scholarly journals Insuficiência renal aguda no Nordeste brasileiro: morbimortalidade e custos públicos

2019 ◽  
Vol 13 ◽  
Author(s):  
Edison Vitório de Souza Júnior ◽  
Diego Pires Cruz ◽  
Gabriel Aguiar Nunes ◽  
Giovanna Maria Nascimento Caricchio ◽  
Sávio Luiz Ferreira Moreira ◽  
...  

Objetivo: descrever a morbimortalidade hospitalar e custos públicos relacionados à insuficiência renal aguda no Nordeste brasileiro. Método: trata-se de estudo quantitativo, ecológico e descritivo realizado com dados do Sistema de Informações Hospitalares. Coletaram-se as variáveis: internações; óbitos; mortalidade; valores dos serviços hospitalares; valores médios gastos com as internações e média de permanência hospitalar. Analisaram-se os dados com estatística descritiva, apresentando-os em tabelas elaboradas pelo software Excel. Resultados: registraram-se 21.100 internações, 4.460 óbitos e mortalidade de 21,1%. Destacaram-se a Bahia nas internações (28,6%) e óbitos (28,7%) e Sergipe na letalidade (35,6%). Gerou-se custo público superior a R$ 37,6 milhões e a Bahia responsabilizou-se por 32,1%. Revelou-se valor médio de R$ 1.969,97 para cada internação e a média de permanência hospitalar foi de 10,2 dias. Conclusão: conclui-se que as variáveis epidemiológicas apresentaram maior prevalência nos Estados da Bahia e Sergipe. Evidenciou-se, além disso, comportamento crescente das internações, implicando o incremento dos custos públicos. Descritores: Saúde Pública; Nefrologia; Nefropatias; Epidemiologia; Custos de Cuidados de Saúde; Sistemas de Informação. Abstract Objective: to describe hospital morbidity and mortality and public costs related to acute renal failure in northeastern Brazil. Method: this is a quantitative, ecological and descriptive study conducted with data from the Hospital Information System. The following variables were collected: hospitalizations; deaths; mortality; values of hospital services; average values spent on hospitalizations and average hospital stay. Data was analyzed with descriptive statistics and presented in tables prepared by Excel software. Results: 21,100 hospitalizations, 4,460 deaths and 21.1% mortality were registered. Bahia stood out in hospitalizations (28.6%) and deaths (28.7%) and Sergipe in lethality (35.6%). It generated a public cost over R $ 37.6 million and Bahia accounted for 32.1%. An average value of R $ 1,969.97 was revealed for each hospitalization and the average hospital stay was 10.2 days. Conclusion: it is concluded that the epidemiological variables were more prevalent in the states of Bahia and Sergipe. In addition, the increasing behavior of hospitalizations was evidenced, implying an increase in public costs. Descriptors:  Public Health; Nephrology; Kidney Diseases; Epidemiology; Health Care Costs; Information Systems.Resumen Objetivo: describir la morbimortalidad hospitalaria y los costos públicos relacionados con la Insuficiencia Renal Aguda en el Noreste de Brasil. Método: se trata de un estudio cuantitativo, ecológico y descriptivo realizado con datos del Sistema de Informaciones Hospitalarias. Se recogieron las siguientes variables: hospitalizaciones; muertes, mortalidad, valores de los servicios hospitalarios; promedio de valores gastados en admisiones y promedio de permanencia hospitalaria. Los datos se analizaron con estadísticas descriptivas y se presentaron en tablas elaboradas por el software Excel. Resultados: se registraron 21.100 admisiones, 4.460 muertes y 21.1% de mortalidad. Bahía se destacó en hospitalizaciones (28.6%) y muertes (28.7%), y Sergipe en letalidad (35.6%). Se generó un costo público de más de R$ 37,6 millones y Bahía fue responsable del 32.1%. El valor medio de R $ 1,969.97 se reveló para cada hospitalización y la permanencia hospitalaria con promedio de 10,2 días. Conclusión: se concluye que las variables epidemiológicas presentaron mayor prevalencia en los Estados de Bahía y Sergipe. Además, hubo evidencia de un mayor comportamiento de hospitalización, lo que implica un aumento en los costos públicos. Descriptores: Salud Pública; Nefrología; Enfermedades Renales; Epidemiología; Costos de la Atención en Salud; Sistemas de Información.

