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A relação das urgências hospitalares e a produtividade: análise de 36 hospitais do SNS de 2015 a 2019
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RESUMO - Introdução: As urgências representam uma carga de trabalho importante para os médicos, o que pode dificultar a realização da atividade programada e aumentar a necessidade de recursos. O estudo tem como principal objetivo medir a relação entre utilização das urgências hospitalares e produtividade dos médicos nos hospitais do Serviço Nacional de Saúde (SNS) no período de 2015 a 2019.
Metodologia: Este é um estudo quantitativo classificado como observacional, retrospetivo, transversal e ecológico com dados referentes ao período de 2015 a 2019 cujo objetivo é medir a relação entre a utilização das urgências hospitalares e a produtividade dos médicos em 36 hospitais do Serviço Nacional de Saúde (SNS). Os dados mensais das urgências hospitalares e da produtividade foram obtidos através do Portal da Transparência do SNS e serão analisados em 3 etapas: Análise Descritiva Univariável (tabelas de distribuição de frequências e medidas de localização e dispersão), Análise Bivariável (gráficos de cruzamento entre variáveis) e Análise Multivariável (regressão linear simples).
Resultados: Foram obtidos 2160 dados dos 36 hospitais durante 5 anos: média, por hospital, de 327 médicos, 23.860 consultas, 2.486 cirurgias, 12.940 urgências e uma produtividade média de 83,77. Cerca de 86,1% dos 36 hospitais situam-se no Norte, Centro e LVT, 80,6% da amostra tratam-se de hospitais não universitários e 19,4% de hospitais universitários. Os hospitais universitários demonstraram ter um efeito negativo na produtividade (-16,364 unidades), os hospitais de dimensão “Muito Grande” tiveram um efeito positivo (23,304 unidades) na produtividade e, em mais destaque, as urgências hospitalares apresentaram uma relação negativa/inversa e estatisticamente significativa (-1,662 unidades) com a produtividade.
Conclusões: Existe uma relação inversa entre as urgências hospitalares e a produtividade, sendo que, quanto maior for o peso das urgências menor será a produtividade dos médicos nos hospitais do Serviço Nacional de Saúde (SNS) em Portugal no período de 2015 a 2019, no entanto, são necessários mais estudos para confirmar esta relação.
ABSTRACT - Introduction: The emergencies represent an important workload for doctors, which can make it difficult to carry out the scheduled activity and increase the need for resources. The main objective of the study is to measure the relationship between the use of hospital emergencies and the productivity of doctors in hospitals of the National Health Service (SNS) in the period from 2015 to 2019. Methods: This is a quantitative study classified as observational, retrospective, cross-sectional and ecological with data referring to the period from 2015 to 2019 whose objective is to measure the relationship between the use of hospital emergencies and the productivity of doctors in 36 hospitals of the National Health Service (SNS). Monthly data on hospital emergencies and productivity were obtained through the SNS Transparency Portal and will be analyzed in 3 stages: Univariable Descriptive Analysis (frequency distribution tables and measures of location and dispersion), Bivariable Analysis (cross-graphs between variables) and Multivariate Analysis (simple linear regression). Results: 2160 data were obtained from 36 hospitals over 5 years: average, per hospital, of 327 doctors, 23.860 medical appointments, 2.486 surgeries, 12.940 emergencies and an average productivity of 83,77. About 86,1% of the 36 hospitals are located in the North, Center and LVT, 80,6% of the sample are non-university hospitals and 19,4% are university hospitals. University hospitals were shown to have a negative effect on productivity (-16,364 units), hospitals of a “Very Large” dimension had a positive effect (23,304 units) on productivity and, more prominently, hospital emergencies showed a negative/inverse relationship and statistically significant (-1.662 units) with productivity. Conclusions: There is an inverse relationship between hospital emergencies and productivity, and the greater the weight of emergencies, the lower the productivity of doctors in hospitals of the National Health Service (SNS) in Portugal in the period from 2015 to 2019, however, further studies are needed to confirm this relationship.
ABSTRACT - Introduction: The emergencies represent an important workload for doctors, which can make it difficult to carry out the scheduled activity and increase the need for resources. The main objective of the study is to measure the relationship between the use of hospital emergencies and the productivity of doctors in hospitals of the National Health Service (SNS) in the period from 2015 to 2019. Methods: This is a quantitative study classified as observational, retrospective, cross-sectional and ecological with data referring to the period from 2015 to 2019 whose objective is to measure the relationship between the use of hospital emergencies and the productivity of doctors in 36 hospitals of the National Health Service (SNS). Monthly data on hospital emergencies and productivity were obtained through the SNS Transparency Portal and will be analyzed in 3 stages: Univariable Descriptive Analysis (frequency distribution tables and measures of location and dispersion), Bivariable Analysis (cross-graphs between variables) and Multivariate Analysis (simple linear regression). Results: 2160 data were obtained from 36 hospitals over 5 years: average, per hospital, of 327 doctors, 23.860 medical appointments, 2.486 surgeries, 12.940 emergencies and an average productivity of 83,77. About 86,1% of the 36 hospitals are located in the North, Center and LVT, 80,6% of the sample are non-university hospitals and 19,4% are university hospitals. University hospitals were shown to have a negative effect on productivity (-16,364 units), hospitals of a “Very Large” dimension had a positive effect (23,304 units) on productivity and, more prominently, hospital emergencies showed a negative/inverse relationship and statistically significant (-1.662 units) with productivity. Conclusions: There is an inverse relationship between hospital emergencies and productivity, and the greater the weight of emergencies, the lower the productivity of doctors in hospitals of the National Health Service (SNS) in Portugal in the period from 2015 to 2019, however, further studies are needed to confirm this relationship.
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Hospitais Produtividade Serviço de Urgências SNS Portugal Hospitals Productivity Emergencies Department National Health Service