scholarly journals Previous hospital admissions in risk adjustment for mortality of elderly patients admitted with hip fracture

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Helen Machareth ◽  
Cláudia Coeli ◽  
Rejane Pinheiro
Keyword(s):  
Information System ◽  
Hip Fracture ◽  
Health System ◽  
Risk Adjustment ◽  
Hospital Information System ◽  
Hospital Admissions ◽  
Hospital Death ◽  
The Public ◽  
Unified Health System ◽  
Ischemic Diseases

ABSTRACTIntroductionThe Hospital Information System of the Brazilian Unified Health System (SIH-SUS) can be an important tool in evaluating care through comparisons of mortality rates among hospitals. However, the SIH-SUS has limited availability of data on comorbidities, which are needed in order to measure the severity of patients' condition for risk adjustment when comparing mortality among hospitals. ObjectivesTo analyze previous hospital admissions as an indicator of severity of patients' condition using as an example hip fracture admissions. ApproachWe analyzed 1984 patients with 62 years of age or older with hip fracture who were admitted to the public health system in Rio de Janeiro City between 2010 and 2011. The causes of previous hospital admissions were obtained through probabilistic record linkage with the SIH-SUS for all causes of admissions between 2008 and 2010. We analyzed the association between the patient having had a any previous admission, adjusted by sex and age, with hospital death, through a logistic regression model. We also analyzed the association between groups of causes of admission with hospital death. ResultsHaving had at least one previous hospital admission due to any cause before the admission for hip fracture was associated with a 77% increase in the odds of hospital death (CI 95% = 1.06 – 2.94). Among comorbidities, the most relevant were severe or moderate kidney disease with OR = 20.196 (CI 95% = 3.042 – 134.092), ischemic diseases with OR = 9.099 (CI 95% = 0.973 – 85.106), pneumonia with OR = 3.619 (CI 95% = 0.977 – 13.401) and diverse fractures and lesions with OR = 2.041 (CI 95% = 0.900 – 4.627). We were not able to analyze the association for some comorbidities due to an absence in outcome variability in some groups. ConclusionResults point to a promising use of previous hospital admissions in the Hospital Information System as a proxy for patient's risk adjustment.

scholarly journals Retrospective study of the distribution of doctors in municipalities of extreme poverty in Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B L O Luizeti ◽  
E M M Massuda ◽  
L F G Garcia
Keyword(s):  
Public Health ◽  
Health System ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Extreme Poverty ◽  
The Public ◽  
The North ◽  
Unified Health System ◽  
Shortage Of Doctors ◽  
Demographic Distribution

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.

scholarly journals Cost of diseases related to alcohol consumption in the Brazilian Unified Health System

2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Evandro Silva Freire Coutinho ◽  
Luciana Bahia ◽  
Laura Augusta Barufaldi ◽  
Gabriela de Azevedo Abreu ◽  
Thainá Alves Malhão ◽  
...  
Keyword(s):  
Information System ◽  
Relative Risk ◽  
Alcohol Consumption ◽  
Health System ◽  
Health Problem ◽  
Hospital Care ◽  
Meta Analysis ◽  
Direct Costs ◽  
Unified Health System ◽  
Consumption Rates

ABSTRACT OBJECTIVE To estimate the direct costs associated to outpatient and hospital care of diseases related to alcohol consumption in the Brazilian Unified Health System. METHODS Attributable populational risks were estimated for the selected diseases related to the use of 25 g/day or more of ethanol (risk consumption), considering a relative risk (RR) ≥ 1.20. The RR estimates were obtained from three meta-analysis. The risk consumption rates of the Brazilian population ≥ 18 years old were obtained by a national survey. Data from the Hospital Information System of SUS (HIS-SUS) were used to estimate the annual costs of the health system with the diseases included in the analysis. RESULTS The total estimated costs for a year regarding diseases related to risk consumption were U$8,262,762 (US$4,413,670 and US$3,849,092, for outpatient and hospital care, respectively). CONCLUSIONS Risk consumption of alcohol is an important economic and health problem, impacting significantly the health system and society.