2019 ◽  
Vol 13 ◽  
Author(s):  
Edison Vitório de Souza Júnior ◽  
Sarah Rodrigues Silva ◽  
Gabriel Aguiar Nunes ◽  
Larissa Vasconcelos Santos ◽  
Débora Fraga de Souza ◽  
...  

Objetivo: descrever os gastos públicos com as hospitalizações devido às hepatites virais no Nordeste brasileiro entre 2013 e 2017. Método: trata-se de um estudo quantitativo, ecológico e descritivo com dados do Sistema de Informações Hospitalares. Analisaram-se os dados com o auxílio do software Excel, utilizando-se frequências absolutas e relativas e apresentando-os em tabelas. Resultados: registraram-se 4.317 internações para o tratamento das hepatites virais no Nordeste brasileiro. Destaca-se a prevalência de internações no ano de 2014 (40,6%), no Estado do Maranhão (27,2%) e nas instituições públicas (50,2%). Gerou-se, além disso, um impacto financeiro superior a R$ 1,3 milhão aos cofres públicos e o Maranhão representou o maior ônus (21,3%). Conclusão: torna-se necessário o incremento nas taxas diagnósticas e terapêuticas, especialmente, no Estado do Maranhão, por evidenciar a maior quantidade de internações, implicando maiores gastos públicos hospitalares. Descritores: Epidemiologia; Saúde pública; Vigilância em Saúde Pública; Custos de Cuidados de Saúde; Sistemas de informação.Abstract Objective: describe public expenditure on hospitalizations due to viral hepatitis in northeastern Brazil between 2013 and 2017. Method: this is a quantitative, ecological and descriptive study with data from the Hospital Information System. Data was analyzed with the aid of Excel software, using absolute and relative frequencies and presented in tables. Results: 4,317 hospitalizations were registered for the treatment of viral hepatitis in Northeastern Brazil. The prevalence of hospitalizations in 2014 (40.6%), in the State of Maranhão (27.2%) and in public institutions (50.2%) stands out. In addition, there was a financial impact of over R $ 1.3 million on public coffers and Maranhão represented the largest burden (21.3%). Conclusion: it is necessary to increase the diagnostic and therapeutic rates, especially in the state of Maranhão, as it shows the largest number of hospitalizations, implying higher public hospital expenses. Descriptors: Epidemiology; Public Health; Public Health Surveillance; Health Care Costs; Information Systems.Resumen Objetivo: describir los gastos públicos con las hospitalizaciones debido a las hepatitis virales en el noreste de Brasil entre 2013 y 2017. Método: se trata de un estudio cuantitativo, ecológico y descriptivo, con datos del Sistema de Informaciones del Hospital. Los datos se analizaron con el auxilio del software Excel utilizando frecuencias absolutas y relativas y presentadas en tablas. Resultados: se registraron 4,317 hospitalizaciones para el tratamiento de las hepatitis virales en el noreste de Brasil. Se destaca una mayor prevalencia de hospitalizaciones en 2014 (40.6%), en el Estado de Maranhão (27.2%) y en las instituciones públicas (50.2%). Además, se generó un impacto financiero de más de R $ 1,3 millones para las arcas públicas y Maranhão fue responsable de una mayor carga (21,3%). Conclusión: se torna necesario el aumento en las tasas diagnósticas y terapéuticas, especialmente en el Estado de Maranhão, ya que se evidencia una mayor cantidad de hospitalizaciones, lo que implica mayores costos hospitalarios. Descriptores: Epidemiología; Salud Pública; Vigilancia En Salud Pública; Costos De La Atención En Salud; Sistemas de Información.


