Acolhimento com avaliação e classificação de risco : análise da demanda atendida no pronto socorro de um hospital escola

AUTOR(ES)

Vivian Biazon El Reda Feijó

FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

20/08/2010

RESUMO

The area of emergency care is an important component of health care. The increasing demand in recent years and insufficient structuring of the health care network are factors that contribute to the overload of the emergency services, turning these in one of the most problematic areas of the SUS. With this in mind, the Health Ministry established in 2004 the National Program for Humanization (PNH), proposing tools and devices that can effectively enhance the assurance of comprehensive care. The reception with risk assessment and classification (AACR) stands out as a directive. Considering the scarcity of studies related to the use of the AACR protocol in emergency services of high complexity and their deployment in the Emergency Room of the University Hospital of Londrina-PR, this study aimed to analyze the demand that sought treatment in this service by the criteria of the AACR protocol, and, more specifically, identify the characteristics and factors associated both to the demand and its adequation to the purpose of the service. The study population consisted of 976 people who sought treatment from June 2008 to May 2009, selected by systematic sampling. Data were collected from the records of AACR protocol and medical forms when the outcome has been treatment in this service. Information was entered and stored in the software Epi Info version 3.5.1 for Windows and analyzed using the SAS software. The association between these and the variables response risk assessment was assessed using chi-square or Fisher exact test. Were considered suitable to the demand for treatment at the tertiary hospital the patients classified as red, yellow, and green; those classified as blue were considered unsuitable. The results show that 82% of the patients were classified as suitable to the service, according to the protocol criteria. The predominant gender was male aged 20-59 years. The demand for care was higher on weekdays during business hours, coinciding with the shift of greater demand of the less severe cases. Statistics analysis found a significant association of the variable origin of demand and demand schedule with adequacy of demand. The variables clinic responsible for care, destination after medical care, accompaniment in this service, SSVV, time of complaint, procedures performed and comorbidities show significant association with the risk assessment assigned by colors. It concludes from the results of this study that the implementation of AACR contributed in the identification of the most serious cases and in the organization of demand. However, the adequacy of demand also depends of organization of the local health system as a whole. Based in this information, other emergency services may be motivated to incorporate this work and management technology.

ASSUNTO(S)

serviços de saúde - avaliação serviços de saúde - acolhimento avaliação de riscos de saúde política de saúde humanização na saúde saúde pública health risk assessment public health health services evaluation

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