of help. This helpline offers counseling, information, and referral services to support individuals in managing their gambling habits.
For additional assistance, the Gambling Help Online website is a valuable resource that offers 24/7 support through chat, forums, and self-help tools. This online platform provides a safe space for individuals to seek guidance and connect with others facing similar challenges. By promoting responsible gaming practices and providing accessible support services, Australia aims to create a safer and healthier environment for individuals affected by gambling addiction.
As we navigate the world of gaming, it’s crucial to prioritize responsible habits and seek help when needed. Australia offers a range of resources and support systems for individuals struggling with gambling-related issues. From national helplines like Gambling Help Online to state-specific services such as Gamblers Help in Victoria, assistance is readily available. Remember, taking control of your gaming behavior is a proactive step towards a healthier relationship with gambling. By staying informed and reaching out for help when necessary, we can ensure that our gaming experiences remain enjoyable and safe.
Estima-se que nos países em desenvolvimento, 25% dos pacientes com diabetes desenvolverão pelo menos uma úlcera do pé durante a vida. Contudo, ainda faltam evidências sobre a epidemiologia e custos do “pé diabético” no Brasil e no mundo. Os custos da saúde são cinco vezes maiores em indivíduos com diabetes e úlceras no pé quando comparados com a ausência de úlceras. Esses custos estão principalmente relacionados às hospitalizações, mas também com o tratamento e acompanhamento de pacientes ambulatoriais.
O objetivo deste estudo foi estimar os custos médicos diretos do “pé diabético” na perspectiva do sistema público de saúde brasileiro (SUS), em 2014. Um modelo de árvore de decisão foi construído para descrever várias síndromes clínicas hipotéticas relacionadas ao “pé diabético”: pé neuroisquêmico, úlcera ativa do pé (com/sem infecção), osteomielite com/sem amputação, e tratamento clínico pós-amputação. Os parâmetros e fontes do modelo epidemiológico para o caso base e análises de sensibilidade foram obtidos na literatura nacional e estimativas populacionais (IBGE). Utilizou-se a metodologia do micro-custeio a partir de um painel de 12 especialistas que estimaram a utilização de recursos de saúde para cada caso clínico (visitas profissionais de saúde; exames de imagem e laboratório; medicamentos; procedimentos e terapias não farmacológicas; desbridamento e curativos, sapatos ortopédicos e muletas). Para estimativa dos custos hospitalares utilizou-se a metodologia do macro-custeio, ou seja, os valores reembolsados pelo SUS para pacientes hospitalizados a partir do Sistema Nacional de Informações sobre Hospitalização.
(SIH-SUS). Foram consideradas as principais doenças relacionadas através dos CID10 registrados como causa de internação, categorizando-as em dois grupos: (1) diagnóstico principal de diabetes com um procedimento médico relacionado ao “pé diabético” (tratamento de ulceras infectadas, revisão de coto cirúrgico, amputação); e (2) diagnóstico principal de qualquer uma das seguintes condições médicas relacionadas ao “pé diabético”: neuropatias, úlceras, gangrena, osteomielite e amputações.
Assumindo uma prevalência de 6,4%, teríamos 9,2 milhões de adultos com diabetes no Brasil, cerca de 829.724 de indivíduos com pé neuro-isquêmico, dos quais 43.726 com úlceras no pé. Estimamos que a maioria desses pacientes seria tratada como pacientes ambulatoriais (n = 42.983), e destes, metade deles teria uma úlcera infectada (n = 21.492). O número estimado de indivíduos amputados seria de 11.284.
O custo médio anual estimado para o tratamento ambulatorial de um indivíduo com “pé diabético” foi de R$ 600,44 (DP R$ 183) para o pé neuro-isquêmico sem úlcera, R$ 712,95 (DP R$ 501) para úlcera não infectada, R$ 2.824,89 (DP R$ 2.061) para úlcera de pé infectada e R$ 1.047,85 (DP R$ 497) para acompanhamento clínico de pacientes amputados. Os custos médicos anuais totais estimados para todo o Brasil no caso base foram de R$ 586,1 milhões, variando de R$ 188,5 milhões para R$ 1,27 bilhões em análises de sensibilidade. A maior parte dos custos (85%) foi para o tratamento de pacientes com pé neuroisquêmico com úlcera (R$ 498,4 milhões).
Em 2014, um total de 22.244 pacientes com diagnóstico de diabetes mellitus com procedimentos relacionados ao pé diabético foram hospitalizados. Como esperado, o custo médio mais alto por paciente foi observado para pacientes com diabetes em que foi realizada amputação / desarticulação do membro inferior. O custo total estimado para tods estas condições foi de R$ 17,27 milhões. As hospitalizações devido a outros diagnósticos de complicações relacionadas ao pé diabético totalizaram 28.133, principalmente gangrena em indivíduos com diabetes (n = 15.419). Considerando todas as hospitalizações juntas, os custos para todo o país atingiram R$ 48,4 milhões em 2014.
Essas estimativas foram consideradas conservadoras já que apenas os médicos diretos foram incluídos. Os custos não médicos, perda de produtividade, custos com órteses e próteses, custos de assistência domiciliar e serviços sociais para pacientes que sofreram amputação nas extremidades inferiores, não foram incluídos neste estudo. Assim sendo, o impacto econômico geral do “pé diabético” seria ainda mais significativo no Brasil.
Dra. Luciana Bahia | CRM-RJ 52-52723/7
- Mestre em Endocrinologia e Doutora em Biociência
pela Universidade do Estado do Rio de Janeiro