PEDIATRICS ◽  
1973 ◽  
Vol 51 (5) ◽  
pp. 840-848
Author(s):  
Eli H. Newberger ◽  
John J. Hagenbuch ◽  
Nancy B. Ebeling ◽  
Elizabeth Pivchik Colligan ◽  
Jane S. Sheehan ◽  
...  

Social service personnel from one public and two voluntary agencies were integrated into a consultation group in an academic pediatric hospital, leading to a reduction in the actual cost of medical services and the risk of reinjury subsequent to the diagnosis of child abuse. In the 1969-1970 hospital year, 62 cases of child abuse were seen, of which 39 were hospitalized. The average hospital stay was 29 days; the average hospital cost $3,000. Total hospital costs for the 39 cases were $123,000, of which bed costs made up $95,000. There were at least three subsequent incidents of child abuse in these 39 cases, and there was one subsequent death; the reinjury rate was 10% for hospitalized cases. In September 1970 the Trauma X Group, an interdisciplinary, interagency consultation unit based in the hospital, was formed. With formal consultation and continued surveillance after discharge by the Trauma X Group, the following data were obtained from the 1970-1971 hospital year. Of 86 cases, 60 were hospitalized. The average hospital stay was 17 days; the average hospital cost $2,500. Total hospital costs for the 60 cases was $150,000, of which bed costs made up $101,000. There was one incident of reinjury and no deaths subsequent to diagnosis in these 60 cases; the reinjury rate was 1.7%. The risk of reinjury calculated from a modified life table was reduced from 8% in the year previous to the formation of the group to 7% and 2%, respectively, in the subsequent year and six-month periods, supporting the dollar-cost impression of effectiveness. Foster placement, furthermore, was infrequent and does not explain the differential impact of the Trauma X Group in the intervals under study.


2020 ◽  
Vol 9 (4) ◽  
pp. 5-10
Author(s):  
Margarita N. Slesarevskaya ◽  
Salman Kh. Al-Shukri ◽  
Arkadiy V. Sokolov ◽  
Igor V. Kuzmin

The results of surgical treatment of 59 women (average age 31.9 1.3 years) who underwent laser ablation of paraurethral cysts using the Lakhta-Milon laser apparatus (Russia) (diode laser with a wavelength of 0.97 m) are presented. The postoperative period in all patients proceeded without serious complications. The average hospital stay was 1.7 1.5 days. 4 weeks after surgery, all 59 patients noted improvement such as lack of dysuria, only 10 (16.9%) had minor discharge from the genital tract. 6 weeks after surgery all 59 operated patients had wound epithelization. Conclusion: The treatment of paraurethral cysts should be surgical and as radical as possible. The operation of choice is laser ablation of paraurethral formations.


2018 ◽  
Vol 99 (2) ◽  
pp. 345-349
Author(s):  
S B Sangadzhiev ◽  
L E Slavin ◽  
R T Zimagulov ◽  
R R Yakhin ◽  
M S Sangadzhiev ◽  
...  

Aim. Clinical justification for the necessity of sanitation surgeries for cholelithiasis and abdominal wall hernias in patients intended for heart valve surgery. Methods. The study is based on the analysis of operative treatment results of 54 patients admitted to surgical department of Interregional clinical diagnostic center (Kazan) in 2007-2017 with cholelithiasis and abdominal wall hernias, who underwent laparoscopic cholecystectomy or herniotomy before or after an open heart surgery in cardiac surgical department No. 2 of the hospital. All patients were divided into two clinical groups. Group 1 consisted of 36 patients with a history of prosthetic heart valve, taking long-term warfarin. The comparison group included 18 patients, who at the first stage before cardiac surgery underwent sanitation surgeries for cholelithiasis and/or abdominal wall hernias. As part of the research, statistical analysis of intergroup differences was performed using non-parametric Mann-Whitney U-tests. Intergroup differences were determined by gender, age and type of cardiac and general surgical pathology. Results. The analysis of the study groups showed that the average hospital stay among patients with long-term use of indirect anticoagulants was 15±1 day and varied from 12 to 19 days. The results indicate more than two-fold increase of an average hospital stay compared to patients, who underwent the same surgeries before cardiac interventions (р <0.05). Conclusion. Before performing cardiac valve replacement with planned life-term or long-term use of anticoagulants with concomitant general surgical pathology (cholelithiasis, abdominal wall hernias with a tendency to strangulate), at the first stage, it is reasonable to perform so called sanitation surgeries aimed at eliminating abdominal pathology; such approach significantly decreases hospital stay of patients, and potentially contributes to lower probability of hemorrhagic complication incidences during the surgery and in the early post-operative period.