scholarly journals Automatic Alerts for Methicillin-Resistant Staphylococcus aureus Surveillance and Control: Role of a Hospital Information System

1996 ◽  
Vol 17 (8) ◽  
pp. 496-502 ◽  
Author(s):  
Didier Pittet ◽  
Edith Safran ◽  
Stephan Harbarth ◽  
François Borst ◽  
Pascale Copin ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Information System ◽  
Infection Control ◽  
Hospital Information System ◽  
Hospital Admissions ◽  
Control Measures ◽  
Clinical Microbiology Laboratory ◽  
Infection Control Program ◽  
Methicillin Resistant

AbstractBackground: Methicillin-resistant Staphylococcus aureus (MRSA) is an escalating problem in hospitals worldwide. The hospital reservoir for MRSA includes recognized and unrecognized colonized or infected patients, as well as previously colonized or infected patients readmitted to the hospital. Early and appropriate infection control measures (ICM) are key elements to reduce MRSA transmission and to control the hospital reservoir.Objective: To describe the role of an expert system applied to the control of MRSA at a large medical center (1,600 beds) with high endemic rates.Methods: The University Hospital of Geneva has an extended hospital information system (HIS), DIOGENE, structured with an open distributed architecture. It includes administrative, medical, nursing, and laboratory applications with their relational databases. Among available patient databases, clinical microbiology laboratory and admission-discharge-transfer (ADT) databases are used to generate computer alerts. A laboratory alert (lab alert) is printed daily in the Infection Control Program (ICP) offices, listing all patients with cultures positive for MRSA detected within the preceding 24 hours. Patients might be either newly detected patients colonized or infected with MRSA, or previously recognized MRSA patients having surveillance cultures. The ICP nurses subsequently go to the ward or call the ward personnel to implement ICM. A second alert, the “readmission alert,” detects readmission to the hospital of any patient previously colonized or infected with MRSA by periodic queries (q 1 min) to the ADT database. The readmission alert is printed in the ICP offices, but also forwarded with added guidelines to the emergency room.Results: During the first 12 months of application (July 1994 to June 1995), the lab alert detected an average of 4.6 isolates per day, corresponding to 314 hospital admissions (248 patients); the use of this alert saved time for the ICP nurses by improving work organization. There were 438 readmission alerts (1.2 alerts per day) over the study period; of 347 patients screened immediately upon readmission, 114 (33%) were positive for MRSA carriage. Delayed recognition of readmitted MRSA carriers decreased significantly after the implementation of this alert; the proportion of MRSA patients recognized at the time of admission to the hospital increased from 13% in 1993 to 40% in 1995 (P<.001).Conclusions: Hospital information system-based alerts can play an important role in the surveillance and early prevention of MRSA transmission, and it can help to recognize patterns of colonization and transmission.

scholarly journals Sobre ausências e silenciamentos: uma análise dos sentidos do Sistema Único de Saúde no Caderno Vida, do Diário do Nordeste

2018 ◽  
Vol 12 (1) ◽  
pp. 152
Author(s):  
Clarisse Castro Cavalcante ◽  
Kátia Lerner
Keyword(s):  
Health Services ◽  
Qualitative Analysis ◽  
Health System ◽  
The Public ◽  
Discursive Strategies ◽  
Unified Health System ◽  
Social Discourses ◽  
The Senses

