Figure 1
Brazil and its States with the Paraná highlighted in purple, alongside the 22 Health Regions of Paraná and location of their municipalities according to population size classification (2021). The shapefile for the basemap was obtained from the Brazilian Institute of Geography and Statistics (17).
Table 1
Data sources for analysis.
| SOURCE | VARIABLES | REFERENCE |
|---|---|---|
| DATASUS – Mortality Information System (SIM) | Mortality
| (25) |
| DATASUS – Hospitalizations Information System (SIH) | Hospitalizations
| (25) |
| IBGE – Brazilian Institute of Geography and Statistics | Population by
| (26) |
| IPARDES – Institute of Economic and Social Development of Paraná | Municipal Performance Index (IPDM) | (29) |
Figure 2
Structure of the ischemic heart disease dataset stratified by sex, race, and age group for the development of the statistical model.
Figure 3
3A Absolute values of hospitalization from ischemic heart disease. 3B Absolute values of deaths from ischemic heart disease. Panels 3C and 3D present the temporal distribution of the standardized incidence ratio (SIR) and standardized mortality ratio (SMR) of ischemic heart disease (IHD) in municipalities of Paraná from 2010 to 2021. Panels 3E and 3F show the geographic distribution of the mean SIR and SMR for IHD, in the municipalities of Paraná from 2010 to 2021. The shapefile for the basemap was obtained from the Brazilian Institute of Geography and Statistics (17).
Table 2
Summaries of the probability distributions of the covariate coefficients for Standardized Incidence Rate (SIR) and Standardized Mortality Rate (SMR).
| COVARIATES | SIR | SMR | ||||
|---|---|---|---|---|---|---|
| MEAN | 95% CI | RR | MEAN | 95% CI | RR | |
| Intercept | –6.875 | –7.334; –6.415 | – | –5.716 | –7.002; –4.430 | – |
| IPDM | –8.274 | –8.859; –7.689 | 0.000 | –9.824 | –11.437; –8.210 | 0.000 |
| Small-size municipalities | 3.311 | 3.082; 3.540 | 27.412 | 2.752 | 0.765; 4.739 | 15.673 |
| Medium-size municipalities | 1.877 | 1.748; 2.006 | 6.533 | 1.807 | 1.451; 2.163 | 6.092 |
| Large-size municipalities | – | – | – | – | – | – |
| Marginal log-Likelihood | –880.98 | –182.91 | ||||
| WAIC | 1,198.2 | 299.3 | ||||
[i] 95% CI: 95% credibility interval. RR: Relative risk.
Figure 4
4A Relative risk estimates of standardized incidence ratio (SIR) per municipality and health region and scatter plot of SIR RR values per health region from 2011 to 2021 in Paraná. 4B Average SIR RR in municipalities by health region from 2010 to 2021. 4C Graphs with temporal presentation of average SIR RR in municipalities by health region, from 2010 to 2021. The shapefile for the basemap was obtained from the Brazilian Institute of Geography and Statistics (17).
Figure 5
5A Relative risk estimates of standardized mortality ratio (SMR) per municipality and health region and scatter plot of SMR RR values per health region from 2011 to 2021 in Paraná. 5B Average SMR RR in municipalities by health region from 2010 to 2021. 5C Graphs with temporal presentation of average SMR RR in municipalities by health region, from 2010 to 2021. The shapefile for the basemap was obtained from the Brazilian Institute of Geography and Statistics (17).
Figure 6
Relative risk of SIR in panel A and SMR in panel B, between 2010–2021. The mean was indicated as a black dot, in each municipality category.