Author(s):  
Jeniffer Araújo Valentim da Silva ◽  
Marcele Pescuma Capeletti Padula ◽  
Camila Waters

Objetivo: Identificar o perfil epidemiológico, clínico e o desfecho dos pacientes com Traumatismo Cranioencefálico (TCE). Métodos: Pesquisa retrospectiva realizada com pacientes com idade maior ou igual a 18 anos, que estiveram internados na Instituição no ano de 2017, vítimas de TCE por qualquer etiologia. Resultados: Analisados 268 prontuários, sendo 78,7% do sexo masculino, com uma média de idade de 51 anos e maior incidência na faixa etária dos 31 a 50 anos (38,4%). A maioria (76,1%) chegou ao Pronto Socorro (PS) pelo Serviço de Atendimento Móvel de Urgência (SAMU), com uma média da Escala de Coma de Glasgow de 12 pontos, sendo que 78,0% apresentavam TCE leve (13 a 15 pontos), 14,2% apresentavam TCE grave (3 a 8 pontos) e 7,8% apresentavam TCE moderado (9 a 12 pontos). A maioria (57,5%) apresentou o TCE por queda, seguido de 16,0% por atropelamento, 12,0% por agressão, 5,9% por politrauma de mecanismos desconhecidos, 5,6% por acidente de moto, 1,9% por acidente automobilístico e 1,1% por ferimento por arma de fogo. A maioria (84,3%) ficou internada no hospital por até 10 dias, com uma média de internação hospitalar de seis dias, 92,9% receberam tratamento clínico (conservador) e 85,8% receberam alta hospitalar. Conclusões: Prevaleceram indivíduos do sexo masculino, com uma média de idade de 51 anos, encaminhados ao PS pelo SAMU, vítimas de TCE leve, ocasionado por queda, com uma média de internação hospitalar de seis dias, recebendo tratamento clínico e com desfecho de alta hospitalar.Palavras chave: Perfil de saúde, Lesões encefálicas traumáticas, Traumatismo cerebrovascularABSTRACTObjective: To identify the epidemiological, clinical profile and outcome of patients with Traumatic Brain Injury (TBI). Methods: Retrospective research conducted with patients aged 18 years or older, who were admitted to the Institution in 2017, victims of TBI due to any etiology. Results: 268 medical records were analyzed, of wich 78,7% were male, with an average age of 51 years and a higher incidence in the age group from 31 to 50 years (38,4%). The majority (76,1%) arrived at the Emergency Room (ER) through the Mobile Emergency Service (SAMU), with an average of the Glasgow Coma Scale of 12 points, with 78,0% having mild TBI (13 at 15 points), 14,2% had severe TBI (3 to 8 points) and 7,8% had moderate TBI (9 to 12 points). The majority (57,5%) presented TBI due a fall, followed by 16,0% due to being run over, 12,0% due to aggression, 5,9% due to polytrauma of unknown mechanisms, 5,6% due to motorcycle accident, 1,9% due to automobile accident and 1,1% due to firearm injury. The majority (84,3%) stayed in the hospital for up to 10 days, with an average hospital stay of six days, 92,9% received clinical treatment and 85,8% were discharged. Conclusions: Male individuals prevailed, with an average age of 51 years, referred to ER by SAMU, victims of mild TBI, caused by a fall, with an average hospital stay of six days, receiving clinical treatment and with outcome of discharge hospital.Keywords: Health profile, Traumatic brain injury, Cerebrovascular trauma


