RESUMOOBJETIVO: Avaliar os fatores associados aos custos hospitalares no tratamento de idosos com fratura de quadril (FQ) em um hospital público. MÉTODOS: Foi realizado um estudo de coorte retrospectivo de prontuários de um hospital público da Região Metropolitana de Porto Alegre (RS). Foram incluídos 134 prontuários de idosos com diagnóstico de FQ, internados no período de julho de 2014 a outubro de 2016. RESULTADOS: A idade dos idosos variou de 61 a 96 anos, com média de 79,4 anos (± 8,8). Houve predominância do gênero feminino (73,1%). O tempo médio de internação hospitalar foi de 13,87 dias. Na avaliação da presença de morbidades associadas, 56 (41,7%) apresentaram pelo menos uma morbidade, e 64 (47,7%), de duas a seis morbidades associadas. O custo médio das internações por paciente foi de R$ 9.390,21 (US$ 2.745). Na composição geral dos custos, os serviços de enfermagem, nutrição, hotelaria e limpeza, materiais, medicamentos e diárias representaram 78,3% dos gastos, seguidos pelas órteses e próteses (10,7%) e pelos honorários médicos (10%). Ocorreu associação significativa entre o tempo para iniciar a cirurgia e a média de permanência (p < 0,001), entre o tempo para dar início à cirurgia e os custos hospitalares (p < 0,001), e entre as comorbidades e os custos hospitalares (p < 0,001). CONCLUSÃO: Além dos custos diretos da assistência, foram identificados como fatores associados aos custos o número de morbidades, a média de permanência e o tempo para iniciar a cirurgia. Quanto maior o tempo entre a fratura e a cirurgia, maior foi o custo total. PALAVRAS-CHAVE: idoso; custos; fraturas do quadril. ABSTRACT OBJECTIVE:To evaluate associated factors with hospital costs in the treatment of elderly patients with hip fracture in a public hospital. METHODS: A retrospective cohort study of medical records from a public hospital in the metropolitan area of Porto Alegre (RS) was performed. They included 134 medical records of elderly patients with hip fracture diagnosis, hospitalized from July 2014 to October 2015. RESULTS: The age of patients ranged from 61 to 96 years old, with an average of 79.4 years (± 8.8). There was a predominance of the female gender (73.1%). The average length of hospital stay was 13.87 days. In assessing the presence of associated morbidities, 56 (41.7%) had at least one morbidity, and 64 (47.7%) had two to six associated morbidities. The average cost of hospitalization per patient was R$ 9.390.21 (US$ 2,745). At the general composition of costs, nursing and nutrition services, hostelry and cleaning materials, medicines and daily expenses accounted for 78.3% of the expenditures, followed by orthotics and prosthetics (10.7%) and medical fees (10%). There was a significant association between the time to start the surgery and the average length of stay (p < 0.001), between the time to start the surgery and hospital costs (p < 0.001), and between the sum of morbidity and hospital costs (p < 0.001). CONCLUSION: In addition to the direct costs, the comorbidities, the average residence time and th...
O autoconhecimento é a capacidade de integrar diferentes fontes de informações sobre si mesmo e reconhecer suas ações e impactos sobre sua vida, suas ações, considerando seu gênero e demais papéis exercidos no cotidiano. Os desafios evidenciados ao portador de uma doença crônica e complexa como a Doença Inflamatória Intestinal (DII) - o Crohn, exige um constante estado de alerta para manter o controle e administração de sinais e sintomas, assim como, entender que o fato de absorver medicamentos corretos e de vanguarda, não minimiza os gatilhos mentais que possam ser desencadeados através de comportamentos, pensamentos, interações e emoções mal elaborados dentro de si.
Objective: Evaluate the effectiveness of a care program for elderly persons with hip fractures due to a fall, based on a public network in Canoas, Rio Grande do Sul, Brazil. Methods: a prospective cohort study of quantitative character was carried out. A total of 182 elderly person above 60 years diagnosed with hip fractures were included. The sample was divided into two groups, one who underwent their usual treatment (n=91) and another who were included in a care program for elderly persons with hip fractures (n=91). The program had as its main axis a clinical Protocol and an Access Protocol. The treatment of choice was surgical in all cases. In statistical analysis, categorical variables were described by absolute and relative frequencies. The Mann-Whitney test was used to compare numeric variables. In the comparison of proportions, the Pearson's Chi-squared test or Fisher's exact test were applied. The significance level adopted was 5%. Results: The average age was 79.4 years, with a prevalence of the female gender. The most frequent morbidity was hypertension. After the implementation of the program there was a reduction in the average time between the fracture and the beginning of surgery, the average length of hospitalization, the urinary tract infection rate, the death rate and care costs. Conclusion: The care program of elderly persons with hip fractures modified the expected results as it reduced mortality, average hospital stay, postoperative complications and the costs of treatment during the hospitalization.
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