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Abstract(s)
Contextualização: O tabagismo afecta milhões de pessoas por todo o mundo, sendo um dos principais contribuintes para a despesa em saúde, no que respeita ao tratamento das doenças associadas ao tabaco. Nos últimos anos o interesse relativamente ao tabagismo tem vindo a aumentar, principalmente o
tabagismo parental, devido à exposição passiva das crianças ao fumo e aos seus malefícios. De facto, em diversos estudos, o tabagismo parental encontra-se associado ao desenvolvimento de bronquiolite infantil, uma infecção das vias respiratórias inferiores, considerada a doença respiratória mais comum em crianças com idade inferior a quatro anos. É a principal causa de internamento nos meses de Inverno, sendo o VSR o principal agente infeccioso envolvido. Diversos investigadores, têm estimado os custos inerentes ao tratamento de
doenças relacionadas com o tabagismo referindo gastos elevados, contudo a
maioria reportam-se a realidades internacionais. A aposta na prevenção tem
evidenciado grandes ganhos em saúde já concretizados, mas muitos outros há ainda a alcançar.
Objectivos: Identificar se existe relação entre o tabagismo dos pais e a incidência de bronquiolite infantil; Verificar se o comportamento individual de fumar de um dos progenitores tem influência diferente nos custos hospitalares de internamento; Verificar o número médio de dias de internamento por bronquiolite de acordo com tabagismo ou não dos pais; Calcular o custo médio hospitalar de internamento por bronquiolite vs custo médio hospitalar de uma
consulta de cessação tabágica; Traduzir resultados em termos de ganhos para
a saúde.
Metodologia: Realizou-se um estudo retrospectivo e descritivo-correlacional,
envolvendo as crianças internadas com bronquiolite no serviço de pediatria do
Centro Hospitalar Cova da Beira, entre o período de 1 de Outubro de 2009 e 31
de Março de 2010. Procedeu-se à recolha de informação através de um questionário aplicado aos pais para caracterização sócio-demográfica e socioeconómica da criança e para identificação dos hábitos tabágicos dos pais. Relativamente aos custos de internamento por cada criança com bronquiolite e dos custos inerentes à consulta de cessação tabágica, os dados foram
recolhidos através da base de dados hospitalar e da codificação por GDH.
Resultados e Conclusões: Foram incluídas no estudo 62 crianças, 50% do sexo masculino e 50% do sexo feminino, com média de idades de 11,5 meses, quase metade (48,3%) nasceu durante os meses mais frios, entre Outubro e
Março. Destas crianças internadas, 53,2% eram filhas de pais não fumadores e apresentaram um tempo médio de internamento de 6 dias, com um custo médio hospitalar por criança internada de 3232,7€. Os custos hospitalares inerentes à consulta de cessação tabágica foram de 79,41€ por doente tratado.
Após a análise dos dados observa-se que não existe relação entre o tabagismo dos pais e a bronquiolite infantil. Contudo verifica-se, através da correlação de Pearson, que o comportamento de fumar dos progenitores
relaciona-se de forma diferente com os custos de internamento hospitalar, uma
vez que a mãe apresenta uma relação significativa (p=0,004), contrariamente
ao pai, que não apresenta relação significativa (p=0,678). Através do teste do
X2, com valor de significância de 0,242, verifica-se ainda que não existe diferença entre o tempo de internamento das crianças filhas de pais fumadores e das crianças filhas de pais não fumadores. Relativamente, aos custos hospitalares inerentes à consulta de cessação tabágica são em muito inferiores
aos custos hospitalares de internamento por bronquiolite. Por fim, conclui-se
que existem ganhos em saúde com o incentivo à cessação tabágica, ainda que
reduzidos em relação aquilo que seria desejado. Estes ganhos envolvem as
mães que deixaram de fumar durante a gravidez, os pais que aceitaram ingressar na consulta de cessação tabágica e as crianças que deixaram de ser expostas pelos pais ao fumo do tabaco.
