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Advisor(s)
Abstract(s)
Introdução: A Insuficiência Cardíaca é um problema grave de saúde pública em Portugal e no
mundo, com alta morbilidade e mortalidade, com custos elevado para os serviços de saúde
(102 bilhões de euros por ano (2012)). Apesar da alta prevalência desta patologia, não há
estudos que abordem essa patologia do ponto de vista económico. Os objetivos deste estudo
são: 1. Avaliar o custo de pacientes com tratamento de IC em num hospital secundário. 2.
Avaliar as variáveis que têm maior influência no custo.
Metodologia: A metodologia escolhida foi um estudo observacional retrospetivo com análise
estatística. A população foram todos os pacientes hospitalizados por 8 meses com o
diagnóstico primário de IC na ICD-10 na enfermaria de medicina interna. Os critérios de
exclusão foram: idade menor de 18 anos, transferência para outro hospital, abandono e alta
por ordem médica, processo mal codificado e período de internação <24 h. As variáveis foram
organizadas em grupos: Demografia, Diagnóstico, Testes Diagnósticos Complementares,
Terapia Farmacológica, Dados Clínicos, Procedimentos, Profissionais e Hospitalização.
Resultados: O paciente com IC (nº156) é predominantemente feminino (54%), com média de
idade de 83,85 ± 7,641 anos, com Rankin 1-3, com IC crônica (88,6%) em NYHA IV (97,5%).
HFmEF (34,8%), etiologia isquémica (24,7%), sendo a infeção a principal causa de
descompensação (50,6%). Apresentam uma média de 5, 96 ± 2,43 comorbidades (ATS mais
frequente (88,6%)). Permaneceram 12,7 ± 7,942 dias no hospital, 51,9% foram para o
domicílio (com uma taxa de mortalidade de 5,1%).
O custo total foi 64841,6 € (4103,90 ± 2563,36) e um custo total diário de 355,99 ±
113,91.Os testes complementares de diagnóstico representaram 15,55% dos custos
(100858,04 €), os procedimentos representam 14,27% (112004,45 €), terapia farmacológica
4,41% (28649,94 €), profissionais de saúde 18,02% (116848,58 €) e hospitalização 44,67%
(289767,05 €).
Nos testes paramétricos foi identificada diferença estatística significativa entre
a autonomia do utente, causa de descompensação, diabetes mellitus, a clearence de
creatinina e os dias de internamento. A clearence de creatinina também apresentou
diferença estatística no custo total.
Conclusão: Existem diferentes fatores que agravam a IC e, consequentemente, agravam os
custos, mas esse fato não foi comprovado neste estudo, exceto pela clearence da creatinina.
Apesar das características da IC sejam bem definidas, o estudo do seu custo ainda é
uma área desconhecida.
Introduction: The Heart Failure is a serious public health problem in Portugal and worldwide with high morbidity and mortality and has a high cost (102 billion euros per year (2012)). Despite of the high prevalence of this pathology, there are no studies that approach this pathology from an economic point of view. The objectives of this study are: 1. To evaluate the cost of patients with HF treatment in a secondary hospital. 2. To evaluated which variables has most influence in the cost. Methodology: The study was a retrospective observational study with statistical analysis. The population was all hospitalized patients for 8 months with the primary diagnosis of HF in ICD10 in the internal medicine ward. Exclusion criteria were: less than 18 years of age, transfer to other hospital, abandonment and discharge against medical orders, poorly coded process and hospitalization period < 24h h. The variable was organized in groups: Demography, Diagnosis, Complementary Diagnostic Tests, Pharmacological Therapy, Clinical Data, Procedures, Professionals and Hospitalization. Results: The HF patient (nº156) is predominantly: female (54%), with an aged average of 83.85 ± 7.641 years, with a Rankin 1-3, with chronic HF (88.6%) in NYHA IV (97, 5%) in HFmEF (34.8%), ischemic etiology (24.7%), an infection being the main cause of decompensation (50.6%). They have an average of 5, 96 ± 2.43 comorbidities (most frequent HTA (88.6%)). They stayed 12.7 ± 7.942 days in the hospital, 51,9 % went Home (with a mortality rate of 5,1%). The total cost was 64841.6 €, (4103.90 ± 2563.36) and a total daily cost of 355.99 ± 113.91. Complementary diagnostic tests were accounted for 15.55% of costs (100858.04 €), procedures represent 14.27% (112004.45 €), pharmacological therapy 4.41% (28649.94 €), health professionals 18.02% (116848.58 €) and hospitalization 44.67% (289767.05 €). In the parametric tests it was identified statistically significant between days of hospitalization, patient autonomy, cause of decompensation, diabetes mellitus and the days of hospitalization. It was identified statistically significant between days of hospitalization, total cost and the creatinine clearance. Conclusion: There are different factors that aggravate the HF and consequently aggravate the costs but that fact has not been proven in this study except for the creatinine clearance. Although the characteristics of the HF are well defined, the study of her cost is still unknown area.
Introduction: The Heart Failure is a serious public health problem in Portugal and worldwide with high morbidity and mortality and has a high cost (102 billion euros per year (2012)). Despite of the high prevalence of this pathology, there are no studies that approach this pathology from an economic point of view. The objectives of this study are: 1. To evaluate the cost of patients with HF treatment in a secondary hospital. 2. To evaluated which variables has most influence in the cost. Methodology: The study was a retrospective observational study with statistical analysis. The population was all hospitalized patients for 8 months with the primary diagnosis of HF in ICD10 in the internal medicine ward. Exclusion criteria were: less than 18 years of age, transfer to other hospital, abandonment and discharge against medical orders, poorly coded process and hospitalization period < 24h h. The variable was organized in groups: Demography, Diagnosis, Complementary Diagnostic Tests, Pharmacological Therapy, Clinical Data, Procedures, Professionals and Hospitalization. Results: The HF patient (nº156) is predominantly: female (54%), with an aged average of 83.85 ± 7.641 years, with a Rankin 1-3, with chronic HF (88.6%) in NYHA IV (97, 5%) in HFmEF (34.8%), ischemic etiology (24.7%), an infection being the main cause of decompensation (50.6%). They have an average of 5, 96 ± 2.43 comorbidities (most frequent HTA (88.6%)). They stayed 12.7 ± 7.942 days in the hospital, 51,9 % went Home (with a mortality rate of 5,1%). The total cost was 64841.6 €, (4103.90 ± 2563.36) and a total daily cost of 355.99 ± 113.91. Complementary diagnostic tests were accounted for 15.55% of costs (100858.04 €), procedures represent 14.27% (112004.45 €), pharmacological therapy 4.41% (28649.94 €), health professionals 18.02% (116848.58 €) and hospitalization 44.67% (289767.05 €). In the parametric tests it was identified statistically significant between days of hospitalization, patient autonomy, cause of decompensation, diabetes mellitus and the days of hospitalization. It was identified statistically significant between days of hospitalization, total cost and the creatinine clearance. Conclusion: There are different factors that aggravate the HF and consequently aggravate the costs but that fact has not been proven in this study except for the creatinine clearance. Although the characteristics of the HF are well defined, the study of her cost is still unknown area.
Description
Keywords
Custo Insuficiência Cardíaca Internamento