Readmissão hospitalar como indicador de qualidade

Abstract

Patient readmission is defined as the admission of a patient in the same hospital after discharge. This concept has been used as a performance indicator in health systems, which can reflect the quality of care, and allows monitoring of inappropriate or excessive access to hospital admission. Unnecessary readmissions indicate dysfunctional elements in the health system; result in undue risk to patients and unnecessary costs to the system. It's understood that the study of hospital readmissions allows you to monitor results and managerial actions of healthcare organizations, assisting in resource allocation, guaranteed access and adequate supply of health services and actions. The adoption of the indicator as a quality measure is growing in the United States, and recently in some European countries, although there are controversial studies or inconclusive about the use as a quality indicator. Thus, the aim of this study was to investigate hospital readmissions of a large municipality, using descriptive quantitative research design. The study was conducted in Ribeirão Preto, assistance polo and medium and high complexity reference to the 26 municipalities in the area covered by the Regional Health Department XIII, with data from Center for Hospital Data Processing / Regional Observatory of Hospital Care and from Medical Archive and Statistical Service from participant hospitals. The database consisted of 38.145 records hospitalizations resulting from repeated hospitalizations from the same user at one of 11 participating hospitals in the course of 2011. Of the identified hospitalizations, 16.123 were classified as hospital readmissions. The readmission rate for the county was 14.2%, ranging from 2.1 to 31.7% among hospitals. Readmissions occur in up to seven days after discharge from the initial hospitalization, with length of stay less than seven days, with similar distribution between the female and male, in adult patients who have at least one comorbidity. Occurred more frequently in admissions by SUS, in hospitals with over 100 beds and high complexity care. The main causes of readmission turn to diseases related conditions to chronic conditions, especially cancer. From the perspective of quality, with a view to analysis of the three participating hospitals of external quality assessment programs, the adoption of these models aims to reduce readmission rates, when considering the size and complexity of hospital care. Based on these results, it is understood that the use as a outcome indicator should be given in conjunction with other indicators, analyzed according to the institutional reality and intervening factors, particularly with regard to configuration and articulation of different levels of attention and components, as well as the allocation of available resources.

Fatores sociodemográficos: a interferência nos pacientes no período pós confecção de ostomias intestinais

“…A readmissão hospitalar consiste na admissão hospitalar de um paciente em um mesmo hospital, até 30 dias após sua alta. Tal conceito tem sido utilizado como indicador de desempenho nos sistemas de saúde, podendo refletir a qualidade da assistência, além de permitir o monitoramento de acesso inadequado ou excessivo às internações hospitalares (Dias, 2015).…”

Edição Completa

“…Conforme Dias (2015), readmissões desnecessárias indicam elementos disfuncionais no sistema de saúde, acarretam riscos indevidos aos pacientes e custos desnecessários ao sistema.…”

“…No Brasil, segundoDias (2015), no ano de 2011 na cidade de Ribeirão Preto, a taxa de readmissão de 38.145 internações em 11 hospitais, foi de 14,2%, com variação de 2,1 a 31,7% entre os hospitais. As readmissões foram mais prevalentes em hospitais com mais de 100 leitos, de alta complexidade e em internações do Sistema Único de Saúde.…”

Elaboração De Propostas Para Alta Segura Com Uso Do Diagnosis-Related Groups

“…TABELA 2.Com a ineficiência do uso do leito hospitalar, devido ao consumo de diárias hospitalares acima do previsto, perderam-se 71,5 admissões clínicas e 228,7 admissões cirúrgicas. TABELA6.No Brasil, segundoDias (2015), no ano de 2011 na cidade de Ribeirão Preto, a taxa de readmissão de 38.145 internações em 11 hospitais, foi de 14,2%, com variação de 2,1 a 31,7% entre os hospitais. As readmissões foram mais prevalentes em hospitais com mais de 100 leitos, de alta complexidade e em internações do Sistema Único de Saúde.…”