Sobre ausências e silenciamentos: uma análise dos sentidos do Sistema Único de Saúde no Caderno Vida, do Diário do Nordeste On absences and silences: an analysis of the senses of the Unified Health System in the Caderno Vida, Diário do Nordeste ResumoEste artigo tem como objetivo compreender os modos pelos quais o jornal Diário do Nordeste construiu sentidos sobre o Sistema Único de Saúde no seu suplemento semanal dedicado ao tema saúde, o Caderno Vida. Utilizamos como método uma análise qualitativa de seis textos jornalísticos que continham a presença do SUS, baseada no referencial teórico-metodológico da Semiologia dos Discursos Sociais. Entre os principais resultados, observou-se que o Diário do Nordeste constituiu modos de falar sobre o SUS a partir de estratégias discursivas de crítica, tecidas através da visibilidade conferida à ausência de tecnologias nos serviços de saúde e à precariedade no financiamento; e de silenciamentos sobre o SUS a partir de sua não nomeação na divulgação de serviços e políticas de saúde, especialmente quando positivos e valorizados na esfera pública.Palavras-chaves: Mídia; Cotidiano; Jornalismo; Discursos; Sentidos AbstractThis article aims to understand the ways in which the Diário do Nordeste newspaper has constructed senses about the Unified Health System in its weekly supplement dedicated to health, the “Caderno Vida”. We used as a method a qualitative analysis of six journalistic texts that contained the presence of SUS, based on the theoretical and methodological reference of the Semiology of Social Discourses. Among the main results, it was observed that the Diário do Nordeste constituted ways of talking about SUS based on discursive strategies of criticism, woven through the visibility given to the absence of technologies in health services and the precariousness of financing; and of silencing about the SUS from its non-appointment in the dissemination of health services and policies, especially when positive and valued in the public sphere.Keywords: Media; Daily; Journalism; Discourses; Senses  

scholarly journals Costs of bariatric surgery in a teaching hospital and the financing provided by the Public Unified Health System

2010 ◽  
Vol 25 (2) ◽  
pp. 201-205 ◽  
Author(s):  
Wilson Salgado Júnior ◽  
Karoline Calfa Pitanga ◽  
José Sebastião dos Santos ◽  
Ajith Kumar Sankarankutty ◽  
Orlando de Castro e Silva Jr ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health System ◽  
Perioperative Period ◽  
University Hospital ◽  
Retrospective Evaluation ◽  
The Public ◽  
Unified Health System ◽  
The Government ◽  
The Cost ◽  
The University

PURPOSE: Analyze the effect of some measures on the costs of bariatric surgery, adopting as reference the remuneration of the procedure provided by the Unified Health System (SUS). METHODS: A retrospective evaluation conducted in the Costs Section of the University Hospital of Ribeirão Preto, of the costs involved in the perioperative period for patients submitted to bariatric surgery from 2004 to 2007. Changes in the routines and protocols of the service aiming at the reduction of these costs during the study period were also analyzed. RESULTS: Nine patients in 2004 and seven in 2007 submitted to conventional vertical banded "Roux-en-Y" gastric bypass were studied. All patients presented good postoperative evolution. The average cost with these patients was R$ 6,845.17 in 2004. Even though an effort was made to contain expenditures, the cost in 2007 was of R$ 7,525.64 because of the increase in the price of materials and medicines. The Government remuneration of the procedure in the two years was R$ 3,259.72. CONCLUSION: Despite the adoption of diverse measures to reduce the expenditures of bariatric surgery, in fact there was an increase in the costs, a fact supporting the necessity of permanent evaluation of the financing of public health.

scholarly journals A closer look at the epidemiology of schizophrenia and common mental disorders in Brazil

2020 ◽  
Vol 14 (3) ◽  
pp. 283-289
Author(s):  
Randhall Bruce Carteri ◽  
Jean Pierre Oses ◽  
Taiane de Azevedo Cardoso ◽  
Fernanda Pedrotti Moreira ◽  
Karen Jansen ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Health System ◽  
Hospital Admissions ◽  
Common Mental Disorders ◽  
Age Groups ◽  
Epidemiologic Studies ◽  
Emerging Countries ◽  
Unified Health System ◽  
Hospital Expenses ◽  
The Impact

ABSTRACT. Schizophrenia and common mental disorders are noteworthy social and economic concern worldwide. Epidemiologic studies on the impact of specific mental disorders in emerging countries are scarce. Objectives: We aimed to characterize the demographic, social, and economic burden of schizophrenia and common mental disorders patients in the health system in Brazil. Methods: Data on these conditions in Brazil between 2008 and 2019 were collected through the website of the Departamento de Informática do Sistema Único de Saúde (Information Technology Department of the Unified Health System - DATASUS) maintained by the Brazilian Ministry of Health. Mean annual hospital admissions were 154,009.67, and cumulative incidence of 77.44 admissions per 100,000 inhabitants. Results: Average annual hospital expenses were US$ 67,216,056.04, with an average admission cost of US$ 432.58. The most affected age groups were older adults albeit younger individuals showed a trend towards increase of occurrences in recent years. There were a higher number of admissions in men compared to women. Conclusions: We consider the results obtained important to assist in evaluating and guiding public policies regarding the prevention and treatment in health systems.