Background: Cigarette smoking affects millions of people around the world, increasing expenses on health care in relation to treatment of diseases associated with tobacco. All over the years tobacco use, particularly parental one, has taken growing interest because of damages associated to passive exposure of children to smoke curses. In fact, many studies refers that parental smoking is associated to development of paediatric bronchiolitis, a respiratory infection of the lower airways, considered the most common respiratory disease in children under four years. It’s the main cause of hospitalization in winter months, where VSR is a principal infectious agent involved. Many investigators, reporting to international realities, have esteemed costs inherent to smokingrelated illness treatment and report high costs. Preventive bet shows large health gains already concretized, but many others stills to achieve. Objectives: Identify if there is relation between parental smoking and paediatric bronchiolitis incidence; Verify the individual smoking behaviour of a parent has different influence on the costs of hospital admission; Verify mean time (in days) for hospitalization by bronchiolitis according to parental smoking or not; calculate the medium cost of hospitalization by bronchiolitis vs medium cost of medical appointment to smoking cessation. Metodology: Has been conducted a retrospective and descriptive-correlational study, involving children hospitalized by bronchiolitis in the Pediatrics service of Centro Hospitalar Cova da Beira into the period between 1 October 2009 and 31 March 2010. Information has been collected through a questionnaire applied to parents for social-economics and social-demographics characterization of the child as well as the smoking parental habits. In what costs concerns about bronchiolitis hospitalization (for each child) and medical appointment to smoking cessation, data were collected through database and hospital coding for GDH. Results and Conclusions: This study included 62 children, 50% male and 50% female, mean age of 11,5 months. Almost an half (48,3%) have been born during cooler months between October and March. This children 53,2% were with no smoker parents. The hospitalization mean time was 6 days with a mean cost of €3232, per child. The hospital cost to medical appointment to smoking cessation was €79, 41per patient treated. After data analyses it was observed that there is no relation between parental smoking and paediatric bronchiolitis. However, with Pearson correlation, it was verified that smoking behaviour of parents relates differently with hospitalization costs , since mother has a significant relation (p=0,004) contrarily to father, who does not show significant relation (p=0,678). By X2 test, with significance value of 0,242, it was verified that there is no difference between hospitalization mean time for child with smoking or not smoking parents. Relatively to medical appointment to smoking cessation costs, they are much lower than bronchiolitis hospital admission costs. Finally, it was concluded that there are health gains with stop smoking encouragement, however less than it will be desired. Those gains involve mothers who stopped smoking during pregnancy, fathers who agreed to join outpatient smoking cessation and children which are no longer expose to parental tobacco smoke.
Background: Cigarette smoking affects millions of people around the world, increasing expenses on health care in relation to treatment of diseases associated with tobacco. All over the years tobacco use, particularly parental one, has taken growing interest because of damages associated to passive exposure of children to smoke curses. In fact, many studies refers that parental smoking is associated to development of paediatric bronchiolitis, a respiratory infection of the lower airways, considered the most common respiratory disease in children under four years. It’s the main cause of hospitalization in winter months, where VSR is a principal infectious agent involved. Many investigators, reporting to international realities, have esteemed costs inherent to smokingrelated illness treatment and report high costs. Preventive bet shows large health gains already concretized, but many others stills to achieve. Objectives: Identify if there is relation between parental smoking and paediatric bronchiolitis incidence; Verify the individual smoking behaviour of a parent has different influence on the costs of hospital admission; Verify mean time (in days) for hospitalization by bronchiolitis according to parental smoking or not; calculate the medium cost of hospitalization by bronchiolitis vs medium cost of medical appointment to smoking cessation. Metodology: Has been conducted a retrospective and descriptive-correlational study, involving children hospitalized by bronchiolitis in the Pediatrics service of Centro Hospitalar Cova da Beira into the period between 1 October 2009 and 31 March 2010. Information has been collected through a questionnaire applied to parents for social-economics and social-demographics characterization of the child as well as the smoking parental habits. In what costs concerns about bronchiolitis hospitalization (for each child) and medical appointment to smoking cessation, data were collected through database and hospital coding for GDH. Results and Conclusions: This study included 62 children, 50% male and 50% female, mean age of 11,5 months. Almost an half (48,3%) have been born during cooler months between October and March. This children 53,2% were with no smoker parents. The hospitalization mean time was 6 days with a mean cost of €3232, per child. The hospital cost to medical appointment to smoking cessation was €79, 41per patient treated. After data analyses it was observed that there is no relation between parental smoking and paediatric bronchiolitis. However, with Pearson correlation, it was verified that smoking behaviour of parents relates differently with hospitalization costs , since mother has a significant relation (p=0,004) contrarily to father, who does not show significant relation (p=0,678). By X2 test, with significance value of 0,242, it was verified that there is no difference between hospitalization mean time for child with smoking or not smoking parents. Relatively to medical appointment to smoking cessation costs, they are much lower than bronchiolitis hospital admission costs. Finally, it was concluded that there are health gains with stop smoking encouragement, however less than it will be desired. Those gains involve mothers who stopped smoking during pregnancy, fathers who agreed to join outpatient smoking cessation and children which are no longer expose to parental tobacco smoke.
Description
Keywords
Tabagismo parental - Bronquiolite infantil Economia de saúde