Redução do número de internações hospitalares por asma após a implantação de programa multiprofissional de controle da asma na cidade de Londrina

Abstract

Objective: To evaluate the relationship between the reduction in the number of asthma-related hospital admissions and the changes occurring after the intervention performed in the health care system of the city of Londrina, Brazil. Methods: In 2003, an intervention was performed in the local health care system (Family Health Clinics) The steps adopted were as follows: development of a protocol based on the III Brazilian Consensus on Asthma Management; access to free inhaled corticosteroids for patients; training of health professionals; and implementation of educational measures, especially for the community. The authorizations for hospital admission of patients diagnosed with asthma alone between 2002 and 2005 in the city of Londrina were analyzed. Results: The mean age was 14.3 ± 0.5 years, without gender predominance. The number of hospital admissions fell more markedly in 2005 than in the previous years studied. This decline was more pronounced at the Family Health Clinics where professional training occurred earlier. The post-intervention (2004The post-intervention ( -2005 rate of asthma-related hospital admissions (120/100,000 inhabitants) was significantly lower than the pre-intervention (2002)(2003) rate (178/100,000 inhabitants; p < 0.01). Conclusions: The admission curve showed a tendency toward a reduction after 2003, and, aside from the intervention performed, no other factors that would explain the results obtained were identified. The rate at which the number of hospital admissions decreased was in direct proportion to the length of time elapsed since the intervention (greater decreases over time). We conclude that the intervention performed in the local health care system was responsible for the data presented.

The impact of asthma in Brazil: a longitudinal analysis of data from a Brazilian national database system

“…In this context, two Brazilian cities implemented distinct public health care programs for asthma (with the creation of referral centers, easy provision of medications, strict public health care protocols, and professional training) and were successful in achieving an important decrease in the number of asthma-related hospitalizations. 27 , 28 Moreover, in one of these cities (Salvador, in the state of Bahia), the implemented asthma control program showed that, when patients with severe asthma had their disease under control, there was a major decrease in the direct costs of asthma in the families (−89%) and an increase in the overall family income. 29 These local initiatives demonstrate the importance of implementing further effective asthma control programs in public health care systems.…”

Perfil epidemiológico de hospitalizações por asma no Estado de Roraima: análise de dados do Departamento de Informática do Sistema Único de Saúde (DATASUS)

“…Assim, outro ponto importante observado em nossa análise, foi a faixa etária de 5 a 9 anos quais foram dentre as maiores no ano de 2018, nº 34 (35,8%) e no ano de 2022 nº 107 (39,1%). Neto et al, (2008), evidencia que a média de idade de seu estudo foi de 14,3 ± 0,5 anos. Contrapondo, o estudo de Noronha e Campos (2002), quais as faixas etárias acima de 60…”

“…SegundoFajardo et al, (2021), o diagnóstico precoce, o uso adequado dos fármacos, e intervenções investidas em caráter educacional para obter adesão, entre outras ações, podem evitar hospitalizações e óbitos.Conforme o Quadro 3, as faixas etárias dos óbitos foram diversificadas com maior elevação entre 50 a 59 anos, diferentemente das faixas etárias indicadas no grupo etário das internações, observadas na Tabela 1. Podendo assim inferir que a idade pré-escolar é um preditivo de controle da patologia, e que os asmáticos crônicos vão a óbito, em relação à faixa etária de jovens adultos no recorte temporal analisados(Noronha & Campos 2002;Neto et al, 2008; Saldanha e Botelho 2010;Libera et al, 2018). De acordo comPeleteiro et al, (2017), em seu estudo de análise das internações e óbitos por asma em Salvador, os números de óbitos verificados foram em maior quantidade entre os idosos.ParaMarques et al, (2022), em seu estudo, o número de óbitos foi de 2.248 casos, em seu recorte temporal, com maior número na Região Sudeste.…”

An expert review on breaking barriers in severe asthma in Brazil: Time to act

“…These programs resulted in hospitalization reductions of 33% and 74% respectively, as well as cost reductions to the patient and the healthcare system. 33 , 34 Direct asthma-related costs for a participant’s family were reduced from 24% to 2% of their annual income. 35 Comprehensive approaches, such as the ones described above, are critical for asthma control, given the reduction in the burden of disease and associated direct and indirect costs.…”