scholarly journals Technical schools of the Unified Health System: an analysis of nursing education

2020 ◽  
Vol 54 ◽  
Author(s):  
Juliana Costa Ribeiro-Barbosa ◽  
Gilberto Tadeu Reis da Silva ◽  
Simone Coelho Amestoy ◽  
Cristiane Costa Reis da Silva ◽  
Rosana Maria de Oliveira Silva ◽  
...  
Keyword(s):  
Nursing Education ◽  
Health System ◽  
Qualitative Assessment ◽  
Integrative Approach ◽  
Professional Skills ◽  
The Public ◽  
Technical Schools ◽  
Service Community ◽  
Unified Health System ◽  
Teaching Learning

Abstract Objective: To analyze nursing education in the Technical Schools of the Unified Health System in the Northeastern region of Brazil. Method: A documentary study with a qualitative approach, having its locus as Technical Schools of the Unified Health System in the Northeast Region which offer the technical course in nursing. Data sources were the Pedagogical Political Projects of the school and the Teaching Plans of the referred courses, and three structured scripts on the pedagogical aspects of training were used as instruments. The systematization/data analysis was based on thematic content analysis. Results: Technical training in nursing occurs through: an integrative approach, being considered a pedagogical trend; problematizing approach, used as a methodological way for teaching-learning; and qualitative assessment, enhancing the scope of professional skills. Conclusion: The training in focus points to the commitment to the Unified Health System and professional excellence, as it strengthens the integration between teaching-service-community, encourages student proactivity and indicates teaching-learning in the demands of the population and the public health system, and enhances the acquiring and improving professional skills.

scholarly journals Comorbidities and in-hospital death of viral pneumonia adults admitted to SUS (2002–2015)

2021 ◽  
Vol 55 ◽  
pp. 43
Author(s):  
Thais Piazza ◽  
Daniela Pena Moreira ◽  
Hugo André da Rocha ◽  
Agner Pereira Lana ◽  
Ilka Afonso Reis ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Hospital Admissions ◽  
Viral Infections ◽  
Neurological Diseases ◽  
Secondary Data ◽  
Viral Pneumonia ◽  
Hospital Death ◽  
Patient Profile ◽  
Unified Health System ◽  
Hiv Aids

OBJECTIVE To identify demographic and clinical characteristics of adult patients hospitalized in the Brazilian Unified Health System (SUS) due to viral pneumonia and investigate the association between some comorbidities and death during hospitalization. METHODS This retrospective cohort study was conducted with secondary data of adults admitted to SUS due to viral pneumonia between 2002 and 2015. Patient profile was characterized based on demographic and clinical variables. The association between the ten Elixhauser comorbidities and in-hospital death was investigated using Poisson regression models with robust standard errors. Results were quantified as incidence rate ratio (IRR) with 95% confidence intervals (CI), and we built five models using successive inclusion of variables blocks. RESULTS Hospital admissions for viral pneumonias decreased throughout the study period, and it was observed that 5.8% of hospitalized patients had an in-hospital death. We observed significant differences in demographic and clinical characteristics by comparing individuals who died during hospitalization with those who did not, with the occurrence of one or more comorbidities being more expressive among patients who died. Although not considered risk factors for in-hospital death, chronic pulmonary disease and congestive heart failure were the most common comorbidities. Conversely, IRR for in-hospital death increased with other neurological disorders, diabetes, cancer, obesity, and especially with HIV/AIDS. CONCLUSIONS Individuals presenting with pulmonary and cardiovascular diseases require proper attention during hospitalization, as well as those with other neurological diseases, diabetes, cancer, obesity, and especially HIV/AIDS. Understanding the influence of chronic diseases on viral infections may support the healthcare system in achieving better outcomes.

