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Quedas em internamento hospitalar: causas, consequências e custos: estudo de caso numa unidade hospitalar de Lisboa
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Resumo(s)
RESUMO - Os gastos com a saúde em Portugal aumentaram significativamente
nas últimas décadas, apesar de um esforço de contenção
desde 2009. As quedas de doentes são episódios frequentes
nos internamentos de qualquer Unidade Hospitalar,
que podem originar lesões, hospitalizações mais
prolongadas, atraso na reabilitação e aumento de custos
para o serviço. A presente investigação tem por objetivo
analisar quais as causas, consequências e custos de episódios
de quedas notificadas com lesão, de doentes internados
numa Unidade Hospitalar de Lisboa, com natureza de entidade
pública. Utiliza-se uma abordagem quantitativa, do
tipo correlacional-preditivo-transversal, através de uma
análise retrospetiva de 153 notificações de incidentes de
quedas com lesão, durante o ano de 2013. A grande maioria
dos doentes tinha idade compreendida entre 71 e 85 anos,
sendo a média da idade de 72 anos. O principal motivo que
levou à queda foi a busca da satisfação das suas necessidades
fisiológicas (47,7%), com probabilidade de ter sido
provocada pelo estado de saúde do doente (67,3%), com
maior incidência de escoriações e hematomas (em igual
número 28,1%). Os casos de quedas com um nível de lesão
moderado e grave são os que representam um maior valor
médio dos custos, sendo as lesões graves de origem ortopédica
as que acarretaram maiores custos para a Unidade
Hospitalar.
ABSTRACT - Health expenditure in Portugal increased significantly in recent decades, despite an effort to cut costs since 2009. Patient falls are frequent episodes throughout the period of stay in any hospital, which can lead to injuries, longer hospitalizations, delays in rehabilitation, and increased costs to the service. This research aims to analyze causes, consequences, and costs of reported fall events which led to injuries in a public Lisbon hospital. The study is based on a predictive, transversal and cross-sectional approach, through a retrospective analysis of 153 fall incident reports that led to injuries during the year of 2013. The vast majority of patients were between 71 and 85 years old, with an average of 72 years of age. The main reason that led them to fall was autonomous motion to relieve themselves (47.7%), likely caused by patient’s health condition (67.3%), with a higher incidence of bruises and hematomas (both 28.1%). Cases of falls with moderate and severe levels of injury are those that lead to higher average costs, whereas serious orthopedic injuries lead to higher costs for the hospital.
ABSTRACT - Health expenditure in Portugal increased significantly in recent decades, despite an effort to cut costs since 2009. Patient falls are frequent episodes throughout the period of stay in any hospital, which can lead to injuries, longer hospitalizations, delays in rehabilitation, and increased costs to the service. This research aims to analyze causes, consequences, and costs of reported fall events which led to injuries in a public Lisbon hospital. The study is based on a predictive, transversal and cross-sectional approach, through a retrospective analysis of 153 fall incident reports that led to injuries during the year of 2013. The vast majority of patients were between 71 and 85 years old, with an average of 72 years of age. The main reason that led them to fall was autonomous motion to relieve themselves (47.7%), likely caused by patient’s health condition (67.3%), with a higher incidence of bruises and hematomas (both 28.1%). Cases of falls with moderate and severe levels of injury are those that lead to higher average costs, whereas serious orthopedic injuries lead to higher costs for the hospital.
Descrição
Palavras-chave
Economia em saúde Qualidade em saúde Quedas de doentes no internamento Custos hospitalares Healthcare economics Healthcare quality Patient falls during hospitalization Hospital costs
Contexto Educativo
Citação
Romão, Ana Lúcia; Nunes, Susana - Quedas em internamento hospitalar: causas, consequências e custos: estudo de caso numa unidade hospitalar de Lisboa = Falls in hospital stays: causes, consequences and costs: case study in a Lisbon hospital unit. Portuguese Journal of Public Health. ISSN 2504-3137. Vol. 36, Nº 1 (Janeiro/Abril 2018), p. 1-8
Editora
Universidade Nova de Lisboa, Escola Nacional de Saúde Pública