2012 ◽  
Vol 10 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Paul Foreman ◽  
Sam Safavi-Abbasi ◽  
Melanie C. Talley ◽  
Lindsay Boeckman ◽  
Timothy B. Mapstone

Object The authors debate the optimal management for Chiari malformation Type I (CM-I) while sharing their experience with posterior fossa decompression and duraplasty (PFDD). Methods The charts of 48 consecutive pediatric patients surgically treated for CM-I were retrospectively reviewed. Results Patients ranged in age from 2 to 17 years with an average age of 9.8 years. The most common presentations were headache, affecting 34 patients (71%), and pain (neck, back, or extremities), affecting 21 patients (44%). Twenty-seven patients (56%) had a syrinx. All 48 patients underwent PFDD utilizing acellular tissue matrix. The average hospital stay overall was 3.56 days, whereas the average stay for patients with (29 [60%] of 48) or without (19 [40%] of 48) scoliosis and/or syringomyelia was 3.72 and 3.32 days, respectively. The odds of a patient having a hospital stay of 4 or more days was nearly 3 times greater in patients with scoliosis and/or syringomyelia as compared with patients without either condition (OR 2.73, 95% CI 0.74–10.11, p = 0.1330). The average hospital stay for patients 0–8 years of age was 3.29 days; and for those 9–17 years of age, 3.78 days. The odds of a patient having a hospital stay of 4 or more days was nearly 4 times greater in 9- to 17-year-olds as compared with 0- to 8-year-olds (OR 3.73, 95% CI 1.03–13.52, p = 0.0455). Forty patients (89%) experienced early improvement in their signs and symptoms following PFDD. There were 2 revision PFDDs (4%). Conclusions Posterior fossa decompression and duraplasty is a safe and effective surgical option in the management of pediatric CM-I.


2019 ◽  
Vol 13 ◽  
Author(s):  
Edison Vitório de Souza Júnior ◽  
Caroline Valois Cunha ◽  
Gabriel Aguiar Nunes ◽  
Átila Rodrigues Souza ◽  
Jamille Sales da Cruz ◽  
...  

Objetivo: descrever a morbidade e os custos públicos hospitalares pela insuficiência renal crônica no Nordeste brasileiro entre 2013 e 2017. Método: trata-se de estudo quantitativo, ecológico e descritivo elaborado com dados secundários do Sistema de Informações Hospitalares. Estudaram-se as variáveis internações, óbitos, custos hospitalares, valor médio de internação e média de permanência hospitalar, analisando-as com estatística descritiva simples. Resultados: registraram-se 47.882 internações e 6.919 óbitos pela insuficiência renal crônica no Nordeste brasileiro. Informa-se, além disso, que os custos hospitalares pela doença foram superiores a R$ 79 milhões, com valor médio de internação de R$ 1.816,11 e média de permanência de 10,4 dias na unidade hospitalar. Conclusão: conclui-se que a morbidade pela insuficiência renal crônica ainda consiste em sério problema de saúde pública, implicando diretamente o incremento e a ascendência dos custos hospitalares. Adverte-se que este estudo revela dados capazes de despertar o autocuidado da população e de fortalecer as ações da atenção básica na prevenção e controle da doença e de seus fatores etiológicos no intuito de reduzir as hospitalizações e diminuir as onerações. Descritores: Saúde Pública; Epidemiologia; Nefrologia; Nefropatias; Custos de Cuidados de Saúde; Sistemas de Informação.AbstractObjective: to describe morbidity and public hospital costs for chronic renal failure in Northeastern Brazil, between 2013 and 2017. Method: this is a quantitative, ecological and descriptive study based on secondary data from the Hospital Information System. The following variables were studied: hospitalizations, deaths, hospital costs, average hospitalization value and average hospital stay, analyzed using simple descriptive statistics. Results: 47,882 hospitalizations and 6,919 deaths from chronic renal failure were registered in the Brazilian Northeast. In addition, hospital costs for the disease were higher than R$ 79 million, with an average hospitalization value of R$1,816.11 and an average length of stay of 10.4 days in the hospital unit. Conclusion: it can be concluded that morbidity due to chronic renal failure is still a serious public health problem, directly affecting the increase and ascendancy of hospital costs. It is warned that this study reveals data capable of arousing the self-care of the population and strengthening the actions of primary care in the prevention and control of the disease and its etiological factors, in order to reduce hospitalizations and reduce burdens. Descriptors: Public Health; Epidemiology; Nephrology; Kidney Diseases; Health Care Costs; Information Systems. Resumen Objetivo: describir la morbilidad y los costos públicos hospitalarios por la insuficiencia renal crónica en el noreste de Brasil, entre 2013 y 2017. Método: se trata de un estudio cuantitativo, ecológico y descriptivo basado en datos secundarios del Sistema de Información Hospitalaria. Se estudiaron las siguientes variables: hospitalizaciones, defunciones, costos hospitalarios, valor promedio de hospitalización y estadía hospitalaria promedio, se analizaron mediante estadísticas descriptivas simples. Resultados: 47.882 hospitalizaciones y 6.919 muertes por insuficiencia renal crónica se registraron en el noreste de Brasil. Además, los costos hospitalarios por la enfermedad fueron superiores a R$ 79 millones, con un valor de hospitalización promedio de R$ 1.816,11 y una estadía promedio de 10,4 días en la unidad hospitalaria. Conclusión: se puede concluir que la morbilidad debida a insuficiencia renal crónica sigue siendo un grave problema de salud pública, que afecta directamente el aumento y la ascendencia de los costos hospitalarios. Se advierte que este estudio revela datos capaces de despertar el autocuidado de la población y fortalecer las acciones de atención primaria en la prevención y control de la enfermedad y sus factores etiológicos, para reducir las hospitalizaciones y las cargas. Descriptores: Salud Pública; Epidemiología; Nefrología; Enfermedades Renales; Costos de la Atención en Salud; Sistemas de Información.


2021 ◽  
Author(s):  
Bianca Brinques da Silva ◽  
Rebeca Delatorre Fonseca ◽  
Bernardo Neuhaus Lignati ◽  
Lana Caroline Palaver Dall’Ago ◽  
Laura Couto Cosner ◽  
...  

Background: Brazil is the second country in dementia cases prevalence. The populational aging worsens this situation and overloads the healthcare system. Objectives: To analyze the epidemiological data of dementia in the period from 2010 to 2020 in Brazil. Design and setting: Descriptive cross-sectional epidemiological study with patients with Dementia in Brazil between 2010 and 2019. Methods: Study realized using the SUS Hospital Information Systems (SIH/ SUS), with the information provided by the SUS Informatics Department. Results: From 2010 to 2020, Brazil had 170 million dementia cases notifications and 31 thousand hospitalizations. The southeast region had the highest case prevalence (88%), and the North region the lowest (0.36%). The hospitalized patients number per 100.000 inhabitants was highest in the South region (25.11) and lowest in the North region (4.55). The Center-west region had the highest mortality rate (16.43) and the North the lowest (1). 53% of the reported cases were males, being 51% of the hospitalization rate. The mortality rate was higher in female patients (8.58) and 7.18 for male patients. Patients over 70 years accounted for 75% of the deaths. The patients between 30 and 39 years presented the longest average hospital stay (140,6 days). Southeast and South had the longest (122.2) and shortest (15.1) hospital stay in days, respectively. Conclusion: The data showed the disparity among the regions, from hospitalizations to mortality rates. Hence, politics that can embrace the totality of the territory, improving patient comfort, and disease prognostic are needed.


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