scholarly journals HOSPITAL ADMISSIONS FOR STROKE IN THE BRAZILIAN NATIONAL HEALTH SYSTEM: EPIDEMIOLOGICAL FINDINGS FROM 2019-2020

2021 ◽  
Author(s):  
Mariana Guelli ◽  
Tulio Loyola Correa
Keyword(s):  
Health System ◽  
National Health ◽  
Skin Color ◽  
Hospital Admissions ◽  
Age Groups ◽  
National Health System ◽  
National Database ◽  
Cross Sectional ◽  
Unified Health System ◽  
Time Period

Background and Aims Stroke is one of the leading causes of death and disability in adults, accounting for a high number of hospitalizations worldwide.This study aims to evaluate the epidemiology of hospitalizations for stroke in Brazil during 2019 and 2020. Methods Cross-sectional, descriptive and retrospective study, which evaluated the epidemiology of hospital admissions for stroke in the Brazilian National Health System in the years 2019 and 2020.Hospital admissions were evaluated by sex, race and age group using the national database (DATASUS – Department of Informatics of the Unified Health System). The official classification of race/skin color in Brazil is composed of five categories: White, Brown [Pardo], Black,Yellow and Indigenous. Results During this time period, there was a total of 316,859 hospitalizations for stroke in the Brazilian National Health System, with 163,120 (51.5%) hospital admissions in 2019 and 153,739 (48.5%) in 2020. Also, 166,178 (52.4%) patients were male and 150,681 (47.6%) were female. Regarding race (n=250,446); 106,998 (42.7%) patients considered themselves white, 116,601 (46.6%) brown, 17,085 (6.8%) black and 9,762 (3.9%) others. Regarding age groups; 64,939 (20.5%) were >80 years old, 163,114 (51.5%) were 60-79, 74,605 (23.5%) were 40-59 and 14,201 (4.5%) were <40. Conclusions The majority of patients hospitalized for stroke were 60-79 years old and white or brown. The similar number of hospital admissions in 2019 and 2020 may suggest that hospitalizations for stroke were not significantly impacted by hospital’s oversaturation by the COVID-19 pandemic.

scholarly journals Public-private settlement and hospital mortality per sources of payment

2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Juliana Pires Machado ◽  
Mônica Martins ◽  
Iuri da Costa Leite
Keyword(s):  
Hospital Mortality ◽  
Hospital Admission ◽  
Health System ◽  
Hospital Admissions ◽  
Structural Characteristics ◽  
Information Source ◽  
Healthcare Research ◽  
Administrative Databases ◽  
Unified Health System ◽  
The Mean

ABSTRACT OBJECTIVE To analyze if the adjusted hospital mortality varies according to source of payment of hospital admissions, legal nature, and financing settlement of hospitals. METHODS Cros-ssectional study with information source in administrative databases. Specific hospital admission reasons were selected considering the volume of hospital admissions and the list of quality indicators proposed by the North-American Agency for Healthcare Research and Quality (AHRQ). Were analyzed 852,864 hospital admissions of adults, occurred in 789 hospitals between 2008 and 2010, in Sao Paulo and Rio Grande do Sul, applying multilevel logistic regression. RESULTS At hospital admission level, showed higher chances of death male patients in more advanced age groups, with comorbidity, who used intensive care unit, and had the Brazilian Unified Health System as source of payment. At the level of hospitals, in those located in the mean of the distribution, the adjusted probability of death in hospital admissions financed by plan or private was 5.0%, against 9.0% when reimbursed by the Brazilian Unified Health System. This probability increased in hospital admissions financed by the Brazilian Unified Health System in hospitals to two standard deviations above the mean, reaching 29.0%. CONCLUSIONS In addition to structural characteristics of the hospitals and the profile of the patients, interventions aimed at improving care should also consider the coverage of the population by health plans, the network shared between beneficiaries of plans and users of the Brazilian Unified Health System, the standard of care to the various sources of payment by hospitals and, most importantly, how these factors influence the clinical performance.

Sign in / Sign up

Export Citation Format

Share Document