Sistema de regulação: gestão dos encaminhamentos a um hospital de referência
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Data
2019-02-27
Autores
Martin, Luana Bassetto
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Universidade Estadual Paulista (Unesp)
Resumo
INTRODUÇÃO: A regulação de acesso é compreendida como importante ferramenta de gestão do sistema de saúde. OBJETIVO: Conhecer o perfil e demanda de urgência e emer-gência encaminhadas a um serviço de alta complexidade antes e após um sistema de regulação. MÉTODO: Estudo transversal, avaliando, por meio de análise estatística, dois períodos o primeiro de março de 2015 a setembro de 2016 e o segundo de outubro de 2016 a abril de 2018. RESULTADOS: Houve predominância dos moradores de Botucatu sendo 82% adultos e as especialidades mais buscadas foram oftalmologia, clínica médica e ortopedia. 10450 casos foram regulados pela Central de Regulação de Ofertas de Serviços de Saúde, em análise comparativa do período anterior e posterior da implantação da plataforma notou-se aumento na demanda de atendimento dos municípios e na distribuição das especialidades solicitadas. Das solicitações aceitas e encaminhadas ao Hospital das Clínicas prevaleceu o público mascu-lino e as principais hipóteses diagnósticas foram relacionadas à fratura, trauma, afecções car-díacas e acidente vascular cerebral. Após realizou-se um cálculo amostral que evidenciou 12,5% a realização de contrarreferência, analisando a amostra a maioria eram homens com média de idade de 40 anos e o tempo médio de regulação dos casos foi de 1 hora, 43 minutos e 48 segundos com as principais queixas relacionadas à fratura, dor abdominal, infarto agudo do miocárdio e dispneia. CONCLUSÃO: Houve diferença significativa comparando os dois períodos, evidenciando o aumento após a inserção da plataforma, contribuindo na regulação e fluxo do paciente considerando o planejamento de estratégias juntamente com a análise de estrutura dos serviços respeitando o dinamismo da demanda e características encontradas.
BACKGROUND: Access regulation is understood as an important health system manage-ment tool. AIM: To know the profile and demand of urgency and emergency sent to a high complexity service before and after a regulation system. METHOD: Cross-sectional study, evaluating, through statistical analysis, two periods from March 2015 to September 2016 and the second from October 2016 to April 2018. RESULTS: Population of Botucatu was predo-minantly 82% and specialties most sought were ophthalmology, medical clinic and orthope-dics. 10450 cases were regulated by the Central of Regulation of Health Service Offerings, in a comparative analysis of the period before and after the implementation of the platform, there was an increase in the demand for care of the municipalities and in the distribution of the spe-cialties requested. Of the requests accepted and sent to Hospital das Clínicas, the male public prevailed and the main diagnostic hypotheses were related to fracture, trauma, cardiac affecti-ons and stroke. After a sample calculation that showed a 12.5% counterreference, the sample was mostly men with a mean age of 40 years and mean time to regulate the cases was 1 hour, 43 minutes and 48 seconds with the main complaints related to fracture, abdominal pain, acute myocardial infarction and dyspnea. CONCLUSION: There was a significant difference comparing the two periods, evidencing the increase after the insertion of the platform, contri-buting to the regulation and flow of the patient considering the planning of strategies together with the analysis of the structure of the services respecting the dynamism of the demand and characteristics found.
BACKGROUND: Access regulation is understood as an important health system manage-ment tool. AIM: To know the profile and demand of urgency and emergency sent to a high complexity service before and after a regulation system. METHOD: Cross-sectional study, evaluating, through statistical analysis, two periods from March 2015 to September 2016 and the second from October 2016 to April 2018. RESULTS: Population of Botucatu was predo-minantly 82% and specialties most sought were ophthalmology, medical clinic and orthope-dics. 10450 cases were regulated by the Central of Regulation of Health Service Offerings, in a comparative analysis of the period before and after the implementation of the platform, there was an increase in the demand for care of the municipalities and in the distribution of the spe-cialties requested. Of the requests accepted and sent to Hospital das Clínicas, the male public prevailed and the main diagnostic hypotheses were related to fracture, trauma, cardiac affecti-ons and stroke. After a sample calculation that showed a 12.5% counterreference, the sample was mostly men with a mean age of 40 years and mean time to regulate the cases was 1 hour, 43 minutes and 48 seconds with the main complaints related to fracture, abdominal pain, acute myocardial infarction and dyspnea. CONCLUSION: There was a significant difference comparing the two periods, evidencing the increase after the insertion of the platform, contri-buting to the regulation and flow of the patient considering the planning of strategies together with the analysis of the structure of the services respecting the dynamism of the demand and characteristics found.
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Palavras-chave
Enfermagem, Acesso aos serviços de saúde, Referência e Consulta, Nursing, Access to health services, Reference